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This community service aims to strengthen security and support to prevent and reduce the number of violence incidents in schools. The service was carried out with a group intervention method in the form of psychoeducation both training and non-training for the TPPK Task Force, teachers and staff, parents, and students of SDN 1 Cawas. The methods used were FGDs by developing regulations through School SMART GOALS; training psychoeducation to improve knowledge and skills and increase the self-efficacy of the TPPK Task Force; and non-training psychoeducation to increase knowledge and awareness of parents, teachers, and students regarding the prevention and handling of violence in schools. The results of the service showed an increase in knowledge, and self-efficacy of teachers and parents, as well as increased empathy and knowledge about understanding violence in schools and efforts to prevent violence. The psychoeducation activities were able to increase knowledge, skills, and awareness for all elements involved in the school, namely the TPPK Task Force, teachers, parents, and students at SDN 1 Cawas regarding the prevention and handling of violence in schools.

Abstract The melanocortin receptor 4 (MC4R) belongs to the melanocortin receptor family of G-protein coupled receptors and is a key switch in the leptin-melanocortin molecular axis that controls hunger and satiety. Brain-produced hormones such as α-melanocyte-stimulating hormone (agonist) and agouti-related peptide (inverse agonist) regulate the molecular communication of the MC4R axis but are promiscuous for melanocortin receptor subtypes and induce a wide array of biological effects. Here, we use a chimeric construct of conformation-selective, nanobody-based binding domain (a ConfoBody Cb80) and active state-stabilized MC4R-β2AR hybrid for efficient de novo discovery of a sequence diverse panel of MC4R-specific, potent and full agonistic nanobodies. We solve the active state MC4R structure in complex with the full agonistic nanobody pN162 at 3.4 Å resolution. The structure shows a distinct interaction with pN162 binding deeply in the orthosteric pocket. MC4R peptide agonists, such as the marketed setmelanotide, lack receptor selectivity and show off-target effects. In contrast, the agonistic nanobody is highly specific and hence can be a more suitable agent for anti-obesity therapeutic intervention via MC4R.

Abstract Background Metformin is a hypoglycaemic medication that has been proposed to treat or prevent preeclampsia. Combining national birth data from Scotland and Sweden, we investigated whether metformin used during pregnancy was associated with an altered risk of developing a hypertensive disorder of pregnancy. Methods We utilised data from two population-based cohorts: Scotland (2012–2018) and Sweden (2007–2019). Nulliparous women with gestational diabetes or type 2 diabetes who had birth outcome data linked with medications prescribed during pregnancy were included. The association between metformin prescription and hypertensive disorders of pregnancy was characterised using inverse probability weighted regression analysis, adjusting for variables that predict metformin use and potential confounders. Adverse neonatal outcomes were included as secondary outcomes. Results from both countries were then combined in a meta-analysis using a random effects model. Results The Scottish cohort included 3859 women with gestational diabetes or type 2 diabetes. Of these women, 30.8% (n = 1187) received at least one metformin prescription during pregnancy. For Sweden, 7771 women with gestational diabetes were included where 19.3% (1498) used metformin during pregnancy. Metformin prescription was not associated with an altered risk of any hypertensive disorder of pregnancy (Scotland adjusted relative risk (aRR) 0.88 [95% confidence interval (CI) 0.66–1.19]; Sweden aRR 1.08 [95% CI 0.86–1.37]) or preeclampsia (Scotland aRR 1.02 [95% CI 0.66–1.60]; Sweden aRR 1.00 [95% CI 0.72–1.39]). Combining adjusted results in a meta-analysis produced similar findings, with a pooled RR of 0.98 (95% CI 0.79–1.18) for any hypertensive disorder and RR 1.01 ([95% CI 0.73–1.28]) for preeclampsia. For neonatal outcomes, metformin was associated with a reduced risk of birthweight > 4500 g in Scotland (aRR 0.39 [95% CI 0.21–0.71]) but not in Sweden. There was no association between metformin and preterm birth or birthweight

The research focuses on the effective extraction of natural dye from Eucalyptus (Eucalyptus globulus L.) leaves and process optimization of coloration using tencel fabrics. Eucalyptus leaves were extracted using ultrasonic-assisted extraction and applied to tencel fabrics using exhaust dyeing method. The tencel fabric samples were dyed using pre-mordanting, simultaneous-mordanting, and post-mordanting techniques without and with mordants using different concentrations. The dye extraction and dyeing process were investigated at different temperatures and time durations to achieve an optimized process. The dyed samples were examined for color strength (K/S) and CIEL*a*b values by using Data Color spectrophotometer. Additionally, the dyed samples were tested for qualitative and quantitative antibacterial activity using standard protocols. The results revealed that ultrasonic extraction was efficient and effective for the dyeing of tencel using eucalyptus dye at 60°C with a time span of 30 min. The pre-mordanting method demonstrated better results in terms of shade depth and colorfastness. Tencel fabric dyed in the presence of ferrous sulfate mordant revealed superior dyeing results while potassium dichromate showed poor results. All the samples possessed good antibacterial and good fastness properties. Thus, tencel fabrics dyed with eucalyptus dye through ultrasonic at low temperatures and short time could be valuable for textile industry.

Due to the production of huge quantity of potentially toxic and recalcitrant pollutants, which cannot be completely decomposed with conventional biological wastewater treatment processes, in the paper industry, reliable treatment processes are highly required. This study conducted effective experiments of different series of processes to decompose persistent contaminants in the paper wastewater under controlled conditions of the used processes to meet the effluent quality standards of Korea Ministry of Environment in terms of CODMn (< 130 mg/L). For Biological treatment, Fenton, and photo-Fenton processes, various operational parameters were adjusted to determine the optimal conditions for CODMn value. Due to large quantity of refractory contaminants in the wastewater, single treatment process was not enough to meet the requirement of CODMn. Herein, we achieved the goal with two approaches: (1) secondary Fenton oxidation after biological and primary Fenton treatments, and (2) photo-Fenton treatment after biological treatment alone. The secondary Fenton oxidation process is an additional process operated under the same condition of the primary Fenton treatment to treat the effluent from the primary Fenton treatment. Ultimately, the residual CODMn concentrations of the secondary Fenton and single photo-Fenton treatment were 62.7 and 85.3 mg/L, respectively. However, the secondary Fenton required larger amounts of reagents and produced significant amounts of sludge, which require post-treatment, compared to single photo-Fenton treatment. Therefore, it suggests that the application of photo-Fenton was more efficient than the secondary Fenton in terms of economic feasibility and post-treatment requirement.

Amygdalin specifically represents the apricot (Prunus armeniaca) seed in the Rosacea family of plants. Except for cyanogenic glycoside, the seeds include a variety of substances, including trace minerals, vitamins, carbohydrates, organic acids, esters, phenols, and terpenoids. It is well known that bioregulators have the ability to control the activity of certain hormones and enzymes. The current study examined the effect of Iraqi apricot seed extract on physiological parameters in male rats, including blood parameters, hormone parameters, and antioxidant parameters, as well as histological studies of the spleen and testes. The study comprised four groups, each consisting of six animals. The animals in the control group received distilled water as their treatment. G1 received an extract (10 mg b.w.), G2 received an extract (20 mg b.w.), and G3 received an extract (40 mg b.w) orally every day for 30 days. The results showed a significant increase in WBC and blood platelets (P≤0.05), as well as T3 and T4. When compared with the control, TSH shows a significant decrease (P≤0.01) in the three groups. While FSH, LH, and testosterone hormone showed a significant decrease (P≤0.01) in the G1 and G2 groups, MPO, MDA, GPX, SOD, vitamin C, and E showed a significant decrease (P≤0.01) when compared with the control group. Finally, the histological examination showed that the spleen and testis in all groups showed a normal appearance after 30 days.

