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Background: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is associated with acute brain injury (ABI), including central nervous system (CNS) ischemia (defined as ischemic stroke or hypoxic-ischemic brain injury [HIBI]) and intracranial hemorrhage (ICH). Data on prediction models for neurologic outcomes in VV-ECMO are limited. Methods: We analyzed adult (age ≥18 years) VV-ECMO patients in the Extracorporeal Life Support Organization (ELSO) Registry (2009-2021) from 676 centers. ABI was defined as CNS ischemia, ICH, brain death, and seizures. Data on 67 variables were extracted, including clinical characteristics and pre-ECMO/on-ECMO variables. Random forest, CatBoost, LightGBM, and XGBoost machine learning (ML) algorithms (10-fold leave-one-out cross-validation) were used to predict ABI. Feature importance scores were used to pinpoint the most important variables for predicting ABI. Results: Of 37,473 VV-ECMO patients (median age, 48.1 years; 63% male), 2644 (7.1%) experienced ABI, including 610 (2%) with CNS ischemia and 1591 (4%) with ICH. The areas under the receiver operating characteristic curve for predicting ABI, CNS ischemia, and ICH were 0.70, 0.68, and 0.70, respectively. The accuracy, positive predictive value, and negative predictive value for ABI were 85%, 19%, and 95%, respectively. ML identified higher center volume, pre-ECMO cardiac arrest, higher ECMO pump flow, and elevated on-ECMO serum lactate level as the most important risk factors for ABI and its subtypes. Conclusions: This is the largest study of VV-ECMO patients to use ML to predict ABI reported to date. Performance was suboptimal, likely due to lack of standardization of neuromonitoring/imaging protocols and data granularity in the ELSO Registry. Standardized neurologic monitoring and imaging are needed across ELSO centers to detect the true prevalence of ABI.

Hepatic hemangiomas are commonly benign liver tumors, typically asymptomatic and predominantly located in the right lobe. This case report details an exceptional instance of a left-lobe hepatic hemangioma manifesting as an exophytic, pedunculated mass resembling a gastric tumor. A 77-year-old woman with a history of melanoma presented with a mass incidentally discovered during evaluations for chest pain. Advanced imaging techniques, including computed tomography (CT) and endoscopic ultrasound (EUS), identified this mass as a benign, pedunculated hemangioma extending from the left hepatic lobe toward the gastric fundus. Given the tumor's benign nature and the patient's lack of symptoms, a conservative management approach was adopted. This case emphasizes the importance of accurate imaging and diagnostic assessment in managing atypical hepatic hemangiomas, highlighting the need to carefully consider rare growth patterns and locations in differential diagnoses to avoid unnecessary interventions. Such cases reinforce the complexity of diagnosing and managing unusual presentations of common benign tumors.

Urinoma (collection of urine) formation secondary to extracorporeal shock wave lithotripsy (ESWL) is one of the rare complications encountered postprocedure and co-existence of urinoma with steinstrasse is a rare and challenging scenario to manage in the setting of obstructive uropathy. ESWL is known for being noninvasive for breaking kidney and ureteric stones. Urinoma is a collection of urine outside the collecting system in the retroperitoneum or perirenal space. Early detection and management are necessary to prevent complications related to urinoma and steinstrasse. This case report is about a patient who developed urinoma and steinstrasse in the setting of obstructive uropathy after sessions of ESWL on the right side and was managed with a nephrostomy tube and trans-ureteral lithotripsy on the right side and percutaneous nephrolithotomy on the left side after 1 month.

Abstract Background While calcium is known to play a crucial role in mammalian sperm physiology, how it flows in and out of the male gamete is not completely understood. Herein, we investigated the involvement of Na+/Ca2+ exchangers (NCX) in mammalian sperm capacitation. Using the pig as an animal model, we first confirmed the presence of NCX1 and NCX2 isoforms in the sperm midpiece. Next, we partially or totally blocked Ca2+ outflux (forward transport) via NCX1/NCX2 with different concentrations of SEA0400 (2-[4-[(2,5-difluorophenyl)methoxy]phenoxy]-5-ethoxyaniline; 0, 0.5, 5 and 50 µM) and Ca2+ influx (reverse transport) with SN6 (ethyl 2-[[4-[(4-nitrophenyl)methoxy]phenyl]methyl]-1,3-thiazolidine-4-carboxylate; 0, 0.3, 3 or 30 µM). Sperm were incubated under capacitating conditions for 180 min; after 120 min, progesterone was added to induce the acrosome reaction. At 0, 60, 120, 130, and 180 min, sperm motility, membrane lipid disorder, acrosome integrity, mitochondrial membrane potential (MMP), tyrosine phosphorylation of sperm proteins, and intracellular levels of Ca2+, reactive oxygen species (ROS) and superoxides were evaluated. Results Partial and complete blockage of Ca2+ outflux and influx via NCX induced a significant reduction of sperm motility after progesterone addition. Early alterations on sperm kinematics were also observed, the effects being more obvious in totally blocked than in partially blocked samples. Decreased sperm motility and kinematics were related to both defective tyrosine phosphorylation and mitochondrial activity, the latter being associated to diminished MMP and ROS levels. As NCX blockage did not affect the lipid disorder of plasma membrane, the impaired acrosome integrity could result from reduced tyrosine phosphorylation. Conclusions Inhibition of outflux and influx of Ca2+ triggered similar effects, thus indicating that both forward and reverse Ca2+ transport through NCX exchangers are essential for sperm capacitation.

Objective: We aimed to determine if machine learning can predict acute brain injury and to identify modifiable risk factors for acute brain injury in patients receiving venoarterial extracorporeal membrane oxygenation. Methods: We included adults (age ≥18 years) receiving venoarterial extracorporeal membrane oxygenation or extracorporeal cardiopulmonary resuscitation in the Extracorporeal Life Support Organization Registry (2009-2021). Our primary outcome was acute brain injury: central nervous system ischemia, intracranial hemorrhage, brain death, and seizures. We used Random Forest, CatBoost, LightGBM, and XGBoost machine learning algorithms (10-fold leave-1-out cross-validation) to predict and identify features most important for acute brain injury. We extracted 65 total features: demographics, pre-extracorporeal membrane oxygenation/on-extracorporeal membrane oxygenation laboratory values, and pre-extracorporeal membrane oxygenation/on-extracorporeal membrane oxygenation settings. Results: Of 35,855 patients receiving venoarterial extracorporeal membrane oxygenation (nonextracorporeal cardiopulmonary resuscitation) (median age of 57.8 years, 66% were male), 7.7% (n = 2769) experienced acute brain injury. In venoarterial extracorporeal membrane oxygenation (nonextracorporeal cardiopulmonary resuscitation), the area under the receiver operator characteristic curves to predict acute brain injury, central nervous system ischemia, and intracranial hemorrhage were 0.67, 0.67, and 0.62, respectively. The true-positive, true-negative, false-positive, false-negative, positive, and negative predictive values were 33%, 88%, 12%, 67%, 18%, and 94%, respectively, for acute brain injury. Longer extracorporeal membrane oxygenation duration, higher 24-hour extracorporeal membrane oxygenation pump flow, and higher on-extracorporeal membrane oxygenation partial pressure of oxygen were associated with acute brain injury. Of 10,775 patients receiving extracorporeal cardiopulmonary resuscitation (median age of 57.1 years, 68% were male), 16.5% (n = 1787) experienced acute brain injury. The area under the receiver operator characteristic curves for acute brain injury, central nervous system ischemia, and intracranial hemorrhage were 0.72, 0.73, and 0.69, respectively. Longer extracorporeal membrane oxygenation duration, older age, and higher 24-hour extracorporeal membrane oxygenation pump flow were associated with acute brain injury. Conclusions: In the largest study predicting neurological complications with machine learning in extracorporeal membrane oxygenation, longer extracorporeal membrane oxygenation duration and higher 24-hour pump flow were associated with acute brain injury in nonextracorporeal cardiopulmonary resuscitation and extracorporeal cardiopulmonary resuscitation venoarterial extracorporeal membrane oxygenation.

