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Abstract Background The chickpea Cicer arietinum (Fabaceae) field has suffered significant economic losses due to the presence of cotton bollworm, Helicoverpa armigera Hübner (Lepidoptera: Noctuidae). Attempts to control the larval population through chemical pesticides led to some reduction but also resulted in the development of resistance among the larvae. Consequently, the H. armigera population experienced a rapid resurgence in the field. Given the substantial losses caused by Helicoverpa larvae, there is now a growing interest in adopting eco-friendly methods for management. The application of biocontrol agents has emerged as a promising solution for effectively managing the infestation. Results In the laboratory experiment, the entomopathogenic nematodes (EPNs) Steinernema pakistanense NNRC-NB.14, S. balochiense NNRC-NB.23, and S. abbasi NNRC-NB.33 were evaluated for their infectivity and mortality effects on mature cotton bollworm at various concentrations. The study demonstrated that the highest mortality rates were achieved at a concentration of 250 infective juveniles (IJs) per larva after 72 h. Steinernema pakistanense and S. balochiense exhibited higher mortality rates (95–98%) compared to S. abbasi (77%) at higher application concentrations. The field trial results reinforced the laboratory findings, demonstrating a significant decrease in H. armigera larval populations when employing EPN strains, particularly NNRC-NB.14 and NNRC-NB.33, compared to NNRC-NB.23. Despite the initial applications showing relatively low mortality percentages, the most effective larval control occurred after the third application of EPNs. The field trials revealed that, following the third spray, mortality percentages significantly increased from the initial range of 20–32% to a more substantial 70–90%. This cumulative impact highlights the importance of multiple applications in achieving optimal pest control. Conclusion The findings of these studies highlight the promising potential of EPN as an eco-friendly and sustainable method for controlling the cotton bollworm. However, the successful implementation of EPN-based control strategies in agricultural systems requires careful consideration of factors such as nematode species selection, application methods, environmental conditions, and integration with other pest management practices. Further research is needed to optimize the efficacy and practicality of using EPN on a larger scale, addressing issues such as nematode production, formulation, and compatibility with existing farming practice.

Abstract Schiff bases are a diverse group of organic compounds with great pharmaceutical importance due to the presence of carbon–nitrogen double bonds (–C=N–). These compounds are synthesized by the condensation reaction between a primary amine and an aldehyde or ketone in a suitable solvent such as methanol. These compounds have shown antibacterial, antifungal, antiviral, anti-inflammatory, and antioxidant activities, which have garnered the attention of organic chemists in synthesizing these compounds. Recent advances have been summarized in this review paper mainly including compounds with potential antibacterial, antifungal, and antiviral activities. Synthetic schemes are included to provide a better understanding of the Schiff base synthesis mechanism. This review paper will provide a way forward for the pharmaceutical chemist to synthesize new compounds with potential biological activities. Graphical abstract

Maintaining the content quality on social media Q&A platforms is pivotal for user attraction and retention. Automating post quality assessment offers benefits such as reduced moderator workload, amplified community impact, enhanced expert user recognition, and importance to expert feedback. While existing approaches for post quality mainly employ binary classification, they often lack optimal feature selection. Our research introduces an automated system that categorizes features into textual, readability, format, and community dimensions. This system integrates 20 features belonging to the aforementioned categories, with a hybrid convolutional neural network–long short-term memory deep learning model for multi-class classification. Evaluation against baseline models and state-of-the-art methods demonstrates our system’s superiority, achieving a remarkable 21–23% accuracy enhancement. Furthermore, our system produced better results in terms of other metrics such as precision, recall, and F1 score.

