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The soil underneath any type of structure e.g. Building, road, highways etc. should be able to resist loadings, if not so it is subjected to failure. Usually the soil at the site is not ideal from viewpoint of engineering. An approach to this problem, is to improve the soils or to adopt soil stabilization. Various methods of soil stabilization have been developed and in practice across the world. In this research an attempt was made to use the agricultural waste to improve the soil stability, as in Punjab agricultural waste is available in excess. In Punjab, major crops are wheat and rice. So wheat straw is available in excess in Punjab. In Punjab, mostly we have clayey soil. We select the representative samples from different areas of Punjab namely Kasur, Lahore and Sheikhupura and performed certain tests on these samples. The wheat straw totally failed in enhancing compaction, but compressive stress increased up to some extent. So it can be utilized in slopes of embankments of highways, railways etc. but can’t be used in construction of structures. So it is recommended that the future students should very fine wheat straw to make the project better and having a more in depth analysis.

This study aims to identify a correlation between government initiatives and entrepreneurial perception using Global Entrepreneurship Monitor data. It uses the parameters of perceived opportunity, perceived capability, and entrepreneurial intention to correlate them with different government initiatives such as supportive and relevant policies, taxes related policies, government entrepreneurship programs, commercial and legal infrastructure, physical infrastructure and entrepreneurial education at the post-school stage. This multi-level framework is tested using canonical correlation analysis. Results validate our proposed conceptual framework by highlighting that government initiatives are significantly related to perception about opportunities, capabilities, and intention about entrepreneurship. The perception of capabilities and self-efficacy were the most important factors in gauging citizen’s perception about entrepreneurship. Similarly, government policies regarding taxes and bureaucracy, entrepreneurial education at the post-school stage, and physical infrastructure were the most important government interventions in shaping entrepreneurial perceptions among its citizens.

Background: Pakistan has experienced a significant reduction in maternal mortality with a decline of 33 percent between 2006 and 2019. However, the country still grapples with a high number (186 per 100,000 live births) of maternal deaths each year. This study aims to identify socio-demographic and health system related factors associated with maternal mortality. Methods: Using the nested case-control design, we conducted an in-depth analysis of Pakistan Maternal Mortality Survey (PMMS) 2019. We identified 147 maternal deaths occurring within three years prior to the PMMS 2019 as "cases" and 724 women who gave birth and were alive during the same period as "controls". Socio-demographic characteristics of cases and controls were compared, and multivariate regression was employed to investigate the predictors of maternal mortality in Pakistan. Results: Cases and controls were similar on access to antenatal care (ANC) and ANC provider but differed on age, education, number of pregnancies, type of delivery, tetanus toxoid vaccination during last pregnancy, and contraceptive usage. A higher proportion of cases had deliveries by skilled birth attendants (83% compared to 63% among controls) while home deliveries were more common among controls (32% compared to 25% among cases). Odds of maternal death were lowest among women aged 20–29 years (odds ratio–OR: 0.5; 95% CI 0.23–1.07) and those with secondary or higher education (OR: 0.35; 95% CI 0.17–0.74). Surprisingly, deliveries attended by skilled birth attendants were associated with higher odds of maternal death (OR: 4.07; 95% CI 2.19–7.57) compared to those who were not. Conclusion: This study identifies secondary or higher maternal education, having had tetanus injection during the last pregnancy, ever-used contraception or being in the age group of 20–29 years were factors associated with lower risk of maternal mortality. Conversely, skilled birth attendance increases the risk of maternal death in Pakistan. Further investigation is needed into the determinants of high maternal mortality. [ABSTRACT FROM AUTHOR]

The use of sustainable natural fibers as reinforcement in polylactic acid (PLA) composites offers a promising approach to developing environmentally friendly and renewable composite materials. This research article explores the impact of weave designs on various mechanical properties of fiber‐reinforced polymeric composite (FRPC) laminates. Four different weave designs, including 1/1 plain, 2/2 matt, 4/1 satin, and 3/1 twill, were developed using flax yarn obtained from the Linum usitatissimum plant. These weave designs were incorporated into composites by wrapping the flax yarn with PLA filament as the matrix, followed by compression molding. The study examines the static and dynamic mechanical properties of the subsequent flax/PLA composites, including flexural strength, Charpy strength, tensile strength, and viscoelastic characteristics like damping factor, loss, and storage modulus. The plain 1/1–reinforced composite exhibits superior tensile strength (12 MPa), tensile modulus (9800 MPa), and flexural properties (29 MPa) due to the higher number of intersection points in the weave design, while in the case of impact strength (6.7 kJ/m2), satin structure‐reinforced composite showed superior properties due to higher float length of warp yarns and lower intersection points in the weave structure. [ABSTRACT FROM AUTHOR]