Abstract Background Allergic disorders, prevalent global health concerns, afflict a substantial portion of the world’s population. These maladies result from an exaggerated immune system response to ordinarily innocuous substances, such as pollen, dust mites, and specific dietary components. Clinical manifestations of this heightened immune response include itching, swelling, and respiratory impairment, often accompanied by releasing mediators like histamine. The pathophysiological mechanisms of allergy disorders are intricate, arising from a complex interplay between genetic and environmental factors. While clinical presentations may vary, all allergy conditions share a common foundation in the dysregulated immune response to allergens. Result The current aim of this study was to identify innovative anti-allergic agents capable of inhibiting histamine and effectively mitigating allergic reactions by utilizing the computer-aided drug design approach by discovery studio (DS) 2022 v 23.1.1 package. The overarching aim was identifying potential drug candidates targeting the active site within the histamine H1 receptor complex; therefore, a collection of 4000 small druggable compounds was curated from ZINC, PubChem, and DRUG BANK databases sources. Four compounds appeared as promising candidates after assessing docking scores and binding energies. Notably, Compound ID 34154, recognized as tymazoline, showed the highest affinity for the H1 receptor of 3RZE, suggesting it may be the most promising choice for more research. Further chemoinformatic and ADMET (absorption, distribution, metabolism, excretion, and toxicity) analyses were conducted to assess the drug-like qualities of this chosen molecule. In addition, bioisosteric substitution techniques were employed to enhance tymazoline’s ADMET characteristics. Conclusion Tymazoline shows strong binding affinity with 3RZE and verified all the drug-likeness criteria to inhibit the allergic disorders. Furthermore, molecular dynamics (MD) studies corroborated tymazoline’s potential as an anti-allergic agent, demonstrating contact between the ligand and the receptor that is well defined and stable.

The rapid increase in population accelerates the rate of change of Land use/Land cover (LULC) in various parts of the world. This phenomenon caused a huge strain for natural resources. Hence, continues monitoring of LULC changes gained a significant importance for management of natural resources and assessing the climate change impacts. Recently, application of machine learning algorithms on RS (remote sensing) data for rapid and accurate mapping of LULC gained significant importance due to growing need of LULC estimation for ecosystem services, natural resource management and environmental management. Hence, it is crucial to access and compare the performance of different machine learning classifiers for accurate mapping of LULC. The primary objective of this study was to compare the performance of CART (Classification and Regression Tree), RF (Random Forest) and SVM (Support Vector Machine) for LULC estimation by processing RS data on Google Earth Engine (GEE). In total four classes of LULC (Water Bodies, Vegetation Cover, Urban Land and Barren Land) for city of Lahore were extracted using satellite images from Landsat-7, Landsat-8 and Landsat-9 for years 2008, 2015 and 2022, respectively. According to results, RF is the best performing classifier with maximum overall accuracy of 95.2% and highest Kappa coefficient value of 0.87, SVM achieved maximum accuracy of 89.8% with highest Kappa of 0.84 and CART showed maximum overall accuracy of 89.7% with Kappa value of 0.79. Results from this study can give assistance for decision makers, planners and RS experts to choose a suitable machine learning algorithm for LULC classification in an unplanned urbanized city like Lahore.

Rapid advancement in information technology promotes the growth of new online learning communities in an e-learning environment that overloads information and data sharing. When a new learner asks a question, how a system recommends the answer is the problem of the learner’s cold start. In this article, our contributions are: (i) We proposed a Trust-aware Deep Neural Recommendation (TDNR) framework that addresses learner cold-start issues in informal e-learning by modeling complex nonlinear relationships. (ii) We utilized latent Dirichlet allocation for tag modeling, assigning tag categories to newly posted questions and ranking experts related to specific tags for active questioners based on hub and authority scores. (iii) We enhanced recommendation accuracy in the TDNR model by introducing a degree of trust between questioners and responders. (iv) We incorporated the questioner-responder relational graph, derived from structural preference information, into our proposed model. We evaluated the proposed model on the Stack Overflow dataset using mean absolute precision (MAP), root mean squared error (RMSE), and F-measure metrics. Our significant findings are that TDNR is a hybrid approach that provides more accurate recommendations compared to rating-based and social-trust-based approaches, the proposed model can facilitate the formation of informal e-learning communities, and experiments show that TDNR outperforms the competing methods by an improved margin. The model’s robustness, demonstrated by superior MAE, RMSE, and F-measure metrics, makes it a reliable solution for addressing information overload and user sparsity in Stack Overflow. By accurately modeling complex relationships and incorporating trust degrees, TDNR provides more relevant and personalized recommendations, even in cold-start scenarios. This enhances user experience by facilitating the formation of supportive learning communities and ensuring new learners receive accurate recommendations.

Key Clinical Message Benign ancient retroperitoneal schwannomas (BARS) exhibit abdominal masses and flank pain to incidental findings at more advanced stages. Histopathological and immunohistochemical analysis is essential for confirmation of benign nature. Our patient was misdiagnosed as ureteric colic, highlighting the need to consider BARS in differential diagnosis to prevent complications like hydronephrosis. Abstract Ancient schwannomas are usually benign neoplasms that originate from Schwann cells of peripheral nerves. We present a novel case of a 24‐year‐old young male with left flank pain and nausea which was initially thought to be left ureteric colic. However, in‐depth imaging and biopsy revealed a retroperitoneal mass. The definitive diagnosis was narrowed down to Benign Retroperitoneal Ancient Schwannoma (BARS) via immunohistochemistry and histopathological analysis. This often marble‐shaped S100 protein‐positive tumor is an under‐recognized and potential cause of hydronephrosis if localized near the renal structures. In addition, the retroperitoneal location with infrarenal abdominal aortic adherence is another rare peculiarity in the present case that demands prompt diagnosis and surgical excision to avoid any cardiovascular sequelae such as hypotension and abdominal pain, as indicated by the natural history of growth of this benign tumor. Therefore, timely excision of this benign tumor prior to its further proliferation is paramount. We initially planned laparoscopic removal but adopted excision via laparotomy because of the proximity of the vital structures. The postoperative course of the patient was uneventful and subsequently the patient's presenting complaint of left abdominal flank pain greatly improved. The patient was advised to undergo follow‐up computed tomography scan of kidney ureter bladder and RFT evaluation 6 months postsurgery which indicated no evidence of recurrence or iatrogenic complications. The diagnosis and management of the present case share valuable experiences for similar future cases worldwide.

Protein malnutrition is a major public health concern in the developing world. The livestock products are a good source of high-quality protein, but the livestock industry is a source of pollution and one of the leading causes of climate change because the slaughtering of animals results in the accumulation of waste, offals, and several inedible body portions. The rapid increase in the human population and inadequate supply of traditional protein sources have driven a search for novel and alternative protein sources such as edible insects. This review extensively explores the nutritional value, allergenicity, and safety considerations associated with consuming common house crickets and other related insect species. A wide range of cricket protein-based products are currently available and provide some attractive options to the consumers such as protein-enriched bakery products and gluten-free bread for celiac patients. The cricket protein hydrolysates are used as preservatives to improve the stability of cheddar cheese and goat meat emulsions during storage. The risks associated with edible crickets and their products are bacteria, mycotoxins, polychlorinated dibenzodioxins, pesticide residues, heavy metals, and the presence of allergenic proteins.