] Accurate classification of brain tumors is essential for effective medical diagnosis and treatment planning. Traditional approaches rely on convolutional neural networks (CNNs) for tumor detection, but they often suffer from high computational demands due to the large number of parameters. In this paper, we propose a novel approach for brain tumor classification using involutional neural networks (InvNets), which are designed to mitigate the parameter-intensive nature of CNNs. Unlike the spatial-agnostic and channel-specific convolution kernel, the involution kernel is location-specific and channel-agnostic. This location-specific operation allows the network to adapt to various visual patterns with respect to different spatial locations, enhancing its ability to capture intricate features within the medical images. Our study focuses on a four-class brain tumor classification problem, aiming to differentiate between different tumor types based on medical imaging data. In a comparative analysis, we demonstrate that conventional CNNs require over 4 million parameters, whereas our proposed InvNets require less than 0.2 million parameters, making them more efficient and resource-friendly. The evaluation of both CNNs and InvNets is carried out using standard performance matrices: accuracy, precision, recall, F1 score, and AUC-ROC values. Our findings reveal that the InvNets consistently outperform traditional CNNs. The InvNet architecture achieves an impressive 92% accuracy rate, showcasing its potential for accurate brain tumor classification. This improved accuracy, combined with the reduced parameter count, highlights the effectiveness of InvNets for medical image analysis tasks, especially in scenarios with limited computational resources.

Lead (Pb) is a biologically non-essential element in the soil that brutally affects plants and other living organisms in soil; hence, its removal has become a worldwide concern. In this work, a multifunctional nanoscale zerovalent-iron assisted biochar (nFe°/BC) was used to minimize the Pb bioavailability in soil with aim of alleviating the Pb-induced toxicity in sunflower. Results revealed that nFe°/BC treatment had significantly improved plant growth (58%), chlorophyll contents (66%), intracellular permeability (60%), and ratio factor (93%), while decreasing the Pb uptake (78%) in plants. The Pb-immobilization and transformation mechanisms were proposed, suggesting that the presence of organic functional groups over the nFe°/BC surface might induce the complex formation with Pb by the ions exchange process in soil solution. The XPS analysis confirmed that surface-active components (Fe+, O2−, O*, C═O) were the key factor for high Pb-immobilization within soil matrix. In addition, 87% of stable Pb species, including PbCO3, PbO, Pb (OH)2, and Pb-O-Fe were found in the soil surface. Current findings have exposed the diverse functions of nFe°/BC on plant health and established a phenomenon that nFe°/BC application could improve the plant agronomic attributes by regulating the homeostasis of antioxidants and Pb uptake.

To explore the challenges faced by each stakeholder for COPD management, including the patients, their family/caretakers, healthcare professionals, and healthcare policymakers & organizations, the authors conducted a survey during the International Respiratory Forum conference 2022 in Ho Chi Minh City, Vietnam. A total of 140 pulmonologists from 11 countries participated in the study. A predesigned structured questionnaire was developed pertaining to questions related to challenges faced by each stakeholder for COPD management in Low-middle income countries (LMIC). Each group received one of the four sections of the questionnaire. It was found that 47% of doctors thought that patients couldn't understand the early symptoms as indicators of a serious illness and were afraid of forming a dependency on long-term drugs. According to 64% of doctors, the most frequent implications experienced by caregivers when caring for COPD patients were the financial burden of lifelong therapies and disappointments from treatment failure brought on by a lack of access to high-quality or specialized healthcare. Of the difficulties experienced by healthcare professionals, 50% said that misusing investigations for diagnosis resulted in delayed or underdiagnoses of COPD. The biggest issue with COPD referrals in developing nations was general practitioners' ignorance of recognizing highrisk patients and the need for their referrals. Approximately 80% of respondents said that a sizeable percentage of annual healthcare spending was consumed by expenses related to exacerbations and repeated ER visits. It is concluded that the questionnaire responses reflect physicians' perceptions and experiences in routine clinical practice. Increased knowledge of COPD diagnosis and treatment recommendations, as well as proactive identification of patients at higher risk of developing COPD due to environmental or lifestyle exposures, will help with prompt, accurate diagnoses and efficient treatments, ultimately improving patient outcomes. Keywords: COPD Management, Challenges, Developing Countries.

