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Abstract Introduction Point-of-care ultrasound (POCUS) can assist rheumatologists in monitoring disease activity, establishing diagnoses, and guiding procedural interventions. POCUS use has been increasing, but little is known about current use and barriers among rheumatologists. The purpose of this study was to characterize current POCUS use, training needs, and barriers to use among rheumatologists in practice. Methods A prospective observational study of all Veterans Affairs (VA) medical centers was conducted using a web-based survey sent to all chiefs of staff and rheumatology chiefs about current POCUS use, training needs, barriers, and policies. Results All chiefs of staff (n = 130) and rheumatology chiefs at VA medical centers (n = 95) were surveyed with 100% and 84% response rates, respectively. The most common diagnostic POCUS applications were evaluation of synovitis, joint effusion, tendinopathies, bursitis, and rotator cuff. The most common procedural applications were arthrocentesis and joint, bursa, and tendon injection. Most rheumatology chiefs (69%) expressed interest in training for their group. The most common barriers to POCUS use were lack of trained providers (68%), funding for training (54%), training opportunities (38%), funding for travel (38%), and ultrasound equipment (31%). Lack of POCUS infrastructure was common, and few facilities had POCUS policies (20%), image archiving (25%), or quality assurance processes (6%). Conclusion Currently, half of rheumatology groups use diagnostic and procedural ultrasound applications. Most rheumatology groups desire training, and lack of training and equipment were the most common barriers to ultrasound use. Deliberate investment is needed in ultrasound training and infrastructure for systematic adoption of POCUS in rheumatology. Graphical Abstract available for this article. Trial Registration NCT03296280. Graphical Abstract

Abstract Background Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers’ purchase intention of CAMs. Methods This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model. Results This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers’ preferences to purchase CAMs by taking into consideration SMIs’ endorsements. Conclusions This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI’s on the use of CAMs, as well as to regulate the content of these promotional materials.

Background and Objectives: Elevated levels of pro-inflammatory cytokines have been linked to increased mortality in COVID-19 patients. Infliximab, a tumor necrosis factor inhibitor, has been reported to improve outcomes in COVID-19 patients by targeting the hyperinflammatory response. Our objective was to evaluate the effectiveness of incorporating Infliximab into standard care guidelines for the management of COVID-19. Materials and Methods: A retrospective analysis was conducted on 111 participants who were moderate to severe COVID-19 patients admitted to the hospital. Among them, 74 individuals received solely standard treatment, while 37 received standard therapy plus Infliximab. The primary outcomes of the study centered around the changes in laboratory test parameters. The secondary clinical findings included clinical recovery defined as improvement in patient oxygenation, time till recovery, and assessing necessity for ICU admission, and mortality rates. Results: There was no statistical difference observed in the inflammatory markers including, LDH, Ferritin, CRP, neutrophil to lymphocyte ratio (NLR), and P/F ratio between both groups and in the clinical outcomes including clinical recovery (p = 1.0), time to improvement (p = 0.436), and mortality rate (p = 0.601). However, there was a significant increase in secondary infection (45.9%, 20.3%; p = 0.005), and in liver enzymes, ALT (79.5, 50.0 IU/L; p = 0.02) and AST (57.5, 38.0 IU/L; p = 0.019) in the Infliximab group and the standard care group, respectively. Conclusions: Infliximab therapy did not demonstrate significant benefits compared to standard of care in moderate to severe hospitalized COVID-19 patients.

