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INTRODUCTION: In research projects such as vaccine trials, accurate and complete surveillance of all outcomes of interest is critical. In less developed countries where the private sector is the major health-care provider, the private sector must be included in surveillance systems in order to capture all disease of interest. This, however, poses enormous challenges in practice. The process and outcome of recruiting private practice clinics for surveillance in a vaccine trial are described. METHODS: The project started in January 2002 in two urban squatter settlements of Karachi, Pakistan. At the suggestion of private practitioners, a phlebotomy team was formed to provide support for disease surveillance. Children who had a reported history of fever for more than three days were enrolled for a diagnosis. RESULTS: Between May 2003 and April 2004, 5540 children younger than 16 years with fever for three days or more were enrolled in the study. Of the children, 1312 (24%) were seen first by private practitioners; the remainder presented directly to study centres. In total, 5329 blood samples were obtained for microbiology. The annual incidence of Salmonella typhi diagnosed by blood culture was 407 (95% confidence interval (95% CI), 368-448) per 100 000/year and for Salmonella paratyphi A was 198 (95% CI, 171-227) per 100 000/year. Without the contribution of private practitioners, the rates would have been 240 per 100 000/year (95% CI, 211-271) for S. typhi and 114 (95% CI, 94-136) per 100 000/year for S. paratyphi A. CONCLUSION: The private sector plays a major health-care role in Pakistan. Our experience from a surveillance and burden estimation study in Pakistan indicates that this objective is possible to achieve but requires considerable effort and confidence building. Nonetheless, it is essential to include private health care providers when attempting to accurately estimate the burden of disease in such settings. Copyright © 2006 World Health Organization [ABSTRACT FROM AUTHOR]

Venous obstructions and thrombosis can present diagnostic challenges due to their varied presentations and potential for significant complications if untreated. Pulse wave doppler ultrasound via identification of damping or loss of cardiac pulsatility and/ or respiratory phasicity of venous waveforms serves as a practical, noninvasive, fast, and efficient diagnostic tool for identifying venous obstructions in the presence of compressible veins beyond the point of evaluation.We present two cases demonstrating the effectiveness of pulse wave doppler ultrasound in identifying significant and life-threatening venous obstructions. The first case involves a 68-year-old male with an incidental finding of a compressible left subclavian vein showing a monophasic waveform. Further investigation revealed significant compression of the left brachiocephalic vein by an aortic arch aneurysm. The second case describes a 65-year-old male with a compressible right femoral vein but a monophasic waveform, leading to the discovery of extensive thrombosis from the iliac veins to the inferior vena cava. This series proposes to always assess cardiac pulsatility and respiratory phasicity during doppler ultrasound procedure such as thyroid ultrasounds, deep vein thrombosis (DVT) evaluations, and pre-central vein catheterizations for identifying any venous obstructions, whether they are intrinsic or extrinsic, and for reducing the risk of thromboembolic complications., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Cervical cancer, albeit preventable, is the second-most deadly gynecological cancer in developing nations. Little is known about cervical cancer among Bangladeshi women. This study aims to estimate the prevalence of cervical cancer screening and demographic correlates to identify potential variabilities in screening rates among different demographic groups and regions., Methods: This study used secondary data from the WHO STEPS 2018 Survey. We used Bayesian regression to perform the bivariate analyses between the outcome and each explanatory factor, as it generates more acceptable results and improves parameter estimates. The top-ranked socio-demographic factors were identified using a two-step cluster analysis. This method determines the relevance of predictor variables and automatically establishes the number of clusters., Results: The prevalence of Bangladeshi women who had ever been screened for cervical cancer was 6.2%. In the adjusted model, women with the following socio-demographic factors had a higher likelihood of developing cervical cancer: being 18-29 years old (AOR = 3.3, 95% CI: 0.24, 15.27) or 45-59 years old (AOR = 2.8, 95% CI: 1.22, 6.0), currently married (AOR = 2.3, 95% CI: 1.36, 3.70), and employed (AOR = 2.4, 95% CI: 1.40, 4.06). Women in the Barisal division were found to have higher odds of being screened for cervical cancer (AOR = 21, 95% CI: 0.66, 121.97). Cluster analysis found residence status predisposes women to cervical cancer screening., Conclusion: There is a significant potential for substantial reductions in the burden of cervical cancer in Bangladesh by strengthening the application of cervical cancer screening. Future studies should examine how socioeconomic status, culture, and healthcare access affect cervical cancer screening trends for different divisions in Bangladesh. An independent national cancer registry is urgently needed to evaluate screening trends and outcomes., (© 2024. The Author(s).)

Introduction: Graft choice for anterior cruciate ligament reconstruction (ACLR) has been evolving. The peroneus longus tendon (PLT) has been seen as a suitable choice for ACLR, providing comparable results to those of hamstring tendon (HT) autograft, but its clinical relevance in terms of return to sports, to our knowledge, has not been studied., Materials and Methods: One hundred and twenty patients who sustained an isolated ACL injury were enrolled and underwent ACLR using tripled or quadrupled PLT autograft (if graft thickness exceeded 10 mm then tripled) or quadrupled HT autograft. Patients were followed for 24 months. Functional scores (International Knee Documentation Committee [IKDC] and Tegner-Lysholm scores) were assessed preoperatively and at 3, 6, 12, and 24-month post-operatively. Graft diameter and graft harvesting time were measured intraoperatively. Donor-site morbidity was evaluated using subjective evaluation. Time to return to sports in both groups was compared., Results: The mean diameter of the PLT autograft was significantly larger than that of the HT autograft, and the mean graft harvesting time was less (P < 0.001). Patients in the PLT group returned to sports a mean of 36 days earlier than those in the HT group (P < 0.001) and had a lower rate of donor-site morbidity, and better patient-reported outcomes at the knee (P < 0.001). There was a significant difference between the groups in IKDC and Tegner-Lysholm scores at the 24-month follow-up., Conclusion: Despite some donor site complications, such as numbness and infection, both PLT and HT grafts offer acceptable knee stability. However, PLT grafts seem to provide superior subjective functional outcomes based on patient-reported scores. More research is needed to further establish these findings and optimize graft choices for individual patients., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Objective: This systematic review and meta-analysis aimed to compare outcomes between abdominal drain placement and no drain placement post-pancreatectomy., Background: Left pancreatectomy (LP) is a surgical procedure commonly employed for various pancreatic conditions, often associated with postoperative complications like post-operative pancreatic fistula (POPF). While routine abdominal drainage following LP has been standard practice, recent evidence suggests potential benefits of omitting this approach., Methods: A comprehensive search was conducted on PubMed, Cochrane, and Embase from inception up to 15 March 2024, yielding nine studies comprising 15,817 patients. Data were extracted from randomized and non-randomized studies reporting primary and secondary outcomes. The analysis was performed in Revman. Risk ratios were calculated with 95% confidence intervals, and a P -value of <0.05 was considered statistically significant., Results: A total of 13,081 patients underwent drain placement after left pancreatectomy, and 2,736 patients were included in the no-drain group. Out of the total, 45.1% (n=7140) patients were male, with 45.9% (n=6012) males in the drain group and 41.2% (n=1128) males in the no-drain group. Major morbidity, defined as Clavien-Dindo grade ≥III complications, was significantly lower in the no-drain group (relative risk [RR]: 0.77, 95% confidence interval [CI]: 0.64-0.93, P =0.006). Similarly, lower rates of postoperative pancreatic fistula (POPF) (RR: 0.51, 95% CI: 0.38-0.67, P <0.00001), readmission (RR: 0.75, 95% CI: 0.59-0.96, P =0.02), and surgical site infections (RR: 0.82, 95% CI: 0.70-0.95, P =0.009) were observed in the no-drain group. Additionally, a shorter length of hospital stay was noted in this group (mean difference MD: -1.65, 95% CI: -2.50 to -0.81, P =0.0001)., Conclusions: Omitting routine drainage after left pancreatectomy is associated with reduced complications and shorter hospital stays, supporting its potential benefits in improving postoperative outcomes., Competing Interests: CONFLICTS OF INTEREST & FUNDING ; All authors declare no competing interests or funding sources. Declarations of interest: none., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Electrochemical analysis of glucose monitoring without painful blood collection provides a new noninvasive route for monitoring glucose levels. Thus, in this study, biobased cellulosic papers (methylated and phosphorylated one) based glucose monitoring sensor is developed. To achieve high hydrophilicity, microfibrillated cellulose (MFC) were functionalized using hexokinase mediated phosphorylation (-OH to -[Formula: see text]). The instinctive increased surface charge density from 36.2 ± 3.4 to 118.4 ± 1.2 µmol/g and decrease contact angle (45°-22°) confirms the increased hydrophilicity of paper. Furthermore, functionalized phos-MFC paper increase the capillary flow of sweat, required low quantity (1 µl) of sweat for accurate analysis of glucose level. Additionally, chemically induced methyl groups (-CH 3 ) make the sensor more barrier to other chemicals. In addition, a multilayer patch design combined with sensor miniaturization was used to lead to an increase in the efficiency of the sweat collection and sensing processes. Besides, this paper sensor integrated with artificial transdermal drug delivery unit (agarose gel as skin) for monitoring glucose levels in sweat. The patch monitoring system increase the accuracy of sensing with fluctuation in sweat vol. (1-4 µl), temperature (20-70 °C), and pH (4.0-7.0). In addition, temperature dependency artificial transdermal delivery (within agarose gel) of drug metformin agrees the measurement accuracy of sensor, called "switch system" without any error. As a result, the reported MFC paper based multi-patch disposable sensing system provides a novel closed-loop solution for the noninvasive sweat-based management of diabetes mellitus., (© 2024. The Author(s).)

