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Purpose – The present research conducts a thorough review of published literature relevant to earnings management (EM) practices in family firms (FFs), utilizing the Scopus database, intending to identify potential directions for future research. Design/methodology/approach – Through a systematic review, this study focuses on identifying and summarizing trends in publications over the years, the journal outlets, geographical contexts, research methodologies, the temporal evolution of theories and the specific constructs under investigation. Findings – Earlier empirical studies suggest that corporate governance enhances integrity and transparency in FFs, thereby reducing EM practices. Contrarily, compliance with International Financial Reporting Standards (IFRS) seems to offer managers more opportunities for convenient EM rather than restricting such practices. Notably, corporate social responsibility (CSR) practices do not appear to mitigate EM practices consistently. The literature, however, reveals inclusive results and areas requiring deeper exploration for more definitive results. For instance, certain corporate governance mechanisms, such as family-specific social and cultural business characteristics, subjective measures of family businesses, behavioral approaches to family owners' decision-making and directors' personal, psychological and social factors, remain largely untested. Additionally, there is a notable research gap concerning the relationship between IFRS, capital structure and EM. Originality/value – This study’s contributions lie in its comprehensive literature review, identification of research trends and gaps, and its potential to guide future research endeavors in the domain of EM practices in FFs.

Abstract Herein we have reported a fluorescent probe (MB-M) based on MB derivative for Cu2+ ions detection. The probe was well characterized by 1H NMR, 13C NMR and HR-MS spectrum. Probe MB-M showed naked-eyes recognition to Cu2+ as color change from colorless to indigo. The probe exhibited promising features such as high fluorescence and UV–vis selectivity, fast response (5 mint), workable at pH 2–7, and low limit of detection (LOD = 0.33 µM). Probe MB-M was also used for Cu2+ ions imaging in HepG-2 cells and detection in daily life (Test Strip and lake water). Moreover, non-covalent interaction (NCI) and quantum theory of atoms in molecules (QTAIM) analysis were used to study the interaction between MB-M and Cu2+ ions. By examining the electronic characteristics of the complex using natural bond orbital (NBO), electron density difference (EDD), and frontier molecular orbital (FMO) analysis, the sensitivity of MB-M towards Cu2+ ions were investigated. The results illustrated that the interactions between MB-M and Cu2+ ions involved chemisorption.

Background: Functional gastrointestinal disorders (FGIDs) are common disorders characterized by chronic or recurrent gastrointestinal (GI) symptoms, not related to structural or biochemical abnormalities Objective: To determine the frequency of FGIDs in children with complaints of recurrent abdominal pain. Methods: This cross-sectional study was done at the outpatient department of pediatrics, National Institute of Child Health, Karachi, Pakistan from October 2022 to March 2023. Children of either gender aged 1-12 years with complaints of recurrent abdominal pain were analyzed. Socio-demographic characteristics along with presenting complaints and types of FGIDs were noted. Results: In a total of 188 children, the mean age was 7.22±1.96 years while 107 (56.9%) children were boys. The mean duration of symptoms was 2.7±1.8 months. The most frequent presenting complaints were pain during bowel movement, nausea, and epigastric pain reported by 88 (46.8%), 75 (39.9%), and 64 (34.0%) children respectively. Frequency distribution of functional GI disorders revealed that functional abdominal pain was the commonest noted in 72 (38.3%) children while irritable bowel syndrome (IBS) and functional dyspepsia were found among 38 (20.2%) and 37 (19.7%) children respectively. Stratification of functional GI disorders showed a statistically significant relationship (p

Background: With the global increase in antibacterial resistance, the challenge faced by developing countries is to utilize the available antibiotics, alone or in combination, against resistant bacterial strains. We aimed to encapsulate the levofloxacin (LVX) into polymeric nanoparticles using biodegradable polymers i.e. Chitosan and PLGA, estimating their physicochemical characteristics followed by functional assessment as nanocarriers of levofloxacin against the different resistant strains of bacteria isolated from biological samples collected from tertiary care hospital in Lahore, Pakistan. Methods: LVX-NPs were synthesized using ion gelation and double emulsion solvent-evaporation method employing chitosan (CS) and poly-lactic-co-glycolic acid (PLGA), characterized via FTIR, XRD, SEM, and invitro drug release studies, while antibacterial activity was assessed using Kirby-Bauer disc-diffusion method. Results: Data revealed that the levofloxacin-loaded chitosan nanoparticles showed entrapment efficiency of 57.14% ± 0.03 (CS-I), 77.30% ± 0.08(CS-II) and 87.47% ± 0.08 (CS-III). The drug content, particle size, and polydispersity index of CS-I were 52.22% ± 0.2, 559 nm ± 31 nm, and 0.030, respectively, whereas it was 66.86% ± 0.17, 595 nm ± 52.3 nm and 0.057, respectively for CS-II and 82.65% ± 0.36, 758 nm ± 24 nm and 0.1, respectively for CS-III. The PLGA-levofloxacin nanoparticles showed an entrapment efficiency of 42.80% ± 0.4 (PLGA I) and 23.80% ± 0.4 (PLGA II). The drug content, particle size and polydispersity index of PLGA-I were 86% ± 0.21, 92 nm ± 10 nm, and 0.058, respectively, whereas it was 52.41% ± 0.45, 313 nm ± 32 nm and 0.076, respectively for PLGA-II. The XRD patterns of both polymeric nanoparticles showed an amorphous nature. SEM analysis reflects the circular-shaped agglomerated nanoparticles with PLGA polymer and dense spherical nanoparticles with chitosan polymer. The in-vitro release profile of PLGA-I nanoparticles showed a sustained release of 82% in 120 h and it was 58.40% for CS-III. Both types of polymeric nanoparticles were found to be stable for up to 6 months without losing any major drug content. Among the selected formulations, CS-III and PLGA-I, CS-III had better antibacterial potency against gram+ve and gram-ve bacteria, except for K. pneumonia, yet, PLGA-I demonstrated efficacy against K. pneumonia as per CSLI guidelines. All formulations did not exhibit any signs of hemotoxicity, nonetheless, the CS-NPs tend to bind on the surface of RBCs. Conclusion: These data suggested that available antibiotics can effectively be utilized as nano-antibiotics against resistant bacterial strains, causing severe infections, for improved antibiotic sensitivity without compromising patient safety.

Learners’ academic performance is one of the most imperative elements of the classroom and a core responsibility of teachers as well as schools. Thus, it is imperative to manage a classroom in a way that is conducive to teaching and learning that can promote high academic performance. Consequently, the study aimed to examine the role of classroom management in enhancing learners' academic performance. A generic qualitative research method approach was employed in the study. A purposive sampling technique was used to select a total of 18 teachers from six government secondary schools to study the phenomenon. Therefore, it was found that effective classroom management plays an important role in learners' performance. During the research, it was found that the no availability of physical resources and poor classroom management contribute to learners, performance. Based on the research findings it was identified that teacher effectiveness, teacher preparedness and teacher social and emotional proficiency, teacher-learner relationship, and learners' motivation, behavior, and discipline are the major factors that also have a strong role on learners' performance. The schools selected to conduct research are lacking resources, and teachers are not as effective and skilled as required. Due to the lack of resources and skills, teachers can't manage classrooms which can enhance learners' academic performance. It is thus mandatory to provide resources to schools and skills and training to teachers.

