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Abstract Concrete is used worldwide as a construction material in many projects. It exhibits a brittle nature, and fibers' addition to it improves its mechanical properties. Polypropylene (PP) fibers stand out as widely employed fibers in concrete. However, conventional micro-PP fibers pose challenges due to their smooth texture, affecting bonding within concrete and their propensity to clump during mixing due to their thin and soft nature. Addressing these concerns, a novel type of PP fiber is proposed by gluing thin fibers jointly and incorporating surface indentations to enhance mechanical anchorage. This study investigates the incorporation of macro-PP fibers into high-strength concrete, examining its fresh and mechanical properties. Three different concrete strengths 40 MPa, 45 MPa, and 50 MPa, were studied with fiber content of 0–1.5% v/f. ASTM specifications were utilized to test the fresh and mechanical properties, while the RILEM specifications were adopted to test the bond of bar reinforcements in concrete. Test results indicate a decrease in workability, increased air content, and no substantial shift in fresh concrete density. Hardened concrete tests, adding macro-PP fibers, show a significant increase in splitting tensile strength, bond strength, and flexural strength with a maximum increase of 34.5%, 35%, and 100%, respectively. Concrete exhibits strain-hardening behavior with 1% and 1.5% fiber content, and the flexural toughness increases remarkably from 2.2 to 47.1. Thus, macro PP fibers can effectively improve concrete's mechanical properties and resistance against crack initiation and spread.

Abstract Background Complicated mild traumatic brain injury (cmTBI) is a common neurosurgical disorder that consumes a significant amount of healthcare resources without a clearly established benefit. Best practices for the management of cmTBI regarding triage, hospital admission, and the necessity for repeat imaging are controversial. Our objective is to describe the rate of radiographic progression and neurologic decline for isolated traumatic subarachnoid hemorrhage (itSAH) patients admitted to the hospital. We hypothesized that only a minority of itSAH patients suffer radiographic progression and that radiographic progression is not necessarily associated with neurologic decline. Methods Database queries and direct patient chart reviews were used to gather patient data. T-tests and Fisher’s exact tests were performed. Results A total of 340 patients with cmTBI associated with itSAH were included for analysis. The radiographic progression rate was 5.6%. There was no statistically significant association between age, gender, GCS at presentation, anticoagulation status, and risk of radiographic progression. However, subgroup analysis on anticoagulated patients did show those on warfarin had a statistically significant risk of radiographic progression (p = 0.003). No patient developed neurologic decline, irrespective of whether they developed radiographic progression. Conclusion Secondary triaging, hospital admission, ICU stay, and repeat HCT might not be necessary for awake, GCS 13–15 patients with itSAH without any other significant injuries. In the case of anticoagulant use, but not necessarily antiplatelet use, the medication should be reversed, and admission should be considered.

Background & objectives: Biological approaches for vector mosquito control such as sterile insect technique (SIT) requires sterilization of male mosquitoes through specific radiation doses for sterility induction in males. Under the SIT program, the males used must be compatible with the wild males in vigor, flight and selection of mate. Much of this potential is determined by the diet provided in the larval stages and optimizing the irradiation doses that cause complete sterility but have very minimal effect on the lives of irradiated males. The current study is designed to evaluate gamma radiation doses for inducing sterility in male Aedes aegypti mosquitoes with a genomic background from Pakistan (Swat district) and to assess the effects of radiation exposure on the competency of irradiated males and other life traits of irradiated mosquitoes. Methods: Sterilization of 17-hour-old male pupae (groups of 50 pupa/cup in three replicates) of the Ae. aegypti Swat strain was conducted using radiation doses of 30, 60, 70, 90, and 105 gray (Gy) from (Co60) at the Nuclear Institute for Food and Agriculture (NIFA) in Peshawar, Pakistan. Post-irradiated pupae were released in adult cages. Virgin females of the same cohort were released (1:1) to mate with the irradiated males. Mortality, longevity, mating competitiveness of males, and female fecundity were recorded. Results: An average of 71 eggs per female was recorded in control with 86% hatch rate. Individual females mated with a 60 Gy treated males produced 60 ± 0.6 eggs per female with 17% hatch rate, and those mated with 70 Gy males produced 42 ± 0.01 eggs with a nil hatch rate, whereas females mated with males treated with ≥70 Gy doses did not reproduce to next generation. Females in groups of 50 mated with 60, 70 Gy treated males (equal pairs), produced 369±1.3 and 98±0.01 eggs with 15% and zero hatch rate. Significant dose dependent reduction in longevity was observed for >30 Gy doses. The matting competence of irradiated males was about half that of un-irradiated males. Interpretation & conclusion: Aedes aegypti with a Pakistani genomic background treated with a ≥70 Gy dose of gamma radiation induced complete sterility in males and provided the first-step foundation for SIT application in Pakistan. Further extensive studies are required to optimize the SIT techniques so that fully sterile males with very minor quality changes can be produced on large scales for field trials.