Antibiotic resistance is an increasing threat, requiring novel therapeutic solutions. Metal nanoparticles e.g., zinc oxide nanoparticles (ZnO NPs) exhibited the potential against many bacterial pathogens. Strains of Salmonella enterica serovar Typhi resistant to ceftriaxone were reported first from Pakistan in 2016. Since then, S. Typhi is a pathogen of concern globally owing to its rapidly emerging resistance potential against many last resort antibiotics. In the present study, in vitro and in vivo antimicrobial activity of ZnO NPs against multidrug resistant (MDR) and extensively drug resistant (XDR) Salmonella Typhi strains from Pakistan was evaluated. Zinc oxide green nanoparticles (ZnO GNPs), synthesized from Aloe vera, were characterized by SEM, XRD, UV-vis and Raman spectroscopy. In vitro antibacterial activity of two different concentrations of ZnO GNPs (7 and 15%) was checked using agar well diffusion method. Further, broth microdilution and time kill assays were performed using the ZnO GNPs. In vivo assays were conducted in BALB/c mice sepsis models. In all the three methods, agar well diffusion assay broth microdilution and time kill assay, different zinc oxide dihydrate precursor concentrations had shown the antibacterial activity. The minimum inhibitory concentration (MIC) of ZnO GNPs nanoparticles against MDR and XDR S. Typhi strains was found as 16 to 64 µg/ml. In vivo experiment has shown a significant decrease in CFU/ml in the mice treated with ZnO GNPs as compared to the control group. Our findings have revealed that ZnO GNPs have significant antibacterial activity against MDR and XDR S. Typhi, both in vitro and in vivo., (© 2024. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

Introduction: Non-union fractures of the distal femur pose significant challenges in orthopedic surgery, often requiring revision procedures to achieve successful bone healing. In cases where the initial implant has failed, innovative solutions are necessary to promote bone union and functional recovery., Case Report: We present a case of a non-union distal femur fracture in a 22-year-old male patient, with a broken implant in situ. The patient had previously undergone internal fixation with a locking plate, which subsequently failed to promote bone healing. The patient was reoperated using a supracondylar nail and augmented with a distal femur locking plate to address the non-union. The combination of the supracondylar nail and distal femur locking plate successfully provided stability to the fracture site, promoting bone union and enabling functional recovery. Radiographic evidence and clinical assessment demonstrated excellent healing progress., Conclusion: This case report highlights the importance of individualized treatment for non-union distal femur fractures, especially when prior implant failure occurs. The combined approach of a supracondylar nail and distal femur locking plate can be a valuable option in addressing complex non-union fractures, achieving stable fixation, and facilitating successful bone healing., Competing Interests: Conflict of Interest: Nil, (Copyright: © Indian Orthopaedic Research Group.)

Skeletal dysplasias are a heterogeneous group of disorders presenting mild to lethal defects. Several factors, such as genetic, prenatal, and postnatal environmental may contribute to reduced growth. Fourteen families of Pakistani origin, presenting the syndromic form of short stature either in the autosomal recessive or autosomal dominant manner were clinically and genetically investigated to uncover the underlying genetic etiology. Homozygosity mapping, whole exome sequencing, and Sanger sequencing were used to search for the disease-causing gene variants. In total, we have identified 13 sequence variants in 10 different genes. The variants in the HSPG2 and XRCC4 genes were not reported previously in the Pakistani population. This study will expand the mutation spectrum of the identified genes and will help in improved diagnosis of the syndromic form of short stature in the local population., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Methemoglobin is an altered state of hemoglobin where iron in hemoglobin is oxidized and incapable of binding oxygen; leading to complications such as cyanosis, dyspnea, headache, and heart failure. Methemoglobinemia can be congenital or acquired. Congenital methemoglobinemia is a rare disease and its worldwide incidence is unclear. We recently encountered the first documented case of congenital methemoglobinemia at our institution, necessitating perioperative care., Case Presentation: In the present case, a 22-year-old man with congenital methemoglobinemia underwent general anesthesia for dental extraction. The surgeon was informed to avoid local anesthetics and oxygenation was performed with FiO 2 of 1.0. Arterial blood gas analysis showed a PH of 7.337, PaO 2 of 302 mm Hg, PaCO 2 of 44 mm Hg, oxyhemoglobin level of 63.4%, and methemoglobin level of 37.8%. The patient had a stable course. No methylene blue therapy was required, although cyanosis was observed during surgery., Conclusion: In summary, though rare, congenital methemoglobinemia poses fatal risks during surgery. Its management involves preoperative recognition and optimization, oxygenation status, multidisciplinary care, avoiding precipitating or oxidizing agents, discussing treatment options, maintaining cardiopulmonary stability, and ensuring perioperative safety measures with the medical team., Competing Interests: The authors report no conflicts of interest., (© 2024 Saad et al.)

We developed an algorithm for automatically analyzing scattering-based light sheet microscopy (sLSM) images of anal squamous intraepithelial lesions. We developed a method for automatically segmenting sLSM images for nuclei and calculating seven features: nuclear intensity, intensity slope as a function of depth, nuclear-to-nuclear distance, nuclear-to-cytoplasm ratio, cell density, nuclear area, and proportion of pixels corresponding to nuclei. 187 images from 80 anal biopsies were used for feature analysis and classifier development. The automated nuclear segmentation method provided reliable performance with the precision of 0.97 and recall of 0.91 when compared with the manual segmentation. Among the seven features, six showed statistically significant differences between high-grade squamous intraepithelial lesion (HSIL) and non-HSIL (non-dysplastic or low-grade squamous intraepithelial lesion, LSIL). A classifier using linear support vector machine (SVM) achieved promising performance in diagnosing HSIL versus non-HSIL: sensitivity of 90%, specificity of 70%, and area under the curve (AUC) of 0.89 for per-image diagnosis, and sensitivity of 90%, specificity of 80%, and AUC of 0.92 for per-biopsy diagnosis., Competing Interests: The University of Arizona has a technology-licensing agreement with ArgosMD on the reflectance confocal microscopy technology. DK has the rights to receive royalties as a result of this licensing agreement. DK serves as a scientific advisor to ArgosMD. Conflicts of interest resulting from this interest are being managed by the University of Arizona in accordance with its policies., (© 2024 Optica Publishing Group.)

