Search

Abstract Iron (Fe) deficiency in calcareous soils is a significant agricultural challenge, affecting crop productivity and nutritional quality. This study aimed to isolate, characterize, and evaluate Fe solubilizing rhizobacterial isolates from maize rhizosphere in calcareous soils as potential biofertilizers. Forty bacterial isolates coded as SG1, SG2, …, SG40 were isolated and screened for siderophore production, with ten showing significant Fe solubilizing capabilities. These isolates were further assessed for phosphate solubilization and exopolysaccharides production. The selected bacterial isolates were also screened under axenic conditions for their ability to improve maize growth. The isolates SG8, SG13, SG24, SG30 and SG33 significantly enhanced growth parameters of maize. Notably, SG30 showed highest increment in shoot length (58%), root length (54%), root fresh and dry biomass (67% and 76%), SPAD value (67%), relative water contents (69%), root surface area (61%), and Fe concentration in shoots (79%) as compared to control. The biochemical characterization of these strains showed that all these strains have capability to solubilize insoluble phosphorus, produce indole-3-acetic acid (IAA), and ammonia with catalase, urease and protease activity. Molecular identification through 16s rRNA gene sequencing confirmed high similarity (99.7–100%) of the selected isolates to various Bacillus species, including B. pyramidoids, B. firmicutes, and B. cereus. The study provides a strong base for developing eco-friendly, cost-effective biofertilizers to address Fe deficiency in crops and promote sustainable agriculture.

Abstract Green nanotechnology has significant potential for use in agriculture particularly due to their antifungal properties, ability to control fungal diseases and reduce the reliance on chemical fungicides. Biotic stresses in agriculture have caused widespread damage worldwide, and green NPs provided eco-friendly alternatives to traditional chemical treatments, which are frequently toxic and harmful to the ecosystem. Green NPs could become an important tool in modern agricultural practices and environmental remediation if appropriate research is conducted to identify cost-effective production methods as well as safe and sustainable applications. In order to understand the potential of green NPs for sustainable agriculture and identify potential risks, research is ongoing into the effectiveness in agriculture sectors. Research update on green NPs is presented in this paper using data published on science direct over the last 15 to 20 years to clarify and understand the antifungal mechanisms of green metallic NPs, carbon and graphene nanotubes, nanocomposites as well as other type of nanomaterials. These green NPs are found to be more effective against pathogens on crops and humans than conventional fungicide approaches. They are very effective against fungi that affect cereal crops, including Fusarium oxysporum, Botrytis cinerea, and Candida species, etc. The green NPs developed using green synthesis methods are both cost-effective and environmentally friendly. Moreover, research is also required to identify the best methods for applying green NPs for crop production and sustainable agriculture. Furthermore, research should be undertaken to establish the most cost-effective methods of making and deploying green nanoparticles at a large field size study where there is fungal attack that diminishes agricultural output and affects global crop production. Graphical Abstract

Microplastics (MPs) have garnered global attention as emerging contaminants due to their adaptability, durability, and robustness in various ecosystems. Still, studies concerning their combination with heavy metals (HMs), their interactions with soil biota, and how they affect soil physiochemical properties and terrestrial plant systems are limited. Our study was set to investigate the combined effect of HMs (cadmium, arsenic, copper, zinc and lead) contaminated soil of Tongling and different sizes (T1 = 106 µm, T2 = 50 µm, and T3 = 13 µm) of polystyrene microplastics on the soil physiochemical attributes, both bacterial and fungal diversity, compositions, AMF (arbuscular mycorrhizal fungi), plant pathogens in the soil, and their effect on Lactuca sativa by conducting a greenhouse experiment. According to our results, the combination of HMs and polystyrene microplastic (PS-MPs), especially the smaller PS-MPs (T3), was more lethal for the lettuce growth, microbes and soil. The toxicity of combined contaminants directly reduced the physio-biochemical attributes of lettuce, altered the lettuce’s antioxidant activity and soil health. T3 at the final point led to a significant increase in bacterial and fungal diversity. In contrast, overall bacterial diversity was higher in the rhizosphere, and fungal diversity was higher in the bulk soil. Moreover, the decrease in MPs size played an important role in decreasing AMF and increasing both bacterial and fungal pathogens, especially in the rhizosphere soil. Functional prediction was found to be significantly different in the control treatment, with larger MPs compared to smaller PS-MPs. Environmental factors also played an important role in the alteration of the microbial community. This study also demonstrated that the varied distribution of microbial populations could be an ecological indicator for tracking the environmental health of soil. Overall, our work showed that the combination of HMs and smaller sizes of MPs was more lethal for the soil biota and lettuce and also raised many questions for further studying the ecological risk of PS-MPs and HMs.

Abstract Phosphorus (P) use efficiency in alkaline/calcareous soils is only 20% due to precipitation of P2O5 with calcium and magnesium. However, coating Diammonium Phosphate (DAP) with phosphorus solubilizing bacteria (PSB) is more appropriate to increase fertilizer use efficiency. Therefore, with the aim to use inorganic fertilizers more effectively present study was conducted to investigate comparative effect of coated DAP with PSB strains Bacillus subtilis ZE15 (MN003400), Bacillus subtilis ZR3 (MN007185), Bacillus megaterium ZE32 (MN003401) and Bacillus megaterium ZR19 (MN007186) and their extracted metabolites with uncoated DAP under axenic conditions. Gene sequencing was done against various sources of phosphorus to analyze genes responsible for phosphatase activity. Alkaline phosphatase (ALP) gene amplicon of 380bp from all tested strains was showed in 1% w/v gel. Release pattern of P was also improved with coated fertilizer. The results showed that coated phosphatic fertilizer enhanced shoot dry weight by 43 and 46% under bacterial and metabolites coating respectively. Shoot and root length up to 44 and 42% with metabolites coated DAP and 41% with bacterial coated DAP. Physiological attributes also showed significant improvement with coated DAP over conventional. The results supported the application of coated DAP as a useful medium to raise crop yield even at lower application rates i.e., 50 and 75% DAP than non-coated 100% DAP application which advocated this coating technique a promising approach for advancing circular economy and sustainable development in modern agriculture.