Hepatoblastoma is a rare liver cancer that occurs most often in children who present with lower birth weight. Cerebral palsy (CP) is a neurodevelopmental disorder distinguished by irregularities in muscle tone, movement, and motor skills. CP is caused by damage to the developing brain and is often associated with secondary complications such as severe constipation. Clinicians must be aware of sudden worsening constipation occurring in CP children because it can also be a sign of hepatoblastoma. The aim of this review is to summarize the current understanding of the risks for hepatoblastoma development in children with CP. Cancer risks likely include dysfunction of the immune system surveillance in CP children. Elevated C-reactive protein and tumor necrosis factor-alpha levels may be higher in children with CP, which weakens their innate immune system. Metabolic disruption increases the risk of some cancers, and poor nutrition and reduced growth that occur in CP patients may have an impact on cancer development through a loss in immune function. Increased mobility and physical activity can increase the T-cell, natural killer cell, and neutrophil population. Children with CP tend to engage poorly in physical activity, and consequently, their immune system is affected. There are multiple factors associated with CP that increase the risk of childhood cancers such as hepatoblastoma.

Abstract : This research aimed to examine the impact of business capital, duration of company, and business location on the revenue of micro, small, and medium-sized businesses in Bantul Regency, specifically in Banguntapan. This is a quantitative research that employs primary data sources; the population and sample size are 100 Indonesian merchants. The data was collected using a questionnaire with nominal and Likert scales. This study's data was analyzed using multiple regression analysis. The results revealed that: 1) Business capital does not influence on the income of micro, small, and medium firms. 2)The duration of the business had a beneficial and substantial influence on the income of micro, small, and medium firms. 3)Micro, small, and medium-sized businesses' incomes are unaffected by their location. Future study is intended to explore variables other than those analyzed to gain more diverse results and learn about additional aspects that might impact the revenue of micro, small, and medium-sized firms. Abstrak : Tujuan penelitian ini yaitu untuk mengetahui pengaruh dari modal usaha, jangka waktu berdirinya, dan lokasi usaha terhadap pendapatan usaha mikro, kecil, dan menengah di Kabupaten Bantul, khususnya di Banguntapan. Penelitian ini merupakan penelitian kuantitatif yang memakai data primer; populasi dan ukuran sampel yaitu seratus pedagang Indonesia. Pengumpulan data dilakukan dengan memakai kuesioner dengan skala nominal dan likert. Data penelitian ini dianalisis memakai analisis regresi berganda. Hasil penelitian memperlihatkan bahwa: 1) modal usaha tidak memberikan pengaruhnya kepada pendapatan usaha mikro, kecil, dan menengah. 2) lamanya usaha mempunyai pengaruh yang menguntungkan dan besar terhadap pendapatan usaha mikro, kecil, dan menengah. 3) pendapatan usaha mikro, kecil, dan menengah tidak terpengaruh oleh lokasinya. Penelitian di masa depan dimaksudkan untuk mengeksplorasi variabel-variabel selain yang dianalisis untuk mendapatkan hasil yang lebih beragam dan mempelajari aspek-aspek tambahan yang mungkin berdampak pada pendapatan usaha mikro, kecil, dan menengah.

In this investigation, the fractional Hirota–Satsuma coupled Korteweg–de Vries (KdV) problem is solved using two modern semi-analytic techniques known as the Aboodh residual power series method (ARPSM) and Aboodh transform iteration method (ATIM). The two suggested approaches are briefly explained, along with how to use them to solve the fractional Hirota–Satsuma coupled KdV problem. Some analytical approximate solutions for the current problem are derived using the proposed techniques until the second-order approximation. To ensure high accuracy of the derived approximation, they are analyzed numerically and graphically and compared with the exact solutions of the integer cases. The offered techniques demonstrate more accuracy in their outcomes compared to other alternatives. The numerical results show that ARPSM and ATIM are highly accurate, practical, and beneficial for solving nonlinear equation systems. The current results are expected to help many physics researchers in modeling their different physical problems, especially those interested in plasma physics.

This study involved prepare new four complexes of 2-mercaptobenzomidazole with the metals (Cu, Zn, Cd, and Pb). The synthesized complexes were characterize by measuring ultraviolet spectroscopy, the wave length (λ nm) (318, 333.4) of ligand (272, 296.2, 624.8), (254, 306), (257, 311) and (262, 314) of synthesized complexes respectively, then by infrared spectroscopy (FTIR) the results of the infrared spectroscopic examination showed the shifted in the absorption bands of (S-H) and (N-H) groups of the ligand as a result of coordination, molar conductivity, atomic absorption (AAS) spectroscopy and ratio of elements (CHNS) to determine the formulas of the complexes, the complexes shown a distorted octahedral crystal structure, and the molecular formula of the complexes was [M (C7H6N2S)2Cl2]. The synthesized complexes were assessed for their biological activity against different four types of bacteria (Staphylococcus aureus, Escherichia coli, spherical bacteria, Staphylococcus epidermidis, and Klebsiella pneumoniae), in addition to a type of Fungus, Candida albicans, the comparison include the activity of the complexes in relation to the antibiotic penicillin and the activity of 2-mercaptobenzomidazole, the prepared complexes had the highest biological activity compared to ligand and the antibiotic penicillin, the best prepared complex was the cadmium complex, the diameter of inhibition ranged between (27–36 nm) against bacteria and (40 nm) against the fungus, the complexes can be suggested as a more activity antibiotic than ligand and penicillin.

The interest in Data Envelopment Analysis (DEA) has grown since its first put forward in 1978. In response to the overwhelming interest, systematic literature reviews, as well as bibliometric studies, have been performed in describing the state-of-the-art and offering quantitative outlines with regard to the high-impact papers on global applications of DEA and the higher education system (DEA-HE). This study examines 75 systematic literature review (SLR) studies published between 2018 and 2022 and 508 bibliometric studies published between 1992and 2022. Four performance-focused areas are identified through SLR analysis: institutional performance, departmental performance, performance of study program, and performance of other higher education (HE) activities. This study highlights issues, methods, and resolutions in selected SLR literature. Bibliometric analysis revealed an increasing trend in DEA-HE since 2003, with the highest number of publications in 2021. Tommaso Agasisti was the most productive author, and Jill Johnes was the most influential. The journal Scientometric had the most publications in the area. This study lays the groundwork for future research. Future reviewers may find the common practises, constraints, and underlying assumptions presented in this study useful for the selection and analysis of relevant studies.

This research aims to analyze corporate social performance on the cost of equity, cost of debt with institutional ownership, and bank dependency as moderating variables The population of this research is non-financial companies listed on the Indonesian Stock Exchange (IDX), Bombay Stock Exchange (BSE), Malaysia stock exchange (MYX) and e Stock Exchange of Thailand (SET) from 2016-2020. The sample was selected using purposive sampling and 95 companies were obtained as research samples. The type of data used is secondary data. The data used was obtained from the company's annual report. The analysis techniques used in this research are moderating regression analysis and multiple regression analysis. The results of this study indicate that disclosure of corporate social performance does not have a significant effect on the cost of equity. Institutional Ownership moderates the positive and significant relationship between corporate social performance and the cost of equity. bank dependency does not moderate the effect of corporate social performance on the cost of equity. Corporate social performance has a negative and significant effect on the cost of debt. institutional ownership moderates the negative and significant relationship between corporate social performance and the cost of debt. Bank dependency moderates the positive and significant relationship between corporate social performance and the cost of debt.