Objective: The authors aim to evaluate the challenges faced by each stakeholder for Idiopathic pulmonary fibrosis (IPF) management, including the patients, their families/caretakers, Healthcare professionals, and Healthcare policymakers and organizations in Lowmiddle income countries (LMICs) as perceived by 140 pulmonologists from 11 countries who participated in International Respiratory Forum conference 2022 in Ho Chi Minh City, Vietnam. Methodology: A predesigned structured questionnaire was developed about challenges faced by each stakeholder for IPF management. Study participants were randomly divided into four groups, and only one section of the questionnaire was distributed among the participants of each group. Results: It was observed that the physicians greatly supported the psychological well-being of the patients/caregivers and awareness among Healthcare professionals (HCPs) for timely referrals and diagnosis. The caregivers must support the patients to keep their willpower intact. The availability of only those therapies with modest treatment outcomes with no benefits in halting the disease or reducing mortality and the absence of disease-modifying drugs was considered the major challenge faced by Pulmonologists. Patient affordability was considered the key hindering factor affecting High- Resolution Computed Tomography (HRCT) utilization. The development of Interstitial lung disease (ILD) national registries to keep track of disease prevalence and challenges at hand was defined as the urgent healthcare initiatives that need to be taken by the concerned healthcare policymaking authorities. Moreover, the healthcare systems considered comprehensive patient education about disease management and outcomes the most effective self-management strategy to be incorporated and disseminated. Although a small number of patients with ILDs, specifically IPF, receive a prompt and accurate diagnosis, the survey found that protracted delays, frequent misdiagnoses, exposure to expensive and invasive diagnostic procedures, and significant use of healthcare resources mark the more typical diagnostic experience for those with ILD. Conclusion: These findings indicate the requirement for novel diagnostic tools, best clinical practices, and HCPs training to improve the accuracy of diagnoses in ILD patients. Keywords: Idiopathic Pulmonary Fibrosis, Management, Challenges.

Complex graphics of nonlinear dynamical systems perform vital role in many fields, e.g., image compression or encryption, art, science, and so on. Antifractals are generated by applying a map recursively to an initial point in complex plane that have become a significant area of research these days. The purpose of this paper is to investigate the dynamics of antifractals like anti-Julia sets, tricornsand multicorns of antiholomorphic polynomials via CR iteration scheme with s-convexity. Many beautiful aesthetic patterns are visualized for antipolynomial z → zm + c of complex polynomial zm + c, for m ≥ 2 to explore the geometry of antifractals.

The purpose of this paper is to introduce the Mandelbrot and Julia sets by using Picard-Mann iteration procedure. Escape criteria is established which plays an important role to generate Mandelbrot and Julia sets. Also, numerous graphical pictures of these sets have been visualized and certain examples have been recognized. Presented results shows that fractal images generated by Picard-Mann iteration procedure are entirely different from those generated in Mann orbit.

The application of graph theory in the study of molecular physical and chemical properties involves theoretical mathematical chemistry. Atoms, represented by vertices, and edges, represented by bonds between them, are detailed in simple graphs called chemical graphs. The mathematical derivation of the numerical value of a graph is called the molecular descriptor of the graph. Any connected graph wherein no edge is contained in exclusive of a single cycle is called a cactus graph. In the research in this article, expressions for various molecular descriptors of line graph of the graph obtained by the rooted product of the cycle and path graphs are constructed. This article obtained the calculation of molecular descriptors for line graphs of chain ortho cactus and chain para cactus graphs. To predict the biological activity of a compound, the generalized Zagreb index, the first Zagreb index M1G, the second Zagreb index M2G, the F-index, the general Randic index, the symmetric division, the atom bond connectivity (ABC), and the geometric arithmetic (GA) descriptors are created.

