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In the crystal of the title compound, C12H17N3, the molecules are linked by N—H...N hydrogen bonds, generating a C(4) chain extending along the c-axis direction. One of the ethyl groups is disordered over two sets of sites with a refined occupancy ratio of 0.582 (15):0.418 (15).

Background A digital decision support system in healthcare is a digital health intervention that assists healthcare professionals in decision-making by providing treatment recommendations and enhancing diagnostic accuracy and quality of care. This will be the first study in Pakistan to assess the system’s usability, acceptability and effectiveness in improving healthcare outcomes while also evaluating the perceived quality of care. This comprehensive assessment will inform policy development in areas such as the scale-up of digital health interventions, data privacy and technology interoperability. Measures of effectiveness will include changes in clinical outcomes through a patient exit feedback survey. This study aims to evaluate the role of digital decision support systems in healthcare decision-making, which may be integrated into Pakistan’s tele-primary healthcare system.Methods The study will employ a multimethod approach. The data collection tools are adapted from the WHO’s digital health intervention monitoring and evaluation framework and include a technology assessment, healthcare provider surveys, patient exit interviews and focus group discussions with healthcare providers. Purposive sampling will be used for qualitative interviews with providers (doctors) and patients. Government stakeholders, private sectors, multilateral, academia and policymakers will be engaged through a consultative meeting. We will also conduct a literature review, as well as a comprehensive analysis of existing studies, documents and data relevant to digital decision support systems and digital health interventions implemented globally, and assess the performance, challenges and opportunities.Ethics and dissemination The study has been approved by the Ethics Review Committee at The Aga Khan University (2023-8514-26533). The dissemination of study findings through scientific publications and seminars will enable programme managers and policymakers to design tools to improve the quality of care provided through telemedicine platforms. This will contribute to efficient decision-making, access and quality of care for primary healthcare in low-income and middle-income countries. This study will also inform policy regarding the scale-up of decision support systems in primary care settings, data privacy and technology interoperability.

Aim: Innovation is vital in emergency departments (EDs), advancing diagnostics, triage, communication, and personalized treatment to save lives and improve patient outcomes. This study aims to assess the self-perceived innovation capacities of employees in the ED of a major quaternary care hospital in Karachi, Pakistan, to establish a baseline and identify areas for improvement. Materials and Methods: This study employed a descriptive cross-sectional design to assess the innovation skills of employees in the Department of Emergency Medicine and the 24/7 Emergency and Acute Care Service Line at the Aga Khan University Hospital in Karachi, Pakistan. The sample size of 130 employees was determined using non-probability purposive sampling. The study used the Innovation Skills Assessment, a close-ended structured questionnaire, to measure employees’ self-perceived strengths and weaknesses in the four pillars of innovation skills. Descriptive statistics and visualizations were used for data analysis. Ethical approval and informed consent were obtained beforehand. Results: The study showed that employees generally had a positive self-assessment of their innovation skills. There were differences between genders, with males scoring slightly higher. Young employees did not perceive themselves as more innovative, whereas older employees scored lower. Postgraduates and nurses self-assessed higher innovation capacities. Overall, employees showed strengths in idea generation and relationship building but had room for improvement in risk-taking and entrepreneurship. Conclusion: This study emphasizes the importance of fostering innovation in EDs in low-resource settings to improve patient outcomes. These findings can inform targeted interventions to enhance innovation skills and promote a culture of innovation and entrepreneurship in EDs globally, and in healthcare organizations overall. Further research is needed to explore the relationship between self-assessed and actual innovation performance.