ABSTRACT Background Sodium‐glucose cotransporter 2 (SGLT2) inhibitors improve cardiovascular (CV) outcomes in patients with or without Type 2 diabetes and heart failure (HF). However, studies have shown conflicting evidence regarding their efficacy in patients following acute myocardial infarction (MI). We conducted a pilot systematic review and meta‐analysis to synthesise the available evidence regarding the effectiveness of SGLT2 inhibitors in MI. Methods A systematic literature search was conducted using PubMed/MEDLINE, the Cochrane Library and Embase databases to identify randomised controlled trials (RCTs) that compared clinical outcomes of SGLT2 inhibitors with placebo following MI. We conducted the statistical analysis using RevMan, version 5.4 and pooled risk ratios (RRs) along the corresponding 95% confidence interval (CI) for all outcomes. Results Five RCTs reporting data for 11,211 patients were included in our study. The mean follow‐up duration was 43.8 weeks. Our pooled analysis showed that SGLT2 inhibitors significantly reduced the risk of hospitalisations for heart failure (HHF) (RR = 0.76, 95% CI: 0.61–0.88, p = 0.001) in patients with MI. However, the risk of all‐cause mortality (RR = 1.05, 95% CI: 0.78–1.41, p = 0.76), CV mortality (RR = 1.04, 95% CI = 0.84–1.29, p = 0.73) and all‐cause hospitalisations (RR = 1.06, 95% CI: 0.96–1.17, p = 0.25) remained comparable across the two groups. Conclusion SGLT2 inhibitors reduce HHF without affecting all‐cause mortality, CV mortality and all‐cause hospitalisations. However, further evidence is required to reach a definitive conclusion.

Abstract High temperature stress influences plant growth, seed yield, and fatty acid contents by causing oxidative damage. This study investigated the potential of thiourea (TU) to mitigate oxidative stress and restoring seed oil content and quality in canola. The study thoroughly examined three main factors: (i) growth conditions—control and high temperature stress (35 °C); (ii) TU supplementation (1000 mg/L)—including variations like having no TU, water application at the seedling stage, TU application at seedling stage (BBCH Scale-39), water spray at anthesis stage, and TU application at anthesis stage (BBCH Scale-60); (iii) and two canola genotypes, 45S42 and Hiola-401, were studied separately. High temperature stress reduced growth and tissue water content, as plant height and relative water contents were decreased by 26 and 36% in 45S42 and 27 and 42% Hiola-401, respectively, resulting in a substantial decrease in seed yield per plant by 36 and 38% in 45S42 and Hiola-401. Seed oil content and quality parameters were also negatively affected by high temperature stress as seed oil content was reduced by 32 and 35% in 45S42 and Hiola-401. High-temperature stress increased the plant stress indicators like malondialdehyde, H2O2 content, and electrolyte leakage; these indicators were increased in both canola genotypes as compared to control. Interestingly, TU supplementation restored plant performance, enhancing height, relative water content, foliar chlorophyll (SPAD value), and seed yield per plant by 21, 15, 30, and 28% in 45S42; 19, 13, 26, and 21% in Hiola-401, respectively, under high temperature stress as compared to control. In addition, seed quality, seed oil content, linoleic acid, and linolenic acid were improved by 16, 14, and 22% in 45S42, and 16, 11, and 23% in Hiola-401, as compared to control. The most significant improvements in canola seed yield per plant were observed when TU was applied at the anthesis stage. Additionally, the research highlighted that canola genotype 45S42 responded better to TU applications and exhibited greater resilience against high temperature stress compared to genotype Hiola-401. This interesting study revealed that TU supplementation, particularly at the anthesis stage, improved high temperature stress tolerance, seed oil content, and fatty acid profile in two canola genotypes.

Abstract Pea, member of the plant family Leguminosae, play a pivotal role in global food security as essential legumes. However, their production faces challenges stemming from the detrimental impacts of abiotic stressors, leading to a concerning decline in output. Salinity stress is one of the major factors that limiting the growth and productivity of pea. However, biochar amendment in soil has a potential role in alleviating the oxidative damage caused by salinity stress. The purpose of the study was to evaluate the potential role of biochar amendment in soil that may mitigate the adverse effect of salinity stress on pea. The treatments of this study were, (a) Pea varieties; (i) V1 = Meteor and V2 = Green Grass, Salinity Stress, (b) Control (0 mM) and (ii) Salinity (80 mM) (c) Biochar applications; (i) Control, (ii) 8 g/kg soil (56 g) and (iii) 16 g/kg soil (112 g). Salinity stress demonstrated a considerable reduction in morphological parameters as Shoot and root length decreased by (29% and 47%), fresh weight and dry weight of shoot and root by (85, 63%) and (49, 68%), as well as area of leaf reduced by (71%) among both varieties. Photosynthetic pigments (chlorophyll a, b, and carotenoid contents decreased under 80 mM salinity up to (41, 63, 55 and 76%) in both varieties as compared to control. Exposure of pea plants to salinity stress increased the oxidative damage by enhancing hydrogen peroxide and malondialdehyde content by (79 and 89%), while amendment of biochar reduced their activities as, (56% and 59%) in both varieties. The activities of catalase (CAT), superoxide dismutase (SOD), and peroxidase (POD) were increased by biochar applications under salinity stress as, (49, 59, and 86%) as well as non-enzymatic antioxidants as, anthocyanin and flavonoids improved by (112 and 67%). Organic osmolytes such as total soluble proteins, sugars, and glycine betaine were increased up to (57, 83, and 140%) by biochar amendment. Among uptake of mineral ions, shoot and root Na+ uptake was greater (144 and 73%) in saline-stressed plants as compared to control, while shoot and root Ca2+ and K+ were greater up to (175, 119%) and (77, 146%) in biochar-treated plants. Overall findings revealed that 16 g/kg soil (112 g) biochar was found to be effective in reducing salinity toxicity by causing reduction in reactive oxygen species and root and shoot Na+ ions uptake and improving growth, physiological and anti-oxidative activities in pea plants (Fig. 1). Figure 1 A schematic diagram represents two different mechanisms of pea under salinity stress (control and 80 mM NaCl) with Biochar (8 and 16 g/kg soil).

Abstract Water bodies are highly pollution-prone areas in which mercury (Hg) is considered as a major menace to aquatic organisms. However, the information about the toxicity of mercuric chloride (HgCl2) in a vital organ such as the liver of fish is still inadequate. This study aimed to assess the impact of mercuric chloride (HgCl2) exposure on the liver of Channa punctata fish over 15, 30, and 45 days, at two different concentrations (0.039 mg/L and 0.078 mg/L). Mercury is known to be a significant threat to aquatic life, and yet, information regarding its effects on fish liver remains limited. The results of this study demonstrate that exposure to HgCl2 significantly increases oxidative stress markers, such as lipid peroxidation (LPO) and protein carbonyls (PC), as well as the levels of serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) in the fish. Additionally, the transcriptional and protein analysis of specific genes and molecules associated with necroptosis and inflammation, such as ABCG2, TNF α, Caspase 3, RIPK 3, IL-1β, Caspase-1, IL-18, and RIPK1, confirm the occurrence of necroptosis and inflammation in the liver. Histopathological and ultrastructural examinations of the liver tissue further reveal a significant presence of liver steatosis. Interestingly, the upregulation of PPARα suggests that the fish's body is actively responding to counteract the effects of liver steatosis. This study provides a comprehensive analysis of oxidative stress, biochemical changes, gene expression, protein profiles, and histological findings in the liver tissue of fish exposed to mercury pollution in freshwater environments.

Abstract Background Natural and synthetic plant growth regulators are essential for plant health, likewise these regulators also play a role in increasing organic production productivity and improving quality and yield stability. In the present study, we have evaluated the effects of foliar applied plant growth regulators, i.e., moringa leaf extract (MLE) and mepiquat chloride (MC) alone and in combination MC and MLE on the conventional cotton cultivar (CIM 573) and transgenic one (CIM 598). The growth regulators were applied at the start of bloom, 45 and 90 days after blooming. Results The application of MC and MLE at 90 days after blooming significantly improved the relative growth rate, net assimilation rate, the number of bolls per plant, and seed cotton yield. Likewise, the combined application of MLE and MC at 90 days after blooming significantly boosted the nitrogen uptake in locules, as well as the phosphorus and potassium uptake in the leaves of both cotton cultivars. The application of MLE alone has considerably improved the nitrogen uptake in leaves, and phosphorus and potassium contents in locules of Bt and conventional cotton cultivars. Similarly, Bt cotton treated with MLE at 90 days after blooming produced significantly higher ginning out turn and oil contents. Treatment in combination (MLE + MC) at 90 days after blooming produced considerably higher micronaire value, fiber strength, and staple length in conventional cultivar. Conclusion The natural growth enhancer, MLE is a rich source of minerals and zeatin, improving the nutrient absorption and quality of cotton fiber in both conventional and Bt cotton cultivars.

