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Economies are under serious pressure to sustain themselves due to globalization, focusing simply on economic growth and operational efficiency will not yield the desired sustainable financial and economic position for economies. Management of energy efficiency and reducing the energy dependence and intensity is the core objective for the economy and achievement of the above objective financial, economic, and environmental factors need to be studied. Economic wellbeing critically depends on the efficient use of energy and which type of governance mechanism is in place will also define the ways toward energy efficiency. A better understanding of the relationship will help the economies to fulfill their energy needs efficiently, realize developmental goals, and overcome environmental issues. This study examines the relationship between financial, economic, and environmental factors with energy efficiency, intensity, and dependency with moderating role of governance including institutional quality and governance index for belt and road initiative countries. The core objective of the study is to analyze which financial, economic, and environmental factors serve well in the management of energy efficiency, intensity, and dependence issues and how various dynamics of governance policies including market structure moderate the above-mentioned relationship. For this secondary data is used from world development indicators, market insiders, and Chicago Board Options Exchange (CBOE) data. This research will help the researchers and practitioners to achieve long-term economic, financial, and environmental sustainability. The proposed model predicts that 0.44% change in Total Factor Energy Productivity measure of Energy Efficiency, 0.03% changes in Energy use/Purchasing Power Parity ratio measure of Energy Intensity, and 9.63% changes in Energy Reserves/Energy Production ratio measure of Energy Dependence. Results also reveal that environmental factors including Rural population, Urbanization, Co2 emission, energy use, and energy production will contribute most to achieving sustainable economic growth.

This article provides background on community archiving as it relates to a group of faculty members currently working together to address the challenge of reimagining archival education to center non-dominant archival traditions and the restructuring of internship programs to provide financial compensation, by asking how MLIS programs might transform to better serve both minoritized communities and minoritized students. We focus on MLIS Education and Dominant Archival Theories and Practices, to explore the challenges of and possibilities for a large-scale North American effort to support paid internships at community archives.

Objective: To find out the prevalence of antibodies against cytomegalovirus and their association with adverse pregnancy outcome in women, at Isra University Hospital Hyderabad. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynaecology & Obstetrics, Isra University Hospital (IUH) Hyderabad, from Jan to Jun 2018. Methodology: Cytomegalovirus IgM and IgG antibodies in 305 women of reproductive age group were measured using the Enzyme Linked Fluorescent Assaysystem kit. Results: The combined positivity of anti cytomegalovirus IgG and IgM antibodies was 93 (30.40%). About 37 (37.37%) and 28 (34.14%) women were found to be seropositive for cytomegalovirus antibodies who had history of spontaneous miscarriage and recurrent miscarriages respectively. Conclusion: Higher association of seropositivity for cytomegalovirus IgM and IgG with bad obstetrical history and low economy was found.

Abstract Of late, cross‐linked polyethylene insulated aerial bundled cables have replaced conventional copper conductors being resistant to electricity pilferage, offer lower maintenance costs and reduced power losses. However, in coastal areas, aerial bundled cables experience frequent insulation breakdown causing sudden cable failures leading to unexpected power shutdowns. Condition monitoring, employing sophisticated diagnostic techniques, has thus become a major requirement of the energy sector. The reported research work utilizes infrared thermography as one such candidate NDT technique. A novel framework is proposed to investigate the progressive shift in the statistical parameters of the temperature distribution in aerial bundled cables’ insulation, as it degrades over time. The cumulative distribution function of pixel intensity data from a healthy/ operational aerial bundled cable is first compared with a reported failed aerial bundled cable. A prominent difference in 0.9 cumulative distribution function values is observed in the temperature distributions. Therefore, 0.9 cumulative distribution function values are used for degradation quantification with respect to ageing. Degradation rates are then computed using periodically acquired thermographic data from operational aerial bundled cables, installed at two different locations in a coastal region, each subjected to different marine climate. The proposed technique proved effective in degradation rate assessment of insulation of operational aerial bundled cables. Consequently, the results achieved can also be utilized for remaining useful life prediction of these cables.

The Middle East, Gulf Cooperation Council Countries (GCC), and Kuwait, in particular, are currently experiencing a similar transition as the USA in the 1970s regarding the empowerment and independence of women, fueled by a declining birth rate from four per women to less than two. In addition, the percentage of women with university degrees has been increasing at a logarithmic rate every decade since the 1960s in the USA and since 1990 in Kuwait, resulting in women comprising well over half of all university graduates. This has led to women obtaining better jobs and enjoying greater independence to make their own decisions. In the 1960s, Toyota and other Japanese car manufactures used this phenomenon to penetrate the US market, with significant success. Their selling points were lower maintenance requirements, higher reliability, safety, better environment friendliness and slicker interior designs, the last being especially adapted to women’s tastes. We believe that Chinese and Korean electric vehicle (EV) manufacturers will employ the same playbook with similar success, as the Middle East accelerates its readiness for the EV mainstream market. In this study, this prediction was supported by a quantitative questionnaire of 234 educated female Kuwaiti drivers from the ages of 18 to 40 in Kuwait regarding their preferences regarding EVs. The findings indicate that potential female buyers favor EVs for their environmental benefits, regardless of their demographics. Moreover, potential female consumers are highly willing to purchase EVs in the future under three conditions: infrastructure availability, environmental development, and affordability. We believe that this group, in particular, will present the greatest opportunity to EV manufacturers over the next 10 years.

This study examines the role of quality minus junk factor in explaining cross-sectional differences in stock returns for the equity market of Pakistan. A new factor quality minus junk has been added to the existing Fama & French three factor model (1993) as a fourth factor to check whether it is priced as a risk factor. The study also compares the explanatory power of the newly proposed model with the existing single-factor Capital Asset Pricing Model (CAPM) and Fama & French three factor model (1993). A high quality data set of 70 non-financial firms listed on the PSX is employed as a sample for the period 2008- 2016. Results show that quality minus junk factor is priced in the equity market of Pakistan and this newly proposed four factor model has significantly higher explanatory power than the existing three factor model.

Abstract Perovskite solar cells (PSCs) expressed great potentials for offering a feasible alternative to conventional photovoltaic technologies. 2D/3D hybrid PSCs, where a 2D capping layer is used over the 3D film to avoid the instability issues associated with perovskite film, have been reported with improved stabilities and high power conversion efficiencies (PCE). However, the profound analysis of the PSCs with prolonged operational lifetime still needs to be described further. Heading towards efficient and long-life PSCs, in-depth insight into the complicated degradation processes and charge dynamics occurring at PSCs' interfaces is vital. In particular, the Au/HTM/perovskite interface got a substantial consideration due to the quest for better charge transfer; and this interface is debatably the trickiest to explain and analyze. In this study, multiple characterization techniques were put together to understand thoroughly the processes that occur at the Au/HTM/perovskite interface. Inquest analysis using current–voltage (I–V), electric field induced second harmonic generation (EFISHG), and impedance spectroscopy (IS) was performed. These techniques showed that the degradation at the Au/HTM/perovskite interface significantly contribute to the increase of charge accumulation and change in impedance value of the PSCs, hence resulting in efficiency fading. The 3D and 2D/3D hybrid cells, with PCEs of 18.87% and 20.21%, respectively, were used in this study, and the analysis was performed over the aging time of 5000 h. Our findings propose that the Au/HTM/perovskite interface engineering is exclusively essential for attaining a reliable performance of the PSCs and provides a new perspective towards the stability enhancement for the perovskite-based future emerging photovoltaic technology.