Since the beginning of the COVID-19 pandemic various studies have reported that healthcare workers (HCWs) are not only at risk of exposure but also experiencing psychological distress. However, less is known about the mental health outcome of HCWs after their clinical recovery from COVID-19 infection. This study addresses a critical gap in our understanding by focusing on the mental health outcomes of HCWs in Pakistan after their clinical recovery from COVID-19 infection and the resumption of their duties. This cross-sectional, study was conducted among 272 HCWs who had recovered COVID-19 infection. The symptoms of depression were assessed by Patient Health Questionnaire-9. Multivariable logistic regression was performed to identify factors associated with depression. The findings revealed a depression prevalence of 33.82% among the HCWs in the study. Factors such as being female, middle-aged, having lower income, and working in COVID-19 wards increased the risk of depression. Moreover, those who perceived less social support from coworkers and supervisors and experienced an increased workload after resuming duties showed higher depression rates. In conclusion, the study emphasizes that clinical recovery from COVID-19 infection does not guarantee functional recovery for HCWs. To support their psychological well-being and resilience, it underscores the importance of enhanced social support in the workplace for who resume their duties after recovering from COVID-19 infection.

Abstract Background Antimicrobial resistance (AMR) is a global public health concern currently mitigated by antimicrobial stewardship (AMS). Pharmacists are strategically placed to lead AMS actions that contribute to responsible use of antimicrobials; however, this is undermined by an acknowledged health leadership skills deficit. Learning from the UK’s Chief Pharmaceutical Officer's Global Health (ChPOGH) Fellowship programme, the Commonwealth Pharmacists Association (CPA) is focused to develop a health leadership training program for pharmacists in eight sub-Saharan African countries. This study thus explores need-based leadership training needs for pharmacists to provide effective AMS and inform the CPA’s development of a focused leadership training programme, the ‘Commonwealth Partnerships in AMS, Health Leadership Programme’ (CwPAMS/LP). Methods A mixed methods approach was undertaken. Quantitative data were collected via a survey across 8 sub-Saharan African countries and descriptively analysed. Qualitative data were collected through 5 virtual focus group discussions, held between February and July 2021, involving stakeholder pharmacists from different sectors in the 8 countries and were analysed thematically. Data were triangulated to determine priority areas for the training programme. Results The quantitative phase produced 484 survey responses. Focus groups had 40 participants from the 8 countries. Data analysis revealed a clear need for a health leadership programme, with 61% of respondents finding previous leadership training programmes highly beneficial or beneficial. A proportion of survey participants (37%) and the focus groups highlighted poor access to leadership training opportunities in their countries. Clinical pharmacy (34%) and health leadership (31%) were ranked as the two highest priority areas for further training of pharmacists. Within these priority areas, strategic thinking (65%), clinical knowledge (57%), coaching and mentoring (51%), and project management (58%) were selected as the most important. Conclusions The study highlights the training needs of pharmacists and priority focus areas for health leadership to advance AMS within the African context. Context-specific identification of priority areas supports a needs-based approach to programme development, maximising African pharmacists’ contribution to AMS for improved and sustainable patient outcomes. This study recommends incorporating conflict management, behaviour change techniques, and advocacy, amongst others, as areas of focus to train pharmacist leaders to contribute to AMS effectively.

OBJECTIVES:. Studies evaluating telemedicine critical care (TCC) have shown mixed results. We prospectively evaluated the impact of TCC implementation on risk-adjusted mortality among patients stratified by pre-TCC performance. DESIGN:. Prospective, observational, before and after study. SETTING:. Three adult ICUs at an academic medical center. PATIENTS:. A total of 2,429 patients in the pre-TCC (January to June 2016) and 12,479 patients in the post-TCC (January 2017 to June 2019) periods. INTERVENTIONS:. TCC implementation which included an acuity-driven workflow targeting an identified “lower-performing” patient group, defined by ICU admission in an Acute Physiology and Chronic Health Evaluation diagnoses category with a pre-TCC standardized mortality ratio (SMR) of greater than 1.5. MEASUREMENTS AND MAIN RESULTS:. The primary outcome was risk-adjusted hospital mortality. Risk-adjusted hospital length of stay (HLOS) was also studied. The SMR for the overall ICU population was 0.83 pre-TCC and 0.75 post-TCC, with risk-adjusted mortalities of 10.7% and 9.5% (p = 0.09). In the identified lower-performing patient group, which accounted for 12.6% (n = 307) of pre-TCC and 13.3% (n = 1671) of post-TCC ICU patients, SMR decreased from 1.61 (95% CI, 1.21–2.01) pre-TCC to 1.03 (95% CI, 0.91–1.15) post-TCC, and risk-adjusted mortality decreased from 26.4% to 16.9% (p < 0.001). In the remaining (“higher-performing”) patient group, there was no change in pre- versus post-TCC SMR (0.70 [0.59–0.81] vs 0.69 [0.64–0.73]) or risk-adjusted mortality (8.5% vs 8.4%, p = 0.86). There were no pre- to post-TCC differences in standardized HLOS ratio or risk-adjusted HLOS in the overall cohort or either performance group. CONCLUSIONS:. In well-staffed and overall higher-performing ICUs in an academic medical center, Acute Physiology and Chronic Health Evaluation granularity allowed identification of a historically lower-performing patient group that experienced a striking TCC-associated reduction in SMR and risk-adjusted mortality. This study provides additional evidence for the relationship between pre-TCC performance and post-TCC improvement.