Abstract Background As widely known, an intrauterine device (IUD) is a small, typically T-shaped contraceptive device that offers long-term reversible birth control. However, neglecting to remove the IUD can lead to severe complications. This case report showcases an exceptional instance that underscores the potential risks associated with retention of an IUD. Case presentation This case report documents a 40-year-old female who failed to remove her intrauterine device for eight years. Upon her visit to our clinic, she presented with increased urinary frequency, burning micturition, dysuria, and discomfort while emptying her bladder. Medical review consisting of ultrasound (KUB) and X-ray pelvis revealed the intrauterine device had migrated and was encrusted with a stone. We used Holmium laser lithotripsy to break down the stone, before using cystoscope to manually remove the intrauterine device. She made a rapid recovery without any complications. Conclusions In order to raise awareness about forgotten or misplaced IUDs and their complications, we are presenting a case of complete intravesical IUD migration at our clinic. This serves as an educational opportunity to shed light on this uncommon occurrence and emphasize the importance of timely removal and follow-up in patients using intrauterine devices (IUDs).

Abstract Purpose To analyze the prevalence and progression of fulminant type 1 diabetes (FT1D) in Qatar. Methods This retrospective study analyzed consecutive index- diabetic ketoacidosis (DKA) admissions (2015–2020) among patients with new-onset T1D (NT1D) in Qatar. Results Of the 242 patients, 2.5% fulfilled the FT1D diagnostic criteria. FT1D patients were younger (median-age 4-years vs.15-years in classic-T1D). Gender distribution in FT1D was equal, whereas the classic-T1D group showed a female predominance at 57.6% (n = 136). FT1D patients had a mean C-peptide of 0.11 ± 0.09 ng/ml, compared to 0.53 ± 0.45 ng/ml in classic-T1D. FT1D patients had a median length of stay (LOS) of 1 day (1-2.2) and a DKA duration of 11.25 h (11–15). The median (length of stay) LOS and DKA duration in classic-T1D patients were 2.5 days (1-3.9) and 15.4 h (11–23), respectively. The FT1D subset primarily consisted of moderate (83.3%) and severe 916.7%) DKA, whereas classic T1D had 25.4% mild, 60.6% moderate, and 14% severe DKA cases. FT1D was associated with a higher median white cell count (22.3 × 103/uL) at admission compared to classic T1D (10.6 × 103/uL). ICU admission was needed for 66.6% of FT1D patients, compared to 38.1% of classic-T1D patients. None of the patients in the FT1D group had mortality, while two died in the classic-T1D group. Conclusion This is the first study establishing the existence of FT1D in ME, which presented distinctively from classic-T1D, exhibiting earlier age onset and higher critical care requirements. However, the clinical outcomes in patients with FT1D seem similar to classic T1D.

To boost agricultural yields, understanding mineral nutrition’s reliance on fertilizers is crucial, underscoring the need to evaluate nutrient-use efficiency for optimal fertilization. In this regard, a field study was conducted to elaborate the role of phosphorus fertilizer in enhancing growth, yield and marginal rate of return in four wheat varieties; two Zn-biofortified (Zincol-2016 and Akbar-2019) and two standard types (Anaj-2017 and FSD-2008). The study revealed that application of phosphorus significantly enhanced the uptake of nitrogen (N), phosphorous (P) and potassium (K) contents in straw (13 %, 59 % and 79 %) and grains (63 %, 92 % and 28 %) respectively. Similarly, the contents of Zinc (Zn) and iron (Fe) were reduced in straw (23 % and 19 %) and grains (19 % and 18 %) respectively after application of 80 and 120 kg P2O5, however at 40 kg P2O5 the contents of Zn and Fe were slightly enhanced. The grain yield (21 %) and harvest index (11 %) was maximum at 80 kg P2O5 as compared to 40 and 120 kg P2O5. The Marginal rate of return over investment (MRR) in P2O5 was maximum (241 %) in Akbar-2019 when P-fertilizer was applied at the rate of 80 kg P2O5 per ha−1. Regression analysis showed a positive correlation between grain yield and its determinants. Biofortified wheat varieties responded better to 80 kg P2O5, outperforming standard varieties in yield. Additionally, our findings demonstrate a significant upregulation of PSTOL1 gene expression at 80 kg P2O5 level. Concludingly the application of P-fertilizer at the rate of 80 kg P2O5 per ha−1 enhanced growth, yield and rate of return of testing wheat varieties especially the biofortified ones; Zincol-2016 and Akbar-2019.

The current study delves into the impact of irrigation using two distinct water sources (freshwater and brackish water) in conjunction with three salt-tolerant fodder crops (Sesbania, Guar, and Pearl millet) within arid dry-land environments for two year experiments. Brackish water irrigation impedes the growth of all three plant species and reduces water consumption relative to freshwater irrigation. Logistic growth prediction equations for plant height, stem diameter, and the number of branches per plant are formulated across different water qualities irrigation against planting days. Biomass water use efficiency all three plant species having lower under brackish water irrigation. Consequently, the introduction of salt-tolerant plant species under brackish water irrigation presents an eco-friendly approach to harness arid dry-land for agricultural production. Furthermore, the predicted growth equations also provide, crucial insights for enhancing production in dry-land conditions by improving water use efficiency under different water irrigation.

Background Atrioventricular block (AVB) is rare in hyperthyroidism (HTH). Little is known about the true prevalence, clinical course, optimal management, and outcomes of different types of AVBs in patients with HTH. To address these uncertainties, we aimed to conduct a systematic review by combining the available literature to provide more meaningful data regarding AVBs in HTH.Methods We systematically searched PubMed, Scopus, Embase, and Google Scholar for articles reporting patients who developed AVB in the context of HTH. Data were analysed in STATA 16. The main outcomes included types of AVB, frequency of pacemaker insertion, and resolution of AVB. The systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the identification number CRD42022335598.Results A total of 56 studies (39 case reports, 12 case series, 3 conference abstracts, 1 retrospective study, and 1 prospective observational study) with 87 patients were included in the analysis, with a mean age of 39.1 ± 17.6 years. Females constituted 65.7% (n = 48) of the cohort. Complete heart block (CHB) was the most commonly reported AVB (N = 45, 51.7%), followed by first-degree AVB (16.1%) and second-degree AVB (14.9%). Overall, 21 patients underwent pacing. A permanent pacemaker was inserted in one patient with second-degree AVB and six patients with CHB. Mortality was reported in one patient with CHB. The clinical course and management of HTH and AVBs did not differ in patients with CHB or lower-degree blocks. Apart from lower rates of goitre and more use of carbimazole in those who underwent pacing, no differences were found when compared to the patients managed without pacing.Conclusion Current data suggest that CHB is the most common type of AVB in patients with HTH. Most patients can be managed with anti-thyroid management alone. Additionally, whether pacemaker insertion alters the clinical outcomes needs further exploration.

Abstract Genetic diversity plays a critical role in crop improvement. Radish is one of the important vegetable crops of Rabi season, however, there is a lack of information about radish germplasm resources available in Pakistan. The present research was carried out to characterize radish gene pool on the basis of qualitative and quantitative traits. Twelve genotypes of radish comprised of local and exotic sources were evaluated for genetic variability through morphological, quality, and quantitative traits. Analysis of variance depicted maximum variation among genotypes for all studied straits. High genotypic co-efficient of variance (GCV) value (>20%) in all traits indicates that these traits can be improved through selection. The estimate of genotypic co-efficient of variance (GCV) in present research was closer to phenotypic co-efficient of variance (PCV), suggesting the key role of genotype as compared to the environment. However, high heritability along with genetic advance (as % of mean) among studied genotypes suggests that the selection of studied traits simply on phenotypic basis can also be effective for the breeding program. Cluster analysis based on morphological traits, grouped genotypes into three clusters and cluster I, contained the maximum number of genotypes. In correlation analysis, significant positive correlation among plant fresh weight, root length, root weight, number of leaves and yield can be directly used a selection criteria. Studying of variability in qualitative traits through frequency distribution exhibited maximum variation for root shape and root base. This study showed considerable variability exists in studied genotypes that can further be used for the improvement of radish breeding.

