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Objective: To determine the co-relation between perceived social support and stress among nursing staff working in a COVID-19 dedicated hospital setup. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Mental Health (AFIMH), Rawalpindi from 30 Aug 2020 to 02 March 2021. Materials and Methods: We consecutively sampled 128 subjects. All participants were requested to complete a brief demographic sheet, Urdu version of the Depression, Anxiety and Stress Scale 21 (DASS-21) to assess the level of severity of stress among nursing staff and the Urdu version of the Multidimensional Scale of Perceived Social Support (MSPSS). Data analysis was done using SPSS version 23.0. Results: The mean duration of stay of nursing staff in ward was 4.86 ± 2.28 weeks. Sixty-two (48.44%) nurses had duration of 2 to 4 weeks while 66 (51.56%) nurses had duration of more than 4 weeks of stay in the ward. The mean total stress score was 6.86 ± 5.80. The mean multidimensional scale of perceived social support (MSPSS) score was 47.29 ± 22.53. There was significant negative correlation between MSPSS score and stress score (r= -0.396, p-value < 0.05). Conclusion: Results of this study highlighted that a significant negative co-relation is present between perceived social support and stress among nursing staff working in a COVID-19 dedicated hospital setup.

Objective: To determine the sensitivity of axillary ultrasound in detecting axillary nodal metastasis in clinically and radiologically uninvolved axillary nodes in early carcinoma breast by comparing with sentinel node biopsy histopathology on frozen section. Study Design: Comparative cross-sectional study Place and Duration of Study: Breast Clinic, CMH, Rawalpindi Pakistan, from Aug 2020 to May 2021. Methodology: Patients included in the study presented with breast cancer lesions with clinically impalpable axillary lymph nodes aged 18-75. Patients with clinically impalpable nodes underwent an ultrasound of the axilla; if suspicious nodes were found, the patient had subsequent axillary node dissection. Sentinel node biopsy (SLNB) was performed on axillary ultrasound in all patients with no suspicious or benign-looking nodes. Histopathological reporting was taken as standard. Lymph nodal status on axillary ultrasound, SLN biopsy and axillary lymph node clearance were documented and analyzed. Results: Twenty-nine patients were included who had benign-looking lymph nodes on axillary ultrasound and underwent sentinel lymph node biopsy. The mean age of the patients was 54.03 ± 7.94. Out of 29 patients, 24(82.8%) patients had negative Sentinel lymph node biopsy, and 5(17.2%) had positive Sentinel lymph node biopsy, who then underwent axillary lymph node dissection. Conclusion: Sentinel lymph node biopsy is the gold standard to determine axillary lymph nodes involved in early carcinoma breast, which seem benign on pre-operative axillary ultrasound.

Background and Objective: Severe asthma is a heterogeneous disease with subtype classification according to dominant airway infiltrates, including eosinophilic (Type 2 high), or non‐eosinophilic asthma. Non‐eosinophilic asthma is further divided into paucigranulocytic or neutrophilic asthma characterized by elevated neutrophils, and mixed Type 1 and Type 17 cytokines in the airways. Severe non‐eosinophilic asthma has few effective treatments and many patients do not qualify for biologic therapies. The cystic fibrosis transmembrane conductance regulator (CFTR) is dysregulated in multiple respiratory diseases including cystic fibrosis and chronic obstructive pulmonary disease and has proven a valuable therapeutic target. We hypothesized that the CFTR may also play a role in non‐eosinophilic asthma. Methods: Patient‐derived human bronchial epithelial cells (hBECs) were isolated and differentiated at the air‐liquid interface. Single cell RNA‐sequencing (scRNAseq) was used to identify epithelial cell subtypes and transcriptional activity. Ion transport was investigated with Ussing chambers and immunofluorescent quantification of ionocyte abundance in human airway epithelial cells and murine models of asthma. Results: We identified that hBECs from patients with non‐eosinophilic asthma had reduced CFTR function, and did not differentiate into CFTR‐expressing ionocytes compared to those from eosinophilic asthma or healthy donors. Similarly, ionocytes were also diminished in the airways of a murine model of neutrophilic‐dominant but not eosinophilic asthma. Treatment of hBECs from healthy donors with a neutrophilic asthma‐like inflammatory cytokine mixture led to a reduction in ionocytes. Conclusion: Inflammation‐induced loss of CFTR‐expressing ionocytes in airway cells from non‐eosinophilic asthma may represent a key feature of disease pathogenesis and a novel drug target. [ABSTRACT FROM AUTHOR]