Abstract The escalation of global urbanization and industrial expansion has resulted in an increase in the emission of harmful substances into the atmosphere. Evaluating the effectiveness of titanium dioxide (TiO2) in photocatalytic degradation through traditional methods is resource-intensive and complex due to the detailed photocatalyst structures and the wide range of contaminants. Therefore in this study, recent advancements in machine learning (ML) are used to offer data-driven approach using thirteen machine learning techniques namely XG Boost (XGB), decision tree (DT), lasso Regression (LR2), support vector regression (SVR), adaBoost (AB), voting Regressor (VR), CatBoost (CB), K-Nearest Neighbors (KNN), gradient boost (GB), random Forest (RF), artificial neural network (ANN), ridge regression (RR), linear regression (LR1) to address the problem of estimation of TiO2 photocatalytic degradation rate of air contaminants. The models are developed using literature data and different methodical tools are used to evaluate the developed ML models. XGB, DT and LR2 models have high R2 values of 0.93, 0.926 and 0.926 in training and 0.936, 0.924 and 0.924 in test phase. While ANN, RR and LR models have lowest R2 values of 0.70, 0.56 and 0.40 in training and 0.62, 0.63 and 0.31 in test phase respectively. XGB, DT and LR2 have low MAE and RMSE values of 0.450 min-1/cm2, 0.494 min-1/cm2 and 0.49 min-1/cm2 for RMSE and 0.263 min-1/cm2, 0.285 min-1/cm2 and 0.29 min-1/cm2 for MAE in test stage. XGB, DT, and LR2 have 93% percent errors within 20% error range in training phase. XGB has 92% and DT, and LR2 have 94% errors with 20% range in test phase. XGB, DT, LR2 models remained the highest performing models and XGB is the most robust and effective in predictions. Feature importances reveal the role of input parameters in prediction made by developed ML models. Dosage, humidity, UV light intensity remain important experimental factors. This study will impact positively in providing efficient models to estimate photocatalytic degradation rate of air contaminants using TiO2.

Background & objectives: Insect growth regulators (IGRs) are biological hormone analogue or mimics used as pesticides to inhibit the growth of larva during their molting and skin shedding. This study aimed to test the effect of IGRs on the eggs hatching and post-hatching inhibition of Aedes mosquitoes and understanding its effect in the mosquito breeding habitats for reduction in adult emergence. Methods: Experiments on the evaluation of three insect growth regulators (IGRs) for the control of different stages of Aedes aegypti was carried out during 2020-21. Each experiment consisted of four treatments viz., Pyriproxyfen, Novaluron, and Larvicol at 1.0 ppm and distilled water as a control. All experiments were carried out in completely randomized design (CRD) except eggs which were carried out in factorial design each with three replications. Results: All tested IGRs performed better in affecting eggs, larval and pupal stages of Ae. aegypti. Highest eggs hatching inhibition (80%) of fresh eggs occurred in Pyriproxyfen followed by Novaluron (66%) and lowest in Larvicol (62%). Eggs hatch inhibition of embryonated eggs was lower than fresh eggs. Pyriproxyfen caused 69%, Novaluron 59% and Larvicol 39% eggs hatch inhibition of embryonated eggs. Both Pyriproxyfen and Novaluron performed better in causing 98–100% larval mortality followed by Larvicol (39%). Larval development to pupal stage was completely prevented by both Pyriproxyfen and Novaluron. Although Larvicol resulted in lowest eggs hatch and larval inhibition but prevented pupae to emerge as adults. Results further showed 70–89% mortality of 3rd instar larvae of Ae. aegypti when exposed to Pyriproxyfen and Novaluron solutions after 30 days storage at lab. temperature (27±2°C), RH 70±5. Interpretation & conclusion: None of the IGRs was more effective at the pupal stage but showed carry-on activity of growth inhibition and mortality of the successive stages of development when used against eggs stages. Therefore, we recommend early application of IGRs at mosquito habitats during the beginning and onset of the season when very early stages of mosquitoes are available in the field.

Abstract This study presents an experimental and finite element analysis of reinforced concrete beams with solid, hollow, prismatic, or non-prismatic sections. In the first part, a total of six beams were tested under four-point monotonic bending. The test matrix was designed to provide a comparison of structural behavior between prismatic solid and hollow section beams, prismatic solid and non-prismatic solid section beams, and prismatic hollow and non-prismatic hollow section beams. The intensity of shear was maximum in the case of prismatic section beams. The inclusion of a tapered section lowered the demand for shear. In the second part, Nonlinear Finite Element Modeling was performed by using ATENA. The adopted modeling strategy resulted in close agreement with experimental crack patterns at ultimate failure. However, the ultimate failure loads predicted by nonlinear modeling were generally higher than their corresponding experimental results. Whereas in the last part, the developed models were further extended to investigate the effect of the strength of concrete and ratio of longitudinal steel bars on the ultimate load-carrying capacity and cracking behavior of the reinforced concrete beams with solid, hollow, prismatic, or non-prismatic sections. The ultimate loads for each beam predicted by the model were found to be in close agreement with experimental results. Nonlinear modeling was further extended to assess the effects of concrete strength and longitudinal reinforcement ratio on failure patterns and ultimate loads. The parametric study involved beams reinforced with glass fiber-reinforced polymer (GFRP) bars against shear and flexural failure. In terms of ultimate load capacities, diagonal cracking, and flexural cracking, beams strengthened with GFRP bars demonstrated comparable performance to the beams strengthened with steel bars.