Abstract Malaysia's government's decision to reopen schools during the COVID-19 outbreak, especially for students taking important exams, has alarmed the public. However, the Ministry of Education has implemented a COVID-19 Standard Operating Procedure (SOP) for educational institutions. The school management’s ability to protect children from COVID-19 rests on their understanding, attitudes, and practices regarding COVID-19 SOP compliance. This study investigated Selangor, Kuala Lumpur, and Putrajaya school management’s COVID-19 SOP compliance determinants. Multistage sampling was used to sample 740 school management from Kuala Lumpur, Putrajaya, and Selangor. A self-administered questionnaire collected sociodemographic, occupational, and lifestyle data, knowledge, attitude, and practice of COVID-19 SOP compliance. The school management had good knowledge, attitude, and practice toward COVID-19 SOP. Monthly income, school location, smoking status, and physical activity differed significantly from KAP (p

Abstract The stroke field is inevitably connected with imaging in which radiologists fulfill a central role. Our landmark MR CLEAN trial led to the implementation of baseline computed tomography angiography or magnetic resonance angiography in the acute stroke workup and subsequent endovascular treatment (EVT) for ischemic stroke patients with a large vessel occlusion in the anterior circulation, resulting in numerous patients worldwide currently being treated often successfully. A reversal of the pathophysiologic process behind an acute cerebrovascular event was made possible. Subsequently, in the MR CLEAN II trials, the clinical impact of both diagnostic and interventional radiologists remained a cornerstone of our research, which means value-based radiology. Within these MR CLEAN II trials, we proved that aspirin and heparin during EVT should be avoided due to increased symptomatic intracranial hemorrhage risk (MR CLEAN-MED). We concluded there is additional benefit of EVT in the 6-to-24-h window after stroke in the presence of good collaterals on baseline CTA (MR CLEAN-LATE). The impactful success of our stroke trials that changed many guidelines was mainly attributable to (1) the societal burden of the disease, with two thirds of patients dying or being independent at 3 months; (2) the fact that stroke is a common disease, (3) the relatively simple and pragmatic approach of the trials resembling real-world setting; (4) the acceleration of implementation in clinical practice facilitated by a structured approach to guideline development and conditional funding; and foremost (5) the excellent collaboration on a professional level between-disciplines, i.e., diagnostic radiologists, interventionalists, and neurologists. Critical relevance statement The MR CLEAN and MR CLEAN II trials have had tremendous impact on clinical practice, directly by more patients being treated with an effective intervention and indirectly through adoption of evidence-based guidelines. It is in this setting of stroke treatment that diagnostic and interventional radiologists have played a crucial role and created clinical impact.

The main goal of this study is to analyze the nanofluid boundary layer as it flows over a bidirectional, exponentially extending sheet in both convective and magnetic field environments. The mathematical model considers the results of Brownian motion and particle movement caused by a temperature gradient. Using appropriate similarity transformations, governing partial differential equations are converted into ordinary differential systems, and the design of equations is then solved using the Haar wavelet collocation approach. The findings identify unique trends in the distribution of temperature and show relationships with particular sets of parametric values. These results emphasize how important it is to note temperature fluctuations associated with specific parametric settings. The findings are validated by contrasting the results with similar cases from earlier studies in the literature. The findings indicate that temperature distribution is reduced by increasing the Prandtl number. Additionally, the local Biot number has qualitatively similar effects on temperature and concentration profiles. For higher local Biot numbers, the profiles of concentration and temperature are better.

The trade sector is among the top four growing sectors contributing to Bahrain’s GDP. Despite the successful impact of trade on the local economy, there is an apparent disconnect between individuals engaged in trading activities and their physical urban spaces, posing a significant threat to preserving Bahrain’s vibrant social trading culture. The research hypothesis is that effective urban design can significantly improve trading activities in the old city of Manama. Consequently, the research aims to define the role of physical urban design in influencing trade, outline the social impacts of urbanization on traditional and contemporary trading environments, and identify urban principles that affect the physical act of trade. The methodology follows a theoretical study that considers the history of urbanization and its contemporary theories, the impacts of urbanization, and the trading development impacts of urbanization on trading environments in Bahrain. An analytical study is then adopted to analyse the problem, using the “fishbone diagram”, questionnaires and photographic analysis of the area. The findings highlight the importance of utilizing outdoor space, diverse building typologies, organic circulation routes, spatial layout, interior design, landscaping, adaptable design, interaction spaces and intimate spaces within the design of traditional and contemporary trading environments. The research concludes with recommendations to sustainably revive the trading streets in Bahrain. The results provide valuable insights for stakeholders, such as Bahrain Authority for Culture and Antiquities, and those working in architecture, urban and interior design, to reignite informal social trading experiences from the past.

Introduction and objectives There is an unmet need to develop high-quality evidence addressing tuberculosis (TB)-related mental health comorbidity, particularly in the context of lower-middle-income countries. This study aims to examine the effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) versus enhanced treatment as usual (ETAU) in improving depressive symptoms in people with TB and comorbid depression, enhancing adherence with anti-TB treatment (ATT) and its implementation in the real-world setting of Pakistan.Methods We will conduct a pragmatic parallel arm randomised control trial with an internal pilot. A brief psychological intervention based on CBT has been developed using a combination of qualitative and ethnographic studies. The inbuilt pilot trial will have a sample size of 80, while we plan to recruit 560 (280 per arm) participants in the definitive trial. Participants who started on ATT within 1 month of diagnosis for pulmonary and extrapulmonary TB or multidrug resistant TB (MDR-TB) and meeting the criteria for depression on Patient Health Questionnaire-9 (PHQ-9) will be randomised with 1:1 allocation to receive six sessions of CBT (delivered by TB healthcare workers) or ETAU. Data on the feasibility outcomes of the pilot will be considered to proceed with the definitive trial. Participants will be assessed (by a blinded assessor) for the following main trial primary outcomes: (1) severity of depression using PHQ-9 scale (interviewer-administered questionnaire) at baseline, weeks 8, 24 and 32 postrandomisation and (2) ATT at baseline and week 24 at the end of ATT therapy.Ethics and dissemination Ethical approval has been obtained from Keele University Research Ethics Committee (ref: 2023-0599-792), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/CT/000990) and National Bioethics Committee Pakistan (ref: No.4–87/NBC-998/23/587). The results of this study will be reported in peer-reviewed journals and academic conferences and disseminated to stakeholders and policymakers.Trial registration number ISRCTN10761003.

Traditional agricultural irrigation systems suffer from wasting a lot of water allocated for irrigation through evaporation and drainage. To address water waste and increase crop productivity, irrigation scheduling is used, as irrigation scheduling depends on four elements: soil moisture, soil characteristics, weather conditions, and plant type. This paper proposes a new design for monitoring agricultural conditions and controlling the amount of soil moisture by determining the required irrigation water ratios and the ideal time period for irrigating crops. An intelligent control and monitoring algorithm was created using experimental data for a wide range of plants (for soil moisture from 21 to 80 kPa), where plants were classified into three groups according to their common irrigation starting point. Based on the proposed plant classification, three models were provided, where irrigation ratios as the required parameter, soil moisture, plant type, and time interval as input parameters. This algorithm was used to program a custom-made automatic sensor and control device (ASCD). The ASCD is equipped with two input ports to communicate with two types of soil moisture sensors (a resistive sensor and a capacitive sensor) and with three output ports to drive three types of electronic irrigation valves. The ASCD can read from one sensor and drive one electronic valve at a time, the choice of which is made by the farmer. ASCD based the new algorithm showed high accuracy compared to a number of experimental results. The average absolute relative deviation (AAPD) of the new models and experimental data is 5.46 %. The application of the new algorithm shows a reduction in the amount of water used for crop irrigation during the day versus irrigation at night. On the other hand, ASCD has proven its success in sensing and controlling, and it works automatically and independently.

