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Background: Hypertension management typically relies on standardized treatment regimens, which may not account for individual genetic variations that affect drug metabolism and response., Objective: The objective of this study was to evaluate the effectiveness of personalized antihypertensive therapy, guided by pharmacogenetic testing, in terms of blood pressure (BP) control and medication tolerability., Materials and Methods: A retrospective cohort study was conducted at Jinnah Postgraduate Medical Centre, Karachi, from January 2023 to December 2023. The study included 330 hypertensive patients who received either conventional care (n = 165) or personalized therapy directed by pharmacogenetic testing (n = 165). Data on patient demographics, genetic test results, antihypertensive drug prescriptions, and blood pressure readings at baseline, three months, and six months were extracted from electronic health records. Reports of adverse effects were used to assess medication tolerability. Independent t-tests were employed for statistical analysis (SPSS version 25 (IBM Corp., Armonk, NY)) to evaluate changes in blood pressure and adverse effects between the two groups, with a significance level set at p < 0.05., Results: Among the 330 hypertensive patients, the Personalized Therapy group (n = 165) showed a significant reduction in systolic blood pressure by 17.8 mmHg (±6.4) and diastolic blood pressure by 11.3 mmHg (±5.7) over six months, compared to reductions of 8.7 mmHg (±6.7) and 5.7 mmHg (±4.8), respectively, in the Standard Therapy group (n = 165) (p < 0.001). Additionally, the Personalized Therapy group experienced fewer adverse effects, with 15 patients reporting dizziness and five reporting gastrointestinal issues, compared to 30 patients with dizziness and 10 with gastrointestinal issues in the Standard Therapy group., Conclusion: Personalized antihypertensive therapy based on pharmacogenetic testing significantly improves blood pressure control and medication tolerability compared to standard treatment, supporting its broader implementation in hypertension management., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Ethical Committee of Jinnah Postgraduate Medical Centre issued approval F.2-82/2023-GENL/61413/JPMC. Research approval was obtained from Jinnah Postgraduate Medical Centre. All information was hidden to protect patient privacy. Because the research was retrospective in nature, informed permission was not required. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Khan et al.)

The conversion of 5-hydroxymethylfurfural (HMF) into valuable chemicals, such as 2,5-furandicarboxylic acid (FDCA), is pivotal for sustainable chemical production, offering a renewable pathway to biodegradable plastics and high-value organic compounds. This pioneering study explores the synthesis of FeNi nanostructures via aerosol-assisted chemical vapor deposition (AACVD) for the electrochemical oxidation of HMF to FDCA. By adjusting the deposition time, we developed two distinct nanostructures: FeNi-40, which features nanowires with spherical terminations, and FeNi-80, which features aggregated spherical structures. X-ray diffraction (XRD) confirmed that both nanostructures possess a phase-pure face-centered cubic (FCC) crystal structure. Electrochemical tests conducted using FeNi nanocatalysts on Ni foam revealed that FeNi-40 requires a significantly lower onset potential for HMF oxidation (1.32 V vs RHE) compared to FeNi-80 (1.40 V vs RHE). This difference is attributed to the unique nanowire morphology of FeNi-40, which provides a higher density of active sites and a larger electrochemically active surface area, thereby enhancing the efficiency of the electrochemical process. When tested in an H-type electrolyzer with a Nafion membrane, FeNi-40 demonstrated a remarkable Faradaic efficiency of 96.42% and a high product yield, underscoring the potential of morphology-controlled FeNi nanostructures to enhance the efficiency of sustainable electrochemical processes significantly., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Background: Levofloxacin, a fluoroquinolone, is an extensively used antibiotic effective against both positively and negatively staining bacteria. It works by inhibiting bacterial topoisomerase type II and topoisomerase type IV, resulting in impaired DNA synthesis and bacterial cell death. Eryptosis is another term for apoptotic cell death of erythrocyte marked by cell shrinkage, phosphatidylserine (PS) flipping, and membrane blebbing., Methods: The intent of the present research was to look at the eryptotic effect of levofloxacin by exposing erythrocytes to therapeutical doses (7, 14 µM) of levofloxacin for 48 hours. Cell size evaluation, PS subjection to outside, and calcium channel inhibition were carried out to investigate eryptosis. Oxidative stress generated by levofloxacin was measured as a putative mechanism of eryptosis using glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase activities. Similarly, hemolysis measurements demonstrated levofloxacin's cytotoxic effect., Results: Our findings showed that therapeutic doses of levofloxacin can cause a considerable decline in antioxidant enzymes activities, as well as induce cell shrinkage, PS externalization, and hemolysis in erythrocytes. The role of calcium in triggering erythrocyte shrinkage was also confirmed., Conclusion: In conclusion, our findings showed that the indicated levofloxacin doses caused oxidative stress, which leads to erythrocyte death via eryptosis and hemolysis. These findings emphasize the importance of using levofloxacin with caution and the need for additional research to mitigate these side effects., Competing Interests: Conflict of interest: The authors declare no conflict of interest., (© 2024 The Authors.)