Abstract Background Water stress is a major danger to crop yield, hence new approaches to strengthen plant resilience must be developed. To lessen the negative effects of water stress on wheat plants, present study was arranged to investigate the role of synergistic effects of biochar, trans-zeatin riboside (t-ZR), and Azospirillum brasilense on soil improvement and enzymatic activity in water-stressed wheat. Results In a three-replication experiment comprising of four treatments (T0: Control, T1: Drought stress (DS), T2: DS + t-ZR with biochar, T3: DS + A. brasilense with biochar), we observed notable improvements in soil quality and enzymatic activities in water-stressed wheat plants with the application of t-ZR and A. brasilense with biochar. In drought stress, Treatment having the application of A. brasilense with biochar performs best as compared to the other and significant increased the enzymatic activities such as peroxidase (7.36%), catalase (8.53%), superoxide dismutase (6.01%), polyphenol oxidase (14.14%), and amylase (16.36%) in wheat plants. Different enzymatic activities showed different trends of results. Soil organic C, dissolved organic C, dissolved organic N also enhanced 29.46%, 8.59%, 22.70% respectively with the application of A. brasilense with biochar under drought stress condition. Conclusions The synergistic action of A. brasilense and biochar creates an effective microbiological environment that supports essential plant physiological processes during drought stress. This enhancement is attributed to improved soil fertility and increased organic matter content, highlighting the potential of these novel strategies in mitigating water stress effects and enhancing crop resilience.

Objective: To assess the awareness level and need perception of soft skills among general dental practitioners (GDPs), dental residents and specialists. Study Design: Mixed method study Place and Duration of Study: Armed Forces Institute of Dentistry (AFID), Rawalpindi and 28 Military Dental Centre (28 MDC), Lahore Pakistan, from Mar to Sep 2020. Methodology: A mixed method study research design with descriptive and explorative strategies was used to formulate a survey questionnaire and in-depth interviews for participants aged 24-60, medically fit, with a minimum of one year of practical experience, and willing to participate. Results: 136(74.37%) knew the basic concept of soft skills being non-technical skills, as they classified their awareness of soft skills as ‘Partially Aware’. Only 9(4.91%) responded as being ‘Expert’ in this topic. 38(20.76%) were totally ‘Unaware’. Regarding the need for teaching soft skills to dental students, 171(93.44%) participants wanted soft skills teaching to begin in the undergraduate years. Conclusion: Participating dental professionals understood the basic concept of soft skills but needed a formal knowledge of what it entails. There is a dire need for the dental professional to have a satisfactory knowledge of soft skills to improve their overall job performance.

Recent years have witnessed security as a great concern in vehicular networks (VANET). Particularly, Denial of Service (DoS) and Distributed Denial of Service (DDoS) attacks can jeopardize the network by broadcasting a storm of packets. Correspondingly, the network resources are jammed with malicious traffic. In this connection, the existing research presented various techniques to cope with DoS and DDoS attacks. Different from those traditional approaches, this study proposes an Intelligent Intrusion Detection System (IDS) by leveraging Machine Learning (ML). The proposed IDS utilizes a publicly available dataset on the application layer for mitigating DDoS attacks. The designed ML-based IDS relies on combining both the Random Projection (RP) and Randomized Matrix Factorization (RMF) methods to achieve the best results for enhancing the detection capabilities of the IDS. This amalgamation enhances the system's detection capabilities by extracting and analyzing meaningful features from network traffic data. Experimental validation of our approach involves a comprehensive evaluation of various ML models, including Extra Tree Classifier (ETC), Logistic Regression (LR), and Random Forest (RF). Remarkably, the combined accuracy of these models yields an average system accuracy of 0.98, surpassing existing methods. Unlike conventional approaches, our proposed IDS excels in efficiency and exhibits notable performance in detecting DoS and DDoS attacks in VANET. This proficiency ensures the integrity and safety of vehicle communications. Thus, our research substantially contributes to the vehicular network security field. The presented findings establish a foundation for future advancements in securing connected vehicles.

Abstract Transmission lines are a very important and vulnerable part of the power system. Power supply to the consumers depends on the fault‐free status of transmission lines. If the normal working condition of the power system is disturbed due to faults, the persisting fault of long duration results in financial and economic losses. The fault analysis has an important association with the selection of protective devices and reliability assessment of high‐voltage transmission lines. It is imperative to devise a suitable feature extraction tool for accurate fault detection and classification in transmission lines. Several feature extraction techniques have been used in the past but due to their limitations, that is, for use in stationary signals, limited space in localizing nonstationary signals, and less robustness in case of variations in normal operation conditions. Not suitable for real‐time applications and large calculation time and memory requirements. This research presents a discrete wavelet transform (DWT)‐based novel fault detection technique at different parameters, that is, fault inception and fault resistance with proper selection of mother wavelet. In this study, the feasibility of DWT using MATLAB software has been investigated. It has been concluded from the simulated data that wavelet transform together with an effective classification algorithm can be implemented as an effective tool for real‐time monitoring and accurate fault detection and classification in the transmission lines.

Human Activity Recognition (HAR), alongside Ambient Assisted Living (AAL), are integral components of smart homes, sports, surveillance, and investigation activities. To recognize daily activities, researchers are focusing on lightweight, cost-effective, wearable sensor-based technologies as traditional vision-based technologies lack elderly privacy, a fundamental right of every human. However, it is challenging to extract potential features from 1D multi-sensor data. Thus, this research focuses on extracting distinguishable patterns and deep features from spectral images by time-frequency-domain analysis of 1D multi-sensor data. Wearable sensor data, particularly accelerator and gyroscope data, act as input signals of different daily activities, and provide potential information using time-frequency analysis. This potential time series information is mapped into spectral images through a process called use of ’scalograms’, derived from the continuous wavelet transform. The deep activity features are extracted from the activity image using deep learning models such as CNN, MobileNetV3, ResNet, and GoogleNet and subsequently classified using a conventional classifier. To validate the proposed model, SisFall and PAMAP2 benchmark datasets are used. Based on the experimental results, this proposed model shows the optimal performance for activity recognition obtaining an accuracy of 98.4% for SisFall and 98.1% for PAMAP2, using Morlet as the mother wavelet with ResNet-101 and a softmax classifier, and outperforms state-of-the-art algorithms.

Objective To develop and content validate a questionnaire to assess the financial and functional impact of major lower limb amputation in patients with diabetes-related foot disease.Design Prospective observational study.Setting This study was conducted at a tertiary care centre in Pakistan.Participants We conducted a thorough literature review and a group interview with 10 participants, resulting in domain identification and item generation. The group included seven patients with diabetes-related foot disease who underwent major lower limb amputation and three caregivers. Subsequently, a focused group discussion was held to assess overlap and duplication among the items, and two rounds of content validation were carried out by five content and five lay experts in both English and Urdu. Question items with a Content Validity Index (CVI) score of >0.79 were retained, items with a CVI score between 0.70 and 0.79 were revised and items with a CVI score of

Learners’ social skills enhancement is one of the key components of the classroom and the basic obligation of a teacher and school. Thus, it is imperative to manage the classroom in a way that can offer a comfortable teaching-learning environment to learners. Therefore, the study aimed to examine to role of classroom management in enhancing learners' social skills. The interpretive research design was utilized to describe the qualitative data, and a generic qualitative research approach was employed to undertake the study. A total of 18 teachers from six secondary schools were selected by using a purposive sampling technique. It was instituted that classroom management and the social environment of the classroom play a vital role in learners' social skills enhancement. Based on research findings, physical resources, teacher role, class rule, conduct and regulation, socioeconomic status of learners, family background, and poverty are the leading factors that have a strapping role on learners’ skills enhancement. The selected schools to accomplish research are lacking resources, however, teachers are considered as a core in teaching-learning. It is, therefore, obligatory to provide resources to classrooms, skills to teachers, and address learners' socioeconomic status to achieve educational goals and enhance social skills.