Abstract The current study regarding the effects of larval diets on the life table parameters of dengue mosquitoes, Aedes aegypti was conducted under laboratory conditions at 27 ± 2 °C and 60 ± 5% relative humidity at NIFA (Nuclear Institute for Food and Agriculture) Peshawar, Pakistan. The data on life table parameters of Ae. aegypti reared on Diet 1 (replacement diet), Diet 2 (Khan’s diet for Anopheles), Diet 3 (Khan’s modified diet) and Diet 4 (IAEA diet) were analyzed using the age-stage, two-sex life table software. Diet 4 (IAEA) was used as a control for comparison. The results indicated that significantly maximum percentage of egg hatching of Ae. aegypti was observed when reared on Diet 4 (73.86%) and Diet 3 (72.90%), while less % of egg hatching was recorded in Diet 1 (40.67%) and Diet 2 (55.53%). The data further showed that the Diet 3 had a highest intrinsic rate of increase (r) (0.097 ± 5.68 day−1), finite rate of increase (λ) (1.10 ± 6.26 day−1) and net reproductive rate (R 0 ) (11.99 ± 1.52 eggs/female) followed by Diet 2 and Diet 4. The mean generation time (T) of Ae. aegypti reared on Diet 3 (23.67 ± 0.86 days) and Diet 1 (24.05 ± 0.61 days) was significantly shorter than Diet 2 (26.15 ± 0.71 days) and Diet 4 (26.41 ± 0.38 days). The overall results revealed that Diet 3 showed good results at different life table parameters of Ae. aegypti and can be used as the preferred diet in the Sterile Insect Technique (SIT) where the mass culture of mosquitoes is required.

Introduction Intracranial atherosclerotic disease (ICAD) is one of the most prevalent causes of stroke across the world, with a high morbidity and mortality rate. Endovascular treatment (ET) has gained prominence but remains a challenge with unfavorable results. Recent literature has demonstrated that the Resolute Onyx Zotarolimus‐Eluting stent (RO‐ZES) is a technically safe option with low complication rates. Preliminary data has also reported the 30‐day outcomes associated with intracranial stent placement for ICAD with RO‐ZES compared to results from the Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. Here, we aim to compare outcomes at 1 year with the SAMMPRIS trial to further evaluate the efficacy and outcomes of RO‐ZES in a multicenter study with long‐term follow up extending beyond 30 days. Methods Prospectively maintained databases across 7 stroke centers were reviewed to identify adult patients undergoing RO‐ZES placement for treatment of ICAD between January 2019 to May 2023. The primary endpoint was composite of 1‐year stroke, ICH, and/or death. This data was propensity score matched using age, sex, hypertension, diabetes mellitus, smoking status, and impacted vessel for comparison between RO‐ZES and the SAMMPRIS percutaneous angioplasty and stenting groups (S‐PTAS). Results A total of 104 patients met the inclusion criteria for analysis (mean age 62.6, 31.7% female). Impacted vessels included basilar artery (6.7%), internal carotid artery (26.9%), middle cerebral artery (29.8%), posterior cerebral artery (1.0%), and vertebral artery (35.6%). Propensity score match analysis of the 104 patients with S‐PTAS demonstrated 1‐year stroke, ICH, and/or death rate of 11.5% in the RO‐ZES group and 35.6% in the S‐PTAS group (OR 4.17, 95% CI 2.06‐8.96, p=0.001). Conclusion The RO‐ZES system provides a not only safe and effective alternative to other traditional stents, but also demonstrates strong potential to reduce long‐term complications at 1 year compared with the S‐PTAS group. Further prospective multicenter studies are needed to corroborate the findings and compare RO‐ZES directly with other stents.

Introduction: Surgical management of degenerative lumbar spine disorders is effective at improving patient pain, disability, and quality of life; however, obtaining a durable posterolateral fusion after decompression remains a challenge. Interbody fusion technologies are viable means of improving fusion rates in the lumbar spine, specifically various graft materials including autograft, structural allograft, titanium, and polyether ether ketone. This study assesses the effectiveness of Tritanium posterolateral cage in the treatment of degenerative disk disease. Methods: Nearest-neighbor 1:1 matched control transforaminal lumbar interbody fusion with PEEK vs. Tritanium posterior lumbar (PL) cage interbody fusion patients were identified using propensity scoring from patients that underwent elective surgery for degenerative disk diseases. Line graphs were generated to compare the trajectories of improvement in patient-reported outcomes (PROs) from baseline to 3 and 12 months postoperatively. The nominal data were compared via the χ2 test, while the continuous data were compared via Student's t-test. Results: The two groups had no difference regarding either the 3- or 12-month Euro-Qol-5D (EQ-5D), numeric rating scale (NRS) leg pain, and NRS back pain; however, the Tritanium interbody cage group had better Oswestry Disability Index (ODI) scores compared to the control group of the PEEK interbody cage at both 3 and 12 months (p=0.013 and 0.048). Conclusions: Our results indicate the Tritanium cage is an effective alternative to the previously used PEEK cage in terms of PROs, surgical safety, and radiological parameters of surgical success. The Tritanium cohort showed better ODI scores, higher fusion rates, lower subsidence, and lower indirect costs associated with surgical management, when compared to the propensity-matched PEEK cohort.