ABSTRACT: BACKGROUND & OBJECTIVE: Acute testicular pain requires emergency exploration for suspected testicular torsion (TT). It has been suggested that temperature variation is associated with TT. However, it was not possible to conclude whether the higher occurrence of TT was related to TT itself or the effect of the overall higher presentation of acute scrotum. We studied the impact of seasonal and daily temperature variations on acute testicular pain and outcomes. METHODOLOGY: Retrospective data collection on patients required testicular exploration between January 2006 and December 2017 for TT. The Kruskal Wallis test & chi-square tests were used to assess the group difference between continuous and categorical variables, respectively. RESULTS: In total, 502 patients required testicular exploration. The median age and duration of symptoms were 16.4 yrs. (1.3 – 77) and 4 hrs. (1 – 336). Respectively, TT was found in 231 (46%), torsion of the testicular appendix (TTA) in 126 (25%), epididymal inflammation (EI) in 46 (9.2%), and no identifiable cause (NIC) was found in 99 (19.7%). Scrotal explorations were more common in groups with mean daily temperature >6.20C, 60.2% Vs 39.8% while there was no difference in TT 46% Vs 46% in these groups. CONCLUSION: There was no seasonal variation for testicular torsion or operative findings. Cold weather and average low daily temperatures were not related to testicular torsion.

This study explores the thermohydraulic performance of metallic-oxide and carbon-additives-based mono and hybrid nanofluids-cooled micro pin-fin heat sink by adopting the multiphase Eulerian model. The circular configuration is adopted for micro pin-fins, with the staggered arrangement and constant heat flux applied at the base of the heat sink. The mono and hybrid nanofluids are based on an aqueous solution of Ag, MgO, GNP, MWCNT, Ag-MgO, and GNP-MWCNT mono and hybrid nanoparticles, and a pressure drop (Δp) range is applied across the heat sink. The heat transfer and fluid flow performance are evaluated in terms of temperature difference (ΔT), thermal resistance (Rth) of the heat sink, average heat transfer coefficient (havg), average Nusselt number (Nuavg), pumping power (PP), overall performance (OP), and performance evaluation criteria (PEC), whereas the velocity, temperature, pressure coefficient, and flow streamline contours present the qualitative depiction of flow distributions across the heat sink. The results revealed that under certain Δp conditions, the GNP dispersed mono nanofluid showed the highest thermal performance of the micro pin-fin heat sink compared to the water as a coolant. The optimal nanoparticle loading (φ) is found between 0.50 % and 0.75 % of GNP nanoparticles. The maximum enhancement in PEC is achieved at 60 % for φ of 0.50 % and 0.75 % for both Δp of 1120 Pa and 1470 Pa, respectively. At an optimum Δp, the higher average havg, Nuavg, and lower Rth are achieved.

Background: Neuroinflammation is closely related to Alzheimer's Disease (AD) pathology, hence supplements with anti-inflammatory property could help attenuate the progression of AD. This study was conducted to evaluate the potential anti-inflammatory effects of liposome encapsulated thymol (LET), administered orally, in prevention of Alzheimer in a rat model by anti-inflammatory mechanisms. Methods: The rats were grouped into six groups (n = 10 animals per group), including Control healthy (Con), Alzheimer's disease (AD) model, AD model treated with free thymol in 40 and 80 mg/kg body weight (TH40 and TH80), AD model treated with LET in 40 and 80 mg/kg of body weight (LET40 and LET80). The behavioral response of step through latency (Passive Avoidance Test), concentrations of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) and cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) were assessed in serum and hippocampus. Results: The results showed that significant increase in concentrations of IL-1β (P = 0.001), IL-6 (P = 0.001), TNF-α (P = 0.001) and COX-2 (P = 0.001) in AD group compared with healthy control rats. AD induction significantly reduced step through latency and revealed deficits in passive avoidance performance. The results also showed the treatment with free thymol especially in higher concentrations and also LTE could decrease serum concentrations of IL-1β (P

Objective: This study investigated the association between Coronavirus Disease 2019 mRNA vaccination and stroke in Qatar. Methods: Between December 1, 2020, and April 11, 2023, a matched case-control study was conducted to investigate the association between 3036 acute stroke cases and 3036 controls drawn from the entire population of Qatar. Results: The adjusted odds ratio (aOR) for vaccination among cases compared to controls was 0.87 (95% CI: 0.75-1.00). The aOR was 0.74 (95% CI: 0.45-1.23) for a single vaccine dose, 0.87 (95% CI: 0.73-1.04) for primary-series vaccination (two doses), and 0.91 (95% CI: 0.66-1.25) for booster vaccination (three or more doses). The aOR was 0.87 (95% CI: 0.72-1.04) for BNT162b2 and 0.86 (95% CI: 0.67-1.11) for mRNA-1273. Subgroup analyses, considering different durations since vaccination, also demonstrated no association. Subgroup analyses based on nationality, age, number of coexisting conditions, or prior infection status yielded similar results. Subgroup analysis, stratified by stroke type, suggested an association between vaccination and cerebral venous sinus thrombosis (aOR of 2.50 [95% CI: 0.97-6.44]), but it did not reach statistical significance. Conclusion: There was no evidence of an increased risk of stroke following vaccination, both in the short term and in the long term, extending beyond a year after receiving the vaccine.

Background: Blunt trauma Abdomen (BTA) due to RTA is the sixth leading cause of death in India. Conservative management of most blunt abdominal injuries developed from the observation that most of these injuries would ‘heal themselves’ and that operative intervention could interfere with this process. Aim: To evaluate the outcome of conservative management of solid visceral injuries in BTA. Design: Prospective observational study. Methods: Study conducted in the Postgraduate Dept. of Surgery, Govt. Medical College Jammu entailing 72 patients of BTA admitted from October 2018 to November 2019. Results: Out of 72 patients, 56 males were & 16 females. 69.44% had RTA. Most common age group was 21-30 years (30.56%).56.94% patients reported to hospital within 2 to 6 hours. FAST was positive in 95.83% patients. Liver was most commonly affected solid organ. 77.77% were managed conservatively and average hospital stay was 9.78 days. 4.16% patients of BTA expired in the study. Conclusion: In almost all the solitary solid visceral injuries with mild to moderate hemodynamic changes, Non Operative Management (NOM) is highly successful. It is concluded that all the isolated solid visceral injuries must be given fair chance of NOM where facilities of medical care or surgical ICUs are available for continuous monitoring.

Refrigeration has become an integral part of our daily lives and can be regarded as a process whose replacement is nearly impossible. Therefore, the only way of making this process efficient is by reducing the energy consumed by the components of refrigerators. One way of doing this is to reduce the power consumption of compressor by the addition of nanoparticles either in a refrigerant or in a lubricant. This study focusses on producing nanolubricant (Al2O3/Synthetic lubricant) and dispersing the nanolubricant into R-134a compressor. This study investigates that how much power can be reduced when Aluminum oxide (Al2O3) nanoparticles dispersed in SL-32 lubricant (base fluid). A comparison between SL-32 lubricant with and without the addition of Aluminum oxide nanoparticles was done and it showed a reduction of 0.913% in current consumption and 2.74% in power at the same initial temperature of 31°C in both cases. Hence it can be concluded that Alumina nanoparticles can be utilized to reduce the energy utilized by compressors by creating a nanolubricant with SL-32 lubricant.