In this paper we proposed a solar cell having model “Back Contact/CZTS/ZnCdS/ZnO/Front Contact”. CZTS is working as an absorber layer, ZnCdS as a buffer layer and ZnO as a window layer with back and front contacts. The Zn content was varied from 0% to 10% and bad gap was changed from 2.42 to 2.90 eV as described in the literature. The impact of this band gap variation has been observed on the performance of solar cell by using SCAPS-1D software. The efficiency was varied due to variation in bandgap of ZnCdS thin film layer. The simulation was carried out at 300K under A.M 1.5 G 1 Sun illumination. The energy bandgap diagram has been taken from SCAPS to explain the different parameters of solar cell. The effect of ZnCdS having different bandgap values was observed. Then the thickness of CZTS layer was varied to check its effect and hence at 3.0 um gave the imporved efficiency of 13.83% roundabout. After optimization of CZTS layer thickness, the effect of working temperature was examined on the performance of solar cell. The absorption coefficient variation from 1E+4 to 1E+9 cm-1 caused major effects on the characteristics parameters of solar cell along with on J-V characteristics and Quantum Efficiency curve. At 1E+9 cm-1 absorption coefficient the efficiency of solar cell boost up to 16.24%. This is the remarkable improvement in the efficiency of solar cell from 13.82% to 16.24%. After optimization of all parameters, simulation was run at 280K, having CZTS thickness of 3.5 um, with 10% content Zn in ZnCdS (2.90 eV), and absoption coefficient of 1E+9, the model efficiency reached up to 17.6% with Voc of 0.994 V, Jsc 26.1 mA/cm2 and Fill factor was 71.4%.

In this research work, the electrical simulation of 1D5P model solar cell is done using LTSpice-IV simulation software. In this work effect of environmental conditions i.e temperature, solar irradiance, and parasitic parameters i.e series as well as shunt resistances was carried out. It has been discovered that as temperature increases the performance of solar cell decrease because temperature causes to increase the recombination phenomenon and hence lower the performance. However, when the temperature rises from 00C to 500C, the I-V and P-V curves move to the origin showing the negative effect of increasing temperature on the solar cell. Solar irradiance has major role on the performance of solar cell. As solar irradiance increases from 250 Wm-2 to 1000 Wm-2, the performance of solar cell increases accordingly and I-V as well as P-V curve moves away from the origin. It is concluded that for different series resistances, I-V along with P-V characteristic of 1D5P model solar cell varies, as at 0.02Ω series resistance, a maximum short circuit current and maximum power is obtained. But when series resistance increased up 2 ohm only, the I-V and P-V curves moves to origin drastically. Shunt Resistance is the path of reverse current of the cell. As the shunt resistance increases, the path for reverse current decreased, hence all current goes to load, hence maximum power is obtained. Similarly when the value of shunt resistance decreased, the voltage-controlled section of I-V characteristics curve is moved closer to the origin hence reduced the solar cell performance. It's critical to understand how different factors affect the I-V and P-V characteristics curves of solar cells. The open circuit voltage, short circuit current and maximum power is all variable. The influence of these factors may be extremely beneficial when tracking highest power point of a solar cell applying various methods.

Distributed energy resources (DER’s) incorporation in power system brings economical, technical and environmental benefits. Besides these benefits, excess penetration of DER’s elevates technical concerns. Islanding detection is one of main issue and is essential for personnel safety and protection of equipment. This work introduces a passive islanding detection scheme based on phase angle of positive sequence voltage (PAOPSV). The PAOPSV was selected on the basis of rigorous investigation of 13 different indices. Comparative analysis demonstrates that PAOPSV has the best sensitivity and accuracy for islanding detection among all other parameters. An extensive case study considering worst-case scenarios is accomplished in order to check the working efficacy of the suggested scheme that easily discriminates islanding events from non-islanding events such as load switching, different fault types switching, capacitor and motor switching. The suggested scheme is simple with fast execution and easy to implement that is established on IEEE 1547 generic test system in MATLAB/SIMULINK environment. Islanding is detected within 0.10 s even with a zero non-detection zone.

Onychomadesis is an idiopathic shedding of a proximal part of the nail as a result of the temporary suspension of a nail matrix function. It is seen in fingernails, toenails, or both. Various underlying causes like systemic illness, drug reactions, Viral diseases, and bullous diseases have been associated with Onychomadesis. However, the mechanism of any such association remains unclear. Here we present a case of On-ychomadesis and Beau lines in the fingernails of a 13-month-old girl following Hand, foot, and mouth disease. [J Med Allied Sci. 2021; 11(2):183-185]

Objective Tumor necrosis factor α–stimulated gene 6 (TSG‐6) is an anti‐inflammatory protein highly expressed in osteoarthritis (OA), but its influence on the course of OA is unknown. Methods Cartilage injury was assessed by murine hip avulsion or by recutting rested explants. Forty‐two previously validated injury genes were quantified by real‐time polymerase chain reaction in whole joints following destabilization of the medial meniscus (DMM) (6 hours and 7 days). Joint pathology was assessed at 8 and 12 weeks following DMM in 10‐week‐old male and female fibroblast growth factor 2 (FGF2)−/−, TSG‐6−/−, TSG‐6tg (overexpressing), FGF2−/−;TSG‐6tg (8 weeks only) mice, as well as strain‐matched, wild‐type controls. In vivo cartilage repair was assessed 8 weeks following focal cartilage injury in TSG‐6tg and control mice. FGF2 release following cartilage injury was measured by enzyme‐linked immunosorbent assay. Results TSG‐6 messenger RNA upregulation was strongly FGF2‐dependent upon injury in vitro and in vivo. Fifteeen inflammatory genes were significantly increased in TSG‐6−/− joints, including IL1α, Ccl2, and Adamts5 compared with wild type. Six genes were significantly suppressed in TSG‐6−/− joints including Timp1, Inhibin βA, and podoplanin (known FGF2 target genes). FGF2 release upon cartilage injury was not influenced by levels of TSG‐6. Cartilage degradation was significantly increased at 12 weeks post‐DMM in male TSG‐6−/− mice, with a nonsignificant 30% reduction in disease seen in TSG‐6tg mice. No differences were observed in cartilage repair between genotypes. TSG‐6 overexpression was unable to prevent accelerated OA in FGF2−/− mice. Conclusion TSG‐6 influences early gene regulation in the destabilized joint and exerts a modest late chondroprotective effect. Although strongly FGF2 dependent, TSG‐6 does not explain the strong chondroprotective effect of FGF2.