Background: Routine vaccination has remained historically low in major urban pockets of Pakistan, and now lags behind rural vaccination rates. Grossly insufficient publicly funded primary healthcare infrastructure, heterogeneous mix of providers and multi-ethnicity of populations pose challenges in the delivery of essential health services. This paper ascertains factors associated with uptake of routine childhood vaccination, using Pentavalent-3 vaccine, as a proxy indicator for completion of age-appropriate vaccines in urban slums of Karachi, at high risk of Polio and vaccine preventable disease outbreaks. Methods: Data was drawn from baseline assessment of an urban immunization delivery pilot project in urban slums of Karachi, Pakistan. The study sample comprised of 2,097 households with children aged 4–12 months, sampled through a cross-sectional cluster survey, applying a structured questionnaire. Multivariable logistic regression was used to determine the association between Penta-3 vaccination, as the outcome variable, and predictor variables including socio-demographic characteristics and healthcare access factors. Results: The findings showed that the likelihood of being immunized with Penta-3 was higher for non-Pashtun ethnicity [adjusted odds ratio (aOR) 1.69; 95% CI 1.33–2.14], children of educated mothers, secondary or higher [aOR 2.95, 95% CI 2.34–3.71], and those whose fathers were formally employed (aOR 1.53; 95% CI 1.19–1.97). No association was seen by gender of child [aOR 0.89; 95% CI 0.73–1.08], and place of new born delivery [aOR 1.01; 95% CI 0.83–1.24]. Conclusion: Pockets of critically low under-vaccinations within the urban slums of Karachi are associated with Pashtun ethnicity, distance to the vaccination centre, lack of mothers’ education and lack of stable family income as in the case of unemployed and daily wage-earning fathers. Recognition of these factors is required in designing contextually appropriate strategies to address vaccine inequity in urban settings.

Owing to the broad applications of quaternary ammonium salts (QAS), we present the synthesis of benzimidazolium-based analogues with variation in the alkyl and alkoxy group at N-1 and N-3 positions. All the compounds were characterized by spectroscopic techniques and found stable to air and moisture both in the solid and solution state. Moreover, molecular structures were established through single-crystal X-ray diffraction studies. The crystal packing of the compounds was stabilized by numerous intermolecular interactions explored by Hirshfeld surface analysis. The enrichment ratio was calculated for the pairs of chemical species to acquire the highest propensity to form contacts. Void analysis was carried out to check the mechanical response of the compounds. Furthermore, theoretical investigations were also performed to explore the optoelectronic properties of compounds. Natural population analysis (NPA) has been conducted to evaluate the distribution of charges on the synthesized compounds, whereas high band gaps of the synthesized compounds by frontier molecular orbital (FMO) analysis indicated their stability. Nonlinear optical (NLO) analysis revealed that the synthesized QAS demonstrates significantly improved NLO behaviour than the standard urea.

In this study we presented a novel series of NNO tridentate ligands generating imino, amido and oxo donor pocket for Pd(II) coordination. All the compounds were meticulously characterized by elemental analysis and advanced spectroscopic techniques, including FTIR, proton and carbon NMR. The synthesized compounds underwent rigorous evaluation for their potential as anti-cancer agents, utilizing the aggressive breast cancer cell lines MDA-MB (ATCC) and MCF-7 as a crucial model for assessing growth inhibition in cancer cells. Remarkably, the MTT assay unveiled the robust anti-cancer activity for all palladium complexes against MDA-MB-231 and MCF-7 cells. Particularly, complex [Pd(L1)(CH3CN)] exhibited exceptional potency with an IC50 value of 25.50 ± 0.30 µM (MDA-MB-231) and 20.76 ± 0.30 µM (MCF-7), compared to respective 27.00 ± 0.80 µM and 24.10 ± 0.80 µM for cisplatin, underscoring its promising therapeutic potential. Furthermore, to elucidate the mechanistic basis for the anti-cancer effects, molecular docking studies on tyrosine kinases, an integral target in cancer research, were carried out. The outcome of these investigations further substantiated the remarkable anticancer properties inherent to these innovative compounds. This research offers a compelling perspective on the development of potent anti-cancer agents rooted in the synergy between ligands and Pd(II) complexes and presenting a promising avenue for future cancer therapy endeavors.