Background: The incidence of adhesive capsulitis varies from 2-5% in the general population to 20% in people with diabetes. One of the most effective treatment methods is hydrodilatation, which can be done under US-guidance or Fluoroscopic guidance. However, the clinical effectiveness of US-guided injections in comparison to fluoroscopy-guided injections is still debatable. The possibility of severe side effects, the expense, and the time required to carry out this minimally invasive procedure highlight how crucial it is for patients to have a precise intra-articular injection. This study aims to compare the effectiveness of Ultrasound-guided vs. Fluoroscopic guided hydrodilatation for patients with adhesive capsulitis., Methods: Sixty-four patients were randomly selected for hydrodilatation using any one of the techniques. The patients were evaluated for clinical improvements using the visual analog scale (VAS), oxford shoulder score (OSS), and range of motion (ROM)., Results: The US-guided group experienced more pain reduction than the fluoroscopy group within the first four weeks (P < 0.001). The increase in ROM was much more significant in the US-guided group for the first 8 weeks. Improvement in Abduction and External rotation was much more significant (P < 0.001) in the first 4 weeks after hydrodilatation in the US-guided group. The improvement in ROM was maintained on long-term follow-up (mean 24 months), with 45 out of 64 (70.3%) reporting a normal or near normal ROM. On assessing the Oxford shoulder score improvements, the US-guided group's score significantly increased after the first week (P = 0.003), but the fluoroscopy-guided group's score increased after the second week. On comparison between the two groups, the amount of score improvement was more significant in the US-guided group than in the fluoroscopy-guided group in the first 4 weeks (P < 0.001)., Conclusion: US-guided technique for intra-articular injection for patients with adhesive capsulitis provided a quicker pain reduction and a larger improvement in range of motion and overall shoulder functions., Competing Interests: None., (IJBT Copyright © 2024.)

This case report highlights the effective use of intermittent hemodialysis (IHD) in warming a 71-year-old female patient with severe hypothermia who presented with a rectal temperature of 25 °C and signs of hemodynamic instability. The patient, found unconscious after prolonged exposure to cold exacerbated by alcohol consumption, initially showed some improvement in core temperature through active external rewarming methods. However, soon, her temperature plateaued at 27 °C. Patient was deemed unsuitable for extracorporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (CPB) due to her age, and urgent IHD was initiated. This approach resulted in a stable increase in core temperature at approximately 2.0 °C/hr, along with normalization of lactic acidosis, creatinine phosphokinase, and correction of electrolyte imbalances, culminating in her full recovery and discharge after seven days in the hospital.After reviewing this case alongside similar ones from before, this case report highlights the efficacy and safety of IHD as an efficient, readily available, and less invasive method for rewarming moderate to severe hypothermic patients who are hemodynamically unstable patients but do not have cardiac arrest or renal dysfunction. IHD is especially useful when less invasive cooling devices (Artic Sun/ CoolGard) are not available or more invasive extracorporeal life support options (ECMO/ CPB) are either not indicated or unavailable. IHD can also help improve concurrent electrolyte imbalances and/or toxin buildup. The report further emphasizes the necessity of monitoring for potential complications, such as post-dialysis hypophosphatemia and rebound hyperkalemia, following successful rewarming., (© 2024. The Author(s).)

Worldwide environmental challenges pose critical problems with the growth of the global economy. Addressing these issues requires the development of an eco-friendly and sustainable catalyst for degrading organic dye pollutants. In this study, copper-doped magnesium aluminates (Cu x Mg 1-x Al 2 O 4 ) with x = 0.0-0.8 were synthesized using a citrate-based combustion route. The inclusion of Cu(II) significantly impacted the structural, microstructural, optical, and photocatalytic activity of the catalyst. Rietveld analysis of X-ray diffraction powder profiles revealed single-phase spinels crystallized in the face-centered cubic unit cell with Fd 3 ¯ m space group. Chemical states of the ions, surface morphology, and elemental investigation were analyzed by X-ray photoelectron spectroscopy, field-emission scanning electron microscopy, and energy-dispersive X-ray spectroscopy, respectively. UV-visible and diffuse reflectance spectroscopies confirmed the reduction of the band gap due to Cu(II) doping, validated by first-principle investigations using the WIEN2k code. The catalyst with x = 0.8 showed higher photocatalytic efficacy (90% and 93%) for removing two azo organic dye pollutants, rhodamine B and methyl orange, respectively, within 120 min. Degradation kinetics followed a pseudo-first-order mechanism. The doped (0.8) sample was structurally and morphologically stable and reusable under visible irradiation, retaining performance after three runs. Scavenger studies confirmed hydroxyl and superoxide radicals' involvement in the degradation. This work presents an effective approach to enhancing Cu x Mg 1-x Al 2 O 4 catalysts' photodegradation performance, with potential applications in pharmaceuticals and wastewater remediation., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Hereditary hearing loss is a genetically heterogeneous neurosensory disorder that affects many people. Deafness and infertility can coexist in some cases, creating the hearing impairment infertile male syndrome. There are several known molecular mechanisms that can cause deafness either on its own or in conjunction with infertility., Methods and Results: Here, we represent two consanguineous families (A, B), both families had clinical evidence of deafness, and family B also had infertility, so we referred to them as having nonsyndromic hearing loss (NSHL) and hearing impairment infertile male syndrome (HIIMS), respectively. These families' genetic makeup was examined using an Affymetrix GeneChip 250K Nsp array followed by Sanger sequencing. In family A, we identified a novel homozygous stop gain variant [NM&#95;003672.4; c.1000C>T; p.(Gln334*)] and a homozygous missense variant [NM&#95;003672.4; c.684C>A; p.(Asn228Lys)] in family B in CDC14A gene (MIM#603504). In animal models, the CDC14A gene causes both hearing loss and infertility; in addition, it also causes NSHL and HIIMS in humans., Conclusions: Our study on the CDC14A gene has identified two novel variants, crucial for delineating disease boundaries. Variants in exon 10 and upstream cause HIIMS, and those in exon 11 and downstream are linked exclusively to hearing impairment. This precision enhances diagnostics and offers potential for targeted interventions, marking a significant advancement in understanding the genetic basis of these conditions., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 S. Karger AG, Basel.)

Purpose: To explore patient and surgeon characteristics for open globe injury repairs (OGRs) and rates of subsequent operations., Methods: Using a retrospective cohort design, eyes of patients ≥18 years who underwent OGR among 100% Medicare Fee-For-Service dataset from 2011 to 2020 were included. Current Procedural Terminology (CPT®) codes were used to identify OGR. Patient characteristics were reported, and surgeon characteristics were stratified by sex and compared using Chi-square and Student's t-test. Overall rate of subsequent operations was reported, and trends of subsequent operations over time were assessed using Cochrane-Armitage trend test., Results: A total of 16,576 patients with a mean age of 73.89 years (±12.89) underwent OGR. Most patients were White (79.68%, n  = 13,207) and 49.44% ( n  = 8196) were female. More patients resided in a rural area (18.71%; n  = 3102) relative to surgeon location (4.51%, n  = 748; p  < 0.001). A total of 5,898 surgeons performed these OGRs with 77.33% ( n  = 4,561) male and 22.67% ( n  = 1,337) female surgeons. Male surgeons performed most of the OGRs (76.35%, n  = 12,655; p  < 0.001). On average, a surgeon performed a single OGR annually (Mean: 1.08 ± 1.04; Range: 0.11-40). Among all OGRs, 51% (8,452/16,576) had ≥1 subsequent operations in median 29 days (IQR: 10-86), which increased during the last decade from 47% to 51% ( p  = 0.008)., Conclusion: Geographic and workforce disparities in ocular trauma warrant future investigation. Further studies can also assess the reasons for increase in the incidence of subsequent procedures after OGR over time.

Head and neck trauma can result in difficult airway management. A 25-year-old male required emergency tracheal intubation on arrival to the emergency department following a motorbike accident. Despite the presence of a normal capnography a computed tomography scan demonstrated a tracheal opening, an extra-tracheal position of the distal end of the tracheal tube, and extensive subcutaneous emphysema. The tube was re-directed into the trachea and the tracheal injury was surgically repaired. This case highlights that the presence of a normal capnograph does not necessarily mean that the distal end of the tracheal tube resides within the airway., (© 2024 The Author(s). Anaesthesia Reports published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)

Atrichia with papular lesions (APL) is a hair abnormality characterized by loss of hair on the scalp and rest of the body. In a few cases, hair loss is accompanied by the appearance of keratotic papules on the body. It is inherited in an autosomal recessive manner. Sequence variants in the HR (hairless) gene are responsible for this hair abnormality. Here, we present nine consanguineous families and one nonconsanguineous family with clinical manifestations of APL. Whole exome followed by Sanger sequencing and/or direct Sanger sequencing was performed to identify pathogenic variants. The study revealed seven novel pathogenic variants c.794del;p.(Pro265Argfs*98), c.2921-2936del;p.(Tyr974Leufs*16), c.2889C>A;p.(Cys963*), c.2689C>T;p.(Gln897*), c.3186&#95;3187dup;p.(Gln1063Profs*43), c.560dup;p.(Tyr188Ilefs*131), c.2203+5G>C, c.2776+5G>A, and the previously reported variant c.1837C>T;p.(Arg613*) in HR in these families. The study not only expands the mutational spectrum in the HR gene but also highlights the unusual phenotypic findings and will facilitate genetic counseling of families with members showing various types of hair loss disorders in the local population., (© 2024 Japanese Dermatological Association.)