Celiac disease (CD) is a complicated autoimmune disease that is caused by gluten sensitivity. It was commonly believed that CD only affected white Europeans, but recent findings show that it is also prevailing in some other racial groups, like South Asians, Caucasians, Africans, and Arabs. Genetics plays a profound role in increasing the risk of developing CD. Genetic Variations in non-HLA genes such as LPP, ZMIZ1, CCR3, and many more influence the risk of CD in various populations. This study aimed to explore the association between LPP rs1464510 and ZMIZ1 rs1250552 and CD in the Punjabi Pakistani population. For this, a total of 70 human subjects were selected and divided into healthy controls and patients. Genotyping was performed using an in-house-developed tetra-amplification refractory mutation system polymerase chain reaction. Statistical analysis revealed a significant association between LPP rs1464510 (χ2 = 4.421, p = 0.035) and ZMIZ1 rs1250552 (χ2 = 3.867, p = 0.049) and CD. Multinomial regression analysis showed that LPP rs1464510 A allele reduces the risk of CD by ~52% (OR 0.48, CI: 0.24–0.96, 0.037), while C allele-carrying subjects are at ~2.6 fold increased risk of CD (OR 3.65, CI: 1.25–10.63, 0.017). Similarly, the ZMIZ1 rs1250552 AG genotype significantly reduces the risk of CD by 73% (OR 0.26, CI: 0.077–0.867, p = 0.028). In summary, Genetic Variations in the LPP and ZMIZ1 genes influence the risk of CD in Punjabi Pakistani subjects. LPP rs1464510 A allele and ZMIZ1 AG genotype play a protective role and reduce the risk of CD.

Drilling through shale formations can be expensive and time-consuming due to the instability of the wellbore. Further, there is a need to develop inhibitors that are environmentally friendly. Our study discovered a cost-effective solution to this problem using Gum Arabic (ArG). We evaluated the inhibition potential of an ArG clay swelling inhibitor and fluid loss controller in water-based mud (WBM) by conducting a linear swelling test, capillary suction timer test, and zeta potential, fluid loss, and rheology tests. Our results displayed a significant reduction in linear swelling of bentonite clay (Na-Ben) by up to 36.1% at a concentration of 1.0 wt. % ArG. The capillary suction timer (CST) showed that capillary suction time also increased with the increase in the concentration of ArG, which indicates the fluid-loss-controlling potential of ArG. Adding ArG to the drilling mud prominently decreased fluid loss by up to 50%. Further, ArG reduced the shear stresses of the base mud, showing its inhibition and friction-reducing effect. These findings suggest that ArG is a strong candidate for an alternate green swelling inhibitor and fluid loss controller in WBM. Introducing this new green additive could significantly reduce non-productive time and costs associated with wellbore instability while drilling. Further, a dynamic linear swelling model, based on machine learning (ML), was created to forecast the linear swelling capacity of clay samples treated with ArG. The ML model proposed demonstrates exceptional accuracy (R2 score = 0.998 on testing) in predicting the swelling properties of ArG in drilling mud.

Abstract Background: The international ovarian tumor analysis (IOTA) study technique is a specialized method for classifying and identifying adnexal growths. It employs 10 simple ultrasound directions to characterize masses as benign or malignant. Objectives: This study aims to provide pre-operative information to help gynecologists manage ovarian masses, avoiding delays in malignancy treatment and unnecessary surgery for benign lesions. Methods: This was a hospital-based observational study conducted in the radiology department on patients with clinical diagnoses of ovarian masses from August 2020 to March 2022 by prospective randomized sampling method. Patients with suspected ovarian pathology were evaluated using IOTA ultrasound rules and designated benign or malignant. The patients underwent a thorough history and clinical examination. Ultrasound was used to confirm the ovarian origin of the mass and differentiate it as benign or malignant. A transvaginal ultrasound was performed where necessary. Histopathological examination was the gold standard to confirm ultrasound and Doppler findings. Descriptive stats: Frequencies/percentages for categorical data, mean ± SD for normal, median with IQR for non-normal Uncertainty measured by 95% CI. Results: During the study, 50 women were eligible for the study, and the mean age of the participants was 45.3 years. Of 50 patients who underwent surgery, 38 cases were considered benign based on IOTA USG rules, of which 35 were benign and 3 were malignant histologically Eight cases were considered malignant based on IOTA USG rules, of which 6 were malignant and 2 were benign. Four cases were considered indeterminate, with two being benign and two being malignant histologically. If inconclusive cases are classified as malignant, the sensitivity and specificity are 75% and 88%, respectively. Conclusions: USG is an easily available imaging tool that can be used as an initial modality in evaluating ovarian masses. IOTA simple ultrasound rules have diagnostic accuracy in distinguishing benign and malignant ovarian masses and help in management.

Abstract This paper reports the Maisotsenko's cycle‐based waste heat recovery system with enhanced humidification to exploit the maximum waste heat recovery potential of the gas turbine. This research uses an integrated methodology coupling thermodynamic balances with heat transfer model of air saturator. The performance of the system is deduced which are assisted with sensitivity analysis indicating the optimal mass flow rate ratio (0.7–0.8) and pressure ratio (4.5–5.0) between the topping and bottoming cycles, and the air saturator split (extraction) ratio (0.5). The net‐work output, energy, and exergy efficiencies of the system are found to be ≈58.39 MW, ≈55.85%, and ≈52.79%, respectively. The maximum exergy destruction ratios are found as 68.2% for the combustion chamber, 16.0% for the topping turbine, 5.7% for topping compressor, 4.9% air saturator. The integration of Maisotsenko's cycle‐based waste heat recovery system with a comprehensive thermodynamic model, as demonstrated in this research, offers valuable insights into enhancing the efficiency, cost‐effectiveness, and environmental impact of gas turbines. By presenting fundamental equations related to thermodynamic balances, this work serves as an invaluable educational resource, equipping future researchers and students with the knowledge and skills needed to advance the study of thermodynamics and sustainable energy solutions.

Objective: To determine impact of various forms of intra nasal packings and trans-septal suturing (without nasal packing) on cardiopulmonary and metabolic milieu of patients undergoing nasal and paranasal sinus operations. Study Design: Randomized controlled trial. ( Ltr no: IERB-01/3/23/Trg dated 8 March 2023) Place and Duration of Study: Department of Otorhinolaryngology (ENT), Combined Military Hospital, Jhelum Cantonment, Pakistan, from Aug 2022 to Aug 2023. Methodology: Clinical and laboratory markers of cardio-pulmonary and metabolic assessment of 140 subjects were evaluated, who had undergone some form of intranasal packing procedure or trans-septal suturing (without nasal packing) following nose or paranasal sinus operations. Results: Ventilated nasal packs and completely avoiding nasal packing by performing trans-septal suturing have a significant impact on clinical parameters like resting heart rate, respiration, blood pressure, arterial blood pH and arterial blood partial pressure of carbon dioxide (PaCO2) in patients undergoing surgical operations of the nose and paranasal sinuses. Conclusion: We strongly recommend adopting less invasive and technically more advanced operative methodology and refining surgical expertise regarding septal splinting during rhinologic operative procedures, mitigating discomfort and antecedent morbidity in patients undergoing these sino-nasal surgical operations.