Background: Hypothyroidism is one of the mostimportant thyroid disorders, and chronic autoimmune (Hashimoto's) thyroiditis is the most common cause in iodine-replete areas. Anti-thyroglobulin antibodies (anti-Tg Ab) and anti-thyroid peroxidase antibodies (anti-TPO Ab) are commonly associated with the development of chronic autoimmune thyroiditis. However, the precise relationship between them has not been defined yet.Objective: To study the relationship between anti-Tg Ab and anti-TPO Ab among patients with primary hypothyroidism.Materials and Methods: In a cross-sectional study of 169 patients with primary hypothyroidism, their anti-TPO Ab and anti-Tg Ab were measured, analyzed, and correlated together.Results: Positive anti-TPO Ab and anti-Tg Ab were observed in 52.1% of the patients, while 26% and 8.9% of them were only positive for anti-TPO Ab or anti-Tg Ab, respectively, and the remaining 13% showed no positivity for both of them. Anti-Tg Ab titer increased steadily with advancing age in contrast to anti-TPO Ab (P-value = 0.009). The best and highest positive predictive value for having a positive anti-TPO Ab was 91%, and this was obtained at an anti-Tg titer of > 691 IU/mL with a sensitivity of 31% and specificity of 89% at an odds ratio of 3.72 (P-value = 0.014). The best negative predictive value was seen at an anti-Tg Ab titer < 11 IU/mL with a sensitivity of 99% and a specificity of 24% (P-value < 0.001), while a maximum Youden’s value of 1.4 (i.e., maximum sensitivity at a maximum specificity) was obtained at a titer of 26 IU/mL with a positive predictive value of 86% and a negative predictive value of 59% with a sensitivity of 90% and a specificity of 51% (P-value < 0.001).Conclusion: Both anti-Tg Ab and anti-TPO Ab had considerable information in patients with chronic autoimmune hypothyroidism. Anti-Tg Ab tends to be more informative in older people (> 50 years), where it is more prevalent than anti-TPO Ab. At an anti-Tg Ab titer > 691 IU/mL, we most likely will have positive anti-TPO Ab, while at an anti-Tg Ab titer < 11 IU/ml, we most likely have negative anti-TPO Ab.

Abstract Background Pakistan has one of the highest burdens of Hepatitis C virus (HCV) infection globally. To achieve the World Health Organization’s goals for HCV elimination, there is a need for substantial scale-up in testing, treatment, and a reduction in new infections. Data on the population impact of scaling up treatment is not available in Pakistan, nor is there reliable data on the incidence of infection/reinfection. This project will fill this gap by providing important empirical data on the incidence of infection (primary and reinfection) in Pakistan. Then, by using this data in epidemic models, the study will determine whether response rates achieved with affordable therapies (sofosbuvir plus daclatasvir) will be sufficient to eliminate HCV in Pakistan. Methods This prospective multi-centre cohort study will screen 25,000 individuals for HCV antibody (Ab) and RNA (if Ab-positive) at various centers in Pakistan- Karachi (Sindh) and Punjab, providing estimates of the disease prevalence. HCV positive patients will be treated with sofosbuvir and daclatasvir for 12-weeks, (extended to 24-weeks in those with cirrhosis) and the proportion responding to this first-line treatment estimated. Patients who test HCV Ab negative will be recalled 12 months later to test for new HCV infections, providing estimates of the incidence rate. Patients diagnosed with HCV (~ 4,000) will be treated and tested for Sustained Virological Response (SVR). Questionnaires to assess risk factors, productivity, health care usage and quality of life will be completed at both the initial screening and at 12-month follow-up, allowing mathematical modelling and economic analysis to assess the current treatment strategies. Viral resistance will be analysed and patients who have successfully completed treatment will be retested 12 months later to estimate the rate of re-infection. Conclusion The HepFREEPak study will provide evidence on the efficacy of available and widely used treatment options in Pakistan. It will also provide data on the incidence rate of primary infections and re-infections. Data on incidence risk factors will allow us to model and incorporate heterogeneity of risk and how that affects screening and treatment strategies. These data will identify any gaps in current test-and-treat programs to achieve HCV elimination in Pakistan. Study registration This study was registered on clinicaltrials.gov (NCT04943588) on June 29, 2021.

Purpose: Iron deficiency (ID) is a complication of gastrointestinal (GI) cancers that may manifest as iron deficiency anemia (IDA). Serum ferritin monitoring and oral iron supplementation have the limitations of being falsely elevated and poorly absorbed, respectively. This study aims to assess the discordance in surveillance, treatment practices, and awareness of ID/IDA in GI cancer patients by Canadian physicians treating these patients. Methods: From February 2020 to September 2021, a 22-question electronic survey was sent to medical oncologists (MOs), surgical oncologists (SOs), and gastroenterologists (GEs). The survey collected information about four domains: physician demographics, surveillance practices, treatment practices, and awareness of ID/IDA in GI cancer patients and ASCO/ASH guidelines. Results: A total of 108 (34 MOs, 19 SOs, and 55 GEs) of the 872 (12.4%) invited physicians completed the survey. Of these, 26.5% of MOs, 36.8% of SOs, and 70.9% of GEs measured baseline iron parameters, with few continuing surveillance throughout treatment. Ferritin was widely measured by MOs (88.9%), SOs (100%), and GEs (91.4%). Iron was supplemented if ID/IDA was identified pre-treatment by 66.7% of MOs, 85.7% of SOs, and 94.2% of GEs. Parenteral iron was prescribed by SOs (100%), while oral iron was prescribed by MOs (83.3%) and GEs (87.9%). Only 18.6% of physicians were aware of the ASCO/ASH guidelines regarding erythropoiesis-stimulating agents with parenteral iron for treating chemotherapy-induced anemia. Conclusion: Results illustrate variations in practice patterns for IDA management across the different physician specialties. Moreover, there appeared to be gaps in the knowledge and care surrounding evidence-based IDA management principles which may contribute to poor clinical outcomes.

Abstract Both classic and contemporary models of auditory word repetition involve at least four left hemisphere regions: primary auditory cortex for processing sounds; pSTS (within Wernicke’s area) for processing auditory images of speech; pOp (within Broca’s area) for processing motor images of speech; and primary motor cortex for overt speech articulation. Previous functional-MRI (fMRI) studies confirm that auditory repetition activates these regions, in addition to many others. Crucially, however, contemporary models do not specify how regions interact and drive each other during auditory repetition. Here, we used dynamic causal modelling, to test the functional interplay among the four core brain regions during single auditory word and pseudoword repetition. Our analysis is grounded in the principle of degeneracy—i.e., many-to-one structure-function relationships—where multiple neural pathways can execute the same function. Contrary to expectation, we found that, for both word and pseudoword repetition, (i) the effective connectivity between pSTS and pOp was predominantly bidirectional and inhibitory; (ii) activity in the motor cortex could be driven by either pSTS or pOp; and (iii) the latter varied both within and between individuals. These results suggest that different neural pathways can support auditory speech repetition. This degeneracy may explain resilience to functional loss after brain damage.