Background: The intraoperative use of tourniquets is associated with several complications, including hyperthermia. We present the first documented case of tourniquet-induced hyperthermia in a pediatric patient at our institution., Case: A 5-year-old female with no past medical history underwent tendon release surgery for congenital talipes equinovarus under general anesthesia. Following inflation of a pneumatic tourniquet to a pressure of 250 mmHg on her left thigh, the patient experienced a gradual increase in body temperature. Despite the implementation of cooling measures, the temperature continued to increase until it plateaued. The hyperthermia gradually resolved upon deflation of the tourniquet., Conclusions: Tourniquet-induced hyperthermia should be considered as a potential cause of intraoperative hyperthermia, particularly in the absence of typical signs of malignant hyperthermia. Early recognition and appropriate management, including deflation of the tourniquet and implementation of cooling measures, are crucial for preventing potential complications associated with hyperthermia.

The rapid expansion of urbanization and construction activities has led to a significant increase in cement production worldwide, resulting in a surge in cement waste generation. This study aims to provide a comprehensive analysis of the repercussions of cement waste on soil fertility and crop productivity, emphasizing its critical implications for global food security. Through a multidisciplinary approach, encompassing field surveys, laboratory experiments, and statistical modeling, we assess the physicochemical alterations induced by cement waste in agricultural soils. Our findings reveal substantial declines in crucial soil parameters, including pH levels, organic matter content, and nutrient availability, which directly translate into diminished crop yields. Furthermore, the study identifies key mechanisms underlying these detrimental effects, including altered microbial communities and disrupted nutrient cycling processes. In addition, the findings underscore the severity of the issue, revealing substantial declines in soil fertility and crop yields in areas affected by cement waste contamination. Additionally, we discuss potential mitigation strategies and policy interventions aimed at mitigating the adverse effects of cement waste on agricultural systems. By quantifying the extent of soil degradation and crop yield reduction attributed to cement waste, this research underscores the urgency for sustainable waste management practices and highlights the need for policy interventions to safeguard agricultural productivity and ensure global food security in the face of escalating urbanization and construction activities., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Demand for anal cancer screening is expected to rise following the recent publication of the Anal Cancer-HSIL Outcomes Research trial, which showed that treatment of high-grade squamous intraepithelial lesions significantly reduces the rate of progression to anal cancer. While screening for human papillomavirus-associated squamous lesions in the cervix is well established and effective, this is less true for other sites in the lower anogenital tract. Current anal cancer screening and prevention rely on high-resolution anoscopy with biopsies. This procedure has a steep learning curve for providers and may cause patient discomfort. Scattering-based light-sheet microscopy (sLSM) is a novel imaging modality with the potential to mitigate these challenges through real-time, microscopic visualization of disease-susceptible tissue. Here, we report a proof-of-principle study that establishes feasibility of dysplasia detection using an sLSM device. We imaged 110 anal biopsy specimens collected prospectively at our institution's dysplasia clinic (including 30 nondysplastic, 40 low-grade squamous intraepithelial lesion, and 40 high-grade squamous intraepithelial lesion specimens) and found that these optical images are highly interpretable and accurately recapitulate histopathologic features traditionally used for the diagnosis of human papillomavirus-associated squamous dysplasia. A reader study to assess diagnostic accuracy suggests that sLSM images are noninferior to hematoxylin and eosin images for the detection of anal dysplasia (sLSM accuracy = 0.87; hematoxylin and eosin accuracy = 0.80; P = .066). Given these results, we believe that sLSM technology holds great potential to enhance the efficacy of anal cancer screening by allowing accurate sampling of diagnostic tissue at the time of anoscopy. While the current imaging study was performed on ex vivo biopsy specimens, we are currently developing a handheld device for in vivo imaging that will provide immediate microscopic guidance to high-resolution anoscopy providers., (Copyright © 2024 United States & Canadian Academy of Pathology. Published by Elsevier Inc. All rights reserved.)

Telomeres, potential biomarkers of aging, are known to shorten with continued cigarette smoke exposure. In order to further investigate this process and its impact on cellular stress and inflammation, we used an in vitro model with cigarette smoke extract (CSE) and observed the downregulation of telomere stabilizing TRF2 and POT1 genes after CSE treatment. hTERT is a subunit of telomerase and a well-known oncogenic marker, which is overexpressed in over 85% of cancers and may contribute to lung cancer development in smokers. We also observed an increase in hTERT and ISG15 expression levels after CSE treatment, as well as increased protein levels revealed by immunohistochemical staining in smokers' lung tissue samples compared to non-smokers. The effects of ISG15 overexpression were further studied by quantifying IFN-γ , an inflammatory protein induced by ISG15 , which showed greater upregulation in smokers compared to non-smokers. Similar changes in gene expression patterns for TRF2 , POT1 , hTERT , and ISG15 were observed in blood and buccal swab samples from smokers compared to non-smokers. The results from this study provide insight into the mechanisms behind smoking causing telomere shortening and how this may contribute to the induction of inflammation and/or tumorigenesis, which may lead to comorbidities in smokers.

Background: Total knee arthroplasty (TKA) is a common surgical procedure for patients with knee osteoarthritis, often associated with postoperative pain. Effective pain management strategies are essential for improving patient outcomes and satisfaction. This study aimed to compare the efficacy of two analgesic modalities, local infiltration analgesia (LIA) and adductor canal block (ACB), in providing postoperative pain relief for patients undergoing TKA., Methods: This prospective randomized comparative study included 60 patients undergoing TKA for knee osteoarthritis under subarachnoid block (spinal anaesthesia). Patients were divided into two groups: LIA group (local wound infiltration with periarticular injection of bupivacaine 0.125% + dexmedetomidine 1 mcg/kg) and ACB group (ACB with bupivacaine 0.125% + 1 mcg/kg dexmedetomidine). Pain relief was assessed using the Numerical Rating Scale (NRS) score, time to first rescue analgesic requirement (NRS > 3), and total amount of analgesic needed in the first 24 hours post-surgery., Results: The time to first perception of pain with NRS > 3 was 11.30±0.8 hours in the ACB group and 9.40 ± 1.1 hours in the LIA group, with a statistically significant difference (p < 0.001). Additionally, the total number of rescue analgesic doses given in the first 24 hours post-operatively differed significantly between the two groups (p = 0.046)., Conclusion: The study concludes that ACB is an effective postoperative analgesic modality, superior to local infiltration analgesia, for patients undergoing TKA., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khan et al.)

Background: Atrial septal defects can allow right to left shunting of venous blood which presents clinically as platypnea-orthodeoxia syndrome. It is believed that concomitant presence of aortic root pathologies increases the likelihood of shunting., Methods: The study included a review of 510 articles listed in PubMed of patients with platypnea-orthodeoxia syndrome. Case reports of patients with extra-cardiac etiologies of platypnea-orthodeoxia were excluded., Results: We reviewed 191 case reports, and 98 cases (51.3%) had evidence of concomitant aortic root pathology. Furthermore, of the remaining 93 case reports, 69 ones excluded any mention of the nature of the aortic root altogether, further suggesting that this is an underreported number., Conclusions: There is a high prevalence of aortic root pathologies in patients with platypnea-orthodeoxia syndrome secondary to intra-cardiac shunts. In patients with unexplained hypoxemia and incidental finding of aortic root pathology, it may be worthwhile to obtain postural oxygen saturation measurements to exclude intra-cardiac shunts as the potential cause., Competing Interests: The authors declare no conflict of interest., (Copyright 2024, Farooq et al.)