The Government of Pakistan has established clean energy transition goals in the national Alternative and Renewable Energy (ARE) Policy. The goal of this policy is to increase the 30% capacity of green energy in total energy mix by 2030. In this regard, the aim of this study is to develop a de-carbonization plan for achieving net zero emissions through the deployment of a green energy system for the period 2021 to 2040 by incorporating the ARE policy targets. The Low Emissions Analysis Platform (LEAP®) software is used for finding the unidirectional causality among gross domestic product, population within the country, energy demand, renewable energy production and CO2 emissions for Pakistan. The results revealed that energy production of 564.16 TWh is enough to meet the energy demand of 480.10 TWh with CO2 emissions of 22.19 million metric tons, having a population of 242.1 million people and GDP growth rate of 5.8%, in the year 2040 in Pakistan. The share of green energy production is 535.07 TWh, which can be utilized fully for meeting energy demand in the country, and almost zero emissions will produce till 2040. CO2 emissions produced by burning natural gas were 20.64 million metric tons in 2020, which then reduced to 3.25 million metric tons in 2040. CO2 emissions produced by burning furnace oil are also reduced from 4.19 million metric tons in 2020 to 2.06 million metric tons in 2040. CO2 emissions produced by burning coal were 24.85 million metric tons in 2020, which then reduced to 16.88 million metric tons in 2040. Energy demand is directly related to the population and GDP of the country, while renewable utilization is inversely proportional to carbon emissions. The declining trend of carbon emissions in Pakistan would help to achieve net zero emissions targets by mid-century. This technique would bring prosperity in the development of a clean, green and sustainable environment.

Due to the recent climate change, organizations all over the globe are developing plans for reducing carbon emissions by developing clean energy technologies and energy efficient devices. However, the path for transition to green energy system is still unclear and in general, the representation of green energy supply for transition pathways is limited. Therefore, this study outlines a plan for getting Swedish energy sector completely carbon neutral by 2050. The approach can also be applicable to the majority of nations worldwide. Computer based simulations are performed on Energy PLAN software for making clean, green and sustainable energy system that can balance every component of entire energy system during the study period 2022 to 2050. This study takes into account the sustainable use of renewable sources for all economic sectors as well as the interchange of energy with nearby nations under the two scenarios. Additionally, the energy system works in tandem with other industries to create a fully carbon-free environment. The results revealed that, 50% de-carbonization is possible till 2035 and 100% de-carbonization is possible till 2050. This enables a discussion of how ambitious 10-year goals might serve as a first step toward the mid-century elimination of fossil fuels from the energy sector.

Key points The IL29 gene cloning in pSRSapI. IL-29 found as biologically active.

Classifying network traffic is important for traffic shaping and monitoring. In the last two decades, with the emergence of privacy concerns, the importance of privacy-preserving technologies has risen. The Tor network, which provides anonymity to its users and supports anonymous services known as Onion Services, is a popular way to achieve online anonymity. However, this anonymity (especially with Onion Services) is frequently misused, encouraging governments and law enforcement agencies to de-anonymise them. Therefore, in this paper, we try to identify the classifiability of Onion Service traffic, focusing on three main contributions. First, we try to identify Onion Service traffic from other Tor traffic. The techniques we have used can identify Onion Service traffic with >99% accuracy. However, there are several modifications that can be done to the Tor traffic to obfuscate its information leakage. In our second contribution, we evaluate how our techniques perform when such modifications have been done to the Tor traffic. Our experimental results show that these conditions make the Onion Service traffic less distinguishable (in some cases, the accuracy drops by more than 15%.) In our final contribution, we identify the most influential feature combinations for our classification problem and evaluate their impact.

Abstract Background Medical education in Syria still adopts a traditional, teacher-centered curriculum to this day. These elements imply the existence of issues in the learning environment (LE). This study aims to provide the first evaluation of the LE at the largest medical schools in Syria using the DREEM inventory. Methods The three largest medical schools in Syria are the ones at Damascus University (DU), University of Aleppo (AU), Tishreen University (TU). The Arabic version of the DREEM questionnaire was used. Students across all years of study except year 1 were approached. Both paper-based and electronic surveys were conducted. Results A total of 1774 questionnaire forms were completed (DU:941, AU:533, TU: 300). The overall DREEM score at DU, AU, and TU were 100.8 ± 28.7, 101.3 ± 31.7, and 97.8 ± 35.7 respectively with no significant difference (P = 0.254) between the three universities. DREEM subscales concerning Learning, Atmosphere, Academic Self-perception and Social Self-perception had a low score across all universities. Clinical-stage students reported significantly lower perception (P ≤ 0.001) of the LE in comparison to their pre-clinical counterparts across all subscales. Conclusions The findings of this study highlight the significant shortcomings of the medical LE in Syria. If not addressed properly, the academic, clinical, and professional competence of the healthcare workforce will continue to deteriorate. Moreover, the negative LE might be a predisposing factor for medical students’ exodus. The Syrian medical education system requires leaders who are willing to defy the status quo to achieve a true educational transformation.

During the last few decades, nanotechnology has gained many applications in almost all fieldsof life because of the unique properties of nanoparticles (NPs). Nanotechnology has speciallymarked its name in the field of medicine. However, NPs toxicity is detrimental to human healthand is a prime concern in applied medicine. They can cause insomnia, vertigo, madarosis,epistaxis, hypokalemia, lymphopenia, Alzheimer’s and Parkinson’s diseases, etc. There is agap in knowledge regarding the study of the toxicological effects of NPs. Mechanisms thatare responsible for this toxicity are not fully understood yet. Phytochemicals have naturaltherapeutic effects of reducing metal NPs’ toxicity by acting as stabilizers and nontoxicreducing agents. However, the interaction between phytochemicals and NPs is remained to beelucidated. This review will provide in-depth knowledge about the various types of inorganicNPs and their associated toxicities, key parameters determining the toxic behaviour of NPs, andthe mechanisms behind their cytotoxicity. It also emphasizes the need for further research tounderstand the interaction between various phytochemicals and NPs for therapeutic purposes.

Vehicular ad hoc networks (VANETs) are intelligent transport subsystems; vehicles can communicate through a wireless medium in this system. There are many applications of VANETs such as traffic safety and preventing the accident of vehicles. Many attacks affect VANETs communication such as denial of service (DoS) and distributed denial of service (DDoS). In the past few years the number of DoS (denial of service) attacks are increasing, so network security and protection of the communication systems are challenging topics; intrusion detection systems need to be improved to identify these attacks effectively and efficiently. Many researchers are currently interested in enhancing the security of VANETs. Based on intrusion detection systems (IDS), machine learning (ML) techniques were employed to develop high-security capabilities. A massive dataset containing application layer network traffic is deployed for this purpose. Interpretability technique Local interpretable model-agnostic explanations (LIME) technique for better interpretation model functionality and accuracy. Experimental results demonstrate that utilizing a random forest (RF) classifier achieves 100% accuracy, demonstrating its capability to identify intrusion-based threats in a VANET setting. In addition, LIME is applied to the RF machine learning model to explain and interpret the classification, and the performance of machine learning models is evaluated in terms of accuracy, recall, and F1 score.