Objective: Laparoscopic repair of vesicovaginal fistula (VVF) is gaining popularity day by day, but we have limited literature on it. This study is to evaluate the safety, feasibility, and outcomes of laparoscopic VVF repair in a tertiary care center in Eastern India. Subjects and Methods: This study is a single-center retrospective study in which 11 patients of supratrigonal VVF were evaluated who underwent laparoscopic repair. Preoperative workup included history, examination, computed tomography urography, cystoscopy, and vaginoscopy. After informed consent, laparoscopic VVF repair was done under general anesthesia. Duration of surgery, the need for conversion to open procedure, intraoperative bowel injury, the need for postoperative blood transfusion, postoperative hospital stay, postoperative urinary leak, and any incontinence after catheter removal were noted. Results: All the patients had primary supratrigonal fistula of approximate size in the range of 1.5–2.0 cm. All the included patients were operated on successfully by laparoscopic technique with a mean duration of surgery of 177.91 ± 6.14 min. The mean duration of postoperative hospital stay was 4.45 ± 0.52 days. There was no incidence of postoperative urine leak in any patient. After urethral catheter removal, all the patients voided well without any incontinence. Conclusions: Laparoscopic VVF repair is a safe and feasible option with satisfactory intraoperative and postoperative outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to evaluate the role of multiparametric magnetic resonance imaging (mpMRI) as a triage workup in the diagnostic pathway of suspected prostate cancer (PCa) in our population. Material and methods: This prospective observational study was conducted at lesser than details of site are removed for blinded peer review > on biopsy-naive patients from May 2021 to December 2022. We included patients aged 40 to 80 years with clinical suspicion of PCa, prostate-specific antigen (PSA) level >4 ng/mL, abnormal digital rectal examination (DRE), or all the above. All patients first underwent 1.5-T mpMRI and transrectal ultrasound-guided biopsy using the cognitive biopsy technique. Results: A total of 95 patients were included, with the majority of them (64.21%) being ≥66 years old. Of these, 69 patients had abnormal DRE findings, 89 had PSA ≥4 ng/mL, and 64 had both elevated PSA and abnormal DRE findings. PCa was detected in 6.25%, 54.84%, 71.43%, and 96.43% of patients with lesions of Prostate Image Reporting and Data System scores of 2, 3, 4, and 5, respectively. Using Prostate Image Reporting and Data System score of 3 as a biopsy threshold resulted in high sensitivity (98.31%) and low specificity (41.67%) for PCa detection. The proportion of Gleason score of ≥7 cancer-detected cores in the magnetic resonance imaging-guided cognitive biopsy was significantly higher than that in the standard 12-core biopsy (86.54% versus 61.45%; P < 0.001). Conclusion: The incorporation of prebiopsy mpMRI could be used as a diagnostic pathway for suspected PCa before transrectal ultrasound-guided biopsy. [ABSTRACT FROM AUTHOR]

HIV-associated mortality has improved with the advent of antiretroviral therapy, yet neurocognitive decline persists. We assessed the association between psychosocial risk factors and cognitive function among Malaysian PLWH. Data of virally suppressed PLWH (n = 331) on stable ART, from the Malaysian HIV and Aging study was assessed. Psychosocial factors were assessed using the Lubben Social Network Scale-6 (social isolation) and Depression Anxiety Stress Scale-21 (DASS-21). The Montreal Cognitive Assessment (MoCA) with normative standards for the Malaysian population was used to determine cognitive function. Linear and logistic regression were used to assess the associations between cognition, and psychosocial risk factors. Median age of participants was 43.8 years (IQR 37.7–51.0). Participants were predominantly male (82.8%), with secondary education or higher (85.2%). Participants were on ART for 5.7 years (IQR 3.0–9.7), with a mean MoCA score of 24.6 (±3.7). Social isolation was found in 34.6% of participants, and severe depression, severe stress, and severe anxiety in 10.6%, 15.4%, and 6.0% respectively. After adjusting for demographic, clinical, and HIV parameters, MoCA scores were significantly associated with severe stress (β = −0.11, p = 0.02) and having marginal friendship ties (β = −0.13, p = 0.03). Social isolation and severe stress are associated with neurocognitive impairment in PLWH. [ABSTRACT FROM AUTHOR]