Background: With conventional standard treatment modalities, children and adolescents with Hodgkin lymphoma (HL) have long-term overall survival rates of over 90%. However, primary refractory disease may occur in 5%-10% of HL patients, while relapse occurs in 5%-10% of patients with early stage disease and up to 30% in an advanced stage. This retrospective study evaluated patient characteristics in cases of HL relapse and refractory and their response to second-line treatment of standalone chemotherapy or in combination with radiotherapy., Methodology: A retrospective study was conducted by Indus Hospital and Health Network to determine the outcomes of paediatric patients with first and second relapses of HL between 2013 and 2022., Results: A total of 742 patients were diagnosed with HL at Indus Hospital & Health Network. Of these, 48 (6.5%) patients presented with relapse and 35 (4.7%) with refractory disease after initial chemotherapy. In HL relapse patients, 57% were stage IV at initial diagnosis with the most common pathology being nodular sclerosis constituting 42.9% of patients. The most common age group was 6-10 years, 45.8%. B symptoms were experienced by 25 (52%) patients. A time to relapse of >12 months following diagnosis was seen in 69% and 3-12 months was seen in 31%.After receiving second-line treatment, complete remission was achieved by 34 (70.8%) patients, partial remission (PR) was seen in 5 (10.4%), disease progression in 5 (10.4%), 3 (6.3%) patients left during treatment and 1 (2.1%) had a treatment-related mortality. Re-radiation in second-line treatment was only required for 2 patients. The second relapse was seen in 11 (28.2%) of 39 complete and PR patients., Conclusion: Major limitations in the treatment of HL relapse in a low-resource setting are the non-availability of immunotherapy and autologous stem cell transplantation due to extreme financial burden and lack of capacity in facilities. Dedicated efforts are required to provide these facilities free of cost in low-middle income countries (LMICs)., Competing Interests: The authors of this study affirm that there are no conflicts of interest to report pertaining to this research, including but not limited to any financial, personal or professional interests that could pose a conflict with the objectivity, integrity or impartiality of this research project., (© the authors; licensee ecancermedicalscience.)

The development of a successful oncology pharmacy system includes competency training, cost-efficient procurement, proper storage, preparation and administration of chemotherapy, and appropriate waste disposal. Low-middle-income countries such as Pakistan face several challenges within the realm of oncology pharmacy such as the unavailability of training programmes, resources and financial support, and inconsistencies in the safe handling of cytotoxic drugs. The Indus Hospital and Health Network (IHHN) is among the pioneers of oncology pharmacy practices in Pakistan, with a well-established Oncology Pharmacy Team and chemotherapy preparation in accordance with the United States Pharmacopeia 797 and 800 safety guidelines. The My Child Matters Grant was awarded by the Sanofi Espoir Foundation to the Department of Paediatric Hematology and Oncology at IHHN for holistic improvement in childhood cancer care through teaching, training and capacity building. Partnerships were formed with five public-sector paediatric oncology units nationwide. Initiatives were taken to improve oncology pharmacy practices including teaching and training courses, in-person assessment visits, and mentorship and liaison efforts. Despite prevailing challenges, promising improvements were noted at each centre. However, Pakistan needs to establish a national plan for childhood cancer with the creation of regional organisations for the training and monitoring of oncology pharmacists. Centralisation of pharmacy operations within hospitals is essential to maintain the availability, storage, preparation and administration standards of chemotherapy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Produced water (PW) from oil and gas exploration adversely affects aquatic life and living organisms, necessitating treatment before discharge to meet effluent permissible limits. This study first used activated sludge to pretreat PW in a sequential batch reactor (SBR). The pretreated PW then entered a 13 L photobioreactor (PBR) containing Scenedesmus obliquus microalgae culture. Initially, 10% of the PW mixed with 90% microalgae culture in the PBR. After the exponential growth of the microalgae, an additional 25% of PW was added to the PBR without extra nutrients. This study reported the growth performance of microalgae in the PBR as well as the reduction in effluent's total organic carbon (TOC), total dissolved solids (TDS), electrical conductivity (EC), and heavy metals content. The results demonstrated removal efficiencies of 64% for TOC, 49.8% for TDS, and 49.1% for EC. The results also showed reductions in barium, iron, and manganese in the effluent by 95, 76, and 52%, respectively., (© 2024. The Author(s).)

Objectives: Emergency Departments (EDs) play a major role in managing acute and chronic illnesses, especially in low-to-middle-income countries like Pakistan, which lacks effective primary healthcare. This study reports the epidemiology and clinical characteristics of patients presenting over a two-year period at the Indus Hospital and Health Network (IHHN) adult ED in Karachi, Pakistan., Methods: This is a retrospective observational study conducted through chart review of 264,859 patients, aged 16 years and above, who presented to the IHHN ED, Korangi Campus, from January 2019 to December 2020 after obtaining approval from IHHN IRB., Results: Men were found to be the predominant presenting gender, with a slight rise in the number of women in 2020. The most frequent age group in 2019 was 15-25 (27.7%), whereas it was 25-35 years in 2020 (24.1%), with a decline in total number of elderly visits seen in comparison to previous years. The most frequently seen disposition was 'referral to clinic' in 2019 (48.4%) and 'discharged' in 2020 (39%). Out of all dispositions, maximum Length of stay (LOS) was seen in patients who left against medical advice in both years. Patient acuity showed the highest number of P3 (moderately ill) patients in both years. Infectious diseases accounted for greater than 10% of patients in both years (17.2% and16.5%), followed by gastrointestinal complaints (15.7% and 11.3%), genitourinary complaints (14.9% and 7.9%), and trauma (11.9% and 12.4%)., Conclusion: Knowledge of epidemiology and clinical characteristics of patients can help facilitate timely planning of staff deployment and allocation of resources to avoid overcrowding, improve patient outcomes, and increase patient satisfaction through timely management., Competing Interests: Conflict of interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Introduction: Cardiac Implantable Electronic Devices (CIEDs) are widely used for the management of advanced heart failure and ventricular arrhythmias. CIED-Infection (CIED-I) has very high mortality, especially in the subsets of patients with limited health-care access and delayed presentation. The purpose of this study is to identify the risk-predictors mortality in subjects with CIED-I., Methods: We performed a retrospective cohort study of a regional database in patients presenting with CIED infections to tertiary care medical centers across Western New York, USA from 2012 to 2020. The clinical outcomes included recurrent device infection (any admission for CIED-I after the first hospitalization for device infection), septic complications (pulmonary embolism, respiratory failure, septic shock, decompensated HF, acute kidney injury) and mortality outcomes (death during hospitalization, within 30 days from CIED-I, and within 1 year from CIED-I). We studied associations between categorical variables and hard outcomes using χ 2 tests and used one-way analysis of variance to measure between-groups differences., Results: We identified 296 patients with CIED-I, among which 218 (74%) were male, 237 (80%) were white and the mean age at the time of infection was 69.2 ± 13.7 years. One-third of the patients were referred from the regional facilities. Staphylococcus aureus was responsible for most infections, followed by Enterococcus fecalis. On multivariate analysis, the covariates associated with significantly increased mortality risk included referral from regional facility (OR: 2.0;1.0-4.0), hypertension (Odds ratio, OR: 3.2;1.3-8.8), right ventricular dysfunction (OR: 2.6;1.2-5.1), end-stage renal disease (OR: 2.6;1.1-6.2), immunosuppression (OR: 11.4;2.5-53.3), and septic shock as a complication of CIED-I (OR: 3.9;1.3-10.8)., Conclusion: Hypertension, right ventricular dysfunction, immunosuppression, and end-stage renal disease are associated with higher mortality after CIED-I. Disproportionately higher mortality was also noted in subjects referred from the regional facilities. This underscores the importance of early clinical risk-assessment, and the need for a robust referral infrastructure to improve patient outcomes., (© 2023 Wiley Periodicals LLC.)