The pollution of heavy metals (HMs) is a major environmental concern for agricultural farming communities due to water scarcity, which forces farmers to use wastewater for irrigation purposes in Pakistan. Vegetables grown around the cities are irrigated with domestic and industrial wastewater from areas near mining, paint, and ceramic industries that pollute edible parts of crops with various HMs. Cadmium (Cd) is an extremely toxic metal in arable soil that enters the food chain and damages the native biota, ultimately causing a reduction in plant growth and development. However, the use of microbes and growth regulators enhances plant growth and development as well as HM immobilization into the cell wall and hinders their entry into the food chain. Thus, the integrated use of bacterial consortium along with exogenously applied jasmonic acid (JA) mitigates the adverse effect of metal stress, ultimately reducing the metal mobility into roots by soil. Therefore, the current study was conducted to check the impact of Cd-tolerant bacteria and JA on the growth, nutrient status, and uptake of Cd in the cauliflower (Brassica oleracea). Our results demonstrated that increasing concentrations of Cd negatively affect growth, physiological, and biochemical attributes, while the use of a bacterial consortium (SS7 + SS8) with JA (40 μmol L−1) significantly improved chlorophyll contents, stem fresh and dry biomass (19.7, 12.7, and 17.3%), root length and root fresh and dry weights (28.8, 15.2, and 23.0%), and curd fresh and dry weights and curd diameter (18.7, 12.6, and 15.1%). However, the maximum reduction in soil Cd, roots, and curd uptake was observed by 8, 11, and 9.3%, respectively, under integrated treatment as compared to the control. Moreover, integrating bacterial consortium and JA improves superoxide dismutase (SOD) (16.79%), peroxidase dismutase (POD) (26.96%), peroxidase (POX) (26.13%), and catalase (CAT) (26.86%). The plant nitrogen, phosphorus, and potassium contents were significantly increased in soil, roots, and curd up to 8, 11, and 9.3%, respectively. Hence, a consortium of Klebsiella strains in combination with JA is a potential phytostabilizer and it reduces the uptake of Cd from soil to roots to alleviate the adverse impact on cauliflower’s growth and productivity.

Abstract Background The growing popularity and use of complementary and alternative medicine (CAM) products among the general public worldwide has been well documented. This study aimed to investigate the knowledge, attitude, and perceptions (KAP) of Pakistani healthcare professionals (HCP) toward CAM and to document their views on integrating CAM education with the curriculum of undergraduate health science programs. Method A cross-sectional study using simple random sampling was conducted for a duration of ten months among HCPs from Pakistan’s twin cities: Islamabad and RawalpindiThe data were collected using a self-administered and validated (Cronbach’s alpha: 0.71) questionnaire. This questionnaire consisted of five sections, namely; demographic, attitude, perception, integration and knowledge. Result The response rate was 91.20% (500/456). The participants included 160 physicians, 155 nurses,and 141 pharmacists. The majority of the respondents were females, 67.50%, and unmarried (60.50%).The majority of HCPs participating in this study agreed that CAM modalities may benefit conventional medicine system. Likewise, most HCPs perceived different CAM therapies aseffective treatment options. More than 50% HCPs suggested CAM elective courses in the curriculum of the health sciences program.Overall, 79.17% of the HCPs have poor knowledge of CAM. Physicians have the highest knowledge score 25.63%, followed by pharmacists 21.99%, and nurses 12.26%. Knowledge status was significantly associated with age, profession, and experience of practice (p = 0.001,0.001 & 0.019). Conclusion This study revealed that despite the overall positive attitude of HCPs toward CAM, the score of knowledge is low. Therefore, the survey recommends evidence-based guidelines for the rationale use of CAM and updated syllabi of undergraduate health programs which will assist the future HCPs in increasing professionals’ knowledge toachieve better health outcomes for the general public.

Objective: This study aimed to evaluate the potential of ChatGPT to help students for their assess ments via MCQ at different level of cognition by using different subjects of Internal medicine. Methods: This cross-sectional study was conducted in the Department of Internal Medicine in col laboration with post graduate medical education department from June 2023 to August 2023. An MCQ bank was established from three books of MCQ’s on subject of Internal Medicine. Total 1428 MCQ’s were followed for scrutiny and 307 MCQ’s were selected for the assigned task. The selected MCQ’s were manually entered one by one in a fresh Chat GPT session. The response was noted against the replies given in respective MCQ’s book and marked as correct, not correct or partially correct. MCQ’s were categorized as per chapters in Internal medicine and as per cognition level of MCQ’s i.e. C1, C2 and C3. Data was analyzed on SPSS version 21.00. Results: Chat GPT replied with 199 correct replies while 98 were wrong and 10 were partially correct. Chat GPT scored 64% overall in all categories. At level of cognition, it solved C2 MCQ’s by 80 % but scored 69% and 54% in C1 and C3 categories respectively. Chat GPT replied with 80% accuracy for C2 level MCQ’s while results were low for C3 category at around 54%. C1 also had low percentage of correct answers standing close to 69.8%. Almost all subjects showed healthy responses around the mean except for endocrinology and hematology where responses are below 60% and 40% respectively. Conclusion: This study findings suggest that ChatGPT is a useful tool for students and medical educationist with its current framework but a subtle approach should be inclined towards its role in future.

Background: Antenatal care and effective services are the hallmarks of effective pregnancy outcome. Thus, practices by community care providers throughout labor and childbirth might affect health outcomes of newborns. There is a need for proper antenatal checkups in hospital and domiciliary care by community health workers and importance of antenatal care on pregnancy outcomes. Since, every woman has a right to safe delivery that must include proper labor management protocols. Therefore, the purpose of this study was to compare and assess the antenatal care of hospital based and domiciliary services on the outcome of delivery. Methods: This cross-sectional study was conducted from November 2018-April 2019. A sample size of about 300 married females was selected from different towns of Peshawar through non-probability convenient sampling technique. Data was collected using semi structured questionnaire after taking informed consent from the women. Data were analyzed by using SPSS. Chi square test was applied for associations between hospital and domiciliary services and antenatal outcomes in both setups. p-value < 0.05 was considered significant. Results: The comparison of hospital and domiciliary services on the outcome of newborn and mother, showed better services of hospital. Domiciliary care services showed increased number of complications in females during delivery (p-value

The rivers are severely contaminated by human activities due to its massive outflow and industrial effluents. Three economically significant fish species Sperata seenghala, Wallago attu, and Cyprinus carpio from the river water were selected for the assessment of heavy metals (HMs). The edible part of the collected fish from the river sampling sites were analyzed to determine the metal concentrations and potential health risks to humans. The Atomic Absorption Spectroscopy (AAS) technique was used to measure HMs including lead (Pb), chromium (Cr), and copper (Cu) for both water and fish samples. Order of HMs in the fish was found as Pb > Cd > Cr. Levels of HMs in all species were found higher than the European Commission (EC) recommended acceptable levels. The metal pollution index (MPI) indicates that W. attu and S. seenghala, two highly consumed fish species, have accumulated HMs in higher concentrations. Wallago attu has the highest bioaccumulation factor (BAF) for both Pb and Cd permissible levels. For adult and children, the Hazard Index (HI) and Targeted Hazard Quotient (THQ) values were less than 1, which indicated that there would be no non-carcinogenic health consequences. Carcinogenic risk (CR) exposure to Pb, Cd, and Cr for all consumers was found to be higher than the permitted limit (10−6-10−4), while children were found more vulnerable than adults in terms of CR values. The study findings identified several sources of contaminants in the area, including agricultural waste, lubricant usage, and electroplating material production dumping near into the river water. Based on the results of the analysis, metal concentrations exceeded the thresholds for carcinogenic health risks, indicating that fish from the area are generally unsafe to consume. Therefore, immediate action must be taken to reduce or prevent the discharge of contaminants into the river. Additionally, regular monitoring of the river's water quality should be conducted to control the contamination of water.