The proposed work addresses the modeling, control, energy management and operation of hybrid grid connected system with wind-PV-Battery Energy Storage System (BESS) integrated with Fuel Cell (FC) and Electrolyzer. A hybrid PV-Wind-FC with electrolyzer consisting of BESS with the least number of control loops and converters has been proposed. The proposed hybrid system presents a cost efficient solution for integrating PV into a hybrid system by eliminating the PV converter. This includes the design of controllers for grid-connected hybrid systems with a renewable distributed generator (Wind and PV) as a primary source, BESS as a secondary source and FC with Electrolyzer as a tertiary source. In addition, the lead compensator along with integrator is used for obtaining enough phase margin and removing steady state error completely. It increases the stability of the controller and adds phase shift $\varphi _{s}$ at a cross gain frequency ( $\omega _{cut}$ ). The Grid Side Controller (GSC) is capable of providing frequency support to the utility grid, when it is linked to the grid. In the proposed configuration, PV power is maximized and injected into grid through GSC. Rotor Side Converter (RSC) and GSC ensure the support for sharing the burden of the grid station. Moreover, the proposed controller of BESS with coordination of FC eliminates the effect of intermittency of power generated from wind and PV. Excess power production by renewable distribution generation is used by Electrolyzer to generate hydrogen. This hydrogen is further used by FC when there is not enough power generation due to unfavorable weather conditions. The energy management has been presented to fulfill the load profile, avoid BESS overcharging and to minimize the intermittency and fluctuation of Wind and PV sources. This method guarantees steady power flow and service continuity. The Simulink model of the proposed system results validate the efficiency of the proposed hybrid system as compared to the conventional hybrid system reported in the literature. The modeling of the proposed system and analysis has been demonstrated using the MATLAB Simulink model. Lastly, the energy management of the system has also been examined and compared with the conventional power system.

BackgroundOf around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors.MethodsThis cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters.ResultsIn total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7–9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters.ConclusionIncreasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF.

Weeds are common ancestors of modern crops. They are critical source of genes for resistance to diseases, pests and stresses such as drought and extreme environmental conditions. The wild relatives led to improve resistance to wheat curl mite, late blight in potato and to grassy stunt disease in rice. Agricultural pathogens are infecting economically important cash crops and weeds as well. Malvastrum coromandelianum is highly invasive weed specie of family Malvaceae. It is distributed all over the world in all climatic condition of tropical, sub-tropical and temperate region. The Malvaceae family is economically important as cotton (Gossipium hirsutem) belongs to it. M. coromandelianum has ethnobotanical importance and is extensively applied in the treatment of different diseases in south Punjab of Pakistan. It has been observed that there is a specific disease that affects the leaves of M. coromandelianum. In this study, we investigated the disease-causing agents (viruses and bacteria) at molecular level. Molecular investigation includes DNA isolation of unknown pathogens, verification through agarose gel electrophoresis, for identification of bacterial pathogens, 16s RNA primers were applied, and for viral pathogen using specific primers and RCA (rolling circle amplification) product as template. PCR was carried out for the amplification of full-length genomes. Manifestation of 1.4 kb bands showed the presence of the alpha and beta satellite of begomoviruse. Two types of begomoviruses, Malvestrum yellow vain younnan virus (MaYVYV) and Malvastrum yellow vain virus (MaYVV) was confirmed in this weed. The intermediate host Bemisia tabaci is the most common for the begomovirus transmission in crops and weeds. Intercrops and trap-crops techniques decrease the rate of whitefly population. Cultural methods, use of chemicals and biocontrol are useful practices to eliminate whitefly from field.