OBJECTIVE: To find out the level of anxiety among undergraduate students of major public sector dental and medical colleges in Peshawar METHODOLOGY: This cross-sectional, descriptive study was conducted in two public sector hospitals, Khyber Medical College and Khyber College of Dentistry Peshawar, before their annual objective structured clinical examination (OSCE) from March to April 2021. Institutional ethical permission was granted through IREB Ethical approval Certificate. Students of MBBS and BDS were included in the study. Students with any psychiatric illness or thyroidal illness taking medications were excluded. Nonprobability convenience sampling technique was used for sample collection. A validated and pretested generalized anxiety disorder (GAD) 7 scale was used to measure anxiety. Results were analyzed using SPSS version 20. A P- value of less than 0.05 was considered significant. RESULTS: Out of 342 students, 333 (223 MBBS and 110 BDS) were enrolled in the study. Nine students were excluded from the study. One hundred and eighty-eight were male, and 145 were female. The mean age was 23.54±1.98 SD years. Nighty six (28.8%) students had minimal anxiety, 100 (30%) had mild anxiety, 75(22.5%) had moderate anxiety, and 62(18.6%) had severe anxiety. There was a significant difference in anxiety levels of both genders (P-value ≤ 0.001). With a cut-off value of ≥10, 138 (41.4%) had a diagnosis of GAD. There was no significant difference in anxiety levels of MBBS and BDS students (Pvalue 0.073). CONCLUSION: Generalized anxiety disorder affects a large population of medical students, affecting female students more than males.

Flexible pavements are mostly affected by meteorological factors in addition to traffic loads, which results in premature pavement failures like rutting and moisture-induced damage. This study focuses on the impacts of adding various contents of nano-silica (NS), i.e., 2%, 4%, 6%, and 8% (percentage weight of asphalt), along with a constant value of 4.5% styrene-butadiene-styrene (SBS). To assess the effectiveness of modified and unmodified mixtures, the indirect tensile strength (ITS) test, resilient modulus (MR) test, and wheel tracking test were conducted. The MR test was performed at dual temperature values, i.e., 25 °C and 40 °C, and demonstrated different metrological conditions in this region. The tensile strength ratio was used to estimate the mitigation of water losses in hot mix asphalt (HMA) mixtures (specimens) utilizing ITS test results of the conditioned and unconditioned specimens. Moreover, a model was developed for the rutting potential of the modified specimens using multi expression programming (MEP), a sophisticated technique that employs experimental data and suggests an equation for different input variables. The results indicated that the addition of NS to SBS-modified bitumen enhanced different mechanical properties of the specimens, including the stiffness and moisture and rutting resistances. The temperature had adverse effects on the stiffness of the specimens, while the modifiers had a direct relationship with the stiffness. The two-way factorial method justified the effect of the temperature and modifiers on MR with 95% precision, while the MEP model for rutting showed an R2 value of >0.95, which revealed a good relationship between the experimental and predicted data. Furthermore, NS and SBS had a good impact on the mechanical properties of the HMA specimens.

Objective: To compare trans-atrial/Trans-pulmonary and trans-annular/trans-ventricular techniques of surgical correction of tetralogy of fallot. Study Design: Descriptive cross sectional study. Place and Duration of Study: AFIC-NIHD Rawalpindi, from Jan 2005 to Jan 2020. Methodology: Pre-op variables included age, gender, weight, SaO2 and any previous operation (like Modified Blalock Taussig Shunt.) Operative variables were any previous Blalock Taussig Shunts and if present, then their takedown, Cardiopulmonary Bypass Time, Aortic Clamp Time, any Right Ventricle - Pulmonary Artery conduit, Main Pulmonary Artery patch-plasty, Left Pulmonary Artery/ Right Pulmonary Artery patch-plasty, dosage of inotropes and pacing started during weaning off CPB. Post-op variables were mechanical ventilation time (hrs), ventilation time >72 hrs, dosage and duration of inotropes, pacing >24 hrs, renal complications, neurological complications, sepsis, low cardiac output, re-ventilation, tachyarrythmias, any re-opening surgery, mean intensive care unit stay (hrs), overall hospital stay (days) and overall all-cause mortality. Results: A total of 1271 TOF patients were operated. In (38.6%) cases Trans-atrial / Trans-pulmonary approach was used while in 780 (61.3%) correction was done by TAP/TV technique. In both techniques, male patients were 365 (66.4%) vs. 73 (64.1%) females. Mean age was 5 ± 2.3 vs. 4 ± 2.5 years, MPA patch-plasty was 190 ± 5 (38.6%) vs. 780 ± 8 (100%) (p-0.058), RPA/LPA Patch Plasty was 25 ± 6 (5%) vs. 180 ± 10 (23%) (p- 0.025), In ICU, Ventilation hours was 25 ± 8 and 30 ± 12, Ventilation >72 Hrs was 15 (3%) vs. 65 (8.3%) (p-0.015), Inotrope duration >72 Hours was 90 (18.3%) vs. 400 (51.2%) (p-0.338), pacing >24 hours was 30 (6.1%) vs. 150 (19.2%) (p-0.0001), renal complications were 10 (2.3%) vs. 35 (4.4%) (p- 0.285), Neurological complications were 7 (1.4%) vs. 15 (1.9%) (p0.553), Sepsis was 11 (2.2%) vs. 47 (6%) (p-0.33), Low cardiac output was 15 (3%) vs. 66 (8.4%) (p- 1.000), re-ventilation was 10 (2%) vs. 110 (14%) (p- 0.41), Tachy-arrhythmia was 25 (5%) vs. 150 (19.2%) (p- 0.11), re-openings were 19 (3.8%) vs. 65 (8.3%) (p- 0.0003), ICU stay (Hours) was 87 ± 8 vs. 108 ± 10, Mortality was 35 (7.1%) vs. 75 (9.6%) (p-0.094), Mean hospital stay (Days) was 12.2 ± 2.5 vs. 15.8 ± 4.9. Conclusion: Fifteen years’ experience of Tetralogy of fallot corrections at AFIC-NIHD indicates that Trans-atrial / Trans-pulmonary approach is more beneficial to patients due to high survival rate, less morbidity, less hospital stay and an early discharge. This ultimately translates into less financial burden on the patients, hospital, society and the country at large.