IntroductionInfective Endocarditis (IE) is a rare, life-threatening infection of the endocardium with multisystem effects. Culprit microorganisms derived from different niches circulate through the bloodstream and attach to the endocardium, particularly the heart valves. This study aimed to investigate culprit microorganisms among a cross-sectional cohort of IE patients, their associated factors, and to explore the potential relationship to the oral microbiome.MethodsIn this observational study, we undertook a cross-sectional analysis of 392 medical records from patients diagnosed with IE. The primary outcome of this study was to analyse the association between the IE culprit microorganisms and the underlying anatomical types of IE (native valve (NVE), prosthetic valve (PVE), or cardiac device-related (CDE)). Secondary outcomes encompassed a comparative analysis of additional factors, including: the treatment approaches for IE, and the categorisation of blood cultures, extending to both genus and species levels. Additionally, we cross-referenced and compared the species-level identification of IE bacteraemia outcome measures with data from the expanded Human Oral Microbiome Database (eHOMD).ResultsA culprit microorganism was identified in 299 (76.28%) case participants. Staphylococcal infections were the most common (p

Objective: This study aimed to compare the efficacy of ChatGPT and Google Bard as virtual tutors in supporting students across various levels of cognition in MCQ-based assessments in the field of Internal Medicine. Methods: This cross-sectional study was conducted in the Department of Internal Medicine in col- laboration with the Department of postgraduate medical education from June 2023 to October 2023. A comprehensive collection of multiple-choice questions (MCQs) covering various aspects of Internal Medicine was compiled by the research team’s consensus. The items were systematically organized into chapters and further categorized based on cognitive complexity levels (C1, C2, and C3). The cho- sen MCQs were entered into separate sessions of both ChatGPT and Google Bard. The responses from each Artificial Intelligence platform were then compared with the corresponding answers in the designated MCQs book. Recorded responses were classified as accurate, inaccurate, or partially ac- curate. Results: The ChatGPT exhibited an overall success rate of 64%, providing 199 correct responses out of 307 queries, of which 10 were partially correct. By contrast, Google Bard achieved an overall suc- cess rate of 58.95 %, yielding 181 correct responses out of 307 queries, where 16 were partially cor- rect. When stratified by cognitive complexity levels, ChatGPT demonstrated proficiency in solving C2 MCQs at a rate of 80%, whereas the performance rates for the C1 and C3 categories were 69% and 54%, respectively. In contrast, Google Bard displayed a 33% success rate in solving C2 MCQs while achieving success rates of 95% and 53% in the C1 and C3 categories, respectively. Conclusion: The findings of this study suggest that ChatGPT is a more advantageous tool for stu- dents and medical educators than Google Bard. These discerned advantages underscore the poten- tial of ChatGPT to enhance the educational experience within the medical domain.

Myocardial infarction (MI) is a leading cause of morbidity and mortality in the world and is characterized by ischemic necrosis of an area of the myocardium permanently devoid of blood supply. During reperfusion, reactive oxygen species are released and this causes further insult to the myocardium, resulting in ischemia-reperfusion (IR) injury. Since Nrf2 is a key regulator of redox balance, it is essential to determine its contribution to these two disease processes. Conventionally Nrf2 levels have been shown to rise immediately after ischemia and reperfusion but its contribution to disease process a week after the injury remains uncertain. Mice were divided into MI, IR injury, and sham surgery groups and were sacrificed 1 week after surgery. Infarct was visualized using H&E and trichrome staining and expression of Nrf2 was assessed using immunohistochemistry, Western blot, and ELISA. MI displayed a higher infarct size than the IR group (MI: 31.02 ± 1.45%, IR: 13.03 ± 2.57%; p < 0.01). We observed a significantly higher expression of Nrf2 in the MI group compared to the IR model using immunohistochemistry, spot densitometry of Western blot (MI: 2.22 ± 0.16, IR: 1.81 ± 0.10, Sham: 1.52 ± 0.13; p = 0.001) and ELISA (MI: 80.78 ± 27.08, IR: 31.97 ± 4.35; p < 0.01). There is a significantly higher expression of Nrf2 in MI compared to the IR injury group. Modulation of Nrf2 could be a potential target for therapeutics in the future, and its role in cardioprotection can be further investigated.

This work explores the existence and uniqueness criteria for the solution of hybrid Caputo–Hadamard fractional sequential differential equations (HCHFSDEs) by employing Darbo’s fixed-point theorem. Fractional differential equations play a pivotal role in modeling complex phenomena in various areas of science and engineering. The hybrid approach considered in this work combines the advantages of both the Caputo and Hadamard fractional derivatives, leading to a more comprehensive and versatile model for describing sequential processes. To address the problem of the existence and uniqueness of solutions for such hybrid fractional sequential differential equations, we turn to Darbo’s fixed-point theorem, a powerful mathematical tool that establishes the existence of fixed points for certain types of mappings. By appropriately transforming the differential equation into an equivalent fixed-point formulation, we can exploit the properties of Darbo’s theorem to analyze the solutions’ existence and uniqueness. The outcomes of this research expand the understanding of HCHFSDEs and contribute to the growing body of knowledge in fractional calculus and fixed-point theory. These findings are expected to have significant implications in various scientific and engineering applications, where sequential processes are prevalent, such as in physics, biology, finance, and control theory.