Appendicular central osteosarcoma (OSA) is a common and highly aggressive tumour in dogs. Metastatic disease to the lungs is common and even with chemotherapy the prognosis is generally poor. However, few cases survive well beyond reported median survival times. Current methods, including histologic grading schemes, have fallen short in their ability to predict clinical outcome. MicroRNAs (miRNAs) are small molecules present in all tissues and bodily fluids and are dysregulated in cancer. Previous studies have demonstrated the diagnostic and prognostic potential of miRNAs in canine OSA. We sought to investigate multiple miRNA and multiple variable models for diagnosis and prognosis of canine OSA using plasma samples across three populations of dogs from two veterinary biobanks. Fifty-six miRNAs were analyzed by real-time quantitative polymerase chain reaction. MiR-214-3p was the only miRNA with increased expression across all OSA populations compared to controls. Using a decision tree model for diagnosis, miR-214-3p was the first step in this multi-miRNA model. High expression of miR-214-3p alone was also a predictor of shorter overall survival and disease-free interval across all populations. In both multiple miRNA and multiple variable models, miR-214-3p was always the first decision point with high expression consistently predicting a worse prognosis. Additional miRNAs in combination with low expression of miR-214-3p similarly had a worse prognosis demonstrating better outcome prediction using multiple miRNAs compared to using miR-214-3p alone. Multiple variable models only need to use miRNAs to be predictive although clinical parameters such as age, sex, and tumour location were considered. MiR-214-3p is clearly an important prognostic predictor of canine OSA in plasma as supported by previous studies and across our multiple sample populations. Multiple miRNA models provided superior categorization of patients in predicting clinical outcome parameters compared to the single miRNAs. [ABSTRACT FROM AUTHOR]

Introduction: Appropriate perinatal care provision and utilization is crucial to improve maternal and newborn survival and potentially meet Sustainable Development Goal 3. Ensuring availability of healthcare infrastructure as well as skilled personnel can potentially help improve maternal and neonatal outcomes globally as well as in resource-limited settings. Methods: A systematic review on effectiveness of perinatal care regionalization was updated, and a new review on facility-based interventions to improve postnatal care coverage and outcomes was conducted. The interventions were identified through literature reviews and included transport, mHealth, telemedicine, maternal education, capacity building, and incentive packages. Search was conducted in relevant databases and meta-analysis conducted on Review Manager 5.4. We conducted subgroup analysis for evidence from low- and middle-income countries (LMICs). Results: Implementation of regionalization programs significantly decreased maternal mortality in LMICs (OR: 0.43; 95% CI: 0.34–0.55, 2 studies), stillbirth overall (OR: 0.70; 95% CI: 0.54–0.89, 5 studies), perinatal mortality overall (OR: 0.54; 95% CI: 0.5–0.58, 2 studies), and LMICs (OR: 0.54; 95% CI: 0.50–0.58, 1 study). Transport-related interventions significantly decreased maternal mortality overall (OR: 0.55; 95% CI: 0.40–0.74, 1 study), neonatal mortality (RR: 0.76; 95% CI: 0.66–0.88, 1 study), perinatal mortality (RR: 0.86; 95% CI: 0.77–0.95, 1 study), and improved postnatal care coverage (OR: 6.89; 95% CI: 5.15–9.21, 1 study) in LMICs. Adding maternity homes/units significantly decreased stillbirth (OR: 0.75; 95% CI: 0.61–0.93, 1 study) in LMICs. Incentives for postnatal care significantly improved infant mortality (RR: 0.79; 95% CI: 0.65–0.96, 1 study), stillbirth (OR: 0.60; 95% CI: 0.44–0.83, 1 study), and postnatal care coverage (RR: 1.13; 95% CI: 1.03–1.25, 1 study) in LMICs. Telemedicine improved postnatal care coverage significantly in LMICs (RR: 2.54; 95% CI: 1.22–5.28, 3 studies) and decreased maternal mortality (OR: 0.46; 95% CI: 0.21–0.98, 1 study) and infant mortality (OR: 0.65; 95% CI: 0.45–0.95) in LMICs. Maternal education significantly decreased neonatal mortality (RR: 0.75; 95% CI: 0.66–0.84, 2 studies), perinatal mortality (RR: 0.86; 95% CI: 0.77–0.95, 1 study), infant mortality (RR: 0.79; 95% CI: 0.65–0.96, 1 study), and stillbirth (RR: 0.61; 95% CI: 0.45–0.82, 1 study). Capacity-building interventions significantly decreased maternal mortality in LMICs (OR: 0.37; 95% CI: 0.29–0.46, 5 studies), neonatal mortality overall (OR: 0.72; 95% CI: 0.53–0.98, 4 studies) and in LMICs (OR: 0.63; 95% CI: 0.54–0.74, 3 studies, and RR: 0.61; 95% CI: 0.48–0.79, 3 studies), perinatal mortality (OR: 0.53; 95% CI: 0.45–0.62, 2 studies, and RR: 0.86; 95% CI: 0.77–0.95, 1 study), infant mortality (OR: 0.50; 95% CI: 0.43–0.59, 1 study, and RR: 0.79; 95% CI: 0.65–0.96, 1 study), under-5 mortality (RR: 0.79; 95% CI: 0.66–0.94, 1 study), and stillbirth in LMICs (OR: 0.71; 95% CI: 0.62–0.82, 4 studies), and preterm birth overall (OR: 0.39; 95% CI: 0.19–0.81, 1 study). Conclusion: Perinatal regionalization and facility-based interventions have a positive impact on maternal and neonatal outcomes and calls for implementation in high burden settings but a better understanding of optimal interventions is needed through comprehensive trials in diverse settings. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the correlation between authentic leadership and career competence, exploring the mediating roles of tacit knowledge sharing and employee service innovative behavior. Design/methodology/approach: Data were collected using convenience sampling and a time-lagged design from the Pakistani banking sector. The time-lagged design was employed to gather data at two different points in time. SPSS statistical software was used for descriptive analysis, and hypotheses were tested using Mplus. Findings: The results demonstrate that authentic leadership has a significant positive impact on tacit knowledge sharing. This knowledge sharing, in turn, positively impacts employee service innovative behavior, which subsequently enhances career competence. Furthermore, tacit knowledge sharing mediates the relationship between authentic leadership and employee service innovative behavior. Social implications: This study has social implications for organizations aiming to align their inclusive goals with societal needs. The findings can help foster a culture of knowledge sharing, thereby contributing to societal innovation. Originality/value: This study provides valuable insights into how authentic leadership contributes to career competence, thus enriching the existing literature on this topic. [ABSTRACT FROM AUTHOR]