Nowadays, thermal comfort is becoming a major problem for people due to increasing global warming and climatic changes, but it can be resolved by the concept of Heating, Ventilation, and Air Conditioning (HVAC) systems. The purpose of HVAC is to provide occupants with a comfort zone so that they can feel comfortable according to their thermal comfort. The core objective of this study is to design and propose an HVAC system as per actual design conditions for the University Auditorium located in Karachi, Pakistan. A direct Expansion (DX – Type) system is installed in the Auditorium that has exceeded the lifespan of twenty years, refrigerant R-22 which is currently being used has been obsolete due to its high GWP (Global Warming Potential) and ODP (Ozone Depletion Potential) values which are 1810 and 0.05 respectively. To achieve the objective of this study, two approaches are employed. Cooling Load Temperature Difference (CLTD) method & Hourly Analysis Program (HAP) software. The cooling load calculated from the CLTD method is 202 kW equivalent to 57.5 Ton of Refrigeration (TR). On the other side, the cooling load calculated from HAP software is 192.8 kW equivalent to 55 TR. By considering the calculated cooling load for the University Auditorium, two different HVAC systems are proposed, based on Water cooled and Air-cooled Vapor Compression Cycle. After this study, engineers will be able to design an HVAC system for any facility as per design conditions. Also, they can propose different cost-effective and energy-efficient HVAC systems for that particular space.

Objective: to establish how common Gastric Variceal bleeding is in Chronic liver Disease patients to allow them to be screened regularly and avoid morbidity and mortality. Study Design: Cross sectional study. Place and Duration of Study: Gastroenterology Department, Liaquat National Hospital and Medical College, Karachi Pakistan, from Jan to Dec 2020. Methodology: A total of 135 patients with history of melena, hematemesis and known diagnosis of Chronic liver Disease for more than six months who fulfilled the inclusion criteria were enrolled in this study. Gastroscopy was carried out and dilated veins in the gastric fundus, either with active spurter or an overlying punctum, were labelled as Gastric Variceal bleeding. Results: This study included known Chronic Liver Disease patients for duration of 6 months or more with recent stigmata of upper Gastrointestinal Bleed. Out of 135 cases, 76(56.3%) were male and 59(43.7%) were female. Enrolled patients’ mean age was 51.0±5.2 years, and the mean duration of Chronic liver Disease was 4.9±2.6 years. Gastric Variceal bleeding in Chronic liver Disease patients who underwent endoscopy had a frequency of 18(13.3%) times. Conclusion: Gastric Variceal bleeding bleeding is rare but lethal complication of Chronic liver Disease, seen in patients in the age group of

Background: Dementia is a recognized complication of atrial fibrillation (AF). Oral anticoagulant (OAC) therapy can potentially be protective against this complication. Methods: A comprehensive search of MEDLINE and Embase for comparative observational studies reporting the efficacy of OAC therapy for the incidence of dementia in patients with AF was conducted from its inception until March 2023. Studies that had patients with prior use of OAC or with a previous history of dementia were excluded. Results: A total of 22 studies were included in this review involving 617,204 participants. The pooled analysis revealed that OAC therapy, including direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs), was associated with a reduced incidence of dementia in AF patients. Specifically, compared to non-OAC treatment, OACs demonstrated a significant reduction in dementia incidence (HR 0.68, 95 % CI [0.58, 0.80], p

Background: Vascular injuries in simple close fractures are rare and low suspicion risk for primary surgeons. They include thrombus formation, hematomas, pseudoaneurysms, ischemic changes, and absent pulsations. These injuries can cause morbid sequelae, including compartment syndrome, reperfusion injury, exsanguination, and limb loss. Case presentation: Following a closed femoral shaft fracture, a 12-year-old boy came to us with a compromised superficial femoral artery (SFA). At the moment of fixing, there was no evidence of arterial involvement. He presented to the Out-patient Department (OPD) two weeks after the primary surgery with swelling at the fracture site. CT-Angiography was performed, and the swelling was diagnosed as a pseudoaneurysm of the superficial femoral artery, which was repaired using a Great Saphenous Vein (GSV) graft. Conclusion: These uncommon vascular injuries in closed fractures can be identified by a thorough clinical examination and specific diagnostic tests, and with prompt vascular repair, limb-threatening consequences are preventable. In a simple close femur fracture without suspicious signs in clinical findings, it's not a routine practice to check the vascular status by means of fancy and costly diagnostic tests.

Abstract Background Coexistence of TSH-secreting pituitary adenoma (TSHoma) and Graves’ disease (GD) is rare and complicates the management decision. Methods We present a case of the co-existence of TSHoma and GD. In addition, we systematically searched articles describing TSHoma and GD in the same patient published until 20th March 2023, using Pubmed, Scopus and Embase. Case presentation A 46-year-old man presented with symptoms of thyrotoxicosis. His thyroid function tests showed serum TSH 3.35 (reference range 0.3–4.2) mIU/L, FT3 19.7 (3.7–6.4) pmol/L, and FT4 68.9 (11-23.3) pmol/L. The serum TSH receptor antibody was 11.5 mIU/L (positive at ≥ 1.75 mIU/L). Pituitary magnetic resonance imaging showed macroadenoma compressing the optic chiasm. The patient underwent trans-sphenoidal resection of pituitary adenoma. Postoperatively, he remained on maintenance carbimazole and octreotide. Results Fourteen articles comprising 15 patients were identified from the systemic search. A total of 16 patients (including the current case) were included in the systematic review. The mean (± SD) age at diagnosis was 41 ± 13.6 years. The majority were females (75%). The median (IQR) TSH was 1.95 (0.12–5.5) mIU/L, the median (IQR) free T3 was 11.7 (7.6–19.7) pmol/L and the median (IQR) free T4 level was 47.6 (33.3–64.4) pmol/L. Ten (76.9%) patients had positive TSH receptor antibody levels. 84.6% had pituitary macroadenoma. Pituitary surgery was performed in 12 (75%) patients. At the last follow-up, 4 (25%) patients had complete resolution of symptoms after pituitary surgery, 3 (18.7%) were on maintenance treatment with thionamides for GD, 1 (6.25%) on beta-blockers and 1 (6.25%) on somatostatin analog. Conclusion TSHoma and GD can co-exist, and it is essential to identify this rare association as it can significantly impact treatment strategies.

Model-driven development (MDD) in the Artificial Intelligence of Things (AIoT) domain faces significant challenges in ensuring the consistency and preservation of model properties during transformations, often leading to system inconsistencies. This research introduces the Property Preservation Framework (PPF), a novel approach fortified with a Markov chain methodology, specifically designed to address these challenges. The PPF integrates formal procedures and constraint-checking methods to systematically validate and preserve model properties, thereby enhancing the reliability of AIoT systems. Through empirical evaluations, the framework has demonstrated its ability to efficiently determine and verify model characteristics at various transformation stages, significantly reducing the incidence of property violations. The results indicate that the PPF not only ensures overall consistency and reliability but also optimizes resource allocation, thereby enhancing data efficiency during the property validation and preservation processes. These advancements make a substantial contribution to the domain of MDD, providing developers with the methodology to execute model transformations that accurately reflect system requirements and behaviors in AIoT ecosystems. The findings underscore the potential of the PPF to revolutionize AIoT development by ensuring high-quality, dependable, and efficient modeling outcomes.

This paper presents a novel method for using full duplex (FD) communication across shared channels in cellular vehicle-to-everything (C-V2X) networks. Three modes A, B and C have been defined for communication in V2X networks where Mode C for FD communication has been introduced for the first time. We have derived mathematical model for success probability of FD for C-V2X network and formulated expressions for area spectral efficiency (ASE). Dual connectivity (DC) for simultaneous link of receiving vehicle with nearest transmitting vehicle and base station (BS) has also been analyzed for the first time for HD and FD in C-V2X network. Analytical and Monte Carlo simulations results have shown that utilization of FD in C-V2X network provides comparable success probability as compared to HD with improvement in ASE. Success probability of FD remains close to HD in terms of signal to interference noise ratio (SINR) in the range from -40 dBW to 60 dBW. Importance of achieving perfect self-interference cancellation (SIC) for different values of self-interference (SI) in FD network has also been evaluated. FD in C-V2X network has shown to significantly improve ASE with gain of 2.55 dB over Direct Short Range Communication (DSRC) and 2 dB over HD in C-V2X network under specific conditions. No degradation in ASE was observed in case of DC for HD and FD. ASE for FD has shown improvement as compared to HD for DSRC and C-V2X networks when evaluated against density of vehicles, BSs and roads.