Abstract Introduction The primary purpose of this study was to determine adherence and health‐related quality of life (HRQoL) in PWE. Secondary aims were to assess association between adherence and HRQoL and determine predictors of HRQoL in PWE in Pakistan. Methods A descriptive cross‐sectional study was conducted among PWE receiving treatment from two tertiary care hospitals of Pakistan. The HRQoL and adherence were assessed with Urdu versions of Quality of Life in Epilepsy‐31 (QOLIE‐31), and Medication Adherence Rating Scale (MARS). Relationship between HRQoL and adherence was assessed by Pearson's product‐moment correlation coefficient. Forced entry multiple linear models were used to determine relationship of independent variables with HRQoL. Results 219 PWE with a mean (±standard deviation) age, 34.18 (± 13.710) years, participated in this study. The overall weighted mean HRQoL score was (51.60 ± 17.10), and mean score for adherence was 6.17 (± 2.31). There was significant association between adherence and HRQoL in PWE (Pearson's correlation = 0.820–0.930; p ≤ .0001). Multiple linear regression found adherence (B = 16.8; p ≤ .0001), male gender (B = 10.0; p = .001), employment status (employed: B = 7.50; p = .030), level of education (Tertiary: B = 0.910; p = .010), duration of epilepsy (>10 years: B = –0.700; p ≤ .0001), and age (≥46 years: B = –0.680; p ≤ .0001), and ASM therapy (polypharmacy: B = 0.430; p = .010) as independent predictors of HRQoL in PWE from Pakistan. Conclusions The findings suggest PWE from our center have suboptimal adherence which affects HRQoL. Independent factors such as male gender, employment status and duration of epilepsy are predictors of HRQoL.

BackgroundThe taboo of menstruation, lack of discussion on puberty, misinformation and poor awareness on menstrual hygiene management and limited access to safe menstrual products can negatively impact the physical and mental health of women and girls residing in low middle income countries.AimThe aim of the study was to explore the experiences, awareness, perceptions and attitudes of women and girls towards menstrual hygiene management in Pakistan. Moreover, the study also assessed consumer satisfaction towards locally manufactured organic menstrual products.MethodsA descriptive cross-sectional study design was used with a sample of 400 women and girls selected through convenience sampling from high schools, universities, outpatient department and gynaecological clinics located in 2 cities, i.e., Islamabad and Rawalpindi, Pakistan. A pre-structured questionnaire was used to explore experiences, awareness, perceptions and attitudes of women and girls towards menstrual hygiene management. Moreover, each respondent was provided with sample of locally designed and manufactured organic menstrual hygiene & wellness kit by a group of women researchers named “FemPure” including organic sanitary pads, feminine wellness mist and feminine wellness wash. The respondents were asked to use the products and a telephonic follow-up was conducted to assess consumer satisfaction for the products after a period of 1 month. Data was analyzed statistically using SPSS 21.ResultsThe results of the study reported that 86.2% (n = 345) of the respondents had normal periods. Out of 400 respondents, 58.5% (n = 234) knew about any health conditions related to abnormal menstrual cycle while 88.3% (n = 353) were aware of female menstrual hygiene. Majority of the respondents 78.7% (n = 315) felt ashamed while buying sanitary pads. Out of 400 respondents, 5.4% (n = 22) were interested in getting awareness regarding menstrual hygiene. The results of the study showed that all the respondents (100%, n = 400) were satisfied with FemPure organic menstrual products.ConclusionThe study concluded that majority of women and girls faced menstrual hygiene issues during and after the cycle and were eager to receive information on MHM and use organic rash free menstrual wellness products which could be ordered via mobile app. The respondents were satisfied after the use of FemPure organic menstrual products.

In this paper, some fixed point results for multivalued contractions are established in setting G-complete extended fuzzy b-metric spaces. An example is furnished to demonstrate the validity of results. An application of integral type inclusion is given to authenticate the theorems. Our results extend and generalize many existing results in literature.

Background and study aims Endoscopist techniques affect biliary cannulation success and the risk of adverse events during endoscopic retrograde cholangiopancreatography (ERCP). This survey study aims to understand the current practice of biliary cannulation techniques among endoscopists. Methods Practicing endoscopists were sent an anonymous 28-question electronic survey on biliary cannulation techniques and intraprocedural pancreatitis prophylactic strategies. Results The survey was completed by 692 endoscopists (6.2% females). A wire-guided cannulation technique (WGT) was the preferred initial biliary cannulation approach (95%). The preferred secondary approaches were a double-wire (DWT) (65.8%), precut needle-knife technique (NKT) (25.7%), transpancreatic sphincterotomy (5.9%) or other (2.6%). Overall, 18.1% of respondents were not comfortable with NKTs. In the setting of pancreatic duct (PD) access, 81.9% and 97% reported a threshold of three or more wire passes or contrast injections into the PD, respectively, before changing strategy, 34% reported placement of a prophylactic PD stent 200 ERCPs per year) were associated with comfort with precut NKTs and likelihood of prophylactic PD stent (P

This paper deals with the existence and uniqueness of the best proximity points of nonself-mappings in the context of non-Archimedean fuzzy metric spaces. The existence of different proximal quasi-contractive mappings allowed us to generalize some results concerning the existence and uniqueness of the best proximity points in the existing literature. Moreover, an application in computer science, particularly in the domain of words has been provided.

Background: Antimicrobial resistance is one of the biggest challenges to healthcare resulting in increased morbidity and mortality, and associated with drug resistant infections. Community pharmacists (CPs) can play a key role in antimicrobial stewardship (AMS) programs to aid the prudent use of antibiotics, and in infection prevention and control. Objective: The aim of this study was to assess perceptions of CPs regarding their role, awareness, collaboration, facilitators and barriers towards effective AMS practices in Pakistan. Method: ology: A descriptive, cross-sectional study design was adopted, where convenience and snowball sampling methods were applied to enroll respondents (pharmacists working at these community pharmacies in different cities of Pakistan) of the study. After sample size determination, n = 386 CPs were enrolled. A pre-validated questionnaire was used regarding CPs roles and perceptions in association with AMS. Statistical analysis was performed using SPSS v. 21. Results: The results of the study reported that 57.3% (n = 221) of CPs had strong familiarity with term AMS. 52.1% (n = 201) of CPs agreed that they require adequate training to undertake activities in AMS programmes in their setting. The results of the study showed that 92.7% (n = 358) of the pharmacists thought real time feedback would be helpful. Significant association was observed in AMS awareness, approach, collaboration and barriers with regards to the respondents’ gender, age groups and levels of experience in a community pharmacy. Conclusions: The study concluded that CPs were aware of AMS programmes, their relevance and necessity of AMS in their everyday practice, but had inadequate training and resources to implement it in Pakistan.

Abstract NPTs have vast applications because of no tyre puncture, no need for air pressure, low rolling resistance, and also have higher flexibility for design and recyclability. In this research work, different structures of polyurethane (PU) spokes have been designed and analyzed under radial loading conditions which include structures like honeycomb with varying cell angles, simple spoke, and trapezoid type by keeping in view that the cell wall thickness and somehow the mass of the structures remain the same. Based on the Mooney-Rivlin hyper-elastic material model and performing 2D non-linear static structural analysis on different types of NPTs using ANSYS, it has been observed that the simple spoke structure has the lowest spoke stress and deformation values of 2.01 MPa and 11.7 mm, while HC–A1 has the least value of strain energy of 2.58 mJ, at a load of 2500 N. The above results show that the straight spoke structures like simple spoke and trapezoid type have a high load-carrying ability than the honeycomb type NPTs under same boundary conditions. While honeycomb NPTs have higher fatigue life as compared to straight-spoke NPTs.