This research aimed to study on nanocellulose production from palm bunch using process design and cost analysis. Choline chloride based deep eutectic solvent pretreatment was selected for high-purity cellulose separation at mild condition, followed by nano-fibrillation using mechanical treatment. Three types of choline chloride-based deep eutectic solvents employing different hydrogen-bond donors (HBDs) namely lactic acid, 1,3-butanediol and oxalic acid were studied. The optimal cellulose extraction condition was choline chloride/lactic acid (ChLa80C) pretreatment of palm empty bunch at 80 °C followed by bleaching yielding 94.96%w/w cellulose content in product. Size reduction using ultrasonication and high-pressure homogenization produced nanocellulose at 67.12%w/w based on cellulose in raw material. Different morphologies of nanocellulose were tunable in the forms of nanocrystals, nano-rods and nanofibers by using dissimilar deep eutectic solvents. This work offered a sustainable and environmentally friendly process as well as provided analysis of DES pretreatment and overview operating cost for nanocellulose production. Application of nanocellulose for the fabrication of highly functional and biodegradable material for nanomedicine, electronic, optical, and micromechanical devices is achievable in the near future., (© 2024. The Author(s).)

The cooperative, connected, and automated mobility (CCAM) infrastructure plays a key role in understanding and enhancing the environmental perception of autonomous vehicles (AVs) driving in complex urban settings. However, the deployment of CCAM infrastructure necessitates the efficient selection of the computational processing layer and deployment of machine learning (ML) and deep learning (DL) models to achieve greater performance of AVs in complex urban environments. In this paper, we propose a computational framework and analyze the effectiveness of a custom-trained DL model (YOLOv8) when deployed in diverse devices and settings at the vehicle-edge-cloud-layered architecture. Our main focus is to understand the interplay and relationship between the DL model's accuracy and execution time during deployment at the layered framework. Therefore, we investigate the trade-offs between accuracy and time by the deployment process of the YOLOv8 model over each layer of the computational framework. We consider the CCAM infrastructures, i.e., sensory devices, computation, and communication at each layer. The findings reveal that the performance metrics results (e.g., 0.842 mAP@0.5) of deployed DL models remain consistent regardless of the device type across any layer of the framework. However, we observe that inference times for object detection tasks tend to decrease when the DL model is subjected to different environmental conditions. For instance, the Jetson AGX (non-GPU) outperforms the Raspberry Pi (non-GPU) by reducing inference time by 72%, whereas the Jetson AGX Xavier (GPU) outperforms the Jetson AGX ARMv8 (non-GPU) by reducing inference time by 90%. A complete average time comparison analysis for the transfer time, preprocess time, and total time of devices Apple M2 Max, Intel Xeon, Tesla T4, NVIDIA A100, Tesla V100, etc., is provided in the paper. Our findings direct the researchers and practitioners to select the most appropriate device type and environment for the deployment of DL models required for production.

Introduction: Raw milk may contain pathogenic microorganisms harmful to humans, e.g., multidrug-resistant Escherichia coli non-O157:H7, which can cause severe colitis, hemolytic uremia, and meningitis in children. No studies are available on the prevalence of Shiga toxin-producing E. coli (STEC O157:H7) in sick or healthy dairy animals in the Khyber Pakhtunkhwa Province of Pakistan., Aim: This study aimed to isolate, characterize, and detect antibiotic resistance in STEC non-O157:H7 from unpasteurized milk of dairy bovines in this province., Materials and Methods: We collected raw milk samples ( n = 800) from dairy farms, street vendors, and milk shops from different parts of the Khyber Pakhtunkhwa Province. E. coli was isolated from these samples followed by latex agglutination tests for serotyping. The detection of STEC was conducted phenotypically and confirmed by the detection of virulence genes genotypically. An antibiogram of STEC isolates was performed against 12 antibiotics using the disc diffusion method., Results: A total of 321 (40.12%) samples were found to be positive for E. coli in this study. These samples were processed for the presence of four virulence genes ( Stx1 , Stx2 , ehxA , eae ). Forty samples (5.0%) were STEC-positive. Of these, 38%, 25%, 19%, and 18% were positive for Stx1 , Stx2 , ehxA , and eae , respectively. Genotypically, we found that 1.37% of STEC isolates produced extended-spectrum beta-lactamase (ESBL) and contained the bla CTX M gene. Resistance to various antibiotics ranged from 18% to 77%., Conclusion: This study highlights the risk of virulent and multidrug-resistant STEC non-O157:H7 in raw milk and the need for proper quality surveillance and assurance plans to mitigate the potential public health threat.

Anti-cancer peptides (ACPs) are short peptides known for their ability to inhibit tumor cell proliferation, migration, and the formation of tumor blood vessels. In this study, we designed ACPs to target receptors often overexpressed in cancer using a systematic in silico approach. Three target receptors (CXCR1, DcR3, and OPG) were selected for their significant roles in cancer pathogenesis and tumor cell proliferation. Our peptide design strategy involved identifying interacting residues (IR) of these receptors, with their natural ligands serving as a reference for designing peptides specific to each receptor. The natural ligands of these receptors, including IL8 for CXCR1, TL1A for DcR3, and RANKL for OPG, were identified from the literature. Using the identified interacting residues (IR), we generated a peptide library through simple permutation and predicted the structure of each peptide. All peptides were analyzed using the web-based prediction server for Anticancer peptides, AntiCP. Docking simulations were then conducted to analyze the binding efficiencies of peptides with their respective target receptors, using VEGA ZZ and Chimera for interaction analysis. Our analysis identified HPKFIKELR as the interacting residues (IR) of CXCR-IL8. For DcR3, we utilized three domains from TL1A (TDSYPEP, TKEDKTF, LGLAFTK) as templates, along with two regions (SIKIPSS and PDQDATYP) from RANKL, to generate a library of peptide analogs. Subsequently, peptides for each receptor were shortlisted based on their predicted anticancer properties as determined by AntiCP and were subjected to docking analysis. After docking, peptides that exhibited the least binding energy were further analyzed for their detailed interaction with their respective receptors. Among these, peptides C9 (HPKFELY) and C7 (HPKFEWL) for CXCR1, peptides D6 (ADSYPQP) and D18 (AFSYPFP) for DcR3, and peptides P19 (PDTYPQDP) and p16 (PDQDATYP) for OPG, demonstrated the highest affinity and stronger interactions compared to the other peptides. Although in silico predictions indicated a favorable binding affinity of the designed peptides with target receptors, further experimental validation is essential to confirm their binding affinity, stability and pharmacokinetic characteristics., (© 2024. The Author(s).)

Huge amounts of noxious chemicals from coal and petrochemical refineries and pharmaceutical industries are released into water bodies. These chemicals are highly toxic and cause adverse effects on both aquatic and terrestrial life. The removal of hazardous contaminants from industrial effluents is expensive and environmentally driven. The majority of the technologies applied nowadays for the removal of phenols and other contaminants are based on physio-chemical processes such as solvent extraction, chemical precipitation, and adsorption. The removal efficiency of toxic chemicals, especially phenols, is low with these technologies when the concentrations are very low. Furthermore, the major drawbacks of these technologies are the high operation costs and inadequate selectivity. To overcome these limitations, researchers are applying biological and membrane technologies together, which are gaining more attention because of their ease of use, high selectivity, and effectiveness. In the present review, the microbial degradation of phenolics in combination with intensified membrane bioreactors (MBRs) has been discussed. Important factors, including the origin and mode of phenols' biodegradation as well as the characteristics of the membrane bioreactors for the optimal removal of phenolic contaminants from industrial effluents are considered. The modifications of MBRs for the removal of phenols from various wastewater sources have also been addressed in this review article. The economic analysis on the cost and benefits of MBR technology compared with conventional wastewater treatments is discussed extensively.

Despite the availability of technological advances in traditional anti-cancer therapies, there is a need for more precise and targeted cancer treatment strategies. The wide-ranging shortfalls of conventional anticancer therapies such as systematic toxicity, compromised life quality, and limited to severe side effects are major areas of concern of conventional cancer treatment approaches. Owing to the expansion of knowledge and technological advancements in the field of cancer biology, more innovative and safe anti-cancerous approaches such as immune therapy, gene therapy and targeted therapy are rapidly evolving with the aim to address the limitations of conventional therapies. The concept of immunotherapy began with the capability of coley toxins to stimulate toll-like receptors of immune cells to provoke an immune response against cancers. With an in-depth understating of the molecular mechanisms of carcinogenesis and their relationship to disease prognosis, molecular targeted therapy approaches, that inhibit or stimulate specific cancer-promoting or cancer-inhibitory molecules respectively, have offered promising outcomes. In this review, we evaluate the achievement and challenges of these technically advanced therapies with the aim of presenting the overall progress and perspective of each approach., (© 2024. The Author(s).)