Over the past few years, there has been a notable surge in the integration of Blockchain technology into supply chain management systems. This integration holds the promise of enhanced transparency, security, and efficiency in monitoring the movement of goods and services. This study presents a novel approach aimed at fortifying privacy and accuracy within blockchain-based supply chain management systems. The methodology integrates Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) units with secure multi-party computation (MPC) and differential privacy techniques as a hybrid model. The objective is to safeguard the confidentiality of transaction data while enabling precise detection of media tampering. Performance evaluation revolves around three key aspects: accuracy, privacy preservation, and computational efficiency. In terms of accuracy assessment, the proposed hybrid approach is benchmarked against traditional machine learning algorithms including Support Vector Machines (SVM), k-Nearest Neighbors (KNN), and Random Forest. Results indicate superior performance, with the proposed hybrid method achieving an accuracy of 0.95, outperforming conventional algorithms. Precision, recall, and F1-score metrics further confirm the effectiveness of the approach in accurately identifying media tampering instances. Privacy preservation capabilities are evaluated through differential privacy techniques, revealing the method’s ability to inject controlled noise into the data to protect individual privacy. Results demonstrate varying levels of privacy preservation across different settings, highlighting the trade-off between privacy and data utility. Computational efficiency is also scrutinized, considering the additional overhead introduced by privacy preservation mechanisms and secure MPC protocols. While there is a slight increase in computational time, the proposed approach maintains reasonable training and inference times, ensuring practical applicability in real-world scenarios.

Recent advances in Generative Adversarial Networks (GANs) have produced synthetic images with high visual fidelity, making them nearly indistinguishable from human-created images. These synthetic images referred to as deepfakes, have become a major source of misinformation due to social media. Technology is advancing rapidly, so reliable methods for distinguishing real from fake images are needed. The current detection mechanisms require image forensics tools such as error level analysis (ELA), and clone detection to detect manipulated images. These approaches are limited because they require forensics expertise to use, are manual in application nature, and are unscalable, creating a need for a framework for a scalable tool that experts and non-experts can use to combat the spread of manipulated images and preserve digital visual information authenticity. We approach this problem with a multi-model ensemble framework using the transfer learning method to effectively detect fake images. The proposed approach named Multi-Model GAN Guard (MMGANGuard)integrates four models into an ensemble framework to identify GAN-generated image characteristics to improve deepfake detection. The Gram-Net architecture, ResNet50V2, and DenseNet201 models are used with co-occurrence matrices using transfer learning for MMGANGuard. Through comprehensive experiments, the proposed model demonstrates promising results in detecting the deepfake with high accuracy on the StyleGAN dataset. For automated detection of deepfake-generated images, the proposed model exceeded 97% accuracy, 98.5% TPR, 98.4% TPR, and 95.6% TPR in these evaluations, eliminating the need for manual assessment which is promising for future research in this domain.

Recommender systems are crucial in today’s digital world, by enhancing user engagement experience in digital ecosystems. Internet of things (IoT) have huge potential to generate dynamic and real time data. The data generated through IoT are being utilized to extract dynamic context of the user. Integrating recommender systems with context-aware (IoT data) and cross-domain (Knowledge Transfer) capabilities have the capacity to further enhance the accuracy and relevance of recommendation systems. However, recommender systems struggle with the cold start problem, where non-availability of data hinders to make effective recommendations for new users. Therefore, IoT-enabled Context-Aware Cross-Domain Recommender Systems may employ latent user profiling to provide personalized and exceedingly relevant recommendations across domains. The proposed system, named Knowledge Transfer Cross-Domain User Latent Factors (KT-CDULF), creates a user profile that spans multiple data domains, capturing a wide range of user behavior on all domains. The KT-CDULF captures the combined knowledge across domains to make recommendations even with limited user data, i.e. cold start problem. Domain-independent factors, and context can be used across domains to make relevant recommendations. The effectiveness of a recommender system depends on the density of the ratings in the data. To address this, KT-CDULF used two benchmark datasets to create user profiles and an item-rating matrix with additional context extracted from IoT generated dataset. KT-CDULF is evaluated and compared it with state-of-the-art models for recommender systems and achieves an accuracy of 98%, demonstrating the benefits of transferring knowledge containing context across data domains in recommender systems.

Abstract Purpose This study evaluated the safety and feasibility of ablation of both non-muscle invasive and muscle invasive bladder tumors using single- and dual-wavelength diode lasers (980 nm and 980/1470 nm). Methods We retrospectively examined 151 patients with bladder tumors of any type from 2009 to 2021 who underwent V-LABT (visual laser ablation of bladder tumor) with both single- and dual-wavelength diode lasers at Shalamar Hospital Lahore, Pakistan. All procedures were performed by the same surgeon. Shalamar Medical and Dental College review board approved this retrospective cohort study (IRB No. -623-2023). The collected clinical data were consolidated into a single group, encompassing various variables such as the patients’ age, tumor size, number of tumors, tumor location, tumor grade, ablation duration, postoperative catheterization time, bladder discomfort, obturator nerve reflex, intraoperative and postoperative complications, and recurrence of tumors at the ablation sites. The patients were monitored for a minimum of 12 months to observe recurrence at the ablation sites through cystoscopy performed postoperatively every three months. The data were analyzed using Chi-square test, and p value

Connecting smart industrial components to computer networks revolutionizes business operations. However, in the Industrial Internet of Things (IIoT), the sharing of data has bandwidth, computational, and privacy issues. Researchers presented cloud computing and fine-grained access control to overcome these challenges. However, traditional centralized computing systems involve single points of failure. To mitigate these challenges, we have proposed a secure and incentive-based data-sharing framework for IIoT systems using blockchain technology. We leverage blockchain due to its ability to provide secure and tamper-resistant data storage and sharing as participants store their data on a distributed ledger (DL), preventing unauthorized access. A security protocol is designed that utilizes the properties of elliptic curve cryptography (ECC). Moreover, Shapley value is employed to calculate revenue and distribute it fairly. To perform the formal security evaluation, we have conducted extensive simulations using the Automated Validation of Internet Security Protocols and Applications (AVISPA) and Scyther protocol simulation tools, which demonstrated that our protocol is robust against various adversarial attacks. The experimental results show that the proposed incentive distribution framework demonstrated fairness in the distribution of revenue among participants.

Cloud computing platform offers numerous applications and resources such as data storage, databases, and network building. However, efficient task scheduling is crucial for maximizing the overall execution time. In this study, workflows are used as datasets to compare scheduling algorithms, including Shortest Job First, First Come, First Served, (DVFS) and Energy Management Algorithms (EMA). To facilitate comparison, the number of virtual machines in the Visual Studio.Net framework environment is used for the implementation. The experimental findings indicate that increasing the number of virtual machines reduces Makespan. Moreover, the Energy Management Algorithm (EMA) outperforms Shortest Job First by 2.79% for the CyberShake process and surpasses the First Come, First Serve algorithm by 12.28%. Additionally, EMA produces 21.88% better results than both algorithms combined. For the Montage process, EMA performs 4.50% better than Shortest Job First and 25.75% superior to the First Come, First Serve policy. Finally, we ran simulations to determine the performance of the suggested mechanism and contrasted it with the widely used energy-efficient techniques. The simulation results demonstrate that the suggested structural design may successfully reduce the amount of data and give suitable scheduling to the cloud.