In this article, the concept of a Hausdorff fuzzy b-metric space is introduced. The new notion is used to establish some fixed point results for multivalued mappings in G-complete fuzzy b-metric spaces satisfying a suitable requirement of contractiveness. An illustrative example is formulated to support the results. Eventually, an application for the existence of a solution for an integral inclusion is established which involves showing the materiality of the obtained results. These results are more general and some theorems proved by of Shehzad et al. are their special cases.

Objective: The present study is a scoping review of the progress of the field of stem cell research (SCR) in Pakistan in the last two decades. Methods: Data was extracted from electronic search engines, international clinical trial registry platforms, and PubMed and presented in tabular and graphical form. Results: China, India and Iran are investing heavily in SCR. In Pakistan, reasonable growth in terms of the number of publications is observed in this area, however, clinical translation of the field does not demonstrate any considerable progress. The Government of Pakistan has developed the regulatory framework and initiated preliminary policymaking, adopting rules from international regulatory agencies like World Health Organization (WHO) and Federal Drug Authority (FDA), however, further clarity and policymaking are needed to address the growing trend of stem cell tourism in the country. Continued...

This study examines the physical, mechanical, microstructural, and attenuation properties of high-density concrete exposed to temperatures ranging from 200°C to 1200°C. For this purpose, heavy-density concrete containing 25%, 50%, 75%, and 100% dolerite aggregates was developed and compared with three ordinary concrete mixes. Pre- and post-heated concrete specimens were evaluated for mass and density loss, compressive strength, rebound hammer, X-ray and gamma-ray attenuation, Half Value Layer (HVL), and Ten Value Layer (TVL) along with microstructural properties determined by scanning electron microscopy and Energy Dispersive X-ray. The results showed that the incorporation of 75% dolerite aggregate during pre- and post-heating yielded high compressive strength whereas low mass and density loss. The same mixture showed significant improvement in gamma ray shielding at all temperatures. The Half Value Layer and Ten Value Layer values showed a reduction in the thickness of concrete as a shield. It is recommended that dolerite heavy-density concrete is a potential radiation shield at high temperatures ranging from 200°C–1200°C in fourth-generation nuclear power plants.

IntroductionThe burgeoning population of the world is causing food insecurity not only by less food availability but also by the malnutrition of essential nutrients and vitamins. Malnutrition is mostly linked with food having micronutrients lower than the optimal concentration of that specific food commodity and becoming an emerging challenge over the globe. Microbial biofortification in agriculture ensures nutritional security through microbial nitrogen fixation, and improved phosphate and zinc solubilization, which increase the uptake of these nutrients. The present study evaluates the novel plant growth-promoting rhizobacteria (PGPR) to biofortify maize gain.MethodsFor this purpose, a pot and two field experiments for maize were conducted. PGPRs were applied alone and in combination for a better understanding of the biofortification potential of these strains. At physiological maturity, the growth parameters, and at harvest, the yield, microbial population, and nutritional status of maize were determined.Results and discussionResults revealed that the consortium (ZM27+ZM63+S10) has caused the maximum increase in growth under pot studies like plant height (31%), shoot fresh weight (28%), shoot dry weight (27%), root fresh (33%) and dry weights (29%), and microbial count (21%) in the maize rhizosphere. The mineral analysis of the pot trial also revealed that consortium of ZM27+ZM63+S10 has caused 28, 16, 20, 11 and 11% increases in P, N, K, Fe, and Zn contents in maize, respectively, as compared to un-inoculated treatment in pot studies. A similar trend of results was also observed in both field trials as the consortium of ZM27+ZM63+S10 caused the maximum increase in not only growth and biological properties but also caused maximum biofortification of mineral nutrients in maize grains. The grain yield and 1000-grain weight were also found significantly higher 17 and 12%, respectively, under consortium application as compared to control. So, it can be concluded from these significant results obtained from the PGPR consortium application that microbial inoculants play a significant role in enhancing the growth, yield, and quality of the maize. However, the extensive evaluation of the consortium may help in the formulation of a biofertilizer for sustainable production and biofortification of maize to cope with nutritional security.

Monkeypox is primarily a painful cutaneous disease with occasional systemic manifestations. Monkeypox is transmitted predominantly through close physical contact and occasionally sexual contact. The first case was reported in the United States on May 17, 2022, in a recent monkeypox worldwide outbreak. We present a case of severe gastrointestinal bleeding as an atypical manifestation of monkeypox infection in a 40-year-old male with HIV. In our case, monkeypox-induced proctocolitis progressed to severe rectal bleeding requiring one unit of packed red blood cells transfusion despite one week of tecovirimat (TPOXX) therapy. So, patients should be educated about the possibility of unusual complications of monkeypox infection, i.e., bleeding in immunocompromised hosts.

This paper considers an alternated inertial-type extrapolation algorithm for solving bilevel pseudomonotone variational inequality problem in the framework of real Hilbert spaces with split variational inequality and fixed-point constraints of demimetric mapping. The algorithm which involves alternated inertial uses self-adjustment stepsize condition that depends solely on the information from previous iterative step. The bilevel problem considered in the work consists of upper-level problem with an underlying operator which is pseudomonotone, while the lower problem is associated with strongly monotone mapping and the fixed-point constraint of demimetric mapping. Our algorithm is anchored on modified projection and contraction techniques, fused with alternated inertial and relaxation. Under some suitable conditions on the algorithm control parameters, we obtain a strong convergence result of the proposed method without the prior knowledge of the operator norm or the coefficients of the underlying operators within the scope of real Hilbert spaces. Finally, some numerical examples are presented to illustrate the gain of our method in comparison to some related algorithms in the literature.

In the current study, cornstarch-based antimicrobial and edible films were designed using solution-casting methods. The medicinal plants (Acontium heterophyllum, Artemisia annua, and Thymus serpyllum) reinforced the gelatinized solution in different concentrations as fillers. The effect of plant extracts on antimicrobial and antioxidant potential, microstructure, barrier, thermal and mechanical properties of cornstarch-based films (SBFs) was investigated using antimicrobial activity, DPPH free radical scavenging values, scanning electron microscopy, X-ray diffraction, water vapor transmission rate, differential scanning calorimetry, and tensile strength. Likewise, it was depicted that the geometric and crystalline structures of medicinal plants’ reinforced films remained the same even after processing. The mechanical tests indicated that the plant extracts effects are associated with reduced elongation, increasing tensile strength, and Young’s modulus. Morphological analysis revealed the generation of uniform and the compact surfaces. However, films with 10% concentration of plant extracts have the lowest water vapor permeability values, and emerged better barrier properties. Moreover, these films showed the significant antioxidant potential and antimicrobial activity.