Objective: To compare the efficacy of intravenous hydralazine with intravenous labetalol for control of severe hypertension in eclamptic patients. Study Design: Cross-sectional study. Place and Duration of Study: Obstetrics and Gynecology unit “B”, PGMI Lady Reading Hospital Peshawar, from Mar 2017 to Sep 2017. Methodology: Total 206 patients were included in this comparative study. They were randomly divided into two groups; group A and group B, each group comprising of 103 patients. The group A was given 5mg hydralazine as an initial intravenous bolus. After 20 minutes blood pressure was measured and if systolic and diastolic blood pressures were found to be >160 mmHg and>110mmHg respectively, the same dose was repeated maximally 3 times. The group B received 20mg labetalol as an initial intravenous bolus, then after every 20 minutes followed by 80mg to a maximum of three doses if systolic and diastolic blood pressures persisted >160 mmHg and >110mmHg respectively. Results: Mean age in group A was 27 ± 2.93 years whereas in group B mean age was 29 ± 3.18 years. Moreover, blood pressure was effectively lowered in 92% patients of group A and in 90% patients of group B. There was no statistically significant difference found between the efficacies of the two drugs. Conclusion: It was found that efficacy of the two drugs is similar in lowering blood pressure in eclamptic patients.

Developing countries world-wide are witnessing historical growth in their elderly populations, and with it, importantly, a steady rise in the number of people experiencing age-related cognitive decline. This reality has the potential to produce an unprecedented strain on affected families, healthcare systems and taxpayers in the very near future. This study: a) examines the present limits and predicted capacity of Artificial Intelligence (AI) as they relate to the various and complex needs of those hoping to optimize the positive benefits of cognitive training, and b) systematically reviews the efficacy of Human Robot Interaction (HRI) as an intervention strategy for elderly individuals confronting cognitive challenges along the spectrum from Mild Cognitive Impairment (MCI) to Advanced Cognitive Impairment (ACI). The results of this systematic review suggest that, overall, the utilization of humanoid and pet robots, such as NAO and PARO, respectively, produce improvements in cognition and markers of social and emotional health and engagement; however, when embedded with AI with the capacity for Deep Learning the potential of robotic technology to aggressively meet the needs of individuals experiencing age-related cognitive decline will be significant.

Background: The global coronavirus disease 2019 (COVID-19) pandemic, now in its second year, has resulted in a large corpus of literature in a number of disciplines, particularly virology and epidemiology. In contrast, scholarly inquiry in other areas of the health sciences, particularly in media representations and public health communication, is still emerging. Aim: As an integral stakeholder in communication during a pandemic, this descriptive study sought to delineate the media frames of the COVID-19 pandemic in online news headlines in the first month that the COVID-19 was declared a pandemic. Setting: Online news headlines in three global hotspots, namely Italy, the USA and South Africa, during the month of March 2020, were analysed. Methods: Thematic content analysis and epidemic framing typology. Results: The findings indicate that COVID-19 has been internationally portrayed as a lethal pandemic that destroys and disrupts human life. Discursive frames of consequences monopolised its coverage, whilst discursive frames of reassurance were rare, despite the high survival rate. One of the unique findings of this study is that the COVID-19 pandemic coverage included the naming of positive patients, who were thereby made known to the public. Conclusion: Internationally, COVID-19 pandemic coverage used consequence frames that dramatised loss of life instead of deploying frames of reassurance that foreground the high survival rate of this disease. Contribution: Results of the study may help inform public health communication of the COVID-19 pandemic, by offering a detailed description of the frames that journalists use in news headlines, all of which possibly influence public perception of the pandemic. Theoretically, the article has also contributed to the application of epidemic framing typology and has contributed to knowledge in the field of public health communication and the COVID-19 pandemic.

Epilepsy is a neurological disorder characterized by abnormal brain activity. Epileptic patients suffer from unpredictable seizures, which may cause a loss of awareness. Seizures are considered drug resistant if treatment does not affect success. This leads practitioners to calculate the cortical thickness to measure the distance between the brain’s white and grey matter surfaces at various locations to perform a surgical intervention. In this study, we introduce using machine learning as an approach to classify extracted measurements from T1-weighted magnetic resonance imaging. Data were collected from the epilepsy unit at King Abdulaziz University Hospital. We applied two trials to classify the extracted measurements from T1-weighted MRI for drug-resistant epilepsy and healthy control subjects. The preprocessing sequence on T1-weighted MRI images was performed using C++ through BrainSuite’s pipeline. The first trial was performed on seven different combinations of four commonly selected measurements. The best performance was achieved in Exp6 and Exp7, with 80.00% accuracy, 83.00% recall score, and 83.88% precision. It is noticeable that grey matter volume and white matter volume measurements are more significant than the cortical thickness measurement. The second trial applied four different machine learning classifiers after applying 10-fold cross-validation and principal component analysis on all extracted measurements as in the first trial based on the mentioned previous works. The K-nearest neighbours model outperformed the other machine learning classifiers with 97.11% accuracy, 75.00% recall score, and 75.00% precision.

Ever since the discovery of oil in 1938, the State of Kuwait has increasingly sought out international brands in the car market due to the high purchasing power of Kuwaiti nationals. However, the makers of electric vehicles (EVs) have not been able to penetrate this market, with the exception of innovators and early adopters. The phenomenon in disruptive innovation theory—called “Crossing the Chasm”—regarding a mass market appeal has not yet occurred in Kuwait. Through deep interviews with 12 Kuwaiti owners of EVs and automotive dealers who sold either EVs or Hybrid Electric Vehicles (HEVs), 10 key reasons for this phenomenon have been previously revealed, which were used to develop an extensive questionnaire. A total of 472 car drivers aged from 18 to 30, identified as the “early majority”, completed the questionnaire to achieve the objective of identifying the factors required to create a mass market for EVs in Kuwait. The results demonstrated that potential customers highly preferred three different types of attributes of EVs: environmental, financial, and technological. There were significant differences in the identified attributes preferred by Kuwaiti individuals for EVs in terms of the number of cars owned and the sector of employment. Moreover, the results of our study indicate that potential customers are very willing to buy EVs in the future, considering both their financial and infrastructure attributes. There were further significant differences in the identified necessary conditions to buy EVs in terms of educational level and monthly income. This study discusses a variety of valuable promotional tactics, which may be implemented in conjunction with public incentives and policy changes in the State of Kuwait. This information is considered useful for marketers and designers who wish to tap into this lucrative market, which is significantly different from that in the global North.

Introduction Poverty has far-reaching and detrimental effects on children’s physical and mental health, across all geographies. Financial advice and income-maximisation services can provide a promising opportunity for shifting the physical and mental health burdens that commonly occur with financial hardship, yet awareness of these services is limited, and referrals are not systematically integrated into existing healthcare service platforms. We aim to map and synthesise evidence on the impact of healthcare-income maximisation models of care for families of children aged 0–5 years in high-income countries on family finances, parent/caregiver(s) or children’s health and well-being.Methods and analysis To be included in the review, studies must be families (expectant mothers or parents/caregivers) of children who are aged between 0 and 5 years, accessing a healthcare service, include a referral from healthcare to an income-maximisation service (ie, financial counselling), and examine impacts on child and family health and well-being. A comprehensive electronic search strategy will be used to identify studies written in English, published from inception to January 2021, and indexed in MEDLINE, EMBase, PsycINFO, CINAHL, Proquest, Family & Society Studies Worldwide, Cochrane Library, and Informit Online. Search strategies will include terms for: families, financial hardship and healthcare, in various combinations. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies, and grey literature will also be searched. Data on objective and self-reported outcomes and study quality will be independently extracted by two review authors; any disagreements will be resolved through a third reviewer. The protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and dissemination Ethical approval is not required. The results will be disseminated widely via peer-reviewed publication and presentations at conferences related to this field.PROSPERO registration number CRD42020195985.