Recently, analyses of the air quality in Pakistan have received significant interest, especially regarding the impact of air pollutant concentrations on human health. The Atlas of Baseline Environmental Profiling along the China-Pakistan Economic Corridor (CPEC) at five locations in Gilgit-Baltistan (GB) is a major landmark in this regard due to the presence of massive glaciers in the region, which are considered as water reserves for the country. Using various statistical measurements, the air quality was analyzed at the studied geographic locations. Further, air quality was evaluated based on air pollutant data acquired from ambient air monitoring laboratories. For example, 24 h concentrations of particulate matter (PM2.5) were found to range from 25.4 to 60.1 µg/m3, with peaks in the winter season at Gilgit. It was found that PM2.5 values were 1.7 and 1.3 times greater than National Environmental Quality Standards (NEQS) standards only at Gilgit and Chilas, respectively, and 1.5 to 4 times greater than the World Health Organization (WHO) standards at all locations. Similarly, PM2.5 concentrations were found to range from 31.4 to 63.9 µg/m3, peaking at Chilas in summer 2020. The observed values were 1.1 to 1.8 times and 2 to 4.2 times greater than the NEQS and WHO standards, respectively, at all locations. In addition, the average peaks of black carbon (BC) were measured at Gilgit, both in winter (16.21 µg/m3) and summer (7.83 µg/m3). These elevated levels could be attributed to the use of heavy diesel vehicles, various road activities and different meteorological conditions. Pollutants such as carbon monoxide (CO), sulfur dioxide (SO2), nitrogen oxides (NOX) and ozone (O3) were found to be within NEQS and WHO limits. Based on air quality metrics, the effect of PM2.5 on air quality was found to be moderate in Sost, Hunza and Jaglot, while it was at unhealthy levels at Gilgit and Chilas in the winter of 2019; moderate levels were observed at Sost while unhealthy levels were detected at the remaining locations in the summer of 2020. There are no specific guidelines for BC. However, it is associated with PM2.5, which was found to be a major pollutant at all locations. The concentrations of CO, SO2 and O3 were found to be at safe levels at all locations. The major fraction of air masses is received either locally or from transboundary emissions. This study demonstrates that PM2.5 and BC are the major and prevailing air pollutants within the study region, while other air pollutants were found to be within the permissible limits of the WHO and NEQS.

Objective: To determine the frequency of Kell blood group antigens (K and k) in blood donors from northernPakistan. Study Design: Cross sectional study. Place and Duration of Study: The study was carried out at immunohaematology department of Armed Forces Institute of Transfusion (AFIT) Rawalpindi, Pakistan, from 1st Nov 2017 to 31st Dec 2017. Methodology: After approval of Ethical Committee of Armed Forces Institute of Transfusion (AFIT) Rawalpindi, the blood samples of 2000 blood donors were collected. Samples were selected by non-probability consecutive sampling technique. After preliminary blood grouping for ABO and Rh D, these samples were phenotyped for K (kelleher) and k (celleno) antigens. Typing was performed on Biorad® automated blood grouping system by column agglutination technique (CAT), strictly following manufacturer’s instructions. Results: Out of 2000 blood donors, typed for K and k antigens, 1966 were males (98.30%) and 34 were females (1.70%). The frequency of K was 4.05% (81/2000) and that of k was 98.90% (1978/2000). The phenotype K-k+ (95.15%) was most prevalent followed by K+k+ (3.75%), K-k- (0.80%) and K+,k- (0.30%). Conclusion: K antigen frequency is lower than as reported in Caucasions and Saudi Arabia but higher than Indian and African blood donors. This study confirmed that the k (celleno) blood group antigen was highly prevalent antigen in Pakistani population while the K (kelleher) antigen was present in a relatively lower frequency.

In this paper, we extend Jungck–SP iteration with $s$ –convexity in second sense and define its orbit. We prove the fixed point results for fractal generation via extended iteration and utilize these results to develop algorithms for fractal visualization. Moreover, we present some complex graphs of Julia and Mandelbrot sets in Jungck–SP orbit with $s$ –convexity. We also present some examples to show the variation in images with involved parameters.

Objective: The objective of current study was to explore the predictive relationship of perceived stressors and its effects on the overall mental health of medical students. Study Design: Cross-sectional study. Place and Duration of Study: The study was carried out at three private sector medical colleges of Lahore, Pakistan from March 2019 to September 2019. Materials and Methods: For assessment purpose indigenous scale “Perceived Stress Scale for Medical Students (PSSMS)” was used for assessment of stressors and “Depression Anxiety Stress Scale (DASS-21)” was used to evaluate the depression, anxiety and stress among medical students which gives an overall overview of mental health. The sample of 400 medical students was selected by stratified random sampling from different medical colleges of Lahore. Results: Regression analysis revealed very significant predictive relationship of the total of “Perceived Stress Scale for Medical Students (PSSMS) with Total DASS [F (1, 398) = 77.14, p< .001] and its subscales (Social stressors[F (1, 398) = 60.50, p< .001], Mistrust[F (1, 398) = 31.32, p< .001], Academic stressors[F (1, 398) = 36.50, p< .001] and Burnout[F (1, 398) = 28.45, p< .001]) to the DASS total score and individually on the subscales of depression, anxiety and stress at the level of (p