Abstract Preventing bacteria from adhering to material surfaces is an important technical problem and a major cause of infection. One of nature’s defense strategies against bacterial colonization is based on the biohalogenation of signal substances that interfere with bacterial communication. Biohalogenation is catalyzed by haloperoxidases, a class of metal-dependent enzymes whose activity can be mimicked by ceria nanoparticles. Transparent CeO2/polycarbonate surfaces that prevent adhesion, proliferation, and spread of Pseudomonas aeruginosa PA14 were manufactured. Large amounts of monodisperse CeO2 nanoparticles were synthesized in segmented flow using a high-throughput microfluidic benchtop system using water/benzyl alcohol mixtures and oleylamine as capping agent. This reduced the reaction time for nanoceria by more than one order of magnitude compared to conventional batch methods. Ceria nanoparticles prepared by segmented flow showed high catalytic activity in halogenation reactions, which makes them highly efficient functional mimics of haloperoxidase enzymes. Haloperoxidases are used in nature by macroalgae to prevent formation of biofilms via halogenation of signaling compounds that interfere with bacterial cell–cell communication (“quorum sensing”). CeO2/polycarbonate nanocomposites were prepared by dip-coating plasma-treated polycarbonate panels in CeO2 dispersions. These showed a reduction in bacterial biofilm formation of up to 85% using P. aeruginosa PA14 as model organism. Besides biofilm formation, also the production of the virulence factor pyocyanin in is under control of the entire quorum sensing systems P. aeruginosa. CeO2/PC showed a decrease of up to 55% in pyocyanin production, whereas no effect on bacterial growth in liquid culture was observed. This indicates that CeO2 nanoparticles affect quorum sensing and inhibit biofilm formation in a non-biocidal manner.

The asymmetric unit of the title compound, [Tm2(C7H6NO2)6(H2O)4]·2H2O, contains three 4-aminobenzoate (4ABA) ligands, two coordinated water molecules, a thulium metal ion, and a water molecule of crystallization. The overall structure of the complex (4ABA-Tm) is in the form of a dimer. In the dinuclear thulium complex, symmetry-relevant TmO8 coordination polyhedra are formed by the O atoms of two chelating 4-aminobenzoate ligands, the O atoms of two non-chelating 4-aminobenzoate ligands, and two water molecules. The Tm—O bond lengths range from 2.216 (3) to 2.471 (3) Å with the Tm...Tm separation in the dinuclear complex being 4.7863 (5) Å. The crystal structure features O—H...N, N—H...O, and O—H...O hydrogen-bonding interactions. Further stabilization of the crystal packing is due to C—H...π and off-set π–π stacking interactions. Hirshfeld surface analysis indicates that H...H contacts are the most significant contributors to the crystal packing (45.9%). In addition, a void analysis was performed to check the strength of the crystal packing.

Abstract The ethyl 2-[2-(2-nitrobenzylidene)hydrazinyl]thiazole-4-carboxylate (1), a thiazole ester, was synthesized by refluxing 1-(2-nitrobenzylidene)thiosemicarbazide and ethyl bromopyruvate. The compound is characterized by spectrometric, spectroscopic and single crystal (SC-XRD) techniques. Non-covalent interactions that are responsible for crystal packing are explored by Hirshfeld surface analysis. All theoretical calculations were performed by DFT quantum chemical methods using 6-311G(d,p) and cc-pVTZ basis sets and compared. Theoretical harmonic frequencies of ethyl 2-[2-(2-nitrobenzylidene)hydrazinyl]thiazole-4-carboxylate (1) were optimized. Confirmation of hydrogen bonding sites was analyzed by molecular electrostatic potential (MEP) and Mulliken population analysis. The vibrational frequencies of characteristic functional groups and chemical shifts were found in good agreement with experimental assignments. Frontier molecular orbital (FMO) revealed relatively small HOMO–LUMO (highest occupied molecular orbital-lowest unoccupied molecular orbital) gape, which speaks off the nearly planar geometry and extended conjugation, as compared to the substituents with no conjugation possible. It has also been observed that –NO2 substituent plays a vital role for this relatively small HOMO–LUMO gape and overall electronic properties when compared with similar thiazole carboxylates (2–6, Table 6). Ethyl 2-[2-(2-nitrobenzylidene)hydrazinyl]thiazole-4-carboxylate (1) was also evaluated for its anti-oxidant and anti-microbial activities. Graphical Abstract