The series of Bi2O2Se-Ag2Se composites were synthesized by two step solid state reaction followed by Spark plasma sintering. To optimize their thermal transport properties, different weight percent (wt. %) of silver i-e, 10%, 15% and 20%, was added. The room temperature X-ray diffraction (XRD) and high temperature XRD was used to investigate the crystalline phases, whereas the morphological study was conducted through FESEM. The thermal transport properties were evaluated from 323 K to 773 K, to study the effect of silver addition on thermal conductivity of all the composite samples. The reduced thermal conductivity of the composite with decreasing Ag contents is might be attributed to increase of the Ag2Se and Bi2O3 nano-inclusions in Bi2O2Se multi-phase-system that increased the phonon scattering regions and reduced the overall thermal conductivity significantly, up to 54 % for BA15SO as compared to that of BA20CO at 473 K.

Background: Schools in the UK increasingly have to respond to anxiety, depression and conduct disorder as key causes of morbidity in children and young people. Objective: The objective was to assess the comparative effectiveness of educational setting-based interventions for the prevention of anxiety, depression and conduct disorder in children and young people. Design: This study comprised a systematic review, a network meta-analysis and an economic evaluation. Data sources: The databases MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), PsycInfo® (American Psychological Association, Washington, DC, USA) and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to 4 April 2018, and the NHS Economic Evaluation Database (NHS EED) was searched on 22 May 2019 for economic evaluations. No language or date filters were applied. Main outcomes: The main outcomes were post-intervention self-reported anxiety, depression or conduct disorder symptoms. Review methods: Randomised/quasi-randomised trials of universal or targeted interventions for the prevention of anxiety, depression or conduct disorder in children and young people aged 4–18 years were included. Screening was conducted independently by two reviewers. Data extraction was conducted by one reviewer and checked by a second. Intervention- and component-level network meta-analyses were conducted in OpenBUGS. A review of the economic literature and a cost–consequence analysis were conducted. Results: A total of 142 studies were included in the review, and 109 contributed to the network meta-analysis. Of the 109 studies, 57 were rated as having an unclear risk of bias for random sequence generation and allocation concealment. Heterogeneity was moderate. In universal secondary school settings, mindfulness/relaxation interventions [standardised mean difference (SMD) –0.65, 95% credible interval (CrI) –1.14 to –0.19] and cognitive–behavioural interventions (SMD –0.15, 95% CrI –0.34 to 0.04) may be effective for anxiety. Cognitive–behavioural interventions incorporating a psychoeducation component may be effective (SMD –0.30, 95% CrI –0.59 to –0.01) at preventing anxiety immediately post intervention. There was evidence that exercise was effective in preventing anxiety in targeted secondary school settings (SMD –0.47, 95% CrI –0.86 to –0.09). There was weak evidence that cognitive–behavioural interventions may prevent anxiety in universal (SMD –0.07, 95% CrI –0.23 to 0.05) and targeted (SMD –0.38, 95% CrI –0.84 to 0.07) primary school settings. There was weak evidence that cognitive–behavioural (SMD –0.04, 95% CrI –0.16 to 0.07) and cognitive–behavioural + interpersonal therapy (SMD –0.18, 95% CrI –0.46 to 0.08) may be effective in preventing depression in universal secondary school settings. Third-wave (SMD –0.35, 95% CrI –0.70 to 0.00) and cognitive–behavioural interventions (SMD –0.11, 95% CrI –0.28 to 0.05) incorporating a psychoeducation component may be effective at preventing depression immediately post intervention. There was no evidence of intervention effectiveness in targeted secondary, targeted primary or universal primary school settings post intervention. The results for university settings were unreliable because of inconsistency in the network meta-analysis. A narrative summary was reported for five conduct disorder prevention studies, all in primary school settings. None reported the primary outcome at the primary post-intervention time point. The economic evidence review reported heterogeneous findings from six studies. Taking the perspective of a single school budget and based on cognitive–behavioural therapy intervention costs in universal secondary school settings, the cost–consequence analysis estimated an intervention cost of £43 per student. Limitations: The emphasis on disorder-specific prevention excluded broader mental health interventions and restricted the number of eligible conduct disorder prevention studies. Restricting the study to interventions delivered in the educational setting may have limited the number of eligible university-level interventions. Conclusions: There was weak evidence of the effectiveness of school-based, disorder-specific prevention interventions, although effects were modest and the evidence not robust. Cognitive–behavioural therapy-based interventions may be more effective if they include a psychoeducation component. Future work: Future trials for prevention of anxiety and depression should evaluate cognitive–behavioural interventions with and without a psychoeducation component, and include mindfulness/relaxation or exercise comparators, with sufficient follow-up. Cost implications must be adequately measured. Study registration: This study is registered as PROSPERO CRD42016048184. Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 8. See the NIHR Journals Library website for further project information.

Myasthenia gravis (MG) is a chronic autoimmune disease in which autoantibodies destroy acetylcholine receptors at motor end plat of neuromuscular junction which prevent skeletal muscle depolarization and contraction, causes muscle weakness and tiredness upon exertion with a tendency to be subsided after taking some rest or after taking anticholinesterase medication. Symptoms of progression of MG include the involvement of upper and lower extremities and muscle weakness that leads to inability in doing basic motor functions. The diagnosis of myasthenia gravis includes sign and symptoms, clinical examination and laboratory investigation of serum autoantibody (AChR autoantibodies) implicated in the disease pathology. Surgical procedures under general anesthesia in a patient with MG could be very challenging for an anesthetist because of pathophysiological manifestations of the disease. We report a case of a patient undergoing 4 level spinal fixation with coexistent myasthenia gravis (according to Osserman II B), requiring general anesthesia for spinal surgery in prone position. Myasthenia gravis affects the neuromuscular junction that is why it has a great significance of interest for the anesthetist.

Objectives: To determine the antepartum and intrapartum risk factors leading to caesarean section in Primigravidae. Methods: A prospective study of 100 patients conducted in the department of Obstetrics and Gynaecology from January 2018 to June 2018. Data collected included the age of the patient, obstetric history, gestational age, clinical symptoms, antepartum and intrapartum risk factors for LSCS. Results: The most common antepartum risk factor for caesarean section in primigravidae was found to be fetal distress (41%) and the most common intrapartum finding was meconium stained liquor (27%). Conclusion: Presence of risks complicating pregnancies has increased the rates of primary caesarean section. It is prudent to carefully weigh the risks and benefits associated with caesarean section in order to improve the pregnancy outcome.