In this paper, the velocity field and the time dependent shear stress of Maxwell fluid with Caputo fractional derivatives in an infinite long circular cylinder of radius R is discussed. The motion in the fluid is produced by the circular cylinder. The fluid is initially at rest and at time t=0+, cylinder begins to oscillate with the velocity fsinωt, due to time dependent shear stress acting on the cylinder tangentially. The hybrid technique used in this paper for the solution of the problem has less computational efforts and time cost as compared to other commonly used methods. The obtained solutions are in transformed domain, which are expressed in terms of modified Bessel functions I0(·) and I1(·). The inverse Laplace transformation has been calculated numerically by using MATLAB package. The semi analytical solutions for Maxwell fluid with fractional derivatives are reduced to the similar solutions for Newtonian and ordinary Maxwell fluids as limiting cases. In the end, numerical simulations have been performed to analyze the behavior of fractional parameter α, kinematic viscosity ν, relaxation time λ, radius of the circular cylinder R and dynamic viscosity μ on our obtained solutions of velocity field and shear stress. Keywords: Shear stress, Maxwell fluid, Laplace transformation, Velocity field, Modified Bessel function

Intercropping legumes with cereals has been a common cropping system in short-season rainfed environments due to its increased productivity and sustainability. Intercropping barley (Hordeum vulgare L.) with Egyptian clover (Trifolium alexandrinum L.) could increase the grain yield of barley and improve resource use efficiency of the intercropping system. However, non-optimum planting geometry has been a hurdle in the adaptation of barley-based cropping systems. This study was aimed at optimizing the planting geometry, and assess the productivity and profitability of barley-Egyptian clover intercropping system. Ten different planting geometries, differing in number of rows of barley, width and number of irrigation furrows and planting method were tested. Intercropping barley with Egyptian clover improved 56-68% grain yield of barley compared with mono-cropped barley. Barley remained dominant crop in terms of aggressiveness, relative crowding coefficient and competitive ratio. The amount of water used was linearly increased with increasing size of barley strip from 3 to 8 rows. The highest water use efficiency (4.83 kg/cf3) was recorded for 8-row barley strip system with 120 cm irrigation furrows compared to rest of the planting geometries. In conclusion, 8-rows of barley planted on beds with Egyptian clover in 120 cm irrigation furrows had the highest net income and cost benefit ratio. Therefore, it is recommended that this planting geometry can be used for better economic returns of barley-Egyptian clover intercropping system. However, barley strips with >8 rows were not included in this study, which is limitation of the current study. Therefore, future studies with >8 barley rows in strip should be conducted to infer the economic feasibility and profitability of wider barley strips.

In view of the successful applications of graph theory, relationships between the biological activity and chemical structure have been developed. One of the popular topics in graph theory is problems relating to topological indices. Degree-based topological indices, distance-based topological indices, and counting-related topological indices are various types of topological indices. Physiochemical properties such as boiling point and stability of chemical compounds are correlated by these topological indices. A topological index of a graph is a numerical quantity obtained from the graph mathematically. A cactus graph is a connected graph in which no edge lies in more than one cycle. In this study, we have derived certain degree-based topological indices for some families of graphs consisting of graph obtained by the rooted product of paths and cycles and two types of cactus graph (paracactus and orthocactus) with the help of the generalized Zagreb index.

In the fields of chemical graph theory, topological index is a type of a molecular descriptor that is calculated based on the graph of a chemical compound. In 1947, Harry Wiener introduced “path number” which is now known as Wiener index and is the oldest topological index related to molecular branching. Hosoya polynomial plays a vital role in determining Wiener index. In this report, we compute the Hosoya polynomials for hourglass and rhombic benzenoid systems and recover Wiener and hyper-Wiener indices from them.