IntroductionGender inequity in healthcare academia is rising. Female healthcare professionals are struggling to balance their work and family leading to reduced productivity and disparity in three main areas of academic evaluation including teaching, service and research.ObjectiveThe objective of the current study was to explore perceptions of healthcare academicians regarding gender equity and its associated barriers in healthcare academia in Pakistan.MethodologyA qualitative study design was used. Study site for this research included medical colleges, pharmacy schools and healthcare educational institutes. Study respondents included healthcare professionals including doctors and pharmacists working as faculty members. Snow ball sampling was used and interviews were conducted till saturation point was achieved. All interviews recorded were transcribed verbatim. Transcribed interviews were then subject to thematic analysis and were analyzed for relevant content.ResultsThematic analysis of the study yielded many themes and sub themes. The main themes include: Gender equity an issue for healthcare academicians; Barriers toward promoting gender equity among healthcare academicians; Perceived teaching effectiveness among female healthcare academicians; Professional relationship of female healthcare academicians; Representation of female healthcare academicians at leadership positions; Research opportunities for female healthcare academicians; impact of academia as profession on married life and Strategies for improving gender equity disparities in academia of healthcare profession. The results showed that almost all the females as well as male healthcare academicians were of the view that female academicians are competent, hardworking and committed with their jobs. Mixed responses were observed regarding teaching effectiveness of female academicians. Half of the females as well male healthcare academicians thought that female were more effective teachers while other half was of the view that teaching effectiveness is based on individual trait irrespective of gender.ConclusionThe results of the present study concluded that majority of the male as well as female healthcare professionals perceived gender equity as an issue in academia in Pakistan, especially in underprivileged areas. Non-conducive work environment, harassment at workplace and cultural issues were the main barriers identified toward gender equity in healthcare academia in Pakistan.

Abstract Efficient protocols for callus induction and micro propagation of Saussurea costus (Falc.) Lipsch were developed and phytochemical diversity of wild and in-vitro propagated material was investigated. Brown and red compact callus was formed with frequency of 80–95%, 78–90%, 70–95% and 65–80% from seeds, leaf, petiole and root explants, respectively. MS media supplemented with BAP (2.0 mgL−1), NAA (1.0 mgL−1) and GA3 (0.25 mgL−1) best suited for multiple shoot buds initiation (82%), while maximum shoot length was formed on media with BAP (1.5 mgL−1), NAA (0.25 mgL−1) and Kinetin (0.5 mgL−1). Full strength media with IAA (0.5 mgL−1) along with IBA (0.5 mgL−1) resulted in early roots initiation. Similarly, maximum rooting (87.57%) and lateral roots formation (up to 6.76) was recorded on full strength media supplemented with BAP (0.5 mgL−1), IAA (0.5 mgL−1) and IBA (0.5 mgL−1). Survival rate of acclimatized plantlets in autoclaved garden soil, farmyard soil, and sand (2:1:1) was 87%. Phytochemical analysis revealed variations in biochemical contents i.e. maximum sugar (808.32 µM/ml), proline (48.14 mg/g), ascorbic acid (373.801 mM/g) and phenolic compounds (642.72 mgL−1) were recorded from callus cultured on different stress media. Nonetheless, highest flavenoids (59.892 mg/g) and anthocyanin contents (32.39 mg/kg) were observed in in-vitro propagated plants. GC–MS analysis of the callus ethyl acetate extracts revealed 24 different phytochemicals. The variability in secondary metabolites of both wild and propagated plants/callus is reported for the first time for this species. This study may provide a baseline for the conservation and sustainable utilization of S. costus with implications for isolation of unique and pharmacologically active compounds from callus or regenerated plantlets.

This paper presents the effect of tungsten inert gas welding parameters (i.e. welding current, welding speed and filler wire speed) on weld bead geometry, notch tensile strength (NTS) and weld bead hardness of 2.0 mm thick annealed Ti6Al4V titanium alloy sheet welded in a square butt joint configuration using Taguchi L9 (33) three level - three factor matrix. Taguchi’s signal to noise ratios was calculated to obtain optimum welding parameters for Vickers hardness at weld area, Notch tensile strength (NTS), Front bead width (FBW) and Front reinforcement height (FRH). Analysis of Variance (ANOVA) was conducted to find statistically significant and insignificant factors with respect to each response. It was noted that welding speed has significant effect on weld hardness, notch tensile strength, front bead width and height. Optimum parameters for hardness were found to be 120A current, 400 mm / min welding speed and 250mm/min filler wire speed. Confirmation test using the optimal levels of welding parameters was also conducted in order to compare predicted results with values obtained through experimentation.

Abstract The fundamental goal of the study under consideration is to establish some of the existence criteria needed for a particular fractional inclusion model of cantilever beam in the setting of quantum calculus using new arguments of existence theory. In this way, we investigate a fractional integral equation that corresponds to the aforementioned boundary value problem. In a more concrete sense, we design new multi-valued operators based on this integral equation, which belong to the certain subclasses of functions, called α-admissible and α-ψ-contractive multi-functions, in combination with the AEP-property. Also, we use some inequalities such as Ω-inequality and set-valued version inequalities. Moreover, we add a simulative example for a numerical analysis of our results obtained in this study.

Background. Preservation solutions are required for organ viability in deceased donor liver transplantation (LT). However, their role in live donor LT (LDLT) has not been standardized. Methods. Eighty adult recipients who underwent right lobe LDLT at the Department of Liver Transplantation Surgery, Gambat, Pakistan, were studied. Based on shorter cold ischemia time and no back table reconstruction work, recipients were assigned to receive “no preservation solution” (cases/non–histidine-tryptophan-ketoglutarate group; n = 40) or “HTK group” (controls; n = 40). Early allograft dysfunction (bilirubin, transaminases, and international normalized ratio), postoperative complications (biliary and vascular), hospital stay, and 1-y survival were reported. The direct cost was also reported. Results. Demographics and clinical characteristics were comparable in the 2 groups. Comparing cases versus controls, mean bilirubin, alanine aminotransferase, aspartate aminotransferase, and international normalized ratio on postoperative day 7 were similar in the 2 groups. Five (12.5%) cases and 4 (10%) controls developed early allograft dysfunction (P = 0.72). Post-LT complications (biliary leak 2.5% in cases versus 0 in control), strictures (15% in cases versus 17.5% in controls), hepatic artery thrombosis (2.5% versus 00%)‚ and portal vein thrombosis (0 versus 2.5%) were comparable. Mean hospital stay (10.80 + 2.36 and 11.78 + 2.91 d) and 30 d mortality (2.5% versus 5%) were also comparable. Finally, 1-y survival based on Kaplan-Meier analysis was comparable in both groups (ie, 92.5%; non-HTK group versus 90%; HTK group) (P = 0.71). The direct cost of using a non-HTK–based approach was less than the HTK solution. Conclusion. In a selected cohort of right lobe LDLT recipients, preservation solutions can be avoided safely with comparable outcomes.