Current energy crisis and environmental issues, including depletion of fossil fuels, rapid industrialization, and undesired CO2 emission resulting in global warming has created havoc for the global population and significantly affected the quality of life. In this scenario the environmental problems in the forefront of research priorities. Development of renewable energy resources particularly the efficient conversion of solar light to sustainable energy is crucial in addressing environmental problems. In this regard, the synthesis of semiconductors-based photocatalysts has emerged as an effective tool for different photocatalytic applications and environmental remediation. Among different photocatalyst options available, graphene and graphene derivatives such as, graphene oxide (GO), highly reduced graphene oxide (HRG), and doped graphene (N, S, P, B-HRG) have become rising stars on the horizon of semiconductors-based photocatalytic applications. Graphene is a single layer of graphite consisting of a unique planar structure, high conductivity, greater electron mobility, and significantly very high specific surface area. Besides, the recent advancements in synthetic approaches have led to the cost-effective production of graphene-based materials on a large-scale. Therefore, graphene-based materials have gained considerable recognition for the production of semiconducting photocatalysts involving other semiconducting materials. The graphene-based semiconductors photocatalysts surpasses electron-holes pairs recombination rate and lowers the energy band gap by tailoring the valence band (VB) and conduction band (CB) leading to the enhanced photocatalytic performance of hybrid photocatalysts. Herein, we have summarized the latest developments in designing and fabrication of graphene-based semiconducting photocatalysts using a variety of commonly applied methods such as, post-deposition methods, in-situ binding methods, hydrothermal and/or solvothermal approaches. In addition, we will discuss the photocatalytic properties of the resulting graphene-based hybrid materials for various environmental remediation processes such as; (i) clean H2 fuel production, photocatalytic (ii) pollutants degradation, (iii) photo-redox organic transformation and (iv) photo-induced CO2 reduction. On the whole, by the inclusion of more than 300 references, this review possibly covered in detail the aspects of graphene-based semiconductor photocatalysts for environmental remediation processes. Finally, the review will conclude a short summary and discussion about future perspectives, challenges and new directions in these emerging areas of research.

Synthetic supramolecular structures constructed through the cooperative action of numerous non-covalent forces are highly desirable as models to unravel and understand the complexity of systems created in nature via self-assembly. Taking advantage of the low cost of 2,4,6-trichloro-1,3,5-triazine (cyanuric chloride) and the sequential nucleophilic substitution reactions with almost all types of nucleophiles, a series of six structurally related novel s-triazine derivatives 1–6 were synthesized and structurally characterized based on their physical, spectral and crystallographic data. The solid-state structures of all the six compounds showed intriguing and unique molecular duplexes featuring NH···N, CH···O and CH···π interactions. Careful analysis of different geometric parameters of the involved H-bonds indicates that they are linear, significant and are therefore responsible for guiding the three-dimensional structure of these compounds in the solid state. The prevalence of sextuple hydrogen bond array-driven molecular duplexes and the possibility of structural modifications on the s-triazine ring render these novel triazine derivatives 1–6 attractive as a platform to create heteroduplex constructs and their subsequent utility in the field of supramolecular chemistry and crystal engineering.

The pharmacological effectiveness of indoles, benzoxazepines and benzodiazepines initiated our synthesis of indole fused benoxazepine/benzodiazepine heterocycles, along with enhanced biological usefulness of the fused rings. Activated indoles 5, 6 and 7 were synthesized using modified Bischler indole synthesis rearrangement. Indole 5 was substituted with the trichloroacetyl group at the C7 position, yielding 8, exclusively due to the increased nucleophilic character of C7. When trichloroacylated indole 8 was treated with basified ethanol or excess amminia, indole acid 9 and amide 10 were yielded, respectively. Indole amide 10 was expected to give indole fused benoxazepine/benzodiazepine 11a/11b on treatment with alpha halo ester followed by a coupling agent, but when the reaction was tried, an unexpectedly rearranged novel product, 1,3-bezodiazine 12, was obtained. The synthetic compounds were screened for anticholinesterase and antibacterial potential; results showed all products to be very important candidates for both activities, and their potential can be explored further. In addition, 1,3-bezodiazine 12 was explored by DFT studies, Hirshfeld surface charge analysis and structural insight to obrain a good picture of the structure and reactivity of the products for the design of derivatised drugs from the novel compound.