Cellulosic antibacterial fibers have great importance in the manufacturing of healthcare products. In this research work, antibacterial hemp and bamboo fibers were selected for manufacturing two green composite for wound healing. The chitosan was selected to get gel formation and behave as carrier in the manufacturing of cellulosic/chitosan green composite. Moreover, a water-soluble levofloxacin was included to give a release of antibacterial properties. The hemp and bamboo fibers were cleaned and fiber-to-fiber separation was done with a manual comber machine. The chitosan was solubilized using acetic acid and stirred for 12 hours to get a completely clear and viscous gel. Afterward, powder ground hemp and bamboo fibers were separately poured into two separate beakers. Two different types of composites (hemp/chitosan) and Bamboo/chitosan were transferred into petri dishes and dried in the oven at 400C for 24 hours. The samples were loaded with a levofloxacin antimicrobial agent. Both composites (hemp/chitosan, and bamboo/chitosan) were characterized for surface morphology, structural changes and antimicrobial testing against gram-positive and gram-negative bacteria. It was analyzed that without levofloxacin both cellulose/chitosan composites resisted bacteria growth and did not show inhibition zone, but samples loaded with levofloxacin displayed good antibacterial activity and showed excellent zone of inhibition against gram-positive and gram-negative bacteria. Futhermore, FTIR evidenced that there was no formation of cross linking composites, but composites were held together due to chitosan and fibers gel formation.

Misunderstandings in dyadic interactions often persist despite our best efforts, particularly between native and non-native speakers, resembling a broken duet that refuses to harmonise. This paper delves into the computational mechanisms underpinning these misunderstandings through the lens of the broken Lorenz system—a continuous dynamical model. By manipulating a specific parameter regime, we induce bistability within the Lorenz equations, thereby confining trajectories to distinct attractors based on initial conditions. This mirrors the persistence of divergent interpretations that often result in misunderstandings. Our simulations reveal that differing prior beliefs between interlocutors result in misaligned generative models, leading to stable yet divergent states of understanding when exposed to the same percept. Specifically, native speakers equipped with precise (i.e., overconfident) priors expect inputs to align closely with their internal models, thus struggling with unexpected variations. Conversely, non-native speakers with imprecise (i.e., less confident) priors exhibit a greater capacity to adjust and accommodate unforeseen inputs. Our results underscore the important role of generative models in facilitating mutual understanding (i.e., establishing a shared narrative) and highlight the necessity of accounting for multistable dynamics in dyadic interactions.

Background: When surgeons operate under general anesthesia, length of surgery, not only its outcome, matters. In maxillofacial surgery we can reduce the time in reconstructive surgery by using presurgical bended plates in presurgically designed 3D models. Method: The study measured the mean time to bend the plates preoperatively on a printed three-dimensional model and the capability of the plates to adapt well on the mandible intraoperatively in cases of mandibular reconstruction after partial resection of the mandible due to pathology, such as benign aggressive tumors. Results and conclusions: The mean time to bend the plates preoperatively was 17 minutes, with rapid adaptation during surgery. This is important in minimizing the time that the wound is exposed to the environment and minimizes the trauma to the surrounding soft tissues. Multiple checks of the plate if bended at time of surgery can increase trauma to the surrounding soft tissues. The study supports the recommendation of the use of the preoperatively corrected and printed 3D models to prebend the plates pre-operatively. This step should be included as a routine workflow in elective cases, since it is not be possible in cases of emergency or urgency.

Conclusion: Oval and semielliptical 3D-printed wires offered favorable features as lingual retainers.

Direct contact condensation (DCC) is a phenomenon that occurs when vapor is injected into a subcooled water pool and is essential in many industrial devices. However, the actual phenomenon involves non-condensable gases in the vapor, and there has been insufficient research on how non-condensable gases affect direct contact condensation. In this study, through the detailed observation of the bubble collapse behavior using a high-speed video camera, we aimed to clarify the bubble collapse behavior and heat transfer coefficient of vapor bubbles containing non-condensable gas by DCC. Experiments were compared between DCC under pure vapor conditions and DCC under conditions containing non-condensable gas. Characteristic quantities for each condition were calculated from image analysis of the captured images. The temperature distribution inside the plume was also measured using thermocouples. From these data, the relationship between contraction rate and microbubbles diameter and the average heat transfer coefficient (HTC) were estimated. As a result, the construction rate of the plume containing non-condensable gas was reduced to 4 ~ 20 % of that of pure vapor, and large number of microbubbles were observed under lower air mass fraction with the log-normal distribution in diameter. The average HTC decreased to about 5 ~ 13 % when the non-condensable gas was mixed with about 8 % of air mass fraction. These results were proposed to be because vapor concentration decreases as the plume shrinks and vapor diffusion is suppressed by the mass conservation of non-condensable gas as the vapor condenses.

With particular attention to the effects of an electromagnetically induced resistive force on homogeneous–heterogeneous processes and the related homogeneous heat effects, the Casson fluid flow towards a stretching sheet at the magnetohydrodynamic stagnation point is investigated in detail. In this situation, the Laplace approach helps decipher the subtleties of the first-order kinetics governing the fluid’s motion. Notably, the fluid dynamics are largely determined by the homogeneous behaviour expected in the surrounding environment, forming a strong correlation between catalyst temperature on the wall and surface activity. Using conventional differential systems, our analysis gains a great deal from the modified Laplace decomposition method, which allows non-linear systems to be computed and examined. In order to improve understanding, numerical findings are included, and graphs are skillfully used to examine the subtleties of different factors. The in-depth examination also includes the complicated patterns of concentration and temperature, providing insightful information on the intricate interactions between forces and effects in this dynamic system.

Blockchain is an innovative technology that has gained interest in all sectors in the era of digital transformation where it manages transactions and saves them in a database. With the increasing financial transactions and the rapidly developed society with growing businesses many people looking for the dream of a better financially independent life, stray from large corporations and organizations to form startups and small businesses. Recently, the increasing demand for employees or institutes to prepare and manage contracts, papers, and the verifications process, in addition to human mistakes led to the emergence of a smart contract. The smart contract has been developed to save time and provide more confidence while dealing, as well as to cover the security aspects of digital management and to solve negotiation concerns. The smart contract was employed in creating a distributed ledger to eliminate the need for centralization. In this paper, a simple prototype has been implemented for the smart contract integrated with blockchain which is simulated in a local server with a set of nodes. Several security objectives, such as confidentiality, authorization, integrity, and non-repudiation, have been achieved in the proposed system. Besides, the paper discussed the importance of using the Blockchain technique, and how it contributed to the management of transactions in addition to how it was implemented in highly transparent real-estate scenarios. The smart contract was employed in creating a distributed ledger to eliminate the need for centralization. The elliptic-curve public key has been adopted as an alternative for the RSA in a signature generation/verification process and encryption protocol. For secure transactions, The Secure Socket Layer (SSL) also has been adopted as a secure layer in the web browser. The results have been investigated and evaluated from different aspects and the implementation was in a restricted environment. Experiments showed us the complexity of time and cost when using the (ECC) algorithm and using (RSA) algorithm depending on the size and length of the key. So if the size of the key in (ECC) equals (160) bits, and it corresponds to (1024) bits in (RSA), which is equivalent to 40% for (ECC) and 30% for (RSA). As a result, the (ECC) algorithm is complex, its key is smaller and the process of generating the key is faster, so it has achieved a high level of security.

Despite the significant allocation of time and resources to formal classroom English teaching in Indonesia, the outcomes have not been found to be commensurate or equivalent. Despite all the constraints, a minority of EFL learners in Indonesia have have demonstrated exceptional achievements in their learning journey, earning them the recognition of successful learners. This narrative research aims to study the participants’ out-of-class learning experience viewed from the perspective of ecology. To gain extensive exploration of the experience, this study incorporated the participants’ language learning careers (LLC). In order to complement the data and to gain deeper insights into the participants’ experiences, follow-up interviews were also conducted. The result demonstrated that the participants exercised their autonomous learning strategies in three dimensions of learning, namely the emergence of interest, the creation of learning opportunities, and the boundaries crossing. Through these dimensions, the participants navigate and manage the resources, opportunities, and constraint in their learning journey. This study provides insights into the management of learning beyond the classroom through the awareness of the environment.