Background: Most Emergency Departments (EDs) in low- and middle-income countries (LMICs), particularly in Pakistan, are staffed by physicians not formally trained in Emergency Medicine (EM). As of January 2022, there were only 13 residency training programs in EM throughout all of Pakistan. Therefore, an intermediate solution-a one-year training program in EM-was developed to build capacity., Objective: To determine the impact of a novel training program in EM on clinical metrics and outcomes., Methods: The first cohort of a novel, one-year training program-the Certification Program in Emergency Medicine (CPEM)-completed the program in June 2019. The program consisted of two arms: CPEM-Clinical (CPEM-C), which included physicians from the Indus Hospital and Health Network (IHHN) ED; and CPEM-Didactic (CPEM-D), which included physicians from EDs across Karachi. Both groups participated in weekly conferences, such as didactics, small group discussions, workshops, and journal clubs. CPEM-C learners also received clinical mentorship from local and international faculty. Mortality, length of stay (LOS), and time-to-evaluation, as well as metrics in four key areas-patients at risk for cardiovascular disease/acute coronary syndrome, sepsis, respiratory illness, and intra-abdominal trauma-were assessed before and after the initial cohort at IHHN and compared with other groups in IHHN., Findings and Conclusions: More than 125,000 patients were seen from July to December 2017 (pre-CPEM) and July to December 2019 (post-CPEM). Overall, there were significant improvements in all clinical metrics and outcomes, with the exception of LOS and time-to-evaluation, and a trend toward improved mortality. In comparing CPEM graduates to other groups in IHHN ED, most metrics and outcomes significantly improved or trended toward improvement, including mortality. Implementation of a medium-duration, intensive EM training program can help improve patient care and the development of EM as a new specialty in lower-resource settings., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Background: Despite rising childhood cancer incidence, low-middle income countries often fall short of quality resources to prioritize and develop psycho-oncology services. Patients and families suffering from cancer are subject to great psychological distress and require continuous psychosocial support. Unfortunately, a lack of mental health awareness and trained providers remains a pertinent issue in resource-strained countries such as Pakistan., Methods: IHHN has a well-established Psychosocial Department for pediatric oncology patients. Mental health counseling, child life, palliative care, bereavement and, social support are provided by a team of trained psychologists and social workers. In an effort to promote the implementation of this psychosocial model, partnerships were formed with public-sector pediatric oncology units and a structured one week online training module was conducted followed by a 1 week hands-on training., Results: Of the total 67 participants registered, 24 were eligible for certificates. The course was open to healthcare workers around the country, considering that dedicated psychosocial personnel are not present in all units. The highest number of participants were from Karachi, accounting for 56.7% and were psychologists, 32.8%. On feedback, all participants said they would recommend this course to others and 80% chose self-motivation as the reason for enrolling compared to 12% who chose workplace requirement and 4% chose certification. Psychosocial workers selected for hands-on training were empowered to implement the POD model at their units and mentorship was continued after the training., Conclusion: Establishment of counseling and mental health services must be prioritized and integrated into childhood cancer healthcare delivery. Further studies are needed for establishing psychosocial models in low resource settings.

Emergent pericardiocentesis is a potentially life-saving therapeutic procedure. We report a case of hemoperitoneum, a rare but known complication of pericardiocentesis; due to hepatic artery laceration and hepatic artery pseudoaneurysm formation resulting in delayed hemorrhagic shock as a complication of emergent pericardiocentesis. ( Level of Difficulty: Intermediate. )., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2022 The Authors.)

Oncology nurses are stakeholders in the global fight against childhood cancer. In low- to middle-income countries, the burden of care on nursing staff is high, and nurses face several unique challenges. To optimize pediatric.