Nanoparticles have numerous applications and are used frequently in different cooling, heating, treatment of cancer cells and manufacturing processes. The current investigation covers the utilization of tetra hybrid nanofluid (aluminum oxide, iron dioxide, titanium dioxide and copper) for Crossflow model over a vertical disk by considering the shape effects (bricks, cylindrical and platelet) of nanoparticles, electro-magneto-hydrodynamic effect and quadratic thermal radiation. In the current inspection model is first derived given PD-equations and then altered into a system of OD-equations by including similarity variables. The converted ordinary differential equations are solved by using the finite element procedure and the impact of the solution against numerous involved parameters is displayed through tables and graphs. It is observed that tetra-hybrid nanoparticles are recommended better in industrial applications where the highest production of thermal energy. Moreover, an enhancement of thermal production can be achieved utilizing different values of the magnetic parameter, time relaxation number, variable thermal radiation number and magnetic induction number but the opposite trend has been noticed with the effects of radiation number., (© 2024. The Author(s).)

This research explores the 3-D flow characteristics, entropy generation and heat transmission behavior of nanofluids consisting of copper and titanium in water as they flow across a bidirectional apparent, while considering the influence of magneto-hydrodynamics. The thermophysical properties of nanofluids are taken advantage of utilizing the Tiwari and Das demonstrate. The concept of the boundary layer has facilitated the comprehension of the physical ideas derived from it. By applying requisite transformations, the connected intricate sets of partial differential equation have been converted into ordinary differential equation. The modified model is calculated employing the widely recognized technique known as OHAM by using Mathematica program BVPh2.0 Software. For different dimensionless parameters computational and graphical investigations have been performed. It is notice that as fluid parameters change, they exhibit distinct responses in comparison to the temperature, velocity profiles and entropy generation. The results show that velocity profile rise with greater estimates of the magnetic parameter and the rate of entropy formation. Furthermore, thermal profiles become less significant as Eckert and Prandtl numbers increase., (© 2024. The Author(s).)

Dynamical variation of physical properties in a controllable fashion provides exciting possibilities to obtain multifunctional materials. In this work, layer-sliding is employed to modify the structural, interfacial electronic and optical properties of unintercalated and Mg-intercalated two-dimensional (2D) van der Waals heterostructure (vdW-HS) consisting of buckled silicene and hexagonal boron nitride (hBN). The most stable stacking configuration of silicene over hBN is screened out and then intercalated with Mg at the interface. Dynamical-dependent changes in the properties of vdW-HS are performed by sliding silicene over hBN monolayer in the absence and presence of the intercalant. Layer-sliding is carried out in equal length intervals, and various parametric quantities related to the physical characteristics of the vdW-HS are repeatedly calculated and compared. Apart from various parametric quantities, stability of unintercalated and Mg-intercalated vdW-HS is also checked by means of relative total energies, binding energies and vdW gaps along the sliding pathway. Comparison of binding energies shows that the un-slided, half-slided, and fully-slided Mg-intercalated vdW-HS are 1.52, 1.44 and 1.42 eV more stable than the unintercalated vdW-HS. Opening of a small band gap of 12, 31 and 28 meV for un-slided, half-slided and fully-slided unintercalated vdW-HS, respectively, is worth mentioning. To study the interfacial electronic behavior, planar average charge density difference (Δρ) and charge transfer (ΔQ) are also calculated and varied via layer-sliding. Further, we calculated diverse optical spectra such as the complex dielectric function (DF), electron energy loss function [L(ω)], diagonal components of dielectric tensor [ε(iω)], refractive index [n(ω)], extinction coefficient [k(ω)], absorption coefficient [α(ω)], and reflectivity [R(ω)] for un-slided, half-slided and fully-slided unintercalated and Mg-intercalated vdW-HS. Interestingly, the polarization and energy losses have been reduced in the case of Mg-intercalated vdW-HS. The suggested layer-sliding method can be established as a general scheme for bringing multifunctionality into a layered material., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Radiographic measurements are frequently used to classify deformity and determine treatment options. Correlation coefficients can be used to determine inter- and intrarater reliability. Reliability is a required feature of any measurement if the measurement is to provide valid information. We calculated correlation coefficients for standard radiographic measurements used to categorize foot deformities: this was done for 52 sets of radiographs assessed by 5 raters. We aimed for generalizability, and kept rater instructions to match what was originally published for each measurement of interest with schematic illustration. Overall, our results mostly showed a lack of inter-rater reliability (correlation coefficients <0.4), and strong intrarater reliability (correlation coefficients >0.6), for 12 forefoot and 12 rearfoot radiographic measurements that are commonly used. The results of this investigation bring into question the routine use of radiographic measurements to categorize deformity, select treatments, and measure surgical outcomes, between surgeons, because the validity of these measurements appears to be threatened by weak inter-rater reliability. In order for these measurements to be considered useful, it may be necessary for surgeons to more rigorously define and practice making standard radiographic measurements., (Copyright © 2023 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

In this study, a novel magnetic macroporous chitin microsphere (MMCM) was developed for enzyme immobilization. Chitin nanofibers were prepared and subsequently subjected to self-assembly with magnetic nanoparticles and PMMA (polymethyl methacrylate). Following this, microspheres were formed through spray drying, achieving a porous structure through etching. The MMCM serves as an effective support for immobilizing enzymes, allowing for their covalent immobilization both on the microsphere's surface and within its pores. The substantial surface area resulting from the porous structure leads to a 2.1-fold increase in enzyme loading capacity compared to non-porous microspheres. The MMCM enhances stability of the immobilized enzymes under various pH and temperature conditions. Furthermore, after 20 days of storage at 4 °C, the residual activity of the immobilized enzyme was 2.93 times that of the free enzyme. Even after being recycled 10 times, the immobilized enzyme retained 56.7 % of its initial activity. It's noteworthy that the active sites of the enzymes remained unchanged after immobilization using the MMCM, and kinetic analysis revealed that the affinity of the immobilized enzymes rivals that of the free enzymes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence he work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Convoy driving, a specialized form of collaborative autonomous driving, offers a promising solution to the multifaceted challenges that transportation systems face, including traffic congestion, pollutant emissions, and the coexistence of connected autonomous vehicles (CAVs) and human-driven vehicles on the road, resulting in mixed traffic flow. While extensive research has focused on the collective societal benefits of convoy driving, such as safety and comfort, one critical aspect that has been overlooked is the willingness of individual vehicles to participate in convoy formations. While the collective benefits are evident, individual vehicles may not readily embrace this paradigm shift without explicit tangible benefits and incentives to motivate them. Moreover, the objective of convoy driving is not solely to deliver societal benefits but also to provide incentives and reduce costs at the individual level. Therefore, this research bridges this gap by designing and modeling the societal benefits, including traffic flow optimization and pollutant emissions, and individual-level incentives necessary to promote convoy driving. We model a fundamental diagram of mixed traffic flow, considering various factors such as CAV penetration rates, coalition intensity, and coalition sizes to investigate their relationships and their impact on traffic flow. Furthermore, we model the collaborative convoy driving problem using the coalitional game framework and propose a novel utility function encompassing incentives like car insurance discounts, traffic fine reductions, and toll discounts to encourage vehicle participation in convoys. Our experimental findings emphasize the need to strike a balance between CAV penetration rate, coalition intensity, size, and speed to realize the benefits of convoy driving at both collective and individual levels. This research aims to align the interests of road authorities seeking sustainable transportation systems and individual vehicle owners desiring tangible benefits, envisioning a future where convoy driving becomes a mutually beneficial solution.