Double Aortic Arch is a rare congenital cardiovascular anomaly. Its first successful surgery was performed by Robert Gross in 1945 at Children Hospital Boston, USA. It accounts for 0.4 to 1% of all congenital cardiac defects. Patients having a Double Aortic Arch mostly present with symptoms in the 1st week of life but depending upon the severity of symptoms can present at any age in childhood. We present a case report of two month old baby with noisy breathing, intermittent cough, gross jugular notch retraction and sub costal recession. His Cardiac CT was subsequently done which showed a Double Aortic Arch of left dominant variety encircling the trachea. Surgery was done and the encircling artery compressing the trachea was recognized, dissected and interrupted. Marked relief of tracheal and/or esophageal compression was evident from operation day. Post operative recovery was speedy. Patient’s follow up of was done at 1, 4 and 24 weeks. His recovery was unremarkable. Currently he was thriving well.

Abstract Background Ewing’s sarcoma family of tumors consists of small round cell neoplasms, inclusive of primitive neuroectodermal tumor (PNET), Askin’s tumor, and PNET of the bone. Extraosseous Ewing’s sarcoma occurs commonly at bones of lower extremities and paravertebral region of the spine. It rarely presents as a primary intracranial lesion. When intracranial, it can be misdiagnosed as central PNET (e.g., medulloblastoma, pinealoblastoma, or supratentorial PNET), other intracranial lesions, or even as an epidural hematoma. Case presentation We report the case of a 20-year-old patient who presented to the emergency department with complaints of drowsiness, headache, and fever for 1 day. On initial computed tomography (CT) scan of the brain, a right temporal biconvex epidural lesion involving squamous-temporal bone with periosteal reaction was noted. The patient underwent urgent craniotomy, and a tumor was found and excised. Biopsy report confirmed Ewing’s sarcoma. Conclusion Ewing’s sarcoma is a rare intracranial malignancy with only a few cases reported in literature. In a young patient with a biconvex epidural lesion, in the absence of trauma or ongoing infection, the possibility of Ewing’s sarcoma should be considered as well.

Modal parameter identification is considered to be one of the most important tasks in structural health monitoring because it provides a reliable reference for structural vibration control, damage severity, and operational state. Moreover, at present, the combined deterministic-stochastic subspace algorithm is cogitated as one of the key algorithms in the modal parameter identification, which is why it is widely used in the modal parameter identification of bridge structures. In this paper, a novel method is proposed, which is a time-domain identification algorithm, based on sliding window-fuzzy C-means clustering algorithm-combined with deterministic-stochastic subspace identification (SC-CDSI), to achieve online intelligent tracking and identification of modal parameters for nonlinear time-varying structures. First of all, to realize the online tracking and identification process, it is necessary to divide the input and output signal of the nonlinear time-varying structure by windowing; for that, to determine the window function, window size and window step length according to the characteristics of the signal are analyzed. Secondly, in order to satisfy the intelligent identification of effective modals in stability diagram, the fuzzy C-means clustering algorithm is kept as a base, whereas frequency, damping ratio, and modal shapes serve as clustering elements, applied to fuzzy C-means clustering algorithm, and then the intelligent selection of effective modals is achieved. Finally, a shaking table test bridge is used as a modal parameter identification in lab, and its results are compared with the MIDAS finite element results. The compared results show that the proposed SC-CDSI identification algorithm can accurately achieve the intelligent identification of online tracking of the structural frequency, and the identification results are reliable to be used in real-life bridge structures.

Realizing online intelligent identification of bridge modal parameters requires not only the adaptive decomposition of structural response signals but also the enforcement of the automatic identification of modal parameters. Therefore, in this paper, the signal decomposition algorithm-ensemble empirical mode decomposition algorithm (EEMD) is improved to fulfill the above task. First, the adaptive matching algorithm is introduced to deal with the endpoint effect; second, the method of classification is used to avoid modal aliasing. Finally, an index for filtering the effective intrinsic mode function (IMF) components is constructed to realize automatic screening and signal reconstruction of the effective IMF components. At the same time, the first derivative of the singular entropy increment is used to automatically determine the order of the system, and then the spectral clustering algorithm is combined with the stochastic subspace algorithm to ultimately reach the goal of automatic identification of modal parameters.