Drug-loaded nanoparticles (NPs) allow specific accumulation and controlled release of drugs to infected tissues with minimal cytotoxicity. In this study, gemifloxacin conjugated silver nanoparticles (Gemi-AgNPs) were synthesized, and the amplification of their antibacterial potential against the human pathogen as well as their stability was monitored under physiological conditions. Fourier transform infrared spectroscopy (FTIR) analysis demonstrated the interaction between –NH2 and –OH functional moiety and the metal surface. The morphological analyses via transmission electron microscopy revealed that Gemi-AgNPs has a round oval shape and average particle size of 22.23 ± 2 nm. The antibacterial and antibiofilm activities of these NPS showed that Gemi-AgNPs exhibit excellent antimicrobial and biofilm inhibition activity against human pathogens, namely, Proteus mirabilis (P. mirabilis) and methicillin-resistant Staphylococcus aureus (MRSA). A significant increase in the antibiofilm activity of Gemi-AgNPs was confirmed by crystal violet, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) staining, and microscopic analysis. Gemi-AgNPs exhibited the ability to inhibit urease with an IC50 value of 57.4 ± 0.72 µg/mL. The changes in the bacterial cell morphology were analyzed via TEM, which revealed that cell membranes disrupted and completely destroyed the cell morphology by the treatment of Gemi-AgNPs.

Chicken meat is among the common and relatively inexpensive source of protein consumed worldwide from the poultry industry. Many communities show concern regarding the procedure of slaughtering animals for meat consumption due to ethical, religious, or cultural reasons. Liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) based untargeted metabolomics of 40 chicken meat samples were evaluated to differentiate meat samples based on slaughtering methods. Samples were grouped into, Zabiha (cutting neck without detaching spinal cord) and Non-Zabiha (completely detaching neck). A volcano plot reveals at least 150 features found significantly different between the two groups having ≥ 2-fold changes in intensities with p-values ≤ 0.05. Among them 05 identified and 25 unidentified metabolites have clear differences in peak intensities. The identified features can be employed to differentiate meat obtained from different slaughtering methods. A characteristic pattern based on principal component analysis (PCA) and orthogonal partial least square-discriminant analysis (OPLS-DA) was observed among the groups. The results will benefit Halal certification, food safety, and security agencies to curb food fraud.

Gomphotheres existed in the Siwaliks from the middle Miocene (14.2Ma) to the middle Pleistocene (0.8Ma) and became extinct later on. In this paper, we tried to discuss the reasons of such extinction of gomphotheres in the lower Pleistocene time span by considering Linear Enamel Hypoplasia (LEH) among 114 isolated tooth samples to assess whether ecological changes correlate with the stress factor in gomphotheres. For this purpose, the Siwalik gomphotheres were divided into two Groups viz. early gomphotheres (middle Miocene to late Miocene) and late gomphotheres (Pliocene to middle Pleistocene). We presented the hypothesis, that as the gomphotheres are characterized by the brachydonty and relied on browsing for their feeding while inhabiting the semi forest land setting thus, expected to have higher stress in Plio-Pleistocene time span as vegetational change around ~6 Ma may have exerted stress on late gomphotheres. The results for the occurrence of frequency of LEH indicated severe ecological stress in late gomphotheres (33%). The significant differences were found (P < 0.05) among the early gomphotheres and late gomphotheres which can be correlated to the vegetational change from C3 to C4, higher aridity indices and intensified seasonality after the late Miocene vegetational shift which may have resulted in substantial faunal turnover, extinction and speciation. We assume that such palaeoecological changes forced a competition with more pronounced grazers like of family Elephantidae and Bovidae resulting in extinction of gomphotheres during the late Pleistocene in the Siwaliks of Pakistan.