Textile industry utilize a massive amount of dyes for coloring. The dye-containing effluent is released into wastewater along with heavy metals that are part of dye structure. The treatment of textile industry wastewater using conventional techniques (coagulation, membrane technique, electrolysis ion exchange, etc.) is uneconomical and less efficient (for a low concentration of pollutants). Moreover, most of these techniques produce toxic sludge, making them less environmentally friendly. Algae base industry is growing for food, cosmetics and energy needs. Algae biomass in unique compared to lignocellulosic biomass due to presence of various functional group on its surface and presence of various cations. These two characteristics are unique for biochar as a tool for environmental decontamination. Algae biomass contain functional groups and cations that can be effective for removal of organic contaminants (dyes) and heavy metals. Algae can be micro and macro and both have entirely different biomass composition which will lead to a synthesis of different biochar even under same synthesis process. This study reviews the recent progress in the development of an economically viable and eco-friendly approach for textile industry wastewater using algae biomass-derived absorbents. The strategy employed microalgal biochar to remove organic pollutants (dyes) and heavy metals from textile effluents by biosorption. This article discusses different methods for preparing algal biochar (pyrolysis, hydrothermal carbonization and torrefaction), and the adsorption capacity of biochar for dyes and heavy metals. Work on hydrothermal carbonization and torrefaction of microalgal biomass for biochar is limited. Variation in structural and functional groups changes on biochar compared to original microalgal biomass are profound in contract with lignocellulosic biomass. Existing Challenges, future goals, and the development of these technologies at the pilot level are also discussed., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

This study investigates CO 2 biofixation and pyrolytic kinetics of microalga G. pectorale using model-fitting and model-free methods. Microalga was grown in two different media. The highest rate of CO 2 fixation (0.130 g/L/day) was observed at a CO 2 concentration of 2%. The pyrokinetics of the biomass was performed by a thermogravimetric analyzer (TGA). Thermogravimetric (TG) and derivative thermogravimetric (DTG) curves at 5, 10 and 20°C/min indicated the presence of multiple peaks in the active pyrolysis zones. The activation energy was calculated by different model-free methods such as Friedman, Flynn-Wall-Ozawa (FWO), Kissinger-Akahira-Sunose (KAS), and Popescu. The obtained activation energy which are 61.7-287 kJ/mol using Friedman, 40.6-262 kJ/mol using FWO, 35-262 kJ/mol using KAS, and 66.4-255 kJ/mol using Popescu showed good agreement with the experimental values with higher than 0.96 determination coefficient (R 2 ). Moreover, it was found that the most probable reaction mechanism for G. pectorale pyrolysis was a third-order function. Furthermore, the multilayer perceptron-based artificial neural network (MLP-ANN) regression model of the 4-10-1 architecture demonstrated excellent agreement with the experimental values of the thermal decomposition of the G. pectoral. Therefore, the study suggests that the MLP-ANN regression model could be utilized to predict thermogravimetric parameters., 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 © 2022 Altriki, Ali, Razzak, Ahmad and Farooq.)

Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to study group differences in patients presenting with ST-elevation myocardial infarction (STEMI) based on the presence or absence of associated coronary artery aneurysms (CAA). The cause-and-effect relationship between CAAs and STEMI is largely unknown. The Nationwide Readmission database was used to identify and study group differences of patients with STEMI and with and without CAA from 2014 to 2018. The primary outcome in the 2 groups was mortality. Secondary outcomes in the 2 groups included differences in clinical outcomes, cardiovascular interventions performed, and prevalence of coronary artery dissection. The total number of patients with STEMI included was 1,038,299. In this sample, 1,543 (0.15%) had CAA. Compared with those without CAA, patients with CAAs and STEMI were younger (62.6 vs 65.4), more likely to be male (78 vs 66%), and had a higher prevalence of a history of Kawasaki disease (2.5 vs 0.01%). A difference exists in the prevalence of coronary dissection in patients with STEMI with and without CAA (73% vs 1%). Patients with CAA were more often treated with coronary artery bypass grafting (13.1 vs 5.6%), thrombectomy (16.5 vs 6%), and bare-metal stent implantation (8 vs 4.4). Patients in the CAA STEMI group had lower all-cause mortality (6.3 vs 11.7%). In conclusion, there are important differences in patients with STEMI with and without CAA, which include, but are not limited to, factors such as patient profile, the risk for coronary dissection, treatment, outcomes, and mortality., Competing Interests: Disclosures The authors have no conflicts of interest to declare., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Rationale: Approximately 8,000 new cases of pediatric cancer arise annually in Pakistan. However, there is a dire survival rate of 30-35% due to various factors, especially a lack of competent nurses in pediatric oncology care. Public-private partnerships (PPP) supported by a My Child Matters (MCM) Grant from Sanofi Espoir Foundation was granted to Indus Hospital & Health Network (IH&HN) to improve pediatric nursing standards., Methods: Starting in 2016, nurses from hospitals across Pakistan were enrolled in a continuing education program, which included a comprehensive, hands-on training component. A group chat was created following the training for communication and mentorship regarding challenges faced locally., Results: Seventy-seven pediatric oncology nurses were successfully trained by IH&HN over three years., Discussion: Challenges included lack of government funding, shortage of specialist nurses, frequent shifting of nurses away from pediatric care, and indifferent attitudes. Success of the project could have been maximized if trained nurses were motivated and retained by hospitals., Conclusion: Development and maintenance of PPP in national healthcare systems is essential to improve pediatric oncology nursing care., Competing Interests: CONFLICTS OF INTEREST The authors declare that they have no conflicts of interest., (© 2022 Canadian Association of Nurses in Oncology (CANO).)