Objective: To study the effect of cisplatin administration on oxidative stress induced hepatotoxicity in male Sprague Dawley rats. Study Design: Randomized controlled trial. Place and Duration of Study: Study was conducted at department of Physiology, Army Medical College, Rawalpindi. Duration of study was 18 months from Oct 2014 to Apr 2016. Material and Methods: The trial was performed on sixty male Sprague Dawley rats which were distributed randomly into two groups of 30 rats each. Group I received placebo whereas group II received intraperitoneal cisplatin 2mg/kg body weight two times a week for the period of 4 weeks. After successful treatment, animals were sacrificed and terminal blood sample was collected and used for estimation of serum AST, ALT, albumin and 8-isoprostane. Dissection of rats were done and liver tissue sampled. Tissue homogenate was prepared from liver sample which was used for estimation of total glutathione levels. Results: In group I, 8-isoprostane was 18.31 ± 3.35 pg/ml, total glutathione was 4.29 ± 0.42 μmol/L, ALT was 36.93 ± 4.72 IU/L, AST was 124.2 ± 12.75 IU/L and Albumin was 4.11 ± 0.26 g/dl whereas in group II, 8-isoprostane was 67.9 ± 8.14 pg/ml, total glutathione was 1.92 ± 0.28 μmol/L, ALT was 87.17 ± 6.47 IU/L, AST was 357.7 ± 19.37 IU/L and Albumin was 2.12 ± 0.25 g/dl. Levels of serum 8-isoprostane, ALT and AST were significantly raised (p

Objective: To evaluate the effects of autologous platelet-rich plasma on arrangement of collagen fibers at injured Achilles tendon entheses in rabbits. Study Design: Laboratory-based experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi, in collaboration with National Institute of Health, Islamabad, from March to May, 2018. Material and Methods: Forty, healthy, male, “New Zealand white rabbits”, 4-6 months of age, weighing 2000- 2500g, were randomly divided into 4 equal groups (A, B, C and D). Group A served as control, while B, C and D were experimental groups. Injuries were surgically induced at Achilles tendon entheses of rabbits of experimental groups, which were treated with injections of autologous platelet-rich plasma, either at the time of inducing injury or two weeks after injury in groups C and D respectively while group B was left untreated. Animals were sacrificed after 12 weeks. Tissues were processed and stained for histological evaluation. Statistical analysis was done using SPSS version 22. A p-value of ≤0.05 was taken as significant. Results: Experimental group B showed marked deterioration in Bonar’s modified score for arrangement of collagen fibers as compared to the control group A. The scores were significantly improved in treatment groups C and D as compared to group B. Conclusions: Injection of autologous platelet-rich plasma effectively improved the Bonar modified score for arrangement of collagen fibers at injured entheses, 12 weeks after injury as compared to non-treatment group.

Background: Hepatitis B virus (HBV) is hyperendemic in Nigeria. Available literature reveal genotype E as being predominant in West Africa. This study aimed at identifying the current pattern and prevalent genotypes of HBV in Zaria, Nigeria. Materials and Methods: Four millilitre of blood was collected in ethylenediaminetetraacetic acid-container from each of 165 HBV surface antigen-positive participants recruited purposively from the gastroenterology clinic from May to August, 2017. Plasma was separated and frozen at −20°C till analysis. Multiplex-nested polymerase chain reaction using type-specific primers was used to identify the various HBV genotypes. Results: Median (and interquartile range) age of the participants was 31.0 (25.5–39.0) years, with males constituting 107 (64.8%). Majority (83.6%) of the samples analysed were HBV-DNA-positive with 82.6% of the HBV-DNA-positive samples being mixed genotype infections. Irrespective of mode of occurrence, five HBV genotypes were identified with HBV/E (97.1%) being the most predominant, followed by HBV/B (82.6%), HBV/A (24.6%), then HBV/C (17.4%), while HBV/D (0.7%) was the least prevalent. Conclusion: In most (99.1%) of the mixed-infection were a combination of genotype E, the predominant genotype, with other genotypes predominantly genotype B. HBV genotypes E, B, A, C and D are the prevalent genotypes in Zaria, Nigeria, as they occur in single genotype and in mixed-genotypes pattern.

The influence of oleylamine (OLA) concentration on the crystallography, morphology, surface chemistry, chemical bonding, and magnetic properties of solvothermal synthesized CoFe2O4 (CFO) nanoparticles (NPs) has been thoroughly investigated. Varying OLA concentration (0.01–0.1 M) resulted in the formation of cubic spinel-structured CoFe2O4 NPs in the size-range of 20–14 (±1) nm. The Fourier transform spectroscopic analyses performed confirmed the OLA binding to the CFO NPs. The thermogravimetric measurements revealed monolayer and multilayer coating of OLA on CFO NPs, which were further supported by the small-angle X-ray scattering measurements. The magnetic measurements indicated that the maximum saturation (MS) and remanent (Mr) magnetization decreased with increasing OLA concentration. The ratio of maximum dipolar field (Hdip), coercivity (HC), and exchanged bias field (Hex) (at 10 K) to the average crystallite size (Dxrd), i.e., (Hdip/Dxrd), (HC/Dxrd), and (Hex/Dxrd), increased linearly with OLA concentration, indicating that OLA concurrently controls the particle size and interparticle interaction among the CFO NPs. The results and analyses demonstrate that the OLA-mediated synthesis allowed for modification of the structural and magnetic properties of CFO NPs, which could readily find potential application in electronics and biomedicine.

When the habitat occupied by a specialist species is patchily distributed, limited gene flow between the fragmented populations may allow population differentiation and eventual speciation. 'Sky islands'-montane habitats that form terrestrial islands-have been shown to promote diversification in many taxa through this mechanism. We investigate floral variation in Impatiens lawii, a plant specialized on laterite rich rocky plateaus that form sky islands in the northern Western Ghats mountains of India. We focus on three plateaus separated from each other by ca. 7 to 17 km, and show that floral traits have diverged strongly between these populations. In contrast, floral traits have not diverged in the congeneric I. oppositifolia, which co-occurs with I. lawii in the plateaus, but is a habitat generalist that is also found in the intervening valleys. We conducted common garden experiments to test whether the differences in I. lawii are due to genetic differentiation or phenotypic plasticity. There were strong differences in floral morphology between experimental plants sourced from the three populations, and the relative divergences between population pairs mirrored that seen in the wild, indicating that the populations are genetically differentiated. Common garden experiments confirmed that there was no differentiation in I. oppositifolia. Field floral visitation surveys indicated that the observed differences in floral traits have consequences for I. lawii populations, by reducing the number of visitors and changing the relative abundance of different floral visitor groups. Our results highlight the role of habitat specialization in diversification, and corroborates the importance of sky islands as centres of diversification.