The work here reflects synthesis, DFT studies, Hirshfeld charge analysis and crystal data exploration of pharmacologically important (R)-2-(2-(1,3-dioxoisoindolin-2-yl)propanamido)benzoic acid methyl ester (5) to understand its properties for further chemical transformations. The methyl anthranilate (2) was produced by the esterification of anthranilic acid in an acidic medium. The phthaloyl-protected alanine (4) was rendered by the fusion of alanine with phthalic anhydride at 150 °C, followed by coupling with (2) furnished isoindole (5). The characterization of products was performed using IR, UV-Vis, NMR and MS. Single-crystal XRD also verified the structure of (5) in which N-H⋯O bonding stabilizes the molecular configuration of (5), resulting in the formation of S(6) hydrogen-bonded loop. The molecules of isoindole (5) are connected in the form of dimers, and the π⋯π stacking interaction between aromatic rings further stabilizes the crystal packing. DFT studies suggest that HOMO is over the substituted aromatic ring, the LUMO is present mainly over the indole side, and nucleophilic and electrophilic corners point out the reactivity of the product (5). In vitro and in silico analysis of (5) shows its potential as an antibacterial agent targeting DNA gyrase and Dihydroorotase from E. coli and tyrosyl-tRNA synthetase and DNA gyrase from Staphylococcus aureus.

A series of diamines derived transition metal complexes of naproxen with Zn(II), Cu(II), Ni(II), Co(II), Mn(II) have been synthesized and characterized by (FT)-IR, UV-Vis, NMR spectroscopy, magnetic susceptibility, and elemental analysis. Octahedral geometry has been proposed for all synthesized complexes based on magnetic susceptibility and electronic spectra. The crystal structures of Cu(II) complex with 1,2-diaminoethane (4b) is reported in this article. Structural studies provide the confirmation for the formation of Cu(H2O)2 (C2H8N2)2(np)2, which consists of two ionic naproxen moieties with different OMe orientation having intermolecular hydrogen bonding in solid-state. Jack bean Urease study of synthesized metal complexes was conducted and found that Cu and Ni complexes are more active having lower IC50 values against urease enzyme as compared to Zn, Co, and Mn complexes. Furthermore, urease inhibition studies showed that 1,2 diaminoethane and 1,3 diaminopropane derived transition metal complexes of naproxen (4a-e) and (5a-e), respectively have more inhibition efficacy as compared to simple metal naproxen complexes (3a-e). Amongst all, the synthesized complexes 4b and 4c have shown significant inhibition activities with IC50 values of 17.06 ± 0.05 and 18.07 ± 0.17 µM respectively, as compared to the standard drug thiourea.

Herein, we report novel macromolecular prodrugs (MPDs) of flurbiprofen (FLB) onto a cellulose ether, hydroxypropylcellulose (HPC). The FLB was activated with a powerful acylation reagent carbonyldiimadazole (CDI) in N,N′ dimethylacetamide (DMAc) solvent at room temperature. Imidazolide of FLB generated in situ reacts at 80 °C for 24 h with pre-dissolved HPC to prepare HPC-FLB conjugates. The resultant MPDs of FLB showed moderate to high degree of substitution (DS: 0.35–1.3) with good yield (70–82%). Structures were thoroughly characterized using FTIR, UV and NMR spectroscopic analyses. The pharmacokinetic studies showed that the t1/2 and tmax values of FLB from HPC-FLB conjugate were increased substantially as compare to standard FLB indicates enhanced bioavailability of drug after conjugate formation. Remarked anti-inflammatory activity of the HPC-FLB conjugate was also observed.

Polysaccharides are beneficially used as drug carriers via prodrug formation and offer a mechanism for better effectiveness and delivery of the drug. The unique geometry of hydroxypropylcellulose (HPC), a polysaccharide, allows the attachment of drug molecules with a higher degree of substitution because the hydroxyls groups are projected outside the HPC chains. Therefore HPC-Naproxen conjugates, i.e., macromolecular prodrugs, were synthesized using a powerful acylation reagent carbonyldiimadazole (CDI) in N,N' dimethylacetamide (DMAc) solvent. The reactions were carried out at 80 °C under stirring for 24 h and inert environment. This reaction strategy appeared efficient to obtain a high degree of drug substitution (DS = 0.88–1.40) on the polymer parent chain as calculated by UV–visible spectrophotometry after hydrolysis of the samples. The method provides high efficacy as product yields were high (77–81%). Macromolecular prodrugs (MPDs) with different DS of naproxen designed were found soluble in organic solvents.