This study aims to predict the effect of climate change on net irrigation water requirements (NIWR) and agricultural productivity from five common crops (wheat, barley, summer maize, and sorghum) in the Al-Najaf Governorate in Iraq. GFDL-ESM2M mode was used to predict the lower and upper temp and precipitation for two time periods (2020-2080) with 30 years for two periods (P1 and P2) under representative concentrations paths (RCP 2.5, RCP6, and RCP8.5). The CROPWAT model is used to determine NIWR, and the extreme learning model was used to estimate agricultural yields using previous crop yield production and weather data, supported vectors machine (SVM) is executed as a Machines Learns algorithm. Results showed NIWR increment to consider cropping owing to climate change. Barley is the crop most affected by climate change under the (RCP2.5, RCP6, and RCP8.5) scenarios, with increasing crop water requirements (NIWR) of (22%, 23%, and 24% ) for P1 and (23%, 24%, and 29%) for P2, respectively. Summer maize is the crop least affected by climate change under all climate change scenarios, with increasing crop water requirements of (1%, 2%, and 4%) for P1 and (1%, 2%, and 5% for P2. Climate change negatively affects the crop yield of all crops under the different climate change scenarios. The findings of this study could be used as a guide to developing adaptation strategies for dealing with potential changes in water availability and agricultural water productivity due to climate change.

This review evaluates selected advanced oxidation processes (AOPs) - cavitation and photocatalysis - successfully used for wastewater treatment towards degradation of Rhodamine (Rh) dyes. Reactor configuration and impact of process parameters and oxidants addition (hydrogen peroxide, ozone, persulfates) on degradation effectiveness along with degradation mechanisms are discussed. Best technologies provide 100% degradation within 10–30 min. Rhodamine B is effectively degraded in highly acidic conditions (pH 2), while Rhodamine 6G requires basic conditions (pH 10). The most effective oxidants were hydrogen peroxide and ozone. Ecological Structure Activity Relationships (ECOSAR) revealed acute toxicities of the intermediates and by-products of the Rh dye.

The use of Advance Oxidation Process (AOPs) has been extensively examined in order to eradicate organic pollutants. This review assesses the efficacy of photolysis, O3 based (O3/UV, O3/H2O2, O3/H2O2/UV, H2O2/UV, Fenton, Fenton-like, hetero-system) and sonochemical and electro-oxidative AOPs in this regard. The main purpose of this review and some suggestions for the advancement of AOPs is to facilitate the elimination of toxic organic pollutants. Initially proposed for the purification of drinking water in 1980, AOPs have since been employed for various wastewater treatments. AOPs technologies are essentially a process intensification through the use of hybrid methods for wastewater treatment, which generate large amounts of hydroxyl (•OH) and sulfate (SO4·−) radicals, the ultimate oxidants for the remediation of organic pollutants. This review covers the use of AOPs and ozone or UV treatment in combination to create a powerful method of wastewater treatment. This novel approach has been demonstrated to be highly effective, with the acceleration of the oxidation process through Fenton reaction and photocatalytic oxidation technologies. It is clear that Advance Oxidation Process are a helpful for the degradation of organic toxic compounds. Additionally, other processes such as •OH and SO4·− radical-based oxidation may also arise during AOPs treatment and contribute to the reduction of target organic pollutants. This review summarizes the current development of AOPs treatment of wastewater organic pollutants.

Minimally invasive surgery for the treatment of macroscopic cervical cancer leads to worse oncologic outcomes than with open surgery. Preoperative conization may mitigate the risk of surgical approach. Our objective was to describe the oncologic outcomes in cases of cervical cancer initially treated with conization, and subsequently found to have no residual cervical cancer after hysterectomy performed via open and minimally invasive approaches. This was a retrospective cohort study of surgically treated cervical cancer at 11 Canadian institutions from 2007 to 2017. Cases initially treated with cervical conization and subsequent hysterectomy, with no residual disease on hysterectomy specimen were included. They were subdivided according to minimally invasive (laparoscopic/robotic (MIS) or laparoscopically assisted vaginal/vaginal hysterectomy (LVH)), or abdominal (AH). Recurrence free survival (RFS) and overall survival (OS) were estimated using Kaplan–Meier analysis. Chi-square and log-rank tests were used to compare between cohorts. Within the total cohort, 238/1696 (14%) had no residual disease on hysterectomy specimen (122 MIS, 103 AH, and 13 VLH). The majority of cases in the cohort were FIGO 2018 stage IB1 (43.7%) and underwent a radical hysterectomy (81.9%). There was no statistical difference between stage, histology, and radical vs simple hysterectomy between the abdominal and minimally invasive groups. There were no significant differences in RFS (5-year: MIS/LVH 97.7%, AH 95.8%, p = 0.23) or OS (5-year: MIS/VLH 98.9%, AH 97.4%, p = 0.10), although event-rates were low. There were only two recurrences. In this large study including only patients with no residual cervical cancer on hysterectomy specimen, no significant differences in survival were seen by surgical approach. This may be due to the small number of events or due to no actual difference between the groups. Further studies are warranted.

Background: mRNA technology has been used to manufacture the Pfizer vaccine; however, the side effects of Pfizer–BioNTech coronavirus disease 2019 (COVID-19) vaccine among the general population remain unknown. The aim of this study was to investigate the potential side effects of vaccination and the associated risk factors. Methods: A cross-sectional survey-based study was conducted from April 2021 to September 2021 using an online questionnaire to collect data on the side effects after the first and second doses of the vaccine. Participants were classified into the two following groups: Those aged ≤39 and >39 years. Results: The most common side effects following the first dose (≤39 years vs. >39 years) were pain at the vaccination site, fatigue, severe pain at the vaccination site, and fever. Meanwhile, pain at the vaccination site, fever, fatigue, headache, muscle pain, and lethargy were the most common side effects following the second dose of vaccination in both groups. Side effects were more common in women at both doses. The most common reactions at first dose were fatigue, fever, tenderness, lethargy, and muscle pain, whereas fever, fatigue, headache, severe injection site pain, muscle pain, and lethargy were common after the second dose. None of the participants required intensive hospitalization; 4.2% of the participants in both age groups visited the clinics for minor management. Conclusion: Pfizer–BioNTech COVID-19 vaccine was associated with a higher prevalence of local side effects in both sexes and age groups. The sex- and age-based differences warrant further rigorous investigation and standardized methodologies.

The short interval between the collecting and distribution of zakat al-fitr is a recurring issue. As a result, ‘amil does not always pay attention to the ideal route, leading in inefficient transportation expenditures. This study aims to minimize the amount of vehicle mileage that affects fuel consumption. The branch-and-bound algorithm was employed to overcome the distribution route optimization problem by proposing the shortest circuit that traverses each district exactly once and returns to its original district. The procedures involve data collecting, graph analysis, branch-and-bound analysis, MATLAB code development, and the recommendation of the best route. The results indicate that the branch-and-bound algorithm can numerically solve the distribution route optimization corresponding to traveling salesman problem. Furthermore, according to a case study of zakat al-fitr distribution conducted by Eradication of Illiteracy Al Quran (PBHA), the total optimal distance of the computational-based algorithm was 152.9 km, with inter-village routes starting from Sidorejo and then via Sumberarum, Pendoworejo, Gerbosari, Banjaroyo, Banjarasri, Sendangagung, Tuksono, Argodadi, Triwidadi, Jatimulyo, Giripurwo, and ends in Sidorejo.