Background and objectives. Lack of knowledge and awareness about the disease is generally associated with wicked health outcomes. Diabetes is a chronic endocrine disease, affecting people of both genders and across all age groups, and is currently considered a major public health challenge globally. This study aims to assess the public’s knowledge, awareness, and associated demographic factors among general community. Methods. A cross-sectional study was carried out for over 4 months from May to August 2020 using a self-administered, anonymous online questionnaire. All adults of both genders were invited to participate in the study. Individuals who are able to read and understand the English language were included in the study. Data were descriptively analyzed using a statistical package for social science version 26 (SPSS). Results. A total of 427 subjects responded to the questionnaires. More than half of them were male 253 (59.3%), while 174 (40.7%) were female, approximately 49% had a university degree, and 196 (45.9%) were postgraduates. The mean age of the participants was 25.7 ± 6.2 (mean ± SD). Most of them were single 230 (53.9%). The majority of the respondents 367 (85.9%) had heard of hyperglycemia, while a comparable number of 366 (85.7%) were aware of it being a lifelong disease. About 305 (71.4%) of participants knew that genetic factors were associated with hyperglycemia, and more than half of 250 (58.5%) knew that diabetes causes foot problems. There was a significant association between the cause of diabetes with income and educational status (p

Background The Commonwealth Pharmacists Association (CPA) is a charity representing pharmacists across the Commonwealth, with the vision of empowering and collaboratively develop the profession and fully utilise the potential of pharmacists to strengthen health systems through supporting better access to, quality and use of medicines and related services. Commonwealth comprises predominantly of low- and middle-income countries, where limited data often exists in pharmacy practice. There is a recognised need across the Commonwealth to focus on developing, implementing and fully utilising pharmacy professional services to progress universal health coverage and achieve the sustainable development goals, particularly in low and middle-income countries; however, currently a knowledge gap exists in understanding the national priorities in Commonwealth nations. CPA is ideally positioned to access to these nations. The aim of this study was thus to explore the priorities and focus areas of NPAs across the Commonwealth and create evidence for a needs-based approach to inform the support that the Commonwealth pharmacists association can collaboratively and strategically provide to its members to progress towards shared goals. Methods Data were collected virtually on Zoom by conducting interviews using a semi-structured interview guide developed for this study with CPA councillors representing NPAs or their equivalents if no official body existed. An inductive, reflexive, thematic analysis was performed for data analysis. Results In total, 30 councillors were interviewed from 30 low- and medium-income countries. The three main overarching priority areas identified across respective Commonwealth nations developing extended pharmacy services, improving pharmacy education, and developing and redefining the role of NPAs. Conclusions This novel study highlights the collective priorities for the pharmacy profession across the low and middle-income countries of the Commonwealth and the urgent need for supporting NPAs around the three identified overarching priority areas. The mapped-out priorities will inform an evidence-based approach for the CPA to better support NPAs in their mission through advocacy and practitioner development, to fully harness pharmacists’ unique skill set and maximise their contribution to progressing universal health coverage.