Objective: To determine the frequency, cause and type of dental injury in patients reporting to Armed Forces Institute of Dentistry. Study design: Cross-Sectional Survey. Place and Duration of Study: Department of Operative Dentistry Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from Sep 2021 to Sep 2022. Methodology: A questionnaire was filled out for 357 patients reporting dental injury, including the extent of hard and soft tissue injuries. The cause and place of injury occurred; investigations, the treatment provided by the treating dentists ranging from restoration to root canal, type and duration of splint were also recorded. Results: In the current study, 189(52.9%) out of 357 children got injury due to falls to the playground and other places. Maxillary incisors were mostly affected, and 163(45.7%) children had complicated crown fractures. Rigid splinting was done in 39(70.9%) of root fracture cases, while flexible splinting was done in 162(53.6%) patients with complicated crown fracture cases and 81(26.8%) complicated crown fracture cases. In 72(88.8%) cases of uncomplicated crown fracture, indirect pulp capping was done, and in 67(41.1%) cases of complicated crown fracture, root canal treatment were done. Apexification was done in 28(68.3%) of avulsion cases. Conclusion: Our survey showed that most injuries occurred at school and the roadside. Maxillary incisors are primarily involved with complicated crown fractures, which are effectively managed. Keywords: Avulsion, Complicated crown fracture, Dental injury, Splinting.

The efficacy of a plant-based edible vaccine produced in maize by expression of F and HN immunogenic proteins under a seed-specific promoter against Newcastle disease virus (NDV) genotype VII was assessed using cytokine-mediated cellular immune responses in chickens. Using real-time PCR, the mRNA expression of transgenic maize plants was compared to non-transgenic control plants on a relative basis. F and HN genes mRNA expression was found to be 20 and 60 times higher in corn seeds than in leaves, respectively. In maize seeds, 35 µg ml−1 of F protein, or 0.6 percent of total protein, and 41 µg ml−1 of HN protein, or 0.85 percent of total protein, were found using ELISA. The boost in cell-mediated immune response was evaluated in chickens fed with transgenic corn seeds in comparison with control groups. The qPCR analysis showed an increase in the expression of IL-1 (Interleukin-1), IL-2 (Interleukin-2), IL-6 (Interleukin-6), IL-8 (Interleukin-8), IL-10 (Interleukin-10), IL-15 (interleukin-15), Interferon-α, Interferon-β, Interferon-γ, and CCL3 when evaluated at 0, 7th, 14th, 21st, 28th and 35th day in chickens receiving transgenic diet as compared to group 1 receiving non-transgenic diet. The increase in cytokines production was comparable with group 3 immunized with conventional market vaccine. Furthermore, anti-NDV antibodies were also found in the serum of chickens given maize containing immunogenic proteins, but not in the serum of chickens given a regular normal diet, illustrating the antibodies’ specificity produced after feeding. The results demonstrate that transgenic maize consumed orally strongly stimulates the expression of cytokine genes related to cell-mediated immunity, just like commercial vaccines. These results further suggest that these cytokines may be important in initiating cellular immune responses in response to NDV infection.

This study aimed to synthesize and characterize DTX-mPEG-PLA-NPs along with the development and validation of a simple, accurate, and reproducible method for the determination and quantification of DTX in mPEG-PLA-NPs. The prepared NPs were characterized using AFM, DLS, zetasizer, and drug release kinetic profiling. The RP-HPLC assay was developed for DTX detection. The cytotoxicity and anti-clonogenic effects were estimated using MTT and clonogenic assays, respectively, using both MCF-7 and MDA-MB-231 cell lines in a 2D and 3D culture system. The developed method showed a linear response, high precision, accuracy, RSD values of ≤2%, and a tailing factor ≤2, per ICH guidelines. The DTX-mPEG-PLA-NPs exhibited an average particle size of 264.3 nm with an encapsulation efficiency of 62.22%. The in vitro drug kinetic profile, as per the Krosmeyers–Peppas model, demonstrated Fickian diffusion, with initial biphasic release and a multistep sustained release over 190 h. The MTT assay revealed improved in vitro cytotoxicity against MCF-7 and MDA-MB-231 in the 2D cultures and MCF-7 3D mammosphere cultures. Significant inhibitions of the clonogenic potential of MDA-MB-231 were observed for all concentrations of DTX-mPEG-PLA-NPs. Our results highlight the feasibility of detecting DTX via the robust RP-HPLC method and using DTX-mPEG-PLA-NPs as a perceptible and biocompatible delivery vehicle with greater cytotoxic and anti-clonogenic potential, supporting improved outcomes in BC.

The development of tooth is a highly complex procedure and mastered by specific genetic programs. Genetic alterations, environmental factors, and developmental timing can disturb the execution of these programs, and result in various dental anomalies like hypodontia/oligodontia, and supernumerary teeth, which are commonly seen in our clinical practice. Advances in molecular research enabled the identification of various genes involved in the pathogenesis of dental anomalies. In the near future, it will help provide a more accurate diagnosis and biological-based treatment for these anomalies. In this article, we present the molecular phenomenon of tooth development and the genetics of various dental anomalies.

Adequately created well functional haemodialysis access is an important part for the physical and mental wellbeing of renal failure patients. Every effort should be made to enhance the patency of these accesses. Recently, stem cell treatment modalities have opened new avenues in the better patency of arteriovenous fistula. Use of mesenchymal stromal cells (MSC) to prevent venous neointimal hyperplasia have been studied with good success rates. Adopting such costly treatment modalities in low middle income class country like Pakistan is associated with significant challenges. This short report discusses the current role of stem cells in arteriovenous access and how this exciting modality can be utilized in our country. Key Words: Dialysis access, arteriovenous fistula, Stem cell, Mesenchymal stromal cell.

Root knot nematodes are commercially important plant parasites of many vegetable crops in Pakistan. This study investigate antagonistic effect of Pseudomonas spp. against M. incognita on tomato crop. Ten tomato cultivars were screened against RKN infection. Roma was found the most resistant against infection of M. incognita while money maker was found the most susceptible. Gall or egg mass number/indices are more resistant to RKN. Pseudomonas strains inoculated in the infected tomato plants reduced galling index and also improved the growth of the plant. So, it was obvious that bio-control agents also act as PGPR by stimulating plant growth and inducing resistance through the increase of total phenolic contents and salicylic acid. Tomato cv. Roma showed the greatest increase of total phenol contents and salicylic acid exhibiting tolerance against M. incognita infestation. Tomato cv. Roma showed significantly resistant response against root-knot nematode diseases. Pseudomonas showed significant antagonistic potential against M. incognita in tomato plant.

Abstract High toxicity and extensive accessibility of fluoride and cyanide ions in diverse environmental media encouraged attention for scheming well-organized probes for their detection. Keeping in mind we have designed and synthesized thiosemicarbazone-based chemosensors RB-1, RB-2 and RB-3 for the detection of fluoride and cyanide ions. The structural elucidation of the synthesized chemosensors is done by employing different analytical techniques including nuclear magnetic resonance and electronic absorption specrtoscopies. Admirable detection limit, binding constant and fast response time (2 s) to F− and CN− ions enlarged the applications of these chemosensors. Additional confirmation of the sensing ability of these chemosensors is derived from DFT and TDDFT calculations with M06/6-311G(d,p) method by performing FMO, UV–Vis, QTAIM and global reactivity parameters elucidation. Overall results point out that investigated chemosensors are suitable candidates for sensing the F− ions. These chemosensors were successfully applied to detect F− ions in a commercial toothpaste sample.