Abstract Bioconvection due to microorganisms is important area of research, considerably importance for environment and sustainable fuel cell technologies. Buongiorno nanofluid model for Cattaneo-Christov heat and mass flux theory taken into account the Oldroyd-B nanofluid and gyrotactic microorganisms in a rotating system with the effects of Hall current, and Darcy porous medium is scrutinized. The constitutive equations of the problem are transformed into nondimensional equations with the help of similarity transformations. Homotopy analysis method is used to obtain the solution. Graphs and table support the comprehesive representation of the achieved results. Radial velocity is reduced with the increasing values of relaxation time, retardation time and magnetic field parameters while heat transfer is augmented with thermal relaxation time parameter. The nanoparticles concentration is reduced with the increasing values of Schmidt number and the gyrotactic microorganisms concentration is enhanced with the increasing values of Peclet number. A nice agreement is obtained while comparing the present results numerically with the published results. The proposed mathematical model is used in biochemical engineering, meteorology, power and transportation production, optoelectronic and sensing microfabrication.

The aim of the study was extraction of arial part of Euphorbia cyathophora constituents with methanol and evaluate its effect on mitotic index and total chromosomal aberration bone marrow cell and spleen cell in mice 200 gm of E. cyathophora fine powder was defatted then extracted by cold maceration 80% ethanol for seven days. The extract was filtered and dried in a rotary evaporator then the dried extract was suspended with water and consecutively extracted using chloroform, ethyl acetate for each. The aqueous layer was then mixed with 100ml methanol. These fractions are dried under reduced pressure to obtain the dry extract. Twenty-four Albino mice were used for the experiment. The animals were divided into four groups: Group 1: Mice were treated with distilled water. The dose was given daily for seven successive days. Group 2: Mice were treated with a single dose (20mg/kg) of methotrexate (positive control). Group 3: Mice were treated with (100mg/kg) of menthol fraction for seven successive days. Group 4: Mice were treated with (200mg/kg) of methanol fraction for seven successive days. Mice were sacrificed by (spinal dislocation). Samples of bone marrow cells and spleen cells were taken and genotoxic analyses. Methanol fraction of Euphorbia cyathophora at a dose of 100mg/kg demonstrated a significant decrease in mitotic index and a significant increase in total chromosomal aberrations as compared to distilled water in both bone marrow cells and spleen cells (p

The teacher's lack of understanding of the use of technology in the classroom seems to be inversely proportional to the Merdeka Curriculum which requires teachers and students to be able to keep up with technological developments. Therefore, training on the use of the Canva application as a learning medium for elementary school teachers in Magelang was carried out as teacher professional development effort. The aim of this community service is to train elementary school teachers so they can develop their professionalism in developing interactive learning media that suits students' needs in the current era. By carrying out this community service in three different schools with a total of 22 participants, several stages were carried out. These stages consist of analyzing community problems, identifying problems, finding solutions to problems, preparing activities, implementing activities, evaluating activities and results. The evaluation results of this training activity showed that not only can the participants become more familiar with the Canva application, they are also trained to be able to design learning media in the form of presentations and videos using Canva. The participant satisfaction survey also showed positive results, in fact all participants agreed that they would continue to use Canva as a technology for designing learning media in the future. The root of this solution will certainly have an effect on the students' understanding of the participants later. If students have good academic achievements, they will become the next generation of the nation who can solve problems in this country, including poverty. However, this study was also conducted as a form of community service report which hopefully still can be a guideline and reading material for researchers regarding community service out there.

Objectives In low/middle-income countries (LMICs), more than half of patients with first-episode psychosis initially seek treatment from traditional and religious healers as their first care. This contributes to an excessively long duration of untreated psychosis (DUP). There is a need for culturally appropriate interventions to involve traditional and spiritual healers to work collaboratively with primary care practitioners and psychiatrists through task-shifting for early detection, referral and treatment of first episode of psychosis.Methods To prevent the consequences of long DUP in adolescents in LMICs, we aim to develop and pilot test a culturally appropriate and context-bespoke intervention. Traditional HEalers working with primary care and mental Health for early interventiOn in Psychosis in young pErsons (THE HOPE) will be developed using ethnographic and qualitative methods with traditional healers and caregivers. We will conduct a randomised controlled cluster feasibility trial with a nested qualitative study to assess study recruitment and acceptability of the intervention. Ninety-three union councils in district Peshawar, Pakistan will be randomised and allocated using a 1:1 ratio to either intervention arm (THE HOPE) or enhanced treatment as usual and stratified by urban/rural setting. Data on feasibility outcomes will be collected at baseline and follow-up. Patients, carers, clinicians and policymakers will be interviewed to ascertain their views about the intervention. The decision to proceed to the phase III trial will be based on prespecified stop–go criteria.Ethics and dissemination Ethical approval has been obtained from Keele University Ethical Review Panel (ref: MH210177), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/IG/001005) and National Bioethics Committee Pakistan (ref no. 4-87/NBC-840/22/621). The results of THE HOPE feasibility trial will be reported in peer-reviewed journals and academic conferences and disseminated to local stakeholders and policymakers.Trial registration number ISRCTN75347421.

Hydroxysteroid dehydrogenase (HSDs) is an oil-body sterol protein (steroleosin) with an NADP(H) binding domain that belongs to the short-chain dehydrogenase/reductase (SDR) superfamily. There are numerous studies on the characterization of HSDs in plants. However, thus far, the evolutionary differentiation and divergence analysis of these genes remain to be explored. The current study used an integrated method to elucidate the sequential evolution of HSDs in 64 sequenced plant genomes. Analyses were conducted on their origins, distribution, duplication, evolutionary paths, domain functions, motif composition, properties, and cis-elements. Results indicate that except for algae, HSD1 was widely distributed in plant species ranging from lower to higher plants, while HSD5 was restricted to terrestrial plants, and HSD2 was identified in fewer monocots and several dicot plants. Phylogenetic analysis of HSD proteins revealed that monocotyledonous HSD1 in moss and ferns appeared closest to the outgroup, V. carteri HSD-like, M. musculus HSD1, and H. sapiens HSD1. These data support the hypothesis that HSD1 originated in bryophytes and then in non-vascular and vascular plants, followed by HSD5 only in land plants. Gene structure analysis suggests that HSDs in plant species came up with a fixed number of six exons, and the intron phase was primarily 0, 1, 0, 0, and 0. Similarly, duplication analysis revealed that segmental duplications were the main reason for HSDs in plant species. Physicochemical properties suggest that dicotyledonous HSD1s and HSD5s were mainly acidic. The monocotyledonous HSD1s and HSD2s and the dicotyledonous HSD2s, HSD3s, HSD4s, and HSD6s were mainly basic, implying that HSDs in plants may have a variety of functions. Cis-regulatory elements and expression analysis revealed that HSDs in plants might have roles in several abiotic stresses. Due to the high expression of HSD1s and HSD5s in seeds, these HSDs in plants may have roles in fatty acid accumulation and degradation.