Rhizoctonia solani is one of the most common soil-borne fungal pathogens of legume crops worldwide. We collected rDNA-ITS sequences from NCBI GenBank, and the aim of this study was to examine the genetic diversity and phylogenetic relationships of various R. solani anastomosis groups (AGs) that are commonly associated with grain legumes (such as soybean, common bean, pea, peanut, cowpea, and chickpea) and forage legumes (including alfalfa and clover). Soybean is recognized as a host for multiple AGs, with AG-1 and AG-2 being extensively investigated. This is evidenced by the higher representation of sequences associated with these AGs in the NCBI GenBank. Other AGs documented in soybean include AG-4, AG-7, AG-11, AG-5, AG-6, and AG-9. Moreover, AG-4 has been extensively studied concerning its occurrence in chickpea, pea, peanut, and alfalfa. Research on the common bean has been primarily focused on AG-2, AG-4, and AG-1. Similarly, AG-1 has been the subject of extensive investigation in clover and cowpea. Collectively, AG-1, AG-2, and AG-4 have consistently been identified and studied across these diverse legume crops. The phylogenetic analysis of R. solani isolates across different legumes indicates that the distinct clades or subclades formed by the isolates correspond to their specific anastomosis groups (AGs) and subgroups, rather than being determined by their host legume crop. Additionally, there is a high degree of sequence similarity among isolates within the same clade or subclade. Principal coordinate analysis (PCoA) further supports this finding, as isolates belonging to the same AGs and/or subgroups cluster together, irrespective of their host legume. Therefore, the observed clustering of R. solani AGs and subgroups without a direct association with the host legume crop provides additional support for the concept of AGs in understanding the genetic relationships and evolution of R. solani.

Abstract In this paper, we consider a nonlinear sequential q-difference equation based on the Caputo fractional quantum derivatives with nonlocal boundary value conditions containing Riemann–Liouville fractional quantum integrals in four points. In this direction, we derive some criteria and conditions of the existence and uniqueness of solutions to a given Caputo fractional q-difference boundary value problem. Some pure techniques based on condensing operators and Sadovskii’s measure and the eigenvalue of an operator are employed to prove the main results. Also, the Ulam–Hyers stability and generalized Ulam–Hyers stability are investigated. We examine our results by providing two illustrative examples.

Abstract The key objective of this study is determining several existence criteria for the sequential generalized fractional models of an elastic beam, fourth-order Navier equation in the context of quantum calculus (q-calculus). The required way to accomplish the desired goal is that we first explore an integral equation of fractional order w.r.t. q-RL-integrals. Then, for the existence of solutions, we utilize some fixed point and endpoint conditions with the aid of some new special operators belonging to operator subclasses, orbital α-admissible and α-ψ-contractive operators and multivalued operators involving approximate endpoint criteria, which are constructed by using aforementioned integral equation. Furthermore, we design two examples to numerically analyze our results.

Abstract In the existing study, we investigate the criteria of existence of solution for relatively new categories of φ-Caputo fractional differential equations and inclusions problems equipped with nonlocal φ-integral boundary conditions. In order to achieve the desired goal, we use α–ψ-contractive mappings and the theory of approximate endpoint. In the final stage, we exhibit some examples to provide the illustrations of our theoretical findings.

Objective: To compare the quality of intubation and hemodynamic response in children undergoing endotracheal intubation facilitated with propofol versus sevoflurane. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital Multan, from Aug 2018 to Apr 2019. Methodology: A total number of 112 children planned for tracheal intubation were included in this randomized controlled trial. Patients were randomly allocated into two equal groups. In group P (propofol) patient’s 2.5-3.0 mg/kg propofol was given before insertion of endotracheal tube and in group S (sevoflurane) patients 8.0% sevoflurane with 100% O2. Quality of intubation was assessed in all children at the time of intubation. Hemodynamic response of patients was also noted before induction of anesthesia, immediately after intubation and after 5 minutes of intubation. Results: Mean age of children included in this study was 2.11 ± 0.80 years. Quality of intubation was excellent in 51 (91.1%) patients in propofol group and in 38 (67.9%) patients in sevoflurane group (p-value 0.009). Mean HR after 5 minutes of intubation in group S and group P 111.98 ± 5.43 beats/min versus 109.05 ± 5.99 beats/min with p-value 0.008. Mean arterial pressure after 3 minutes of intubation mean arterial pressure in group S and P was 74.58 ± 4.45 mmHg versus 71.0 ± 3.90 mmHg with p-value

Meningitis is an inflammation of the membranes that surround and protect the brain and spinal cord. Typically, the enlargement is caused by a bacterial or viral infection of the fluid around the brain and spinal cord. For many years, licensed vaccinations against meningococcal, pneumococcal, and Haemophilus influenzae diseases have been accessible. Vaccines are meant to protect against the most dangerous strains of these germs, which are known as serotypes or serogroups. There have been significant increases in strain coverage and vaccine availability throughout time, but there is no universal vaccine against these illnesses. In this study, we explore the mathematical features of a new six-compartmental fractal–fractional two-strain model of meningitis. With the use of compact functions and ϕ−ψ-contractions, we establish the existence of solutions. To study the unique solutions, we employ the Banach principle. On the basis of the Hyers-Ulam definition for the fractal–fractional two-strain model of meningitis, stable solutions are examined. From the numerical simulations, we notice that as the fractal–fractional order decreases, the number of infected individuals with strain 1 of meningitis decreases, while the number of infected individuals with strain 2 rises. This means that all serotypes or serogroups need to be controlled effectively for the disease to be closed up.

Idara '' Taleef-o-Tarjama was established in 1962.Its aim was to convert modern knowledge into possible language.This institute translated books of different subjects.In those the books based on children psychology were also translated. Some of these are described here. In this book has been told about children's nature that how does child gets worse. On children psychology has been focused in this book. There is important information for teachers, parents and children in this book.