We theoretically demonstrated a class of plasmonic coupled elliptical nanostructure for achieving a spaser or a nanolaser with high intensity. The plasmonic ellipse is made up of gold film substrate. The proposed structure is then trialed for various light polarizations, moreover, a simple elliptical nanostructure has been chosen primarily from which different cases have been formed by geometry alteration. The structure supports strong coupled resonance mode i.e. localized surface plasmon (LSP). The localized surface plasmon resonance (LSPR) of the investigated system is numerically examined using the finite-element method (FEM). The calculations showed that the LSPR peaks and the local field intensity or near field enhancement (NFE) of the active nanosystem can be amplified to higher values by introducing symmetry-breaking techniques in the proposed ellipse and its variants. The coupled nanostructure having different stages of wavelengths can be excited with different plasmonic resonance modes by the selection of suitable gain media. In addition, a small-sized nanolaser with high tunability range can be developed using this nanostructure. The spaser phenomena are achieved at several wavelengths by changing light polarization and structure alteration methods. Giant localized field enhancement and high LSPR values enable the proposed model to be highly appealing for sensing applications, surface-enhanced Raman spectroscopy, and much more., Competing Interests: The authors have declared that no competing interests exist.

An alternative source of energy and materials with low negative environmental impacts is essential for a sustainable future. Microalgae is a promising candidate in this aspect. The focus of this study is to optimize the supply of nitrogen and carbon dioxide during the cultivation of locally isolated strain Parachlorella kessleri HY-6. This study focuses on optimizing nitrogen and CO 2 supply based on total biomass and biomass per unit amount of nitrogen and CO 2 . Total biomass increased from 1.23 to 2.30 g/L with an increase in nitrogen concentration from 15.8 to 47.4 mg/L. However, biomass per unit amount of nitrogen supplied was higher at low nitrogen content. Biomass and CO 2 fixation rate increased at higher CO 2 concentrations in bubbling air, but CO 2 fixation efficiency decreased drastically. Finally, the energy content of biomass increased with increases in both nitrogen and CO 2 supply. This work thoroughly analyzed the biomass composition via ultimate, proximate, and biochemical analysis. Water is recycled three times for cultivation at three different nitrogen levels. Microalgae biomass increased during the second recycling and then decreased drastically during the third. Activated carbon helped remove the organics after the third recycling to improve the water recyclability. This study highlights the importance of selecting appropriate variables for optimization by considering net energy investment in terms of nutrients (as nitrogen) and CO 2 fixation efficiency and effective water recycling., Competing Interests: The author declares 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 © 2022 Farooq.)

The economic viability of microalgae as a bioenergy source depends on many factors. High CO 2 fixing rate, improved lipids yield, and minimum water footprint are few key parameters. This study investigates the effect of four initial nitrogen concentrations (1-, 2-, 6- and 10-mM as nitrate) on lipids yield, their classification and composition, CO 2 fixation rate, and water quality for further reuse after first cultivation. The initial 6 mM nitrate was found optimum for the growth and overall lipid productivity of Chlorella vulgaris. The maximum quantum efficiency (as Fv/Fm ratio) for algae decreases along with the cell growth profile and depletion of the initial nitrate concentration. CO 2 fixation rate increased initially and peaked during exponential growth and then declined for the rest of the cultivation period. A higher CO 2 fixation rate was recorded at 6 mM, and an overall fixation rate of CO 2 was high at 6 mM. A higher total organic carbon (TOC) is produced in recycled water at a low nitrogen concentration of 1 and 2 mM. TOC changes during the cultivation period and with each reuse of water. Water was recycled twice successfully, while growth was inhibited during the 3rd cycle. Based on all these investigations, 6 mM of initial nitrogen was found optimal at given growth conditions., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The nanoparticles are frequently used in biomedical science for the treatment of diseases like cancer and these nanoparticles are injected in blood which is transported in the cardiovascular system on the principle of peristalsis. This study elaborates the effects of Lorentz force and joule heating on the peristaltic flow of copper and iron oxide suspended blood based nanofluid in a complex wavy non-uniform curved channel. The Brinkman model is utilized for the temperature dependent viscosity and thermal conductivity. The problem is formulated using the fundamental laws in terms of coupled partial differential equations which are simplified using the creeping flow phenomenon. The graphical results for velocity, temperature, streamlines, and axial pressure are simulated numerically. The concluded observations deduce that the solid volume fraction of nanoparticles reduces the velocity and enhance the pressure gradient and accumulation of trapping bolus in the upper half of the curved channel is noticed for temperature dependent viscosity.

This paper reports numerical modeling of perovskite solar cell which has been knotted with Distributed Bragg Reflector pairs to extract high energy efficiency. The geometry of the proposed cells is simulated with three different kinds of perovskite materials including CH3NH3PbI3, CH3NH3PbBr3, and CH3NH3SnI3. The toxic perovskite material based on Lead iodide and lead bromide appears to be more efficient as compared to non-toxic perovskite material. The executed simulated photovoltaic parameters with the highest efficient structure are open circuit voltage = 1.409 (V), short circuit current density = 24.09 mA/cm2, fill factor = 86.18%, and efficiency = 24.38%. Moreover, a comparison of the current study with different kinds of structures has been made and surprisingly our novel geometry holds enhanced performance parameters that are featured with back reflector pairs (Si/SiO2). The applied numerical approach and presented designing effort of geometry are beneficial to obtain results that have the potential to address problems with less efficient thin-film solar cells., Competing Interests: The authors have declared that no competing interests exist.