Hepatocellular carcinoma (HCC) is a typical cancer that has region specified analysis with the incidence of hepatitis C virus (HCV) infection. This study was conducted to improve the understanding of metabolic alterations associated with HCV induced HCC which can open up new strategies to monitor the high risk of HCC. Samples of the subjects with HCV, HCV induced chronic liver disease (CLD), HCV induced HCC, and healthy controls (HS) were collected after complete blood count (CBC), hepatitis viral load, α-fetoprotein (AFP), liver function tests, and albumin. A total of 147 serum samples including HCC (n = 11), CLD (n = 24), HCV (n = 71), and HS (n = 41) were analyzed by LC-ESI-MS/MS. The 21 compounds were found to be responsible for group discrimination after the application of chemometric tools. N-fructosyl tyrosine and hydroxyindoleacetic acid showed an increase in level whereas L-aspartyl-L-phenylalanine and thyroxine showed a consistent decrease in the progression of HCV to HCC in comparison with HS indicating their importance for early detection. The biological pathways such as glycerophospholipid metabolism, phenylalanine, tyrosine, and tryptophan biosynthesis, phenylalanine metabolism and tryptophan metabolism showed alteration in some metabolites. The method was internally validated by ROC plot showing AUC value for HS, HCV, CLD, and HCC as 0.99, 1, 1, and 0.89, respectively; while 16 blind samples were also validated with 93% specificity. The untargeted metabolomics investigation of HCV, CLD, and HCC can help to understand the progression of HCV-induced HCC. It reveals significant differences in metabolites to predict prognostic and diagnostic markers.

Cancer is by far the most common cause of death worldwide. There are more than 200 types of cancer known hitherto depending upon the origin and type. Early diagnosis of cancer provides better disease prognosis and the best chance for a cure. This fact prompts world-leading scientists and clinicians to develop techniques for the early detection of cancer. Thus, less morbidity and lower mortality rates are envisioned. The latest advancements in the diagnosis of cancer utilizing nanotechnology have manifested encouraging results. Cancerous cells are well known for their substantial amounts of hydrogen peroxide (H2O2). The common methods for the detection of H2O2 include colorimetry, titration, chromatography, spectrophotometry, fluorimetry, and chemiluminescence. These methods commonly lack selectivity, sensitivity, and reproducibility and have prolonged analytical time. New biosensors are reported to circumvent these obstacles. The production of detectable amounts of H2O2 by cancerous cells has promoted the use of bio- and electrochemical sensors because of their high sensitivity, selectivity, robustness, and miniaturized point-of-care cancer diagnostics. Thus, this review will emphasize the principles, analytical parameters, advantages, and disadvantages of the latest electrochemical biosensors in the detection of H2O2. It will provide a summary of the latest technological advancements of biosensors based on potentiometric, impedimetric, amperometric, and voltammetric H2O2 detection. Moreover, it will critically describe the classification of biosensors based on the material, nature, conjugation, and carbon-nanocomposite electrodes for rapid and effective detection of H2O2, which can be useful in the early detection of cancerous cells.

Background and objective: The purpose of this study is to compare the attitudes, views, and factors that influence drug abuse among pharmacy and nursing students at a Saudi Arabian university. Materials and Methods: A cross-sectional study, was conducted among pharmacy and nursing students who are currently enrolled in the respective courses at the study site. The data were collected over 4 months from August to November 2019 using structured self-administered paper-based questionnaires. Results: Among the participants, pharmacy students accounted for 184 (58.2%) while 132 (41.8%) of the students were from nursing. More than a third of the students 129, (40.8%) smoked cigarettes. The majority of pharmacy (80.4%) and nursing students (67.4%) reported having undertaken a drug misuse course in college. Among the participants, 132 (41.7%) stated that an offer from friends, followed by joy seeking 129 (40.8%), parents’ divorce 126 (39.8%), having access to drugs 125 (39.5%), family issues 110 (34.8%), 66 (20.8%) having a family member who is addicted, and 101 (31.9%) reported curiosity to be the factors regarding the use of abusive drugs. Transient euphoria (75.9%) followed by depression 197 (62.3%) was the most prevalent physical or psychological change that occurred following drug use. The family size and father’s education have significantly affected the attitudes scores of the students (F = 5.188; p = 0.0001). Conclusion: In this study, joy-seeking, access to drugs, and family issues were found to be the major factors listed as reasons for drug abuse, with some of them being controllable or reversible. Educating about the adverse outcomes of abused drugs is warranted.