Transmission Electron Microscopic (TEM) assessments were performed on the renal cells of common carp Cyprinus carpio to observe the deleterious effects of two organophosphate insecticides, Phorate and Dimethoate. Pesticides such as Phorate and Dimethoate often pollute aquatic systems where they may negatively impact fish, but so far, the ultrastructural toxicity of these pesticides remains poorly understood. Here, we use Transmission Electron Microscopy (TEM) to determine how acute exposure to sublethal concentrations of these two pesticides may affect the renal cells of common carp Cyprinus carpio. For each insecticide, the fish were divided in four experimental conditions: a control and three different exposure concentrations of the pesticide. The Phorate treated fish were exposed to three sublethal concentrations of 0.2 mg/L, 0.4 mg/L, 0.6 mg/L for a duration of 24, 48 & 72 h. The dimethoate treated fish were exposed to three sublethal concentrations of 0.005 mL/L, 0.01 mL/L, 0.015 mL/L for a duration of 24, 48 and 72 h. The two-dimensional transmission electron microscopy revealed ultrastructural abnormalities in the treated fish renal cells when exposed to two toxicants including deformation in the glomerulus, vacuolization of cytoplasm, degenerative nucleus and damaged mitochondria. Furthermore, the ultrastructural abnormalities were more prominent with the increase in the concentrations of both the insecticides and also with their exposure period. Overall, these results provide important baseline data on the ultrastructural toxicity of Phorate and Dimethoate and will allow important follow-up studies to further elucidate the underlying cellular mechanisms of pesticide toxicity in wildlife.

ABSTRACT Staphylococcus pseudintermedius is a major canine pathogen but also occasionally colonizes and infects humans. Multidrug-resistant methicillin-resistant S. pseudintermedius (MDR MRSP) strains have emerged globally, making treatment and control of this pathogen challenging. Sequence type 71 (ST71), ST68, and ST45 are the most widespread and successful MDR MRSP clones. The potential genetic factors underlying the clonal success of these and other predominant clones remain unknown. Characterization of the pangenome, lineage-associated accessory genes, and genes acquired through horizontal gene transfer from other bacteria is important for identifying such factors. Here, we analyzed genome sequence data from 622 S. pseudintermedius isolates to investigate the evolution of pathogenicity across lineages. We show that the predominant clones carry one or more lineage-associated virulence genes. The gene encoding staphylococcal protein A (SpA), a key virulence factor involved in immune evasion and a potential vaccine antigen, is deleted in 62% of isolates. Most importantly, we have discovered that the spa locus is a hot spot for recombination and horizontal gene transfer in S. pseudintermedius, where genes related to restriction modification, prophage immunity, mercury resistance, and nucleotide and carbohydrate metabolism have been acquired in different lineages. Our study also establishes that ST45 is composed of two distinct sublineages that differ in their accessory gene content and virulence potential. Collectively, this study reports several previously undetected lineage-associated genetic factors that may have a role in the clonal success of the major MDR MRSP clones. These data provide a framework for future experimental studies on S. pseudintermedius pathogenesis and for developing novel therapeutics against this pathogen. IMPORTANCE Staphylococcus pseudintermedius is a major canine pathogen but can also occasionally infect humans. Identification of genetic factors contributing to the virulence and clonal success of multidrug-resistant S. pseudintermedius clones is critical for the development of therapeutics against this pathogen. Here, we characterized the genome sequences of a global collection of 622 S. pseudintermedius isolates. We show that all major clones, besides carrying core virulence genes, which are present in all strains, carry one or more lineage-specific genes. Many of these genes have been acquired from other bacterial species through a horizontal gene transfer mechanism. Importantly, we have discovered that the staphylococcal protein A gene (spa), a widely used marker for molecular typing of S. pseudintermedius strains and a potential vaccine candidate antigen, is deleted in 62% of strains. Furthermore, the spa locus in S. pseudintermedius acts as a reservoir to accumulate lineage-associated genes with adaptive functions.

Background: The expansion of umbilical cord blood (UCB) banking necessitates a greater understanding among obstetricians, who are responsible for informing parents about UCB collection and storage. Gaps in knowledge can compromise public UCB banking efforts and result in missed opportunities and misguidance about UCB banking. Methods: A cross-sectional survey was disseminated among obstetricians in Amman, Jordan. The questionnaire aimed to evaluate obstetricians’ knowledge of and attitude toward UCB storage and applications, as well as current practice patterns. Results: Ninety-six obstetricians responded (55% response rate), most of whom were Jordanian (71%), female (83%), resident physicians (59%), and working in either private (43%) or public (42%) hospitals, with an average of 6.5 years in practice. Only 26% had personal experience in UCB collection, and only 20% had received education on UCB collection. Nearly three-fourths said their hospitals lacked standard operating procedures, guidelines, or infectious disease screening for UCB units. Overall knowledge about UCB was moderate, with the internet as the most common source (54%). Overall attitudes were positive, especially in desire to expand personal knowledge about UCB, integrate information into medical residency curricula, and establish a public UCB bank in Jordan. However, many believed that ethical (61%) and religious (56%) controversies surround UCB donation. Conclusions: This study identifies deficiencies in quality control and experience in UCB collection in Jordan, as well as areas of inadequate knowledge, false beliefs, and negative attitudes among obstetricians. These issues can contribute to public misinformation and should be addressed through improved medical education on this topic.

Hypertension is a problem in Indonesia, with 34.1% prevalence. The number reflected the number of hypertensive patients in the 2016 clinic report of Pasirjambu Public Health Center as the most prominent non-communicable disease. This research aimed to discover the specific age of onset and risk factors of hypertension in the village where the health center located. A rapid survey collected the data in May 2017, where 210 women (representing their household) were chosen by randomization inside their respective clusters. Risk factors were analyzed by a robust and parsimonious logistic regression model along with probability count on age as the final prediction. The prevalence of hypertension was 59.5% (95%CI=52.9, 66.2%). Risk factors for hypertension were age (OR=1.06, p=0.00), stress (OR=1.74, p=0.09) and family history (OR=1.99, p=0.03) but the protective factor was consumption frequency of salty food (OR=0.64, p=0.10). In conclusion, a woman would have a 42.9% chance (95%CI=33.7, 52.1%) for having hypertension at 40 years old of age after adjusted by other risk factors. Despite only two modifiable risk factors that can be intervened with, it would be worth trying to decrease the pace of onset in hypertension and the prevalence. KEMUNGKINAN HIPERTENSI BERDASAR ATAS USIA PADA WANITA Hipertensi merupakan sebuah masalah di Indonesia dengan prevalensi sebesar 34,1%, angka tersebut terlihat dalam laporan tahunan Puskesmas Pasirjambu sebagai penyakit tidak menular terbanyak di wilayah kerjanya. Tujuan penelitian ini adalah mengetahui usia munculnya hipertensi dan faktor risikonya. Pengumpulan data dilakukan melalui survei cepat di bulan Mei 2017, melibatkan 210 wanita yang mewakili rumah tangganya dipilih secara random. Faktor risiko dianalisis menggunakan regresi logistik dengan hasil akhir berupa prediksi kemungkinan. Hasil penelitian menunjukkan prevalensi hipertensi sebesar 59,5% (IK95%=52,9; 66,2%). Usia (OR=1,06; p=0,00), stres (OR=1,74; p=0,09) dan riwayat hipertensi dalam keluarga (OR=1,99; p=0,03) menjadi faktor risiko, sedangkan frekuensi konsumsi makanan asin (OR=0,64; p=0,10) menjadi faktor protektif. Setelah adjusted terhadap variabel lain, kemungkinan untuk hipertensi seorang wanita usia 40 tahun sebesar 42,9% (IK95%=33,7; 52,1%). Pencegahan untuk menurunkan prevalensi dan laju insidensi dapat dilakukan pada usia tersebut walaupun hanya ada dua faktor risiko yang dapat dimodifikasi.