Ticks pose a major threat to cattle health and production in Pakistan because they transmit pathogens of diseases like Babesiosis and Theileriosis. Hyalomma spp., found across Africa, Asia, and Europe, are especially problematic. This study explored biocontrol of Hyalomma spp. using spore-free fungal culture filtrates collected from dairy farm soil in Kohat, Pakistan. Three fungal species of the genera Alternaria, Aspergillus, and Penicillium were isolated, and their filtrates were tested against tick adults and larvae. Filtrate concentrations were prepared at different strengths. Data were taken after the exposure of adults and larvae ticks to various concentrations of the fungal filtrates. Results indicated that at 100% concentration, all fungal filtrates induced 100% mortality in adults and larvae. Decreasing filtrate concentration lowered tick mortality. The lowest concentration caused the least mortality. The effect was time- and dose-dependent. In conclusion, spore-free fungal culture filtrates can provide biocontrol of Hyalomma spp. in a time- and concentration-dependent manner. Further research should explore the active compounds causing mortality and optimal application methods. The process outlined here provides a natural biocontrol alternative to chemical pesticides to reduce tick infestations and associated cattle diseases in Pakistan.

Breast cancer is the most common cancer among women globally and presents a significant challenge due to its rising incidence and fatality rates. Factors such as cultural, socioeconomic, and educational barriers contribute to inadequate awareness and access to healthcare services, often leading to delayed diagnoses and poor patient outcomes. Furthermore, fostering a collaborative approach among healthcare providers, policymakers, and community leaders is crucial in addressing this critical women's health issue, reducing mortality rates, alleviating, and the overall burden of breast cancer. The main goal of this review is to explore various techniques of machine learning algorithms to examine high accuracy and early detection of breast cancer for the safe health of women., (© 2023 John Wiley & Sons Ltd.)

Electrochemical biosensing has evolved as a diverse and potent method for detecting and analyzing biological entities ranging from tiny molecules to large macromolecules. Electrochemical biosensors are a desirable option in a variety of industries, including healthcare, environmental monitoring, and food safety, due to significant advancements in sensitivity, selectivity, and portability brought about by the integration of electrochemical techniques with nanomaterials, bio-recognition components, and microfluidics. In this review, we discussed the realm of electrochemical sensors, investigating and contrasting the diverse strategies that have been harnessed to push the boundaries of the limit of detection and achieve miniaturization. Furthermore, we assessed distinct electrochemical sensing methods employed in detection such as potentiometers, amperometers, conductometers, colorimeters, transistors, and electrical impedance spectroscopy to gauge their performance in various contexts. This article offers a panoramic view of strategies aimed at augmenting the limit of detection (LOD) of electrochemical sensors. The role of nanomaterials in shaping the capabilities of these sensors is examined in detail, accompanied by insights into the chemical modifications that enhance their functionality. Furthermore, our work not only offers a comprehensive strategic framework but also delineates the advanced methodologies employed in the development of electrochemical biosensors. This equips researchers with the knowledge required to develop more accurate and efficient detection technologies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Shahid, Nazir, Khan, Sabahat and Naeem.)

Mobile robots are increasingly employed in today's environment. Perceiving the environment to perform a task plays a major role in the robots. The service robots are wisely employed in the fully (or) partially known user's environment. The exploration and exploitation of the unknown environment is a tedious task. This paper introduces a novel Trimmed Q-learning algorithm to predict interesting scenes via efficient memorability-oriented robotic behavioral scene activity training. The training process involves three stages: online learning and short-term and long-term learning modules. It is helpful for autonomous exploration and making wiser decisions about the environment. A simplified three-stage learning framework is introduced to train and predict interesting scenes using memorability. A proficient visual memory schema (VMS) is designed to tune the learning parameters. A role-based profile arrangement is made to explore the unknown environment for a long-term learning process. The online and short-term learning frameworks are designed using a novel Trimmed Q-learning algorithm. The underestimated bias in robotic actions must be minimized by introducing a refined set of practical candidate actions. Finally, the recalling ability of each learning module is estimated to predict the interesting scenes. Experiments conducted on public datasets, SubT, and SUN databases demonstrate the proposed technique's efficacy. The proposed framework has yielded better memorability scores in short-term and online learning at 72.84% and in long-term learning at 68.63%., (© 2023. The Author(s).)

Polydactyly is the most common limb malformation that occurs in 1.6-10.6 per one thousand live births, with incidence varying with ancestry. The underlying gene has been identified for many of the ~100 syndromes that include polydactyly. While for the more common form, nonsydromic polydactyly, eleven candidate genes have been reported. We investigated the underlying genetic cause of autosomal recessive nonsyndromic postaxial polydactyly in four consanguineous Pakistani families. Some family members with postaxial polydactyly also present with syndactyly, camptodactyly, or clinodactyly. Analysis of the exome sequence data revealed two novel homozygous frameshift deletions in EFCAB7: [c.830delG;p.(Gly277Valfs*5)]; in three families and [c.1350&#95;1351delGA;p.(Asn451Phefs*2)] in one family. Sanger sequencing confirmed that these variants segregated with postaxial polydactyly, i.e., family members with postaxial polydactyly were found to be homozygous while unaffected members were heterozygous or wild type. EFCAB7 displays expressions in the skeletal muscle and on the cellular level in cilia. IQCE-EFCAB7 and EVC-EVC2 are part of the heterotetramer EvC complex, which is a positive regulator of the Hedgehog (Hh) pathway, that plays a key role in limb formation. Depletion of either EFCAB7 or IQCE inhibits induction of Gli1, a direct Hh target gene. Variants in IQCE and GLI1 have been shown to cause nonsyndromic postaxial polydactyly, while variants in EVC and EVC2 underlie Ellis van Creveld and Weyers syndromes, which include postaxial polydactyly as a phenotype. This is the first report of the involvement of EFCAB7 in human disease etiology., (© 2023. The Author(s), under exclusive licence to European Society of Human Genetics.)

The tillering phase of wheat (Triticum aestivum ) crops is extremely susceptible to drought. We explored the potential of silver nanoparticles (AgNPs) in protecting wheat genotypes from drought injury during this sensitive stage. After treating with AgNPs (60ppm), the plants were submitted to different water levels; i.e. 100% field capacity (FC), 75% FC (mild drought), 50% FC (moderate drought) and 25% FC (severe drought) from 15 to 41days after sowing (tillering phase). Leaf physiological data were collected at stress termination, while yield attributes were recorded at crop maturity. We found that increasing drought intensity significantly impaired leaf physiology and grain yield of both studied genotypes. Compared with control, moderately and severely drought-stressed plants produced 25% and 45% lesser grain yield per spike, respectively (averaged across genotypes and years of study). Likewise, moderate and severe drought reduced photosynthesis by 49% and 76%, respectively, compared with control. In contrast, AgNPs significantly restored leaf physiological functioning and grain yield formation at maturity. For example, under moderate and severe drought, AgNPs-treated plants produced 22% and 17% more grains per plant, respectively, than their respective water-treated plants. Our study suggests that exogenous AgNPs can protect wheat crops from drought during early development stages.

Road network extraction is a significant challenge in remote sensing (RS). Automated techniques for interpreting RS imagery offer a cost-effective solution for obtaining road network data quickly, surpassing traditional visual interpretation methods. However, the diverse characteristics of road networks, such as varying lengths, widths, materials, and geometries across different regions, pose a formidable obstacle for road extraction from RS imagery. The issue of road extraction can be defined as a task that involves capturing contextual and complex elements while also preserving boundary information and producing high-resolution road segmentation maps for RS data. The objective of the proposed Archimedes tuning process quantum dilated convolutional neural network for road Extraction (ATP-QDCNNRE) technology is to tackle the aforementioned issues by enhancing the efficacy of image segmentation outcomes that exploit remote sensing imagery, coupled with Archimedes optimization algorithm methods (AOA). The findings of this study demonstrate the enhanced road-extraction capabilities achieved by the ATP-QDCNNRE method when used with remote sensing imagery. The ATP-QDCNNRE method employs DL and a hyperparameter tuning process to generate high-resolution road segmentation maps. The basis of this approach lies in the QDCNN model, which incorporates quantum computing (QC) concepts and dilated convolutions to enhance the network's ability to capture both local and global contextual information. Dilated convolutions also enhance the receptive field while maintaining spatial resolution, allowing fine road features to be extracted. ATP-based hyperparameter modifications improve QDCNNRE road extraction. To evaluate the effectiveness of the ATP-QDCNNRE system, benchmark databases are used to assess its simulation results. The experimental results show that ATP-QDCNNRE performed with an intersection over union (IoU) of 75.28%, mean intersection over union (MIoU) of 95.19%, F1 of 90.85%, precision of 87.54%, and recall of 94.41% in the Massachusetts road dataset. These findings demonstrate the superior efficiency of this technique compared to more recent methods.