Introduction: As coronavirus disease 2019 (COVID-19) is a new disease which has ruining and dismantling the harmony of people internationally, its development and spread, creates turmoil, nervousness and dread among worldwide. Aim: To evaluate seriousness of peritraumatic problems among southern Indian inhabitants during the COVID-19 pandemic. Methodology: A referral sampling technique was continued until a sufficient sample size was reached, while this self-administered survey catches insights about depression, fears, psychological change, evasion cognitive change, and collectively quantifies the stress on a scale of 0–60. Expressive factual examinations were utilized to sum up clear cut information and inferential measurable investigations included Chi-square tests and Pearson's correlations were done. Results: The study included only those participants who understood English and had access to the internet. Inconsequential outcomes were found among gender in which both male and female members frequently showed apprehension and nervousness about COVID-19. 44.8% tried not to watch the news on COVID-19 as they were excessively frightened and make frenzy to family members. 90.9% of participants with lower education levels were more stressed over the thought of getting COVID-19 when showing manifestations related with the novel corona virus, which was statistically significant. Conclusion: The current assessment shows that almost all the study participants have felt restless, uncomfortable and terrified of watching the news whilst stressed over appearances related with COVID-19 due to their greater access to information.

OBJECTIVE: To determine the frequency of clinical manifestation of type 1 diabetes mellitus patients presented in tertiary care hospitals in Karachi METHODOLOGY: A descriptive cross-sectional study was conducted from July 2015 to January 2016 at Out Patient Department of National Institute of Child Health, Karachi, Pakistan. A total of 90 children aged less than 18 years of either gender with type 1 diabetes mellitus (T1DM) were included through the non-probability consecutively sampling technique. Children who were immunocompromised or taking any drug which could cause hyperglycemia were excluded from the study. Various clinical presentations in terms of Diabetic ketoacidosis (DKA), weight loss, polydipsia, and polyuria were recorded. Data were entered and analyzed by using SPSS version 19.0. RESULTS: The age range was from 1 to 18 years (average age of 8.5+4.15 years) with a mean duration of symptoms 2.3+1.2 weeks. Out of 90 patients, 48 (53%) were male and 42 (47%) were female. There were 56(62.2%) were with DKA, 33(36.66%) were with weight loss, 65 (72.2%) were with polydipsia, and 76 (84.4%) were with polyuria. A significant association of polyuria was observed with the age of the patients (p-value

Salinity stress is considered the most devastating abiotic stress for crop productivity. Accumulating different types of soluble proteins has evolved as a vital strategy that plays a central regulatory role in the growth and development of plants subjected to salt stress. In the last two decades, efforts have been undertaken to critically examine the genome structure and functions of the transcriptome in plants subjected to salinity stress. Although genomics and transcriptomics studies indicate physiological and biochemical alterations in plants, it do not reflect changes in the amount and type of proteins corresponding to gene expression at the transcriptome level. In addition, proteins are a more reliable determinant of salt tolerance than simple gene expression as they play major roles in shaping physiological traits in salt-tolerant phenotypes. However, little information is available on salt stress-responsive proteins and their possible modes of action in conferring salinity stress tolerance. In addition, a complete proteome profile under normal or stress conditions has not been established yet for any model plant species. Similarly, a complete set of low abundant and key stress regulatory proteins in plants has not been identified. Furthermore, insufficient information on post-translational modifications in salt stress regulatory proteins is available. Therefore, in recent past, studies focused on exploring changes in protein expression under salt stress, which will complement genomic, transcriptomic, and physiological studies in understanding mechanism of salt tolerance in plants. This review focused on recent studies on proteome profiling in plants subjected to salinity stress, and provide synthesis of updated literature about how salinity regulates various salt stress proteins involved in the plant salt tolerance mechanism. This review also highlights the recent reports on regulation of salt stress proteins using transgenic approaches with enhanced salt stress tolerance in crops.

This research targets to present a case study on the annual comparative assessment of photovoltaic thermal collectors (PV/T) by using water and Ag/water nanofluid for five different cities in Pakistan. The assessment is conducted at monthly, daily, and hourly resolutions. PV/T collector is imitated through a set of energy balance based physical models which are solved numerically for two working fluids (i.e. water and Ag/water nanofluid) in a yearly simulation format (with hourly, daily, and monthly predictions) for five major cities of Pakistan (Taxila, Peshawar, Multan, Lahore, and Karachi). Detailed comparative assessment is carried out based on the performance indicators such as electrical efficiency, thermal efficiency, heat gain, and net electricity power generation. In the results section, hourly, daily, and monthly patterns of performance indicators using water and Ag/water nanofluid are reported, followed by a comparative study between the different cities having different climatic conditions. The sensitivity of nanofluid's mass flow rate and its particle concentration on the performance indicators is also reported, and the analysis of the sensitivity of the nanofluid characteristics on the pumping and the net useful power is also presented. Assessment has indicated that the overall efficiency for Taxila, Peshawar, Multan, Lahore, and Karachi cities are similar and around 66% despite having different latitude and longitudinal locations. While using silver nanofluid as a working fluid, compared to the usage of pure water as a working fluid, overall lesser efficiency is seen at around 63.80%, for selected cities.

Fragile X-associated tremor/ataxia syndrome (FXTAS) and fragile X syndrome (FXS) are primary examples of fragile X-related disorders (FXDs) caused by abnormal expansion of CGG repeats above a certain threshold in the 5′-untranslated region of the fragile X mental retardation (FMR1) gene. Both diseases have distinct clinical manifestations and molecular pathogenesis. FXTAS is a late-adult-onset neurodegenerative disorder caused by a premutation (PM) allele (CGG expansion of 55–200 repeats), resulting in FMR1 gene hyperexpression. On the other hand, FXS is a neurodevelopmental disorder that results from a full mutation (FM) allele (CGG expansions of ≥200 repeats) leading to heterochromatization and transcriptional silencing of the FMR1 gene. The main challenge is to determine how CGG repeat expansion affects the fundamentally distinct nature of FMR1 expression in FM and PM ranges. Abnormal CGG repeat expansions form a variety of non-canonical DNA and RNA structures that can disrupt various cellular processes and cause distinct effects in PM and FM alleles. Here, we review these structures and how they are related to underlying mutations and disease pathology in FXS and FXTAS. Finally, as new CGG expansions within the genome have been identified, it will be interesting to determine their implications in disease pathology and treatment.