Objective: To find out the relationship between recurrent laryngeal nerve(s) (RLN) and inferior thyroid artery (ITA) in patients undergoing thyroid surgery in our population. Study Design: Descriptive, cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi and Combined Military Hospital Rawalpindi from Aug 2008 to Dec 2014. Material; and Methods: One hundred recurrent laryngeal nerves, 50 right and 50 left were studied in 64 patients. All cases of benign goiter, malignant T1, T2 goiter, completion thyroidectomy cases on virgin side were included. Malignant T3, T4 cases, redo surgery, and large multi nodular goiter, cases in which posterior nodules have displaced the nerve (s) were excluded from the study. The course of the nerve was dissected in the thyroid vicinity and its relation with the inferior thyroid artery was recorded and photographed. All the data and special points were noted by the surgeons themselves in a register in all the cases and photographs were also taken. The data was entered and analyzed using statistical package for social sciences (SPSS) version 16. A p-value of

Objective: To determine the complete clinical response in rectal carcinoma after neoadjuvant chemo radiation. Study Design: Cross-sectional study. Place and Duration of Study: This study was conducted in Clinical Oncology department, Jinnah Postgraduate Medical Centre Karachi, from Jan 2016 to Jan 2017. Material and Methods: Seventy Two Patients meeting the inclusion criteria were enrolled in study after complete staging workup. Neoadjuvant concurrent chemoradiotherapy was planned, consisting of oral capecitabine 825mg/m2 BID five days a week along with 50.4 Gy Radiotherapy with linac machine. Radiation was delivered over a period of 5 weeks at a rate of 1.8 Gy/day. Patients received Radiotherapy in Atomic Energy Medical Centre (AEMC) and in Sindh Institute Urology & Transplant (SIUT), Radiation department. Chemotherapy was given in clinical oncology department of JPMC. Sixty one patients completed planned treatment and were available for post concomitant chemo radiotherapy response assessment with Pelvic CT/MRI after 6-8 weeks of completion of concomitant chemo radiotherapy. Response assessment was done according to Response Evaluation Criteria in solid tumor (RECIST) criteria version 1.1 and then Patients were referred for surgical evaluation. Result: A total of 61 cases of locally advanced adenocarcinoma rectal cancer patients were included in the study. Mean age of the patients was 41 years with ± 17.06 years SD. Complete clinical response was identified in 4 (6.6%) while 31 (50.8%) were identified as partial response, progressive disease was 13 (21.3%) and 13 (21.3%) were with stable disease. All confounding variables were found statistically significant with p-value found less than 0.05. Conclusion: Neo-adjuvant chemoradiotherapy for locally advanced rectal cancer is associated with high rates of tumor response in terms of downs tagging (complete & partial) and is relatively safe with acceptable morbidity, which favors its use in future.

Objective: Evaluation of single preoperative dose of pregabalin in terms of postoperative pain after laparoscopic cholecystectomy. Study Design: Randomized controlled trial (RCT). Place and Duration of Study: Study was conducted in Surgical Department of Military Hospital Rawalpindi over a period of one year fromJan 2013 to Dec 2013. Material and Methods: One hundred patients (50 in each group) were included in this study. They were divided into two groups. Group-A was given pregabalin and group-B was given placeboafter laparoscopic cholecystectomy. Results: Mean age was 38.2 ± 11.0 years in group A and 36.9 ± 11.7 years in group B. Regarding distribution of gender, 14 patients (28.0%) in group-A and 17 patients (34.0%) in group-B were males while 36 patients (72.0%) in group-A and 33 patients (66.0%) in group-B were females. Mean visual analogue score at 24 hours was 4.98 ± 1.87 and 6.58 ± 2.03 in group-A and B, respectively. The difference between two group was statistically significant (p

Data-driven knowledge acquisition is one of the key research fields in data mining. Dealing with large amounts of data has received a lot of attention in the field recently, and a number of methodologies have been proposed to extract insights from data in an automated or semi-automated manner. However, these methodologies generally target a specific aspect of the data mining process, such as data acquisition, data preprocessing, or data classification. However, a comprehensive knowledge acquisition method is crucial to support the end-to-end knowledge engineering process. In this paper, we introduce a knowledge acquisition system that covers all major phases of the cross-industry standard process for data mining. Acknowledging the importance of an end-to-end knowledge engineering process, we designed and developed an easy-to-use data-driven knowledge acquisition tool (DDKAT). The major features of the DDKAT are: (1) a novel unified features scoring approach for data selection; (2) a user-friendly data processing interface to improve the quality of the raw data; (3) an appropriate decision tree algorithm selection approach to build a classification model; and (4) the generation of production rules from various decision tree classification models in an automated manner. Furthermore, two diabetes studies were performed to assess the value of the DDKAT in terms of user experience. A total of 19 experts were involved in the first study and 102 students in the artificial intelligence domain were involved in the second study. The results showed that the overall user experience of the DDKAT was positive in terms of its attractiveness, as well as its pragmatic and hedonic quality factors.