Abstract The main intention of this article is that new techniques of existence theory are used to derive some required criteria pertinent to a given fractional multi-term problem and its inclusion version. In such an approach, we do our research on a fractional integral equation corresponding to the mentioned BVPs. In more precise words, by virtue of this integral equation, we construct new operators which belong to a special category of functions named α-admissible and α-ψ-contraction maps coupled with operators having (AEP)-property. Next, by considering some new properties on the existing Banach space having properties (B) and ( C α ) $(C_{\alpha })$ , our argument for ensuring the existence of solutions is completed. In addition, we also add two simulative examples to review our findings by a numerical view.

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

Plant diseases are one of the major threats to global food production. Efficient monitoring and detection of plant pathogens are instrumental in restricting and effectively managing the spread of the disease and reducing the cost of pesticides. Traditional, molecular, and serological methods that are widely used for plant disease detection are often ineffective if not applied during the initial stages of pathogenesis, when no or very weak symptoms appear. Moreover, they are almost useless in acquiring spatialized diagnostic results on plant diseases. On the other hand, remote sensing (RS) techniques utilizing drones are very effective for the rapid identification of plant diseases in their early stages. Currently, drones, play a pivotal role in the monitoring of plant pathogen spread, detection, and diagnosis to ensure crops’ health status. The advantages of drone technology include high spatial resolution (as several sensors are carried aboard), high efficiency, usage flexibility, and more significantly, quick detection of plant diseases across a large area with low cost, reliability, and provision of high-resolution data. Drone technology employs an automated procedure that begins with gathering images of diseased plants using various sensors and cameras. After extracting features, image processing approaches use the appropriate traditional machine learning or deep learning algorithms. Features are extracted from images of leaves using edge detection and histogram equalization methods. Drones have many potential uses in agriculture, including reducing manual labor and increasing productivity. Drones may be able to provide early warning of plant diseases, allowing farmers to prevent costly crop failures.

Many farmers’ incomes in developing countries depend on the cultivation of major crops grown in arid and semi-arid regions. The agricultural productivity of arid and semi-arid areas primarily relies on chemical fertilizers. The effectiveness of chemical fertilizers needs to improve by integration with other sources of nutrients. Plant growth-promoting bacteria can solubilize nutrients, increase plant nutrient uptake, and supplement chemical fertilizers. A pot experiment evaluated the promising plant growth-promoting bacterial strain’s effectiveness in promoting cotton growth, antioxidant enzymes, yield, and nutrient uptake. Two phosphate solubilizing bacterial strains (Bacillus subtilis IA6 and Paenibacillus polymyxa IA7) and two zinc solubilizing bacterial strains (Bacillus sp. IA7 and Bacillus aryabhattai IA20) were coated on cotton seeds in a single as well as co-inoculation treatments. These treatments were compared with uninoculated controls in the presence and absence of recommended chemical fertilizer doses. The results showed the co-inoculation combination of Paenibacillus polymyxa IA7 and Bacillus aryabhattai IA20 significantly increased the number of bolls, seed cotton yield, lint yield, and antioxidants activities, including superoxide dismutase, guaiacol peroxidase, catalase, and peroxidase. Co-inoculation combination of Bacillus subtilis IA6 and Bacillus sp. IA16 promoted growth attributes, including shoot length, root length, shoot fresh weight, and root fresh weight. This co-inoculation combination also increased soil nutrient content. At the same time, Paenibacillus polymyxa IA7 + Bacillus aryabhattai IA20 increased nutrient uptake by plant shoots and roots compared.

Abstract We investigate the existence and uniqueness of solutions to a coupled system of the hybrid fractional integro-differential equations involving φ-Caputo fractional operators. To achieve this goal, we make use of a hybrid fixed point theorem for a sum of three operators due to Dhage and also the uniqueness result is obtained by making use of the Banach contraction principle. Moreover, we explore the Ulam–Hyers stability and its generalized version for the given coupled hybrid system. An example is presented to guarantee the validity of our existence results.

Background: Diaphragmatic injuries following blunt or penetrating thoraco-abdominal trauma are rare, but can be life-threatening. Rib fractures are the most common associated injury in patients with a traumatic diaphragmatic injury (TDI). We hypothesized that the pattern of rib fracture injuries could dictate the likelihood of acute TDIs. Methods: A retrospective study was carried out between April 2014 and October 2018 to analyze patients with TDIs and rib fractures at a major trauma center in London, United Kingdom. Results: Over the study period, 1,560 patients had rib fractures, of whom 14 had associated diaphragmatic injuries. Left-sided diaphragmatic injuries were found in 8 patients (57%) . A significant proportion of the rib fractures were located posterolaterally (44.9%). The highest frequency of fractures was found in ribs 5–10, which accounted for 74% of all the fractures. Ten patients underwent surgery, of whom 7 were diagnosed with a diaphragmatic injury intraoperatively after video-assisted thoracoscopic surgery assessment of the pleural cavity. Two patients died due to severe injuries of other organs and the remaining 2 patients were managed conservatively. Conclusion: Our series of patients demonstrates a relationship between significant rib fractures and diaphragmatic injuries in trauma patients, and the diagnostic difficulties in identifying the condition. We found that the location of the rib fractures and the pattern of injury in patients with TDIs were much lower and posterolateral in the chest wall without a preference for laterality. We suggest using a thoracoscope in patients undergoing chest wall surgery post-trauma to aid in diagnosing this condition.

The aim of this paper is to introduce the notion of Suzuki type multivalued contraction with simulation functions and then to set up some new fixed point and data dependence results for these type of contraction mappings. We produce an example to support our results. Moreover, we present an application to functional equation arising in dynamical system.

Abstract Background Crimean Congo Haemorrhagic Fever (CCHF), a tropically neglected infectious disease caused by Nairovirus, is endemic in low middle-income countries like Pakistan. Emergency health care professionals (HCPs) are at risk of contracting nosocomial transmission of CCHF. We, therefore, aim to analyze the knowledge, attitudes, and perceptions (KAP) of at-risk physicians, nurses, and pharmacists in Pakistan and the factors associated with good KAP. Method A validated questionnaire (Cronbach’s alpha 0.71) was used to collect data from HCPs in two CCHF endemic metropolitan cities of Pakistan by employing a cross-sectional study design. For data analysis percentages, chi-square test and Spearman correlation were applied by using SPSS version 22. Results Of the 478 participants, 56% (n = 268) were physicians, 37.4% (n = 179) were nurses, and 6.5% (n = 31) were pharmacists. The proportion of HCPs with good knowledge, attitude, and perception scores was 54.3%, 81, and 69%, respectively. Being a physician, having more work experience, having a higher age, working in tertiary care settings, were key factors for higher knowledge (p