Purpose: To present a unique case of streptococcus dysgalactiae keratitis with progression to corneal perforation and endophthalmitis, in the setting of epidermal growth factor receptor inhibitor (erlotinib) therapy for advanced non-small cell lung cancer. Observations: An 89-year-old female with non-small cell lung cancer on erlotinib presented with corneal perforation due to infectious keratitis. Microbial cultures grew streptococcus dysgalactiae, a virulent pathogen known to affect immunocompromised patients that has not been previously described to cause infectious keratitis. Despite aggressive medical intervention, the clinical course was complicated by rapid progression to no light perception visual acuity in the setting of endophthalmitis with orbital cellulitis, necessitating evisceration. Conclusions and Importance: Epidermal growth factor receptor inhibitor therapy can result in significant ocular complications including dry eyes, epithelial keratopathy, non-healing abrasions, infectious keratitis, and rarely, corneal melting and perforation. These side effects can predispose patients to aggressive infections with rare organisms, highlighting the importance of understanding the ocular side effects of systemic chemotherapeutic agents.

The anthropogenic impact of conventional energy sources encourages the utilization of renewable energy, as it has become a strategic commodity for economic growth. On the other hand, institutional stability is the pre-requisite without which environmental quality cannot be assured and the economy cannot function. However, in recent literature, very little consideration has been given to this important phenomenon. This study is set to analyze the energy-institutional stability-economic growth nexus, as well as the energy-institutional stability-environmental quality nexus, by incorporating the Cobb Douglas production function and the Diet and Rosa environmental function respectively. The sample consists of the D-8 countries and the time period spans 1990 to 2016. To analyze the developed models, Autoregressive Distributive Lag (ARDL), Fully Modified Ordinary Least Square (FMOLS) and Dynamic Ordinary Least Square (DOLS) tests are applied, along with other econometric techniques. The panel ARDL statistics indicate significant cointegration among all variables of both functions, while the FMOLS test reveals that consumption of both nonrenewable and renewable energy has a positive impact on economic growth, as well as on environmental degradation. Further, results indicate that institutional stability is crucial for establishing a nation on a sound footing and protecting environmental quality. Based on these results, the study suggests a blend of both types of energy and a gradual transition toward renewable energy sources, with better implementation of policies and technological advances, to produce, preserve, and transmit renewable energy production.

This study demonstrated the deposition of size-controlled gold (Au) nanoclusters via direct-current magnetron sputtering and inert gas condensation techniques. The impact of different source parameters, namely, sputtering discharge power, inert gas flow rate, and aggregation length on Au nanoclusters’ size and yield was investigated. Au nanoclusters’ size and size uniformity were confirmed via transmission electron microscopy. In general, Au nanoclusters’ average diameter increased by increasing all source parameters, producing monodispersed nanoclusters of an average size range of 1.7 ± 0.1 nm to 9.1 ± 0.1 nm. Among all source parameters, inert gas flow rate exhibited a strong impact on nanoclusters’ average size, while sputtering discharge power showed great influence on Au nanoclusters’ yield. Results suggest that Au nanoclusters nucleate via a three-body collision mechanism and grow through a two-body collision mechanism, wherein the nanocluster embryos grow in size due to atomic condensation. Ultimately, the usefulness of the produced Au nanoclusters as catalysts for a vapor–liquid–solid technique was put to test to synthesize the phase change material germanium telluride nanowires.

Feedback is one of the significant factors for the mental mapping of an environment. It is the communication of spatial information to blind people to perceive the surroundings. The assistive smartphone technologies deliver feedback for different activities using several feedback mediums, including voice, sonification and vibration. Researchers 0have proposed various solutions for conveying feedback messages to blind people using these mediums. Voice and sonification feedback are effective solutions to convey information. However, these solutions are not applicable in a noisy environment and may occupy the most important auditory sense. The privacy of a blind user can also be compromised with speech feedback. The vibration feedback could effectively be used as an alternative approach to these mediums. This paper proposes a real-time feedback system specifically designed for blind people to convey information to them based on vibration patterns. The proposed solution has been evaluated through an empirical study by collecting data from 24 blind people through a mixed-mode survey using a questionnaire. Results show the average recognition accuracy for 10 different vibration patterns are 90%, 82%, 75%, 87%, 65%, and 70%.

Abstract The dusty regolith covering the surfaces of asteroids and planetary satellites differs in size, shape, and composition from terrestrial soil particles and is subject to environmental conditions very different from those found on Earth. This regolith evolves in a low ambient pressure and low-gravity environment. Its response to low-velocity impacts, such as those that may accompany human and robotic exploration activities, may be completely different than what is encountered on Earth. Experimental studies of the response of planetary regolith in the relevant environmental conditions are thus necessary to facilitate future Solar System exploration activities.We combined the results and provided new data analysis elements for a series of impact experiments into simulated planetary regolith in low-gravity conditions using two experimental setups and a range of microgravity platforms. The Physics of Regolith Impacts in Microgravity Experiment (PRIME) flew on several parabolic aircraft flights, enabling the recording of impacts into granular materials at speeds of ∼ 4–230 cm/s. The COLLisions Into Dust Experiment (COLLIDE) is conceptually close to the PRIME setup. It flew on the Space Shuttle in 1998 and 2001 and more recently on the Blue Origin New Shepard rocket, recording impacts into simulated regolith at speeds between 1 and 120 cm/s.Results of these experimental campaigns found that there is a significant change in the regolith behavior with the gravity environment. In a 10 −2 g environment (with g being the gravity acceleration at the surface of the Earth), only embedding of the impactor was observed and ejecta production was produced for most impacts at > 20 cm/s. Once at microgravity levels ( 10 cm/s. The measured ejecta speeds were somewhat lower than the ones measured at reduced-gravity levels, but the ejected masses were higher. In general, the mean ejecta velocity shows a power-law dependence on the impact energy with an index of ∼ 0.5. When projectile rebound occurred, we observed that its coefficients of restitution on the bed of regolith simulant decrease by a factor of 10 with increasing impact speeds from ∼ 5 up to 100 cm/s. We could also observe an increased cohesion between the JSC-1 grains compared to the quartz sand targets.