Carbon dots (CDs) are a new class of nanomaterials exhibiting high biocompatibility, water solubility, functionality, and tunable fluorescence (FL) property. Due to the limitations of batch hydrothermal synthesis in terms of low CDs yield and long synthesis duration, this work aimed to increase its production capacity through a continuous flow reactor system. The influence of temperature and time was first studied in a batch reactor for glucose, xylose, sucrose and table sugar precursors. CDs synthesized from sucrose precursor exhibited the highest quantum yield (QY) (175.48%) and the average diameter less than 10 nm (~6.8 ± 1.1 nm) when synthesized at 220°C for 9 h. For a flow reactor system, the best condition for CDs production from sucrose was 1 mL min -1 flow rate at 280°C, and 0.2 MPa pressure yielding 53.03% QY and ~ 6.5 ± 0.6 nm average diameter (6.6 mg min -1 of CDs productivity). CDs were successfully used as ciprofloxacin (CP) nanocarrier for antimicrobial activity study. The cytotoxicity study showed that no effect of CDs on viability of L-929 fibroblast cells was detected until 1000 µg mL -1 CDs concentration. This finding demonstrates that CDs synthesized via a flow reactor system have a high zeta potential and suitable surface properties for nano-theranostic applications., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2023 The Author(s). Published by National Institute for Materials Science in partnership with Taylor & Francis Group.)

Background: Blindness is a common problem in every society and country. The problem ranges from complete blindness to partially sighted in the affected population. India has close to 12 million visually impaired people. Orthopaedic problems are not uncommon in blind. Orthopaedic Surgeons though had been aware of the postural and gait abnormalities in blind but very few published studies have systematically focused on the effect of blindness on the development of posture and gait., Methods: Case Control study done for the orthopaedic evaluation of the blind and partially sighted individuals. The study population included 242 students of Ahmadi School for the Blind, Aligarh Muslim University, Aligarh (India), as the cases and another matched set of 250 non-blind children. All the children were assessed for the orthopaedic problems like degree of ligamentous laxity, spinal alignment, foot morphology and alignment of hips, knees and ankles. Standing posture and gait were also examined and recorded. Ligamentous laxity was assessed according to the method adopted by Beighton et al. 10 Chi-square test was applied using IBM SPSS 23.0., Results: 139 children (57.4 %) were found to have laxity of the ligaments. 72 children (29.7 %) had spine deformities, out of which kyphosis was present in 34 (47.2 %), scoliosis in 23 (31.9 %), lordosis in 13 (18.0 %), and meningomyelocele in 2 (2.9 %) children. 119 children (49.1 %) had foot deformities. 37 children (15.2 %) had knee deformity. 22 children (9.0 %) showed evidence of cerebral palsy. 216 children (89.2 %) had varying degrees of postural abnormalities. The data was statistically significant when compared with the control group (P < 0.05)., Conclusion: Blindness causes a wide range of complicated sensory and motor problems that frequently forces people into isolation. Blind rehabilitation requires an interdisciplinary approach. Orthopaedic problems are quite common in blind individuals and should be dealt separately., Competing Interests: On behalf of all authors, the corresponding author states that there is no conflict of interest., (© 2023 Delhi Orthopedic Association. All rights reserved.)

Objectives: Sexual gender minority (SGM) populations are at risk for human papillomavirus (HPV)-related cancers of the anogenital tract and oropharynx and often face barriers to health care. The goals of this document are to clarify language to provide inclusive care for SGM populations and to provide recommendations for screening and prevention of HPV-related cancers in SGM populations., Materials and Methods: An expert committee convened by the American Society for Colposcopy and Cervical Pathology performed a narrative review of the literature through February 2023. A comprehensive MEDLINE database search was performed for relevant studies. The literature review was divided into categories by organ/topic and by SGM population. Given the variability in available data for several of the categories, recommendations were made based on national guidelines where appropriate or expert opinion where there were less data to support risk-based guidelines., Results: Definitions and terminology relevant to SGM populations are presented. The authors advocate the adoption of sexual orientation gender identity data collection and an organ-based screening approach, which is possible with knowledge of patient anatomy, sexual behaviors, and clinical history. This includes screening for cervical cancer per national recommendations, as well as screening for anal, vulvar, vaginal, penile, and oral cancers based on risk factors and shared clinical decision making. The authors recommend consideration of HPV vaccination in all SGM individuals up to age 45 years old who are at risk., Conclusions: An organ-based screening approach is part of a global strategy to create an inclusive care environment and mitigate barriers to screening and prevention of HPV-mediated cancers in SGM populations., Competing Interests: The authors have declared they have no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.)

Methods: The authors conducted a survey for practicing gynecologists recruited through academic institutions, professional societies, and professional groups on social media resulting in 196 respondents. The survey, fielded between January and June 2022, included questions on knowledge, attitudes, training, and practices regarding anal cancer prevention (ACP). Descriptive statistics and χ 2 analysis were completed., Results: In terms of knowledge regarding ACP, over 80% of respondents identified certain clinical indications for anal cancer screening. However, only 36% respondents selected the 3 correct ACP screening tools. Twenty-seven (13.9%) respondents reported receiving training on ACP in medical school, whereas 50 (25.9%) reported receiving training during residency. Only 21% of respondents reported that they perform anal cytology, and 32% reported that they perform digital anal rectal examinations. One hundred thirty-six respondents (75.56%) affirmed that they needed additional training on ACP to be able to provide this service to their patients, and 95 (53.1%) stated they were extremely likely to participate in ACP training if given the opportunity., Conclusion: Although a limited proportion of practicing gynecologists are trained in ACP, there is willingness to participate in training if it were made available and to incorporate ACP into their practices., (Copyright © 2023, ASCCP.)

Environment perception plays a crucial role in enabling collaborative driving automation, which is considered to be the ground-breaking solution to tackling the safety, mobility, and sustainability challenges of contemporary transportation systems. Despite the fact that computer vision for object perception is undergoing an extraordinary evolution, single-vehicle systems' constrained receptive fields and inherent physical occlusion make it difficult for state-of-the-art perception techniques to cope with complex real-world traffic settings. Collaborative perception (CP) based on various geographically separated perception nodes was developed to break the perception bottleneck for driving automation. CP leverages vehicle-to-vehicle and vehicle-to-infrastructure communication to enable vehicles and infrastructure to combine and share information to comprehend the surrounding environment beyond the line of sight and field of view to enhance perception accuracy, lower latency, and remove perception blind spots. In this article, we highlight the need for an evolved version of the collaborative perception that should address the challenges hindering the realization of level 5 AD use cases by comprehensively studying the transition from classical perception to collaborative perception. In particular, we discuss and review perception creation at two different levels: vehicle and infrastructure. Furthermore, we also study the communication technologies and three different collaborative perception message-sharing models, their comparison analyzing the trade-off between the accuracy of the transmitted data and the communication bandwidth used for data transmission, and the challenges therein. Finally, we discuss a range of crucial challenges and future directions of collaborative perception that need to be addressed before a higher level of autonomy hits the roads.

Blood pressure management is a critical aspect of patient care, particularly in surgical and critical care settings. Closed-loop systems, which utilize real-time data and feedback to adjust treatment interventions, have gained attention for their potential to enhance blood pressure control. This review explores the application of closed-loop systems in blood pressure management. We discuss various closed-loop approaches, including their mechanisms, benefits, and limitations. By harnessing real-time patient data and feedback, closed-loop systems can tailor interventions dynamically, thus enhancing blood pressure regulation. Additionally, we examine the integration of advanced monitoring technologies and artificial intelligence algorithms in closed-loop systems. The review highlights recent studies and their findings, emphasizing the evolving landscape of closed-loop blood pressure management across different clinical scenarios. From the perioperative period to critical care settings, closed-loop systems hold the potential to optimize patient outcomes by precisely adjusting vasopressor administration in response to continuous blood pressure fluctuations. By providing insights into the current state of closed-loop systems for blood pressure control, this review offers a comprehensive overview of their potential contributions to improved patient outcomes and future directions for research and implementation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Baykuziyev et al.)