Background: The main cause for low mungbean [Vigna radiata (L.) R. Wilczek] productivity is mungbean yellow mosaic virus (MYMV). Generally, the management of MYMV relies upon frequent insecticide sprays to control its vector (whitefly) and genetic resistance. However, disease forecast models can help to economize the pesticide sprays. Hence current study was designed to identifying environmental factor that promote disease development and developing a disease prediction model. Methods: One hundred and twenty-seven mungbean accessions were planted for two years (2012 and 2013) and infection was dependent on natural inoculum. Weekly and daily data on disease incidence and environmental variables were collected and analyzed using correlation and stepwise regression analysis. Results: Wind velocity and high temperature had a negative relation with disease occurrence during both years, whereas low temperature, rainfall, and relative humidity, had positive relationship based on linear regression. The environmental conditions responsible for the highest disease incidence were, maximum temperature (32–34 °C), relative humidity (72–75 %), minimum temperature (27–29 °C), rainfall (1.8–2.1 mm) and wind velocity (3–4.5 km/hr) during both growing seasons Overall, five environmental variable multiple regression model encompassing relative humidity, wind speed, rainfall, suboptimum temperature, and optimum temperatures accommodate the data rightly explaining 83 % variation in disease outgrowth. Conclusion: The observed MYMV disease occurrence values for most of the mungbean genotypes, and those predicted by the model were very close. This multi-environmental variable model can be utilized to provide early warning forecasts for the management of MYMV in Pakistan.

Azurin is a natural protein produced by Pseudomonas aeruginosa that exhibits potential anti-tumor, anti-HIV, and anti-parasitic properties. The current study aimed to investigate the potential of azurin protein against breast cancer using both in silico and in vitro analyses. The amino acid sequence of Azurin was used to predict its secondary and tertiary structures, along with its physicochemical properties, using online software. The resulting structure was validated and confirmed using Ramachandran plots and ERRAT2. The mature azurin protein comprises 128 amino acids, and the top-ranked structure obtained from I-TASSER was shown to have a molecular weight of 14 kDa and a quality factor of 100% by ERRAT2, with 87.4% of residues in the favored region of the Ramachandran plot. Docking and simulation studies of azurin protein were conducted using HDOCK and Desmond servers, respectively. The resulting analysis revealed that Azurin docked against p53 and EphB2 receptors demonstrated maximum binding affinity, indicating its potential to cause apoptosis. The recombinant azurin gene was successfully cloned and expressed in a BL21 (DE3) strain using a pET20b expression vector under the control of the pelB ladder, followed by IPTG induction. The azurin protein was purified to high levels using affinity chromatography, yielding 70 mg/L. In vitro cytotoxicity assay was performed using MCF-7 cells, revealing the significant cytotoxicity of the azurin protein to be 105 µg/mL. These findings highlight the potential of azurin protein as an anticancer drug candidate.

MicroRNAs miR-29a and miR-192 are involved in inflammatory and fibrotic processes of chronic liver disease, and circulating miR-29a is suggested to diagnose fibrosis progression due to hepatitis C virus (HCV) infection. This study aimed to evaluate the expression profile of circulating miR-192 and 29a in a patient cohort with a high frequency of HCV genotype-3. A total of 222 HCV blood samples were collected and serum were separated. Patients were classified into mild, moderate, and severe liver injury based on their Child–Turcotte–Pugh CTP score. RNA was isolated from the serum and used for quantitative real-time PCR. The HCV genotype-3 (62%) was the predominant HCV genotype. In HCV patients, the serum miR-192 and miR-29a levels were significantly upregulated in comparison to healthy controls (p = 0.0017 and p = 0.0001, respectively). The progression rate of miR-192 and 29a in the patient group with mild was highly upregulated compared to patients with moderate and severe hepatitis infection. The ROC curve of miR-192 and miR-29a of moderate liver disease had a significant diagnostic performance compared to the other HCV-infected groups. The increase in miR-29a and miR-192 serum levels was even slightly higher in patients with HCV genotype-3 than in non-genotype-3 patients. In conclusion, serum miR-192 and miR-29a levels significantly increased during the progression of chronic HCV infection. The marked upregulation in patients with HCV genotype-3 suggests them as potential biomarkers for hepatic disease, independently of the HCV genotype.

Objective: To compare the efficacy of intra-articular injection of methyl prednisolone with ketorolac for improvement in range of motion in various shoulder joint disorders. Study Design: Quasi-experimental study. Place and Duration of Study: Departments of Internal and Rehabilitation Medicine, Combined Military Hospital Mangla, from Nov 2018 to May 2019. Methodology: Through non-probability consecutive sampling, patients with shoulder disorders were enrolled in the study and divided into two groups. Group A received intra articular corticosteroid injection and group B received intra-articular Ketorolac injection. Outcome was measured in terms of improvement in shoulder range of motion. Results: A total of 60 patients were selected, 40 (66.7%) male and 20 (33.3%) female. 30 (50%) patients had adhesive capsulitis, 24 (40%) had rotator cuff syndrome and 6 (10%) had impingement syndrome. 24 patients received methyl prednisolone acetate injection while 36 received ketorolac injection. There was no significant difference in the mean gain in flexion, extension, abduction, internal or external rotation between both groups (p=0.224, p=0.261, p=0.884, p=0.238, and p=0.584 respectively). Conclusion: There was no significant difference in efficacy of corticosteroid and ketorolac when injected intra-articularly in shoulder joint disorders.

Abstract Background Peutz-Jeghers syndrome is an autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps in the gastrointestinal tract (GIT). There have also been cases of extra GIT polyps such as the renal pelvis, urinary bladder, lungs and nares. Bladder hamartoma is an extremely rare finding, with only 12 cases described in the literature up to now. The rarity of the condition necessitates a comprehensive compilation of managements up to now so as to provide a better tool for the treatment of such conditions in the future. Case presentation A twenty-year-old male, known to have Peutz-Jeghers syndrome, presented to us complaining of obstructive urinary symptoms. A urethrogram done showed a filling defect at the base of the urinary bladder. The mass was resected transurethrally, and histopathology revealed a hamartoma of the bladder. The patient has since remained tumor-free on follow-up. Conclusions Transurethral resection of the bladder mass proved to be an effective therapy in this patient with no recurrence on the patient’s follow-up till now. There is still, however, a dearth of knowledge regarding the management of bladder hamartomas owing to the extreme rarity of the case.

Abstract Background Tuberous sclerosis complex (TSC) is a rare genetic disorder characterized by benign hamartomas in multiple organs of the body. Renal angiomyolipomas (AML) are commonly associated with TSC. They are mostly asymptomatic. But large and rapidly growing AMLs with the presence of an aneurysm cause symptoms and pose a life-threatening risk for hemorrhage. Case presentation Our patient is a 25-year-old female who presented to us as an undiagnosed case of tuberous sclerosis having a large abdominal mass. She fulfilled the clinical criteria required for the diagnosis of TSC. The CT scan revealed an 18 × 13 × 33 cm fat-containing lesion in the right kidney with an adjacent aneurysm measuring around 16 cm in diameter. Due to the large size of the AML and associated aneurysm, surgical exploration was mandated. On the contralateral kidney, multiple contrast-enhancing soft-tissue densities were present that appeared suspicious on radiology. So a percutaneous biopsy of those lesions was done. Fortunately, it had the same histopathology as an Angiomyolipoma. Nephrectomy of the right-sided kidney with AML has been done. The left-sided lesions that are less than 2 cm and asymptomatic are kept on close surveillance. Any change in size will prompt therapy with mTOR inhibitors. Conclusion When dealing with bilateral renal AML, it is important to adopt a conservative approach. When intervention is indicated, the least invasive strategy should be sought and enacted. Radical surgery should be the last resort.