Objective: To determine the diagnostic accuracy of CT scan in staging of colorectal carcinoma among biopsy proven patients of colorectal carcinoma by taking histopathological finding as gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Combined Military Hospital Rawalpindi, Six months, from Jul 2015 to Dec 2015. Material and Methods: A total of 176 cases of 15-70 years of age, diagnosed of colorectal carcinoma oncolonoscopic biopsy, were included in the study. Patients with previous malignancies other than colorectal carcinoma, allergy to the contrast agent and pregnant patients were excluded from the study. All the patients then underwent CT scan for detection of the stage of cancer. After surgery, histopathology of the resected specimen was compared with the findings on CT scan. Results: Mean age was 50.27 ± 14.50 years. Out of these 176 patients, 113 (64.20%) were male and 63 (35.80%) were females with ratio of 1.8:1. Among CT positive, 80 were true positive while 11 were false positive. Among, CT negative patients, 12 were false negative while 73 were true negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CT in staging colorectal carcinoma taking histopathology as gold standard was 87.91%, 85.88%, 86.96%, 86.90% and 86.93% respectively. Conclusion: This study concluded that CT scan is a highly sensitive and accurate modality for pre-operative detection of stage of colorectal carcinoma.

Abstract Background YAP, a potent oncogene and major downstream effector of the mammalian Hippo tumor suppressor pathway can act as either oncogene or tumor suppressor gene based on the type of tissue involved. Despite various studies, the role and mechanism through which YAP mediates its tumor suppressor or oncogenic effects are not yet fully understood. Therefore in the present study we aimed to investigate YAP at DNA, mRNA and protein level and also attempted to correlate our molecular findings with various clinicopathological variables of the patients. Methods The study comprised of a total 137 genetically unrelated women with sporadic breast cancer cases and normal adjacent tissues not infiltrated with tumor. Mutation of YAP gene was analyzed by automated DNA sequencing. YAP promoter methylation was studied using MS-PCR. Expression at mRNA and protein level was studied using qPCR and IHC respectively. Results In our study YAP mRNA expression was found to be 8.65 ± 6.17 fold downregulated in 67.15% cases. The expression of YAP when analyzed at the protein level by IHC was found to be absent in 78.83% cases. Results from MS-PCR analysis showed that YAP promoter methylation plays an important role in declining the expression of YAP protein. The absence of YAP protein coincided with 86.60% methylated cases thereby showing a very strong correlation (p = 0.001). We also investigated YAP mutation at the major check point sites in the Hippo pathway and observed no mutation. A significant association was observed on correlating mRNA expression with clinical stages (p = 0.038) and protein expression with ER status (p = 0.018) among Indian breast cancer patients. Conclusion The expression of YAP was found to be downregulated in response to aberrant promoter methylation. The downregulation of YAP are consistent with previous studies suggesting it to have a tumor suppressive role in breast cancer. We did not observe any mutation at the major check point sites in the Hippo pathway.

Objective: To determine the effect of Intravitreal injection of Bevacizumab on IOP in eyes of different axial lengths. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at AFIO Rawalpindi, from Sep 2013 to Jan 2014. Material and Methods: In this study 55 patients scheduled for intravitreal injection of bevacizumab for the treatment of diabetic macular edema were enrolled. An informed written consent was taken from all the patients. All patients underwent clinical ophthalmic examination including uncorrected distance visual acuity, corrected distance visual acuity, slit lamp bio-microscopy and fundus examination with 90 diopter lens. Axial length was measured before IVB using IOL master. Intra Ocular Pressure (IOP) was measured before and after 1 minute of administration of Intravitreal Bevacizumab (IVB) using Tono-Pen. Result: The mean age of patients was 54.51 ± 7.53 years with minimum age of 43 years and maximum age of 70 years. There were 26 (47.3%) male and 29 (52.7%) female patients. The mean axial length of the examined eyes was 21.12 ± 1.80 with range of 6 mm. Mean IOP before IVB was 13.09 ± 1.62 mmHg. After 1 minute of IVB, mean IOP was 32.8 ± 6.19 mmHg. A good correlation was observed between the axial length and intraocular pressure rise after 1 min i.e. Pearson correlation (r.) = -0.914 (p-value

Objective: To compare the corneal endothelial cell density in patients of Pseudoexfoliation syndrome (PXS) with normal healthy controls. Study Design: Cross sectional comparative. Place and Duration of Study: This study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi from Mar 2016 to Jan 2017. Patients and Methods:Patients of PXS and healthy subjects of both genders between ages of 40 and 50 years, with best corrected visual acuity of 6/6 on snellen visual acuity chart were included in the study. All the participants including controls and PXS patients were subjected to ophthalmic clinical examination including corrected distance visual acuity, slit lamp examination by the single trainee researcher to exclude bias. Participants in both groups were evaluated for corneal endothelial cell density (ECD) by using non-contact, TOPCON SP 3000P Specular microscope. Sampling bias was eliminated by analyzing 100 cells in the center of each specular microscope photograph and mean of three readings was analyzed. Results: Both the groups were similar with respect to gender and age. In our study sample there were 29 (58%) males in PXS group and 24 (48%) males in control group with no statistical significant (p-value > 0.05) difference between gender distributions of both groups. The mean age of the PXS group was 46.34 ± 2.932 years, and in control group was 45.54 ± 2.887 years (p-value >0.05). The mean value of ECD was found to be 2021.548 ± 528.142 cells/mm2 in PXS patients and the mean value of ECD in healthy subjects was noted to be 2772.692 ± 383.395 cells/mm2, showing significantly lower ECD in PXS cases. Similarly, significantly higher number of cases 22 (44%) had CED

BACKGROUND: Acne Vulgaris is a frequently seen dermatological condition having physical and psychosocial implications. Current study aims to assess Quality of life (QoL) in acne patients and study the associated risk factors. METHODOLOGY: This descriptive cross sectional study was conducted in 6 months duration at Dept. of Dermatology, Rawal Institute of Health Sciences Islamabad after ethical approval. Total 205 cases of acne (age>12 years) were included. Patients with severe systemic illness and endocrine disease were excluded. Global Acne Grading Scale (GAGS) was used to grade acne as mild, moderate or severe. Quality of life assessed by Cardiff Acne disability index (CADI) with outcome as no impairment, mild impairment, moderate impairment or severe impairment. Data analyzed via SPSS version 17 with Chi-square test applied for significance. The p-value

The ambitious target of net-zero emission by 2050 has been aggressively driving the renewable energy sector in many countries. Leading the race of renewable energy sources is solar energy, the fastest growing energy source at present. The solar industry has witnessed more growth in the last decade than it has in the past 40 years, owing to its technological advancements, plummeting costs, and lucrative incentives. The United States is one of the largest producers of solar power in the world and has been a pioneer in solar adoption, with major projects across different technologies, mainly photovoltaic, concentrated solar power, and solar heating and cooling, but is expanding towards floating PV, solar combined with storage, and hybrid power plants. Although the United States has tremendous potential for exploiting solar resources, there is a scarcity of research that details the U.S. solar energy scenario. This paper provides a comprehensive review of solar energy in the U.S., highlighting the drivers of the solar industry in terms of technology, financial incentives, and strategies to overcome challenges. It also discusses the prospects of the future solar market based on extensive background research and the latest statistics. In addition, the paper categorizes the U.S. states into five tiers based on their solar prospects calculated using analytical hierarchy process and regression analysis. The price of solar technologies in the U.S. is also predicted up to 2031 using Wright’s law, which projected a 77% reduction in the next decade.