A novel genetic algorithm-based feature selection approach is incorporated and based on these features, four different ML methods were investigated. According to the findings, ML models could reliably predict bio-oil yield. The results showed that Random forest (RF) is preferred for bio-oil yield prediction (R2 ~ 0.98) and highly recommended when dealing with the complex correlation between variables and target. Multi-Linear regression model showed relatively poor generalization performance (R2 ~ 0.75). The partial dependence analysis was done for ML models to show the influence of each input variable on the target variable. Lastly, an easy-to-use software package was developed based on the RF model for the prediction of bio-oil yield. The current study offered new insights into the pyrolysis process of biomass and to improve bio-oil yield. It is an attempt to reduce the time-consuming and expensive experimental work for estimating the bio-oil yield of biomass during pyrolysis., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Healthcare, as a basic human right, has often become the focus of the development of innovative technologies. Technological progress has significantly contributed to the provision of high-quality, on-time, acceptable, and affordable healthcare. Advancements in nanoscience have led to the emergence of a new generation of nanostructures. Each of them has a unique set of properties that account for their astonishing applications. Since its inception, nanotechnology has continuously affected healthcare and has exerted a tremendous influence on its transformation, contributing to better outcomes. In the last two decades, the world has seen nanotechnology taking steps towards its omnipresence and the process has been accelerated by extensive research in various healthcare sectors. The inclusion of nanotechnology and its allied nanocarriers/nanosystems in medicine is known as nanomedicine, a field that has brought about numerous benefits in disease prevention, diagnosis, and treatment. Various nanosystems have been found to be better candidates for theranostic purposes, in contrast to conventional ones. This review paper will shed light on medically significant nanosystems, as well as their applications and limitations in areas such as gene therapy, targeted drug delivery, and in the treatment of cancer and various genetic diseases. Although nanotechnology holds immense potential, it is yet to be exploited. More efforts need to be directed to overcome these limitations and make full use of its potential in order to revolutionize the healthcare sector in near future.

The polymer solar cells also known as organic solar cells (OSCs) have drawn attention due to their cynosure in industrial manufacturing because of their promising properties such as low weight, highly flexible, and low-cost production. However, low η restricts the utilization of OSCs for potential applications such as low-cost energy harvesting devices. In this paper, OSCs structure based on a triple-junction tandem scheme is reported with three different absorber materials to enhance the absorption of photons which in turn improves the η , as well as its correlating performance parameters. The investigated structure gives the higher value of η = 14.33% with J sc = 16.87 (mA/m 2 ), V oc = 1.0 (V), and FF = 84.97% by utilizing a stack of three different absorber layers with different band energies. The proposed structure was tested under 1.5 (AM) with 1 sun (W/m 2 ). The impact of the top, middle, and bottom subcells' thickness on η was analyzed with a terse to find the optimum thickness for three subcells to extract high η . The optimized structure was then tested with different electrode combinations, and the highest η was recorded with FTO/Ag. Moreover, the effect of upsurge temperature was also demonstrated on the investigated schematic, and it was observed that the upsurge temperature affects the photovoltaic (PV) parameters of the optimized cell and η decreases from 14.33% to 11.40% when the temperature of the device rises from 300 to 400 K.

Employees constitute an integral part of every organization, and their behaviours cultivate success or failure for the entire industry. Each organization should be cognizant of its employees' behaviours that can be translated through their behavioural outcomes. One of such outcomes is the level of gratitude (Shukr in Islamic perspective) that can be conceptualized further by establishing its link with employees' social or pro-social behaviours using lens of Islamic philosophy. The literature from the perspective of Holy Quran and Sunnah (Prophet's practices) suggests that a good number of employees working in different industries have an element of dissatisfaction reflected through various factors including lack of Shukr (gratitude). This calls for a conceptual undertaking along with its subsequent empirical assessment as the former needs a robust and holistic understanding before proceeding to the latter. The study begins with a strong conceptualization by comparing conventional and Islamic perspective of Shukr and to synthesize key factors which can later help in scale development of Shukr. After a careful comparison between conventional and Islamic viewpoints, three components (dimensions) of Shukr were conceptualized such as Shukr bi'l-qalb (gratitude expressed by inner feelings), Shukr bi'l-lisan (gratitude expressed by tongue) and Shukr bi'l-badan wa'l-arkan (gratitude expressed by body and limbs). This conceptualization can potentially serve as a tool to examine the level of contentment, employees exhibit at workplace which eventually leads to life and job satisfaction.

In Pakistan, extensive use of several precarious chewable tobacco formulations has made oral cancer the second leading malignancy. Selection of literature was done by a survey of studies published from 1990 to 2017 mainly, from PUBMED and few from other search engines, on naswar, gutka, areca nut and betel quid, which included published reviews, original articles and other data sources on chewable tobacco, its epidemiology, pathological implications, and psychological effects. These studies have revealed that the chemicals in these formulations bind and mutate DNA of oral mucosa through down regulating cellular repair pathways and upregulating genetic networks associated with pathogenesis. Areca nut, having aercoline (the major alkaloid) causes carcinogenicity, mutagenicity, and genotoxicity of oral mucosa through increased production of growth factors and corticotrophin-releasing hormone, and genetic alteration in expression of CASP8, APAF-1, BAX, BAD, and upregulation of caspas-3. Gutka addiction leads to precancerous lesions resulting in characteristic facial abnormalities, following trismus. Naswar, in addition to oral cancer, causes adverse cardiovascular events by reducing glutathione per oxidase (GPx) and super-oxide dismutase (SOD), serum levels of HDL, whereas, increasing the ratio of cholesterol, LDL, triglycerides and LDL-C/HDL-C. Betel quid (Paan), causes psychoactivity affecting central and autonomic nervous systems leading to dependence with decreased cognition, euphoria, sweating, salivation, palpitation, heightened alertness and zest to work. Metabolically, cardio-acceleration, cortical desynchronisation of EEG, elevated plasma noradrenaline and adrenaline were found. This review highlights the corrosive effects of various most popular chewable tobacco formulations; and damage done by their cocktail of carcinogenic substances and added ingredients, leading to oropharangeal cancer.