The study introduces an efficient data aggregation technique for smart agriculture by leveraging Blockchain technology and a novel method referred to as the “cluster head sleep schedule.” The primary objective is to enhance the data collection process within a large-scale agricultural setting where multiple sensors continually generate vast amounts of data while monitoring and safeguarding crops from pest attacks. The proposed method involves the segmentation of sensors into clusters, each led by a designated cluster head responsible for collecting data from its constituent members deployed in the field to monitor pest attacks and promptly report any issues to the management. To curtail data redundancy, the study employs a fuzzy matrix to group nodes based on high-similarity data. This approach enables the selective suspension of certain nodes while others remain active. The data received from these nodes undergoes analysis using a fuzzy similarity matrix for clustering, ensuring that only unique data is transmitted to the base station. Redundant nodes from all clusters are identified and placed in a sleep mode, thus conserving energy and prolonging the network’s lifespan. This sleep scheduling mechanism is implemented subsequent to data redundancy reduction, facilitating immediate pest attack control in agriculture. By implementing these techniques, smart agriculture stands to benefit from optimized energy utilization and reduced costs associated with monitoring and pest control, thereby fostering sustainable and efficient operations. The cluster head is responsible for storing the data on a base station positioned at the network’s edge, allowing for local processing and prompt communication of pest attack information to the farmer for immediate action. Moreover, this edge system stores the data on a Blockchain network for future analysis and serves as a guideline for pest attack control in the pesticide industry, thereby enhancing data security and immutability. In addition to these advantages, the research also emphasizes the importance of controlling pest attacks to enhance crop production in the field, ultimately contributing to the country’s economic growth. Simulation results affirm that the proposed approach leads to notable cost reductions, decreased energy consumption, improved crop production, precise crop monitoring to prevent pest attacks, and a prolonged network lifespan. These outcomes underscore the effectiveness of this approach within the context of smart agriculture and its role in enhancing the monitoring system for smart agriculture and bolstering security through Blockchain technology.

With the emergence of intelligent services and applications powered by artificial intelligence (AI), the Internet of Things (IoT) affects many aspects of our daily lives. Traditional approaches to machine learning (ML) relied on centralized data collection and processing, where data was collected and analyzed in one place. However, with the development of Deep Federated Learning (DFL), models can now be trained on decentralized data, reducing the need for centralized data storage and processing. In this work, we provide a detailed analysis of DFL and its benefits, followed by an extensive survey of the use of DFL in various IoT services and applications. We have studied the impact of DFL and how to preserve security and privacy by ensuring compliance in machine learning-enabled IoT systems. In addition, we present a generic architecture for a GDPR-compliant DFL-based framework. Finally, we discuss the existing obstacles and possible future research directions for DFL in IoT.

Abstract Background Photosystem II (PSII) constitutes an intricate assembly of protein pigments, featuring extrinsic and intrinsic polypeptides within the photosynthetic membrane. The low-molecular-weight transmembrane protein PsbX has been identified in PSII, which is associated with the oxygen-evolving complex. The expression of PsbX gene protein is regulated by light. PsbX's central role involves the regulation of PSII, facilitating the binding of quinone molecules to the Qb (PsbA) site, and it additionally plays a crucial role in optimizing the efficiency of photosynthesis. Despite these insights, a comprehensive understanding of the PsbX gene's functions has remained elusive. Results In this study, we identified ten PsbX genes in Gossypium hirsutum L. The phylogenetic analysis results showed that 40 genes from nine species were classified into one clade. The resulting sequence logos exhibited substantial conservation across the N and C terminals at multiple sites among all Gossypium species. Furthermore, the orthologous/paralogous, Ka/Ks ratio revealed that cotton PsbX genes subjected to positive as well as purifying selection pressure might lead to limited divergence, which resulted in the whole genome and segmental duplication. The expression patterns of GhPsbX genes exhibited variations across specific tissues, as indicated by the analysis. Moreover, the expression of GhPsbX genes could potentially be regulated in response to salt, intense light, and drought stresses. Therefore, GhPsbX genes may play a significant role in the modulation of photosynthesis under adverse abiotic conditions. Conclusion We examined the structure and function of PsbX gene family very first by using comparative genomics and systems biology approaches in cotton. It seems that PsbX gene family plays a vital role during the growth and development of cotton under stress conditions. Collectively, the results of this study provide basic information to unveil the molecular and physiological function of PsbX genes of cotton plants.

Abstract Background A penile fracture occurs when the tunica albuginea of penis tears during erection. Penile fracture is a rare but serious injury that occurs when the erect penis sustains a traumatic force. It is characterized by a sudden snapping or popping sound, followed by immediate pain, swelling, and discoloration. Its association with concomitant urethral injury is very rare. This case study describes such a rare case. Case presentation In this case study, we present the case of a 47-year-old man who experienced sudden pain and lost erection with a popping sound while having sexual intercourse. There was bloody discharge from the urethral opening and showed the distinct sign of an "Eggplant Deformity." This result confirmed the diagnosis. Immediate surgical intervention revealed damage to the left corpora and urethra. The procedure involved repairing the tunica albuginea covering the corpora tissue and reconstructing the damaged urethra. The surgery went smoothly without complications. The patient reported satisfactory erectile function and normal urination on follow-up visit after 2 months. Conclusion Penile fracture with urethral injury is a rare but serious emergency. Prompt detection and surgical intervention are crucial for optimal outcomes and minimal complications. Depending on severity, either catheterization or repair may be necessary.

Background The New Zealand (NZ) Pae Ora (Healthy Futures) health reforms came into effect in July 2022 with the establishment of Health New Zealand (HNZ) (Te Whatu Ora) and the Māori Health Authority (MHA) (Te Aka Whai Ora) – the organisations charged for healthcare provision and delivery. Given these changes represent major health system reform, we aimed to conduct an early evaluation of the design of the reforms to determine if they can deliver a viable and sustainable NZ health system going forward. Methods The evaluation was informed by Beer’s viable system model (VSM). A qualitative exploratory design with semi-structured interviews and documents analysis using thematic analysis was used. We conducted 28 interviews with senior healthcare managers and reviewed over 300 official documents and news analyses. Results The VSM posits that for a system to be viable, all its five sub-systems (operations; co-ordination; operational control; development and governance) need to be strong. Our analysis suggests that the health reforms, despite their strengths, do not satisfy this requirement. The reforms do appreciate the complexity of the healthcare environment: multiple stakeholders, social inequalities, interdependencies. However, our analysis suggests a severe lack of detail regarding the implementation and operationalisation of the reforms. Furthermore, resourcing and coordination within the reformed system is also unclear. Conclusion The health system reforms may not lead to a viable future NZ health system. Poor communication of the reform implementation and operationalisation will likely result in system failure and inhibit the ability of frontline health organisations to deliver care.

Background The increasing prevalence of diabetic ketoacidosis (DKA) related admissions poses a significant burden on the healthcare systems globally. However, data regarding the predictors of healthcare resource utilization in DKA is limited and inconsistent. This study aimed to identify key predictors of hospital length of stay (LOS), readmission and recurrent DKA episodes.Methods We undertook a retrospective cross-sectional analysis of all DKA admissions from 2015 to 2021 across four hospitals in Qatar. The primary outcomes were the length of stay (LOS), 90-day readmission and 6-month and 1-year DKA recurrence.Results We included 922 patients with a median age of 35 years (25–45). 62% were males with type-1 diabetes-mellitus (T1DM) and type-2 DM (T2DM), present in 52% and 48% of patients. The median LOS was 2.6 days (IQR 1.1–4.8), and the median DKA resolution time was 18 h (10.5–29). Male-gender, new-onset DM, higher Charlson Comorbidity Index (CCI), lower haemoglobin, sodium and potassium, higher urea, longer DKA duration and MICU admission predicted a longer LOS in a multivariate regression analysis. None of the factors were significantly associated with 90-day readmission. Patients with pre-existing T1DM were more likely to have a six-month DKA recurrence than pre-existing T2DM. Patients with a 6-month DKA recurrence, female gender and T1DM had higher odds of 12-month recurrence, whereas a consult with a diabetes educator at the index admission was associated with decreased odds of recurrence.Conclusions/interpretation This is the most extensive study from the Middle-East region reporting on LOS, readmissions and the recurrence of DKA. Results from this study with a diverse population may be valuable for physicians and healthcare systems to decrease the diabetes-related healthcare burden in DKA patients.

In our current study, we apply differential subordination and quantum calculus to introduce and investigate a new class of analytic functions associated with the q-differential operator and the symmetric balloon-shaped domain. We obtain sharp results concerning the Maclaurin coefficients the second and third-order Hankel determinants, the Zalcman conjecture, and its generalized conjecture for this newly defined class of q-starlike functions with respect to symmetric points.