Abstract Introduction Various statistical approaches can be used to deal with unmeasured confounding when estimating treatment effects in observational studies, each with its own pros and cons. This study aimed to compare treatment effects as estimated by different statistical approaches for two interventions in observational stroke care data. Patients and methods We used prospectively collected data from the MR CLEAN registry including all patients (n = 3279) with ischemic stroke who underwent endovascular treatment (EVT) from 2014 to 2017 in 17 Dutch hospitals. Treatment effects of two interventions – i.e., receiving an intravenous thrombolytic (IVT) and undergoing general anesthesia (GA) before EVT – on good functional outcome (modified Rankin Scale ≤2) were estimated. We used three statistical regression-based approaches that vary in assumptions regarding the source of unmeasured confounding: individual-level (two subtypes), ecological, and instrumental variable analyses. In the latter, the preference for using the interventions in each hospital was used as an instrument. Results Use of IVT (range 66–87%) and GA (range 0–93%) varied substantially between hospitals. For IVT, the individual-level (OR ~ 1.33) resulted in significant positive effect estimates whereas in instrumental variable analysis no significant treatment effect was found (OR 1.11; 95% CI 0.58–1.56). The ecological analysis indicated no statistically significant different likelihood (β = − 0.002%; P = 0.99) of good functional outcome at hospitals using IVT 1% more frequently. For GA, we found non-significant opposite directions of points estimates the treatment effect in the individual-level (ORs ~ 0.60) versus the instrumental variable approach (OR = 1.04). The ecological analysis also resulted in a non-significant negative association (0.03% lower probability). Discussion and conclusion Both magnitude and direction of the estimated treatment effects for both interventions depend strongly on the statistical approach and thus on the source of (unmeasured) confounding. These issues should be understood concerning the specific characteristics of data, before applying an approach and interpreting the results. Instrumental variable analysis might be considered when unobserved confounding and practice variation is expected in observational multicenter studies.

The recent advancement of nanoparticles (NPs) holds significant potential for treating various ailments. NPs are employed as drug carriers for diseases like cancer because of their small size and increased stability. In addition, they have several desirable properties that make them ideal for treating bone cancer, including high stability, specificity, higher sensitivity, and efficacy. Furthermore, they might be taken into account to permit the precise drug release from the matrix. Drug delivery systems for cancer treatment have progressed to include nanocomposites, metallic NPs, dendrimers, and liposomes. Materials’ mechanical strength, hardness, electrical and thermal conductivity, and electrochemical sensors are significantly improved using nanoparticles (NPs). New sensing devices, drug delivery systems, electrochemical sensors, and biosensors can all benefit considerably from the NPs’ exceptional physical and chemical capabilities. Nanotechnology is discussed in this article from a variety of angles, including its recent applications in the medical sciences for the effective treatment of bone cancers and its potential as a promising option for treating other complex health anomalies via the use of anti-tumour therapy, radiotherapy, the delivery of proteins, antibiotics, and vaccines, and other methods. This also brings to light the role that model simulations can play in diagnosing and treating bone cancer, an area where Nanomedicine has recently been formulated. There has been a recent uptick in using nanotechnology to treat conditions affecting the skeleton. Consequently, it will pave the door for more effective utilization of cutting-edge technology, including electrochemical sensors and biosensors, and improved therapeutic outcomes.

Magnetic g-Fe2O3@SiO2 core-shell nanocomposite was prepared using Stöber method and functionalized firstly by isopropenyloxytrimethylsilane as a coupling agent to enter active acetylacetone on the surface of nanoparticles, and after that by the synthesized azo dye ligand, 2-(2-benzothiazolyl azo)-4-methoxyaniline. In such a way, g-Fe2O3@SiO2-azo dye hybrid nanocomposite was formed. The structure of the synthesized azo dye was evidenced by physical and chemical analysis using melting point, Fourier-transform infrared spectroscopy (FT-IR), CHNS elemental analysis, proton nuclear magnetic reso­nan­ce (HNMR) and gas chromatography mass spectrometry (GC-MS). The magnetic proper­ties, structure, element composition and morphology characterization of prepared mate­rials (g-Fe2O3, g-Fe2O3@SiO2, and g-Fe2O3@SiO2-azo dye) were investigated by vib­rating sample magnetometer (VSM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), transmission electron spectroscopy (TEM) and field electron scanning electron micro­scopy-energy dispersive X-ray-mapping techniques. The electrochemical perfor­mance of synthe­sized g-Fe2O3, g-Fe2O3@SiO2, and g-Fe2O3@SiO2-2-(2-benzothiazolyl azo)-4-methoxy­aniline) electrodes were carried out using cyclic voltammetry (CV), galva­nostatic charge-discharge (GCD) and electrochemical impedance spectroscopy (EIS). It was shown that the finally prepared g-Fe2O3@SiO2-2-(2-benzothiazolyl azo)-4-methoxy­aniline) hybrid nano­composite electrode possesses good storage charge capability of 580 F g-1 at 1 A g-1.

Presentation of patients in emergency situations can be varied, with confusion being an important management dilemma. Although confusion is usually attributed to neurological conditions, metabolic causes of altered consciousness are important but often overlooked. Moreover, a practical guide for treatment of confusion in patients especially in emergency situations is vital to facilitate prompt management leading to reduction in morbidity and mortality. Therefore, the objective of this study is to design a guidebook for practical approach to patients with confusion due to metabolic conditions. As a result, a guidebook compiling important metabolic causes of confusion, detailing the spectrum of presentation, diagnostic criteria and succinct management algorithms. This novel approach aims to provide medical doctors with a focused and comprehensive guide in dealing with metabolic causes of confusion in a proactive manner as opposed to the traditional reactive method and tailored to local requirements. This guide contains three main metabolic categories: disorders in calcium, sodium and glucose metabolism, with seven subcategories: hypocalcaemia and hypercalcaemia, hyponatraemia and hypernatraemia, hypoglycaemia, and hyperglycaemic emergencies constituting of diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar state (HHS). The innovation facilitating doctors managing patients in a prompt and focused approach is imperative to prevent complications and reduce mortality. This guidebook is a compendium of the more important metabolic derangements leading to confusion, with practical approach to management, aiming to aid health-care workers to recognize and deliver early and prompt treatment of these conditions

Cobalt-based catalysts are expected as one of the most promising peroxymonosulfate (PMS) activators for the removal of organic pollutants from industrial wastewater. However, the easy agglomeration, difficult separation, and secondary pollution of cobalt ions limit their practical application. In this study, a novel, highly efficient, reusable cobalt and nitrogen co-doped monolithic carbon foam (Co-N-CMF) was utilized to activate PMS for ultrafast pollutant degradation. Co-N-CMF (0.2 g/L) showed ultrafast catalytic kinetics and higher total organic carbon (TOC) removal efficiency. Bisphenol A, ciprofloxacin, 2,4-dichlorophenoxyacetic acid, and 2,4-dichlorophenol could be completely degraded after 2, 4, 5, and 5 min, and the TOC removal efficiencies were 77.4 %, 68.9 %, 72.8 %, and 79.8 %, respectively, corresponding to the above pollution. The sulfate radical (SO4•-) was the main reactive oxygen species in Co-N-CMF/PMS based on electron paramagnetic resonance. The ecological structure-activity relationship program analysis via the quantitative structure activity relationship analysis and phytotoxicity assessment revealed that the Co-N-CMF/PMS system demonstrates good ecological safety and ecological compatibility. The Co-N-CMF catalyst has good catalytic activity and facile recycling, which provides a fine method with excellent PMS activation capacity for 2,4-dichlorophenol elimination from simulated industrial wastewater. This study provides new insights into the development of monolithic catalysts for ultrafast wastewater treatment via PMS activation.

In this research, an optimal model will be created to control the storage in the blood bank in Nineveh Governorate by studying the continuous review system for storage in light of the ambiguity of random demand. Data were withdrawn from the blood bank and on three inputs (order quantity, damaged quantity and number of donors), where the data distribution was verified and the normal distribution was also linearly followed. At first, we fogged the data using the ready-made tool in the program ((matlab) and after obtaining the results we entered it onthe neural network (RNN).The best result obtained is the use of the fuzzy neural network as compared to the classical method.