Background: The purpose of this study was to determine the prevalence and clinical effects of untreated dental caries in Pakistani children residing in orphanages using the DMFT and PUFA index; association of decay and untreated dental caries with demographics including type of orphanage; behavioural and dental visiting pattern; and association of dental pain experience and type of orphanage with dental visiting., Methods: A cross-sectional survey was conducted on a total of 753 orphan children belonging to 4-17 years of age group residing in twin cities of Rawalpindi and Islamabad, Pakistan. Clinical examination of children was performed using the DMFT and PUFA index for the assessment of dental caries and untreated decay, followed by questionnaire enquiring about eating and oral hygiene habits, dental visiting pattern and dental pain and swelling experience. Association between dental decay, child's dental visiting and pain as a consequence of untreated decay was carried out using chi square test and logistic regression analysis., Results: The overall caries prevalence was 34.8% and overall prevalence of PUFA/pufa was 15.9%. The mean score of DMFT and dmft was 1.18 (SD 0.39) and 1.04 (SD 0.23), and mean PUFA was 1.18 (SD 0.57) and mean pufa score 1.14 (SD 0.35). Untreated caries ratio was found to be 49.1% indicating half the decay had progressed to involve the pulp. No significant association of gender was found with DMFT, dmft, PUFA and pufa (p > 0.05), however, when analysed individually, the 'D' component of DMFT was significantly associated with male gender (p = 0.05). Furthermore, no significant association of DMFT/dmft or PUFA/pufa in either dentition was found with behavioural characteristics such as dietary and oral hygiene habits. Also, 66.2% children who experienced pain had not been to the dentist in the past year (p = 0.013) and 52.6% children who mentioned experiencing pain at night had not been to the dentist in the past year (p = 0.009). Children with decay were more likely to have visited the dentist (OR 3.3, 95% CI 1.42-7.6, p = 0.006). However, children who reported to have experienced pain were less likely to have visited the dentist in the past year (OR 0.53, 95% CI 0.32-0.88, p = 0.014)., Conclusions: Moderate levels of decay were found in the sample with 'd' component majorly responsible for the cumulative DMFT index. However, alarmingly almost half of the decay component (49.1%) had progressed to involve the pulp. Experiencing pain in teeth prompted dental visits. Initiation of preventive services for children residing in orphanages in Pakistan would help greatly towards reducing the burden of untreated decay.

In this work, the effects of several factors, such as temperature, reaction time, and solvent and acid quantity on in situ transesterification yield of wet Nannochloropsis salina were investigated. Under equivalent total solvent volume to biomass ratio, pure alcohol showed higher yield compared to alcohol-chloroform solvent. For esterifying 200 mg of wet cells, 2 ml of methanol and 1 ml of ethanol was sufficient to complete in situ transesterification. Under temperatures of 105 °C or higher, 2.5% and 5% concentrations of sulfuric acid was able to successfully convert more than 90% of lipid within 30 min when methanol and ethanol was used as solvents respectively. Also, it was verified that the optimal condition found in small-scale experiments is applicable to larger scale using 2 L scale reactor as well., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Microalgal biofuels are not yet economically viable due to high material and energy costs associated with production process. Microalgae cultivation is a water-intensive process compared to other downstream processes for biodiesel production. Various studies found that the production of 1 L of microalgal biodiesel requires approximately 3000 L of water. Water recycling in microalgae cultivation is desirable not only to reduce the water demand, but it also improves the economic feasibility of algal biofuels as due to nutrients and energy savings. This review highlights recently published studies on microalgae water demand and water recycling in microalgae cultivation. Strategies to reduce water footprint for microalgal cultivation, advantages and disadvantages of water recycling, and approaches to mitigate the negative effects of water reuse within the context of water and energy saving are also discussed., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objectives: We sought to determine the role of obesity and insulin resistance (IR) in the pathogenesis of inflammation in metabolic syndrome (MetS)., Methods: Our study included 100 patients with MetS and 100 age and gender matched control patients who attended a tertiary care laboratory in Rawalpindi, Pakistan. Anthropometric data was obtained including height and weight to calculate body mass index. A record of patient's blood pressure (BP), waist circumference (WC) and hip circumference (HC) was made. Biochemical analysis included measurements of fasting glucose, triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), insulin, and high-sensitivity C reactive protein (hsCRP). IR was determined by the homeostasis mode assessment insulin resistance (HOMA-IR) method., Results: The levels of hs-CRP were found to be elevated in all patients with MetS where it correlated significantly with all its components including measures of obesity, fasting insulin and glucose levels, IR, TG and HDL-c. However, on linear regression analysis only WC, fasting insulin, and HOMA-IR remained significantly correlated with hs-CRP., Conclusion: MetS is a condition characterized by chronic low-grade inflammation, which arises because of increased abdominal adiposity and IR. Large multicenter studies are needed to gain insight into its pathogenesis and derive treatment strategies.

The present study assessed the use of hydrolysate of lipid extracted algal biomass (LEA) combined with the sugar factory wastewater (SFW) as a low cost nutrient and a carbon source, respectively for microalgal cultivation. Microalgal strain Ettlia sp. was both mixotrophically and heterotrophically cultivated using various amounts of hydrolysate and SFW. The culture which was grown in medium containing 50% LEA hydrolysate showed highest growth, achieving 5.26 ± 0.14 gL(-1) after 12 days of cultivation. The addition of SFW increased the lipid productivity substantially from 5.8 to 95.5 mg L(-1)d(-1) when the culture medium was fortified with 20% SFW. Gas chromatography analysis indicated a noticeable increase of 20% in C16 and C18 fraction in FAME distribution under above condition. Therefore, it can be concluded that the combination of LEA hydrolysate and sugar factory waste water can be a powerful growth medium for economical algal cultivation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