Abstract Background Dengue is becoming more common in Pakistan with its alarming spreading rate. A historical review needs to be carried out to find the root causes of dengue dynamics, the factors responsible for its spread and lastly to formulate future strategies for its control. Methods We searched (January, 2015) all the published literature between 1980 and 2014 to determine spread/burden of dengue disease in Pakistan. Results A total of 81 reports were identified, showing high numbers of dengue cases in 2010, 2011, and 2013. The tendency of dengue to occur in younger than in older age groups was evident throughout the survey period and all four serotypes were recorded, with DENV1 the least common. Most dengue hemorrhagic fever (DHF) cases fell in the 20–45 years age range. High frequencies tended to be observed first in the Southern coastal region characterized by mild winters and humid warm summers and then the disease progressed towards the lowland areas of the Indus plain with cool winters, hot summers and monsoon rainfall. Based on this survey, new risk maps and infection estimates were identified reflecting public health burden imposed by dengue at the national level. Conclusions Our study showed that dengue is common in the three provinces of Pakistan, i.e., Khyber Pakhtunkhwa (KP), Punjab and Sindh. Based on the literature review as well as on our study analysis the current expansion of dengue seems multifactorial and may include climate change, virus evolution, and societal factors such as rapid urbanization, population growth and development, socioeconomic factors, as well as global travel and trade. Due to inadequate remedial strategies, effective vector control measures are essential to target the dengue vector mosquito where high levels of human-vector contact occur. The known social, economic, and disease burden of dengue is alarming globally and it is evident that the wider impact of this disease is grossly underestimated. An international multi-sectoral response, outlined in the WHO Global Strategy for Dengue Prevention and Control, 2012–2020, is now essential to reduce the significant influence of this disease in Dengue endemic areas. Overall gaps were identified in knowledge around seroprevalence, dengue incidence, vector control, genotype evolution and age-stratified serotype circulation.

Triterpenes possess anti-inflammatory and anti-nociceptive effects. In this study anti-inflammatory activities of Asparacosin A were evaluated' using in-vitro cyclooxygenases 1 and 2 (COX-1/2) inhibition assays. Moreover, anti-nociceptive activities were assessed in-vivo by carrageenan-induced paw edema test, xylene-induced ear edema tests, and acetic acid-induced writhing and formalin tests. Additionally molecular docking was conducted to elucidate the binding mechanism of the compound and to correlate the in-vitro findings with the in-silico data. Oral administration of Asparacosin A at the doses of 10, 20, and 40 mg/kg induced significant anti-inflammatory effects (*p < 0.05, **p < 0.01, and ***p < 0.001) in a dose-dependent manner in both models. Asparacosin A also inhibited the human recombinant COX-2 enzyme and caused a dose-dependent decrease in the levels of TNF-α, IL-1β, and PGE2 in the carrageenan-induced paws. Moreover, Asparacosin A displayed significant anti-nociceptive effects (*p < 0.05, **p < 0.01, ***p < 0.001) at the doses of 10, 20, and 40 mg/kg in acetic-acid induced writhing test. However, in formalin test, Asparacosin A (10–40 mg/kg, p.o) produced anti-nociceptive effects only in the late phase, similar to the effect observed with the reference drug celecoxib (50 mg/kg, p.o). Molecular docking was carried out on both COX-1 and COX-2 structures which revealed that Asparacosin A targets allosteric binding site similar to the binding mode of the selective COX inhibitor. In conclusion, Asparacosin A exhibits anti-inflammatory and peripheral anti-nociceptive activities which are likely mediated via inhibition of COX-2 enzyme and inflammatory cytokines. Furthermore, Asparacosin A can serve as a model to obtain new and more selective potent anti-inflammatory and anti-nociceptive drugs.

A young emaciated male, known case of celiac disease came with the complains of diarrhea along with 5kgs of weight loss in 3 months' time. He had severe electrolyte abnormalities along with low albumin, low calcium and a high phosphate with deranged liver function test. Ultrasound abdomen had shown fatty liver. Nutrition consult was sought and he was found to have a BMI of 6.8kg/m2. He was started on nutrition support along with supportive therapy, which resulted in weight gain and improvement in his condition.