Goat management in rural areas is still commonly done traditionally with little regard for health factors. One factor is the presence of parasitic worms in the goat's digestive tract which causes disturbed growth. The research aims to evaluate the effect of the addition of turmeric and multinutrient block plus (MNBP) in eliminating endoparasites and increasing feed intake of Jawarandu goats. The material used was 12 male Jawarandu goats weighing an average of 20 kg. A completely randomized design was used in this study with 4 treatments and 3 replications. Treatment T0: basal ration + MNBP; T1: T0 + 1% turmeric; T2: T0 + 3% turmeric; T3: T0 + 5% turmeric. The parameters observed were feed intake, weight gain, number of endoparasites and total eggs per gram of feces. Data analysis using analysis of variance significance level of 5% to determine the effect of treatment. If there is a treatment effect, it is followed by Duncan's multiple range test. The results showed a decrease in the number of endoparasites. The best treatment to induce an antibody system is T2 treatment, namely the addition of turmeric with a level of 3%. Feed intake was not significantly increasing although improving body weight gain in T2 and T3. The conclusion of the study is that the administration of MNBP and turmeric with a level of 5% has not been able to eliminate all endoparasites until the 28th day. MNBP and turmeric are useful as natural antioxidants. Increased level of turmeric can increase weight gain and immune system of goats. Keyword: Multinutrient blocks, turmeric, Jawarandu goats, endoparasite, feed intake

Keywords: ageing; HIV; PWH; WHO model of healthy ageing; interventions; life course, 1 | INTRODUCTION At the end of 2019, there were an estimated 38 million people living with HIV (PLWH) globally and approximately 7.5 million were 50 years and older [1]. [...]

Background: The Zindagi Mehfooz (safe life; ZM) electronic immunization registry (EIR) is a comprehensive suite of digital health interventions that aims to improve equitable access, timeliness, and coverage of child immunizations through a smartphone-based app for vaccinators, web-based dashboards for supervisors and managers, text message alerts and reminders for caregivers, and a call center. It has been implemented at scale in Sindh Province, Pakistan. Objective: This study aimed to present findings from an evaluation of the ZM-EIR suite of digital health interventions in order to improve data availability and use as a contribution, among other immunization program interventions, to enhanced immunization outcomes for children aged 12-23 months in Sindh Province. Methods: The mixed methods study included (1) analysis of ZM-EIR system data to identify high-, moderate-, and low-adoption and compliance sites; (2) in-depth interviews with caregivers, vaccinators, supervisors, and managers in the Expanded Program for Immunization (EPI); and (3) pre-post outcome evaluation using vaccine coverage from the Multiple Indicator Cluster Surveys (MICS) 2014 and 2018-2019. Key outcomes of interest were improved data availability, use and contribution to immunization outcomes, including receipt of individual antigens (Bacillus Calmette-Guérin [BCG], pentavalent [Penta] 1-3, measles), full immunization (all antigens), and zero-dose children defined as children aged 6-23 months who have not received the first dosage of the diphtheria-pertussis-tetanus 1/Penta vaccine. Results: By registering newborns, providing alerts and reminders, and tracking their immunization completion, the ZM-EIR improved data availability and use in the EPI. The ZM-EIR was well received by EPI administrators, supervisors, vaccinators, and caregivers. The key benefit highlighted by ZM-EIR users was a list of children who missed scheduled vaccines (defaulters). Through greater availability and use of data, the ZM-EIR implementation, as part of a broader package of immunization program–strengthening activities in Sindh Province, may have contributed to an increase in immunization coverage and timeliness for BCG vaccinations and a decrease in zero-dose children in 2018-2019 from 2014. Additional findings from the study included the dual burden of reporting on paper and gender-related considerations of female caregivers not wanting to provide their phone numbers to male vaccinators, creating barriers to greater uptake of the ZM-EIR. Conclusions: The ZM-EIR is a promising technology platform that has increased the availability and use of immunization data, which may have contributed, along with other intensive immunization program interventions, to improvements in immunization outcomes through systematic registration of children, alerts and reminders, and increased use of data for planning and monitoring by the EPI. Trial Registration: ISRCTN Registry ISRCTN23078223; https://doi.org/10.1186/ISRCTN23078223 [ABSTRACT FROM AUTHOR]

Background: Double-J (DJ) stents have become an essential tool in the field of urology. Forgotten DJ stents are associated with significant morbidity and mortality, if not intervened timely. Aims and Objectives: In this study, we report our experience of forgotten stents related complications, along with its management and steps taken by us in preventing stent-related morbidity. Materials and Methods: We retrospectively analyzed the records of patients presented to the Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna with forgotten or long-term retention of DJ stents from January 2021 to December 2022. All cases were reviewed for age, gender, symptoms, indication of stent insertion, duration of stent insertion, radiological images, and procedures performed for management. Results: The mean age of the patients was 49.23 years. The mean duration of the indwelling stent in situ was 16.61 months. Presenting complaint was flank pain, recurrent urinary tract infection, dysuria, hematuria, and irritative lower urinary tract symptoms. Common indications of indwelling stents were ureteroscopic lithotripsy, percutaneous nephrolithotomy, and Laparoscopic pyeloplasty. Cystoscopy, ureteroscopy, cystolithotripsy, percutaneous nephrolithotomy, and open surgery were done to extract the forgotten DJ stent. Conclusion: Forgotten DJ stents are a source of severe morbidity. Patients and relatives counseling before and after the procedure is necessary in reducing stent-related complications. [ABSTRACT FROM AUTHOR]