In this work, a cooperative algal-bacterial system that efficiently degrades thiocyanate (SCN(-)), a toxic contaminant, and exhibits high lipid productivity, was developed. A consortium of mixed bacteria (activated sludge) and microalgae was sequentially cultivated under photoautotrophic and photoheterotrophic modes. The hydrolysis of SCN(-) to ammonium (NH4(+))-nitrogen and subsequent nitrification steps were performed by the initial activated sludge under lithoautotrophic conditions. The NH4(+) and oxidized forms of nitrogen, nitrite (NO2(-)) and nitrate (NO3(-)), were then assimilated and removed by the microalgal cells when light was supplied. After the degradation of SCN(-), the cultivation mode was changed to photoheterotrophic conditions in a sequential manner. Algal-bacterial cultures containing Chlorella protothecoides and Ettlia sp. yielded significantly increased lipid productivity under photoheterotrophic conditions compared to photoautotrophic conditions (28.7- and 17.3-fold higher, respectively). Statistical methodologies were also used to investigate the effects of volatile fatty acids and yeast extract on biomass and lipid production., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To determine the frequency of waterpipe smoking in students of different age groups., Study Design: Cross-sectional survey., Place and Duration of Study: Karachi, Pakistan, from February 2012 to February 2013., Methodology: The subjects were divided into two age groups. Group-I comprised of 13 - 17 years old randomly selected students from O' Level schools in Karachi and group-2 included 23 - 27 years old undergraduate and postgraduate students again randomly selected from various institutions in Karachi. A questionnaire was filled with prior consent, basic education on waterpipe smoking was given, and all the questions of the survey form were explained to the subjects according to context., Results: In group-1, 39% students smoked waterpipe. Most students had been smoking waterpipe for the last 2 years. In group-2, 48% individuals smoked waterpipe, majority of smokers indulged in the last 5 years and among them, most were falling within the last 2 years., Conclusion: The frequency of waterpipe smoking in teenage students was 39% and older students for 48%. Social and recreational use of waterpipes is widespread among both groups despite being acknowledged by majority as a health hazard.

Identification of novel microalgal strains with high lipid productivity is one of the most important research topics in renewable biofuel research. However, the major bottleneck in the strain screening process is that currently known methods for the estimation of microalgal lipid are laborious and time-consuming. The present study successfully employed sulpho-phospho-vanillin (SPV) colorimetric method for direct quantitative measurement of lipids within liquid microalgal culture. The SPV reacts with lipids to produce a distinct pink color, and its intensity can be quantified using spectrophotometric methods by measuring absorbance at 530nm. This method was employed for a rapid quantification of intracellular lipid contents within Chlorella sp., Monoraphidium sp., Ettlia sp. and Nannochloropsis sp., all of which were found to have lipid contents ranging in between 10% and 30%. Subsequent analysis of the biomass using gas chromatography confirmed that our protocol is highly accurate (R(2)=0.99)., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Microalgae biorefinement has attracted in intensive academic and industrial interest worldwide for its potential to replace petrol biofuels as economically and environmentally advantageous alternatives. However, harvesting and lipid extraction remain as critical and difficult issues to be resolved. In the present study, four amino-groups functionalized organic-nano clays were prepared. Specifically, Mg or Al or Ca backboned and covalently linked with 3-aminopropyltriethoxysilane or 3-[2-(2-aminoethylamino)ethylamino]propyltrimethoxysilane by sol-gel reaction under ambient conditions, resulted in Mg-APTES clay, Al-APTES clay, Ca-APTES clay, and Mg-N3 clay, respectively. Each organic-nanoclay was utilized for lipid extraction from wet microalgae biomass. As a result, the lipid-extraction efficiency of paste docosahexaenoic acid (DHA)-rich Chlorella sp. with low lipid content was high, while one of paste oleaginous Chlorella sp. with high lipid content was relatively low. Despite the low lipid-extraction efficiencies in all of the wet microalgae biomass, the conversion of the extracted lipids' fatty acids to biodiesel was nearly 100%., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

A cultivation system in the two-stage photoautotrophic-photoheterotrophic/mixotrophic mode was adapted to maximize lipid productivity of two freshwater strains of Chlorella sp. grown in brewery wastewater (BWW). The endogenous Chlorella sp. isolated from BWW had a higher growth rate than wild-type Chlorella vulgaris (UTEX-265) while C. vulgaris (UTEX-265) had a higher maximal biomass and lipid contents than that of endogenous Chlorella sp., resulting in more than 90% of the inorganic nutrients in both total nitrogen (TN) and phosphorus (TP) was removed during the first stage in the two-stage photoautotrophic-photoheterotrophic mode in each Chlorella sp. The maximal biomass and lipid contents of C. vulgaris (UTEX-265) for single stage photoautotrophic cultivation were 1.5 g/L and 18%, respectively. Importantly, during two-stage photoautotrophic-photoheterotrophic cultivation for C. vulgaris (UTEX-265), the biomass was increased to 3.5 g/L, and the lipid productivity was increased from 31.1 to 108.0mg/L day., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

In microalgae-based biorefinement, one of the highest practical priorities is to reduce the costs of downstream processes. As one potential solution, microalgae harvesting by organoclays has received particularly keen research interest. In the present study, cationic charged aluminum- and magnesium-backboned organoclays were synthesized and solubilized in aqueous solution due to their high-density of amino sites. Each, within 30 min of its injection into 1.7 g/L-concentration microalgal feedstocks, effected harvesting efficiencies of almost 100% at concentrations above 0.6 g/L while maintaining a neutral pH. Conclusively, organoclays, if recycled efficiently, can be uniquely effective microalgae harvesting agents., (Copyright © 2013 Elsevier Ltd. All rights reserved.)