Objective: To test the relative efficacy of pyriproxyfen and methoprene on mortality, deformity, inhibition and emergence to adult stages of Culex quinquefasciatus and Aedes albopictus. Methods: Serial dilutions (0.01–0.05 mg/L) of methoprene, pyriproxyfen 0.5 water dispersible granules (WDG) and pyriproxyfen 1.0 WDG were used to assess mortality and inhibition of 3rd instar larvae of Aedes albopictus and Culex quinquefasciatus. Each concentration and control was replicated four times in completely randomized design. Data on larval mortality, growth inhibition, deformities and adult's emergence was recorded weekly. On the basis of best comparative performance, the efficacy of pyriproxyfen 1.0 WDG at 0.1 g/m3 was also tested in the field by collecting treated water samples monthly for 1–6 months after field application. Twenty five 3rd instar larvae of Aedes and Culex spp. of the same cohorts were used for bioassays and compared with larvae in control cups containing 1 L of untreated tap water. Results: Results revealed variations in fatality of different insect growth regulators (IGRs) to the 3rd instar larvae of Culex and Aedes mosquitoes. Among the IGRs, pyriproxyfen 1.0 WDG was found best that exhibited significantly high emergence inhibition against Culex and Aedes spp. Based on the results, the IGRs were classified in terms of the tested parameters in order of pyriproxyfen 1.0 WDG > pyriproxyfen 0.5 WDG > methoprene. In case of field studies, pyriproxyfen 1.0 WDG, pool data of the entire target treated sites showed minimum adult emergence from water sampled of habitats treated with 0.1 g/m3 of pyriproxyfen 1.0 WDG. Conclusions: It is thus concluded that IGRs can be utilized as environment friendly control measures for Culex and Aedes spp. of mosquitoes on small and large scale. This will reduce the use of conventional insecticides by the public health authorities and help in reducing selection pressure of insecticides.

Data-driven stochastic subspace identification (DATA-SSI) is frequently applied to bridge modal parameter identification because of its high stability and accuracy. However, the existence of abnormal data and noise components may make the identification result of DATA-SSI unreliable. In order to achieve a reliable identification result of the bridge modal parameter, a data inspecting and denoising method based on exploratory data analysis (EDA) and morphological filter (MF) was proposed for DATA-SSI. First, EDA was adopted to inspect the data quality for removing the data measured from malfunctioning sensors. Then, MF along with an automated structural element (SE) size determination technique was adopted to suppress the noise components. At last, DATA-SSI and stabilization diagram were applied to identify and exhibit the bridge modal parameter. A model bridge and a real bridge were used to verify the effectiveness of the proposed method. The comparison of the identification results of the original data and improved data was made. The results show that the identification results obtained with the improved data are more accurate, stable, and reliable.

BACKGROUND:Aedes aegypti and Aedes albopictus play a fundamental role in transmission of dengue virus to humans. A single infected Aedes mosquito is capable to act as a reservoir/amplifier host for dengue virus and may cause epidemics via horizontal and vertical modes of dengue virus (DENV) transmission. The present and future dengue development can be clarified by understanding the elements which help the dissemination of dengue transmission. The current study deals with molecular surveillance of dengue in addition to ecological and social context of 2013 dengue epidemics in Swat, Pakistan. METHODS:Herein, we reported dengue vectors surveillance in domestic and peridomistic containers in public and private places in 7 dengue epidemic-prone sites in District Swat, Pakistan from July to November 2013. Using the Flaviviruses genus-specific reverse transcriptase (RT) semi nested-PCR assay, we screened blood samples (N = 500) of dengue positive patients, 150 adult mosquito pools and 25 larval pools. RESULTS:The 34 adult and 7 larval mosquito pools were found positive. The adult positive pools comprised 30 pools of Ae. aegypti and 4 pools of Ae. albopictus, while among the 7 larval pools, 5 pools of Ae. aegypti and 2 pools of Ae. albopictus were positive. The detected putative genomes of dengue virus were of DENV-2 (35% in 14 mosquito pools & 39% in serum) and DENV-3 (65% in 27 mosquito pools & 61% in serum). The higher vector density and dengue transmission rate was recorded in July and August (due to favorable conditions for vector growth). About 37% of Ae. aegpti and 34% Ae. albopictus mosquitoes were collected from stagnant water in drums, followed by drinking water tanks (23% & 26%), tires (20% & 18%) and discarded containers (10% & 6%). Among the surveyed areas, Saidu was heavily affected (26%) by dengue followed by Kanju (20% and Landikas (12%). The maximum infection was observed in the age group of 45 (25%) years and was more in males (55.3%) as compare to females (44.7%). The increase in vector mosquito density and the subsequent viral transmission was determined by a complex interplay of ecological, biological and social factors. CONCLUSION:The suitable environmental conditions and discriminable role of Aedes through trans-ovarial transmission of DENV is indispensable in the recent geographic increase of dengue in Pakistan. Climate change affects the survival and dispersion of vectors as well as the transmission rates of dengue. Control of Aedes mosquitoes (vectors) and elimination of breeding sources must be emphasized and prioritized. Such actions may not only reduce the risk of dengue transmission during epidemics, but also minimize the chances of dengue viruses establishment in new (non endemic) areas of the region.