Abstract Background Breast cancer is the most common cancer in females and is ranked second in cancer-related deaths all over the world in women. Despite improvement in diagnosis, the survival rate of this disease has still not improved. X-linked Inhibitor of Apoptosis (XIAP) has been shown to be over-expressed in various cancers leading to poor overall survival. However, the role of XIAP in breast cancer from Middle Eastern region has not been fully explored. Methods We examined the expression of XIAP in more than 1000 Middle Eastern breast cancer cases by immunohistochemistry. Apoptosis was measured by flow cytometry. Protein expression was determined by western blotting. Finally, in vivo studies were performed on nude mice following xenografting and treatment with inhibitors. Results XIAP was found to be over-expressed in 29.5% of cases and directly associated with clinical parameters such as tumor size, extra nodal extension, triple negative breast cancer and poorly differentiated breast cancer subtype. In addition, XIAP over-expression was also significantly associated with PI3-kinase pathway protein; p-AKT, proliferative marker; Ki-67 and anti-apoptotic marker; PARP. XIAP over-expression in our cohort of breast cancer was an independent poor prognostic marker in multivariate analysis. Next, we investigated inhibition of XIAP using a specific inhibitor; embelin and found that embelin treatment led to inhibition of cell viability and induction of apoptosis in breast cancer cells. Finally, breast cancer cells treated with combination of embelin and PI3-kinase inhibitor; LY294002 synergistically induced apoptosis and caused tumor growth regression in vivo. Conclusion These data suggest that XIAP may be playing an important role in the pathogenesis of breast cancer and can be therapeutically targeted either alone or in combination with PI3-kinase inhibition to induce efficient apoptosis in breast cancer cells.

Case-Based Learning (CBL) has become an effective pedagogy for student-centered learning in medical education, which is founded on persistent patient cases. Flippped learning and Internet of Things (IoTs) concepts have gained significant attention in recent years. Using these concepts in conjunction with CBL can improve learning ability by providing real evolutionary medical cases. It also enables students to build confidence in their decision making, and efficiently enhances teamwork in the learing environment. We propose an IoT-based Flip Learning Platform, called IoTFLiP, where an IoT infrastructure is exploited to support flipped case-based learning in a cloud environment with state of the art security and privacy measures for personalized medical data. It also provides support for application delivery in private, public, and hybrid approaches. The proposed platform is an extension of our Interactive Case-Based Flipped Learning Tool (ICBFLT), which has been developed based on current CBL practices. ICBFLT formulates summaries of CBL cases through synergy between students' and medical expert knowledge. The low cost and reduced size of sensor device, support of IoTs, and recent flipped learning advancements can enhance medical students' academic and practical experiences. In order to demonstrate a working scenario for the proposed IoTFLiP platform, real-time data from IoTs gadgets is collected to generate a real-world case for a medical student using ICBFLT.

Students have diverse learning needs and unique learning styles. Providing options in assessments to address those needs helps eliminate rote learning and also addresses learner diversity (Pauline & Collings,2018). This study aims to promote student learning by designing teaching activities and assessments to support all students. This experimental study addressed learners having different learning styles and investigated the impact of equitable assessment practice grounded on universal design for learning on the academic achievement of 64 9th graders in a Physics course at a Secondary School in Pakistan. The relationship of VARK learning style on academic achievement was also investigated. The results indicated a significant difference (p = 0.00 < 0.05; Mean difference = 4.031) between the academic achievement of the control and the experimental group supporting equitable assessments and the UDL approach. The correlation between the learning style and academic achievement was not significant. The outcomes of the study recommend that consideration of learning style and needs of students while designing the learning and assessment content can bring better learning outcomes. The results also showed that there is a moderately positive correlation between bimodal learning style and a moderately negative correlation between auditory learning style with the academic achievement of students. It is recommended that the learning style and individual needs of the students should be addressed during the learning and assessment phase.