Background: Maternal nutrition is critically important for the well-being of both the mother and the developing fetus. Multiple micronutrient (MMN) supplements have the added advantage of addressing nutritional deficiencies. This study aimed to review the effects of MMN supplementation trials to prevent maternal and fetal complications from the preconception period to the post-natal phase by incorporating adequate micronutrients into the daily diet. Methodology: A comprehensive review of online literature was conducted following PRISMA guidelines. Three databases--PubMed, ScienceDirect, and Google Scholar--were searched for clinical trials from 2019 to 2023. MeSH terms such as "maternal," "micronutrient supplementation," "Pakistan," "trials," "clinical trials," and "micro-element supplementation" were used with Boolean operators "AND" and "OR." Titles and abstracts of the articles were screened initially, followed by full-text reviews in the second round. A total of seven articles meeting the inclusion criteria and diagnostic accuracy (STARD) were selected. Results: Risk of bias and quality assessment of clinical trials were evaluated using a 23-item questionnaire, with scores ranging from 0 to 2. Conclusion: Nutritional supplements were found to be most effective when taken daily for three months before conception and continued throughout the first trimester of pregnancy. [ABSTRACT FROM AUTHOR]

The use of plant protection products (PPPs) has become fundamental to guarantee excellent field productivity. Nevertheless, their usage presents critical issues, such as the quantity of substances used, the relative toxicity, and the contamination of nearby fields caused by atmospheric drift. This study focuses on the characterization of aerosol droplets of PPPs produced by spraying a chemical marker, fluorescein, with an orchard airblast sprayer equipped with conventional hollow cone (HC) and anti-drift air inclusion (AI) nozzles, using a wind tunnel as a controlled environment. A particle/droplet image analysis was employed to study the droplet production of the nozzles, while a liquid chromatography tandem mass spectrometry (HPLC-MS/MS) analysis allowed us to evaluate samples collected using a cascade impactor located at 5 m, 10 m, and 20 m from the emission point. Overall, HC nozzles are very accurate at producing specific drop size distributions (DSDs), while AI nozzles produce a much wider DSD, concentrating the largest part of the distributed volume into droplets of a larger size. The marker concentration was much lower for the AI nozzles compared to the HC nozzles; moreover, the two nozzles show a similar trend in the coarse droplet range, while significantly differing in the fine droplet spectrum. [ABSTRACT FROM AUTHOR]