Background: Enterococci are the most common cause of healthcare associated urinary tract infections. The frequency of isolation of enterococci from urinary tract of hospitalized patients has risen. Vancomycin resistant enterococci along with other multidrug resistant bacteria are the main concerns for physicians. Enterococci may also act as vehicle for spread of resistant genes. The objective of this study was to determine the antimicrobial susceptibility pattern of different enterococcal species isolated from urine samples. Material & Methods: This cross-sectional study was conducted at Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi. Hundred enterococcal isolates cultured from urinary specimens were processed from October 2011 to March 2012. In-vitro drug-susceptibility tests of enterococci isolated were performed on Mueller Hinton agar. Results: A total of 100 urine specimens yielding growth of enterococci were studied. Among these only 7 samples were from OPD, the rest were from different wards. The mean age was 55±24.58 (range 8-89) years. Sixty-six (66%) of the isolates were from males while 34(34%) from females. Enterococcus faecalis was isolated in 81(81%) cases while Enterococcus faecium in 19(19%). Regarding sensitivity, 100% isolates were susceptible to linezolid, 99% to teicoplanin, 97% to vancomycin, 88% to imipenem, 87% to co-amoxiclav, 81% to nitrofurantoin, 75% to ampicillin, whereas the susceptibility to ciprofloxacin and tetracycline was 42% and 38% respectively. Conclusion: Enterococci have emerged from being harmless commensals to versatile lethal pathogens. The rising antibiotics resistance is worrisome as the commonly used antibiotics for the treatment of nosocomial UTI are less effective.

Acetylcholinesterase (AChE) inhibitors are well established therapeutic agents for clinical management of Alzheimer's Diseases and other disorders associated with deficient cholinergic neurotransmission. In the current investigation, a new inhibitor has been reported for its significant AChE inhibitory. euchrestifoline was isolated from the extract of Murraya paniculata. Isolated compound showed significant enzyme inhibitory activity (IC50 value: 93.1 ± 0.0 ?M). Molecular docking revealed structural insights behind its significant inhibitory activity. Various molecular interaction were found between euchrestifoline and Ache especially Ser122, Trp84 and Tyr121. This study indicated promising potential of euchrestifoline to be further developed and explored as potential lead compound.

Rhododendron arboreum various fractions of bark as well as the isolated compounds were investigated against pathogenic fungi to provide evidence for the folkloric uses reported in the traditional system. Various solvent fractions and compounds were tested using agar well diffusion method at concentrations of 50, 25 and 12.5 mg/mL, the maximum inhibition recorded against fungi 17-32, 15-27 and 10-24 mm for methanol extract, 16-28, 14-26 and 10-22 mm to ethyl acetate extract, 17-21, 8-18 and 10-16 to chloroform extract and 8-15 and 8-12 mm to n-hexane extract respectively. Maximum inhibition at 10, 5 and 2.5 mg/mL of isolated triterpenoids was recorded against such as fungi 28-44, 25-42 and 20-40 mm for 3β-acetoxyurs-11,12-epoxy-13β,28-olide, 23-44, 20-42 and 15-40 mm for betulin and 17-40, 15-37 and 13-34 for lupeol respectively. It is concluded from the present study that the antifungal activity of the extracts may be due to the presence of 3β-acetoxyurs-11,12-epoxy-13β,28 - olide, betulin, lupeol and taraxerol.

Cycloxygenase inhibitors are one of the main class of therapeutic agents for management of inflammation. New COX inhibitors are discovered from natural and synthetic sources. In the current investigation taraxerol acetate have been discovered as a new COX inhibitor. Taraxerol acetate showed considerable inhibitory activity against both COX-1 (IC50: 116.3 ± 0.03 ?M) and COX-2 (IC50: 94.7 ± 0.02 ?M) enzymes using in-vitro enzyme inhibition assay. Molecular docking revealed significant interactions of taraxerol acetate with the important amino acid residues surrounding the inhibitor in binding pocket of COX-2 enzyme. This study indicate potential of taraxerol acetate to be further explored and modified as a new lead compound for better management of inflammatory conditions via targeting COX enzymes.

The title compound, C14H18N2O2, contains two geometrically different molecules in the asymmetric unit: the basal plane of the cyclohexane chair and the N-[pyridin-3-ylmethylidene]methanamine moiety are oriented at dihedral angles of 71.77 (7)° and 83.42 (8)°. In the crystal, the molecules are linked by O—H...N hydrogen bonds, generating C(13) head-to-tail chains extending along the base vector [103]. R22(26) ring motifs are formed due to the C—H...·O interactions that link neighbouring chains. There also exist π–π interactions [centroid–centroid separation = 3.6925 (12) Å] between the symmetry-related pyridine rings of one of the independent molecules.

Objective: The frequency of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites due to hepatitis “C” virus and efficacy of Ciprofloxacin in its treatment. Material and methods: This study was conducted in medical units of Khyber Teaching Hospital, Peshawar from July, 2008 to Jan, 2009. A total of 100 patients were studied. All those patients who had either already diagnosed or had symptoms and signs of chronic liver disease were included in the study. The main tool for the diagnosis of SBP was diagnostic peritoneal paracentesis which was then repeated after giving 200mg I.V ciprofloxacin for 5 days. Results: The overall frequency of Spontaneous Bacterial Peritonitis in cirrhotic patients with ascites due to HCV was 38 in 100 patients (38%). 52 males and 48 females were studied. Among 38 patients with SBP, 20 were males and 18 were females. All the patients with SBP were put on intravenous ciprofloxacin for 5 days and 79 % of them responded completely. Conclusion: Spontaneous bacterial peritonitis is a common complication of liver cirrhosis leading to significant morbidity and mortality. Although SBP responds excellently to Ciprofloxacin as shown in this study (79 %), even then the morbidity and mortality is high.