Root-knot nematodes Meloidogyne incognita (Kofoid and White) Chitwood and Rhizoctonia bataticola (Taub.) Butler, fungus, are very dangerous root damaging pathogens. Present study was planned to establish a chemical control of these root deteriorating pathogens under lab conditions as well as in field. Maximum death rate of nematode juveniles and minimum numbers of nematode eggs hatched were recorded in plates treated with Cadusafos (Rugby® 100G) @12 g/100 ml and Cartap® (4% G) @9g/100 ml. Chemical treatment of Rhizoctonia bataticola with Trifloxystrobin + Tebuconazole (Nativo®) @0.2 g/100 ml and Mancozeb + Matalaxyl (Axiom) @0.25 g/100 ml significantly controlled the mycelial growth in plates. The best treatments tested in laboratory were applied in field as protective and curative treatments. Results proved that chemical control of root-knot nematode and root rot fungi by tested chemicals at recommended time and dose is a significant management technique under field conditions.

The building sector is targeting net-zero emissions through the integration of renewable energy technologies, especially for space cooling and heating applications. In this regard, the use of solar thermal concentrating collectors is of vital importance. The performance of these collectors increases by using an efficient fluid such as a nanofluid due to their high thermal conductivity. This research addresses the preparation, stability analysis, and characterisation of metallic and non-metallic oxide nanofluids and their experimental analysis in a compound parabolic collector (CPC) system. Five different combinations of nanofluids are used with different volumetric concentrations (0.025%, 0.05%, and 0.075%) including multi-wall carbon nanotube with water (MWCNT–H2O), multi-wall carbon nanotube with ethylene glycol (MWCNT–EG), aluminium oxide with water (Al2O3–H2O), aluminium oxide with ethylene glycol (Al2O3–EG), and magnesium oxide with ethylene glycol (MgO–EG). The prepared nanofluids are characterised in terms of thermal conductivity and viscosity. Detailed experimentation is performed to investigate the CPC system integrated with the nanofluids. The results obtained from the detailed characterisation of the MWCNT–H2O nanofluid showed that the nanofluids have a 37.17% better thermal conductivity than distilled water as a primary fluid, and the MWCNT–EG nanofluid has demonstrated an increase in viscosity by 8.5% compared to ethylene glycol (EG). The experimental analysis revealed that the thermal efficiency of the collector integrated with the MWCNT–H2O nanofluid is increased by 33% compared to water. Meanwhile, the thermal efficiency of the collector with MWCNT–EG was increased by 24.9% compared to EG. Moreover, a comparative analysis among metallic nanofluids was also performed, i.e., Al2O3–H2O, Al2O3–EG, and MgO–EG. In each case, the thermal efficiency of the collector was recorded, which was greater than the base fluid by percentages of 29.4%, 22.29%, and 23.1%, respectively. The efficiency of non-metallic nanofluids is better than metallic nanofluids by 7.7%. From the obtained results, it can be concluded that the CPC system performed best with MWCNT–H2O compared to any other combination of nanofluids.

Objective: To determine the screening efficacy of exercise tolerance test in the diagnosis of coronary artery disease in asymptomatic physically active adults. Study Design: Hospital-based cross-sectional validation study. Place and Duration of Study: Department of Medicine, Combined Military Hospital Mangla Cantonment, from Jan 2019 to Nov 2019. Methodology: Eight Hundred and Four patients fulfilling the inclusion criteria were included in study after obtaining informed written consent. All the enrolled subjects underwent an exercise tolerance test. Those subjects who had a normal exercise tolerance test were not assessed further and those who had an abnormal or inconclusive exercise tolerance test were referred to Armed Forces Institute of Cardiology/National Institute of Heart Diseases for coronary angiography. A database was maintained and used for further analysis. Results: Exercise tolerance test positivity is very low in asymptomatic young and active males, which was established to be 9% in our study. Similarly it was found that the positive predictive value of an abnormal exercise tolerance test result is also unacceptably low i.e. 18%. Conclusion: The diagnostic yield of exercise tolerance test remains low in view of a very high rate of false positive results, technical & procedural shortfalls and ethical constraints of subjecting asymptomatic persons to invasive and expensive coronary angiography.

This paper aims to numerically investigate the thermal-hydraulic performance of dimpled tubes having various geometric pitches under a constant external heat flux of 10 kW/m2 for a wide range of Reynolds numbers (Re). The performance of enhanced tubes consisting of ellipsoidal 0°, teardrop, and ellipsoidal 45° dimples of equivalent volumes are compared using steady-state Reynolds-Averaged Navier-Stokes simulations. It is observed that the performance of dimpled tubes vary significantly with dimple pitch (P) and Re variation. Therefore, optimum pitches and working ranges of Re are identified for all dimpled tube configurations by varying 3.2mm≤P≤13.2mm and 9000≤Re≤40000. The ellipsoidal 45° and teardrop dimpled tubes have been found to have an optimum pitch of 3.2 mm, and suitable working ranges of 9000≤Re≤30000 and 14000≤Re≤40000. The ellipsoidal 45° and teardrop dimpled tubes with optimum pitch enhanced thermal-hydraulic performance up to 45.7% and 31.2%, respectively. However, ellipsoidal 0° tubes have relatively short working ranges with limited thermal-hydraulic performance improvement. An in-depth analysis of local drag and heat transfer characteristics of individual dimples along with their effects on the overall performance of the tubes are also carried out. Lastly, new correlations of Nusselt number and friction factor are proposed for optimum dimpled tubes.

Rice is one of the most important crops in Pakistan, grown all over the world. Rice production has decreased due to susceptibility to a number of biological and abiotic factors. One of the oldest diseases is bacterial leaf blight of rice. The causative agent of the disease is Xanthomonas oryzae pv. oryzae. In this study, seedlings of four commercially grown rice varieties were sown by following the randomized complete block design (RCBD). Four treatments were used to manage the disease and to promote the plant growth. Correlation and regression analysis was used to study the relation of BLB disease and environmental factors. It was observed that plant height increased by the application of NPK followed by Farm yard manure, boron and leaf manure. Panicle length and weight was maximum in boron treated plants while minimum in FYM. Minimum disease severity was recorded in NPK treatment followed by boron FYM and leaf manure. All the environmental variables showed significantly negative relationship with the development BLB disease. These results would be beneficial for the farming community to devise management options against BLB disease.

In the fifteenth century, trained individuals called' barber surgeons' mastered the art of handling sharp instruments and performing basic surgical procedures. They even founded a 'United Company of Barber Surgeons' in 1540.1 Besides shaving and haircutting, they were trained to perform dental extractions and a few surgical procedures. Later in 1745, qualified doctors and surgeons came together and founded 'Company of Surgeons' in the UK, which later became the Royal College of Surgeons in London.2 This progression from anecdotal experiences of the guild of barbers to a formal society that helped the implementation of scientifically reasoned decisions by Royal College Surgeons was only possible because surgeons were able to appreciate the value of the evidence and incorporate it into their practices. Continuous...

Research in surgery has led to significant advances over the last century in terms of how medicine is practised in and outside the operating rooms today. Surgical research in the developed countries is responsible for most of this advancement, but it is often inapplicable in resourcelimited settings in the developing world. Lower- and middle-income countries are in a unique position to take this work further, but they are limited by certain barriers. These barriers could broadly be classified under social and cultural, infrastructure, financial, ethical, and personal categories. These barriers are often not fully realised, but can potentially be addressed with concerted efforts to continue the advancement of medicine for everyone. Continuous...