Protective coatings for harsh environments are always welcome, but they must overcome profound challenges, including corrosion and wear resistance. The purpose of this study is to look into the long-term potentiodynamic polarization measurements and dry tribometric behavior of plasma-sprayed amorphous coatings on AISI 1035 mild steel. To investigate the impact of unique active polarization potentials on the electrochemical studies of the iron-based amorphous layer, which compares favorably to AISI 1035 mild steel, the active potential polarization curve and friction coefficient tests were performed. Scanning electron microscopy (SEM) and energy dispersive x-ray (EDX) analyses were used to investigate the coating’s corrosion behavior. Their mechanical (Tribometric tests at higher sliding speeds) and chemical properties (electrochemical potentiodynamic polarization investigations) have also been thoroughly investigated. There is enough validation that these protective coatings can be used in hostile environments. The effects of long-term corrosion for 24 and 48 h were thoroughly examined. Tribometric examinations revealed that amorphous layers are highly resistant under dry conditions, as they offered a very low and stable friction coefficient less than 4 μ with micro Vickers hardness 1140 ± 22.14 HV, which is more than twice as compared to mild steel AISI 1035. The corrosion resistance of coatings in 3.5 wt % NaCl solution displays active transition characteristics of activation, passivation, over passivation, and pitting, as shown by the potentiodynamic polarization curves.

Abstract Detection of metabolic signature for breast cancer (BC) has the potential to improve patient prognosis. This study identified potentially significant metabolites differentiating between breast cancer patients and healthy controls to help in diagnosis, grading, staging and determination of neoadjuvant status. Serum was collected from 152 pre-operative breast cancer (BC) patients and 155 healthy controls in this case-controlled study. Gas chromatography-mass spectrometry (GC-MS) was used to obtain metabolic profiles followed by chemometric analysis with the identification of significantly differentiated metabolites including 7 for diagnosis, 18 for grading, 23 for staging, 15 for stage III subcategory and 10 for neoadjuvant status (p-value

There is an increasing number of devices available for the Internet of Multimedia Things (IoMT). The demands these ever-more complex devices make are also increasing in terms of energy efficiency, reliability, quality-of-service guarantees, higher data transfer rates, and general security. The IoMT itself faces challenges when processing and storing massive amounts of data, transmitting it over low bandwidths, bringing constrained resources to bear and keeping power consumption under check. This paper’s research focuses on an efficient video compression technique to reduce that communication load, potentially generated by diverse camera sensors, and also improve bit-rates, while ensuring accuracy of representation and completeness of video data. The proposed method applies a video content-based solution, which, depending on the motion present between consecutive frames, decides on whether to send only motion information or no frame information at all. The method is efficient in terms of limiting the data transmitted, potentially conserving device energy, and reducing latencies by means of negotiable processing overheads. Data are also encrypted in the interests of confidentiality. Video quality measurements, along with a good number of Quality-of-Service measurements demonstrated the value of the load reduction, as is also apparent from a comparison with other related methods.

We investigate the validity of generalized second law of thermodynamics of a physical system comprising newly proposed dark energy model called Ricci-Gauss-Bonnet and cold dark matter enveloped by apparent horizon and event horizon in flat Friedmann-Robertson-Walker (FRW) universe. For this purpose, Bekenstein entropy, Renyi entropy, logarithmic entropy, and power law entropic corrections are used. It is found that this law exhibits the validity on both apparent and event horizons except for the case of logarithmic entropic correction at apparent horizon. Also, we check the thermodynamical equilibrium condition for all cases of entropy and found its vitality in all cases of entropy.

In this paper, we consider the flat FRW spacetime filled with interacting dark energy and dark matter in fractal universe. We work with the three models of dark energy named as Tsallis, Renyi and Sharma−Mittal. We investigate different cosmological implications such as equation of state parameter, squared speed of sound, deceleration parameter, statefinder parameters, ω e f f − ω e f f ′ (where prime indicates the derivative with respect to ln a , and a is cosmic scale factor) plane and Om diagnostic. We explore these parameters graphically to study the evolving universe. We compare the consistency of dark energy models with the accelerating universe observational data. All three models are stable in fractal universe and support accelerated expansion of the universe.