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Abstract Antibiotics, improper food, and stress have created a dysbiotic state in the gut and almost 81% of the world’s population has been affected due to the pandemic of COVID-19 and the prevalence of dengue virus in the past few years. The main intent of this study is to synthesize nanosynbiotics as nu traceuticals by combining probiotics, and prebiotics with nanoformulation. The effectiveness of the nanosynbiotics was evaluated using a variety of Nutra-pharmacogenetic assays leading to an AI-integrated formulation profiling was assessed by using machine learning methods. Consequently, Acetobacter oryzoeni as a probiotic and inulin as a prebiotic has been chosen and iron-mediated nanoformulation of symbiotic is achieved. Nanosynbiotics possessed 89.4, 96.7, 93.57, 83.53, 88.53% potential powers of Nutra-pharmacogenetic assays. Artificial intelligent solid dispersion formulation of nanosynbiotics has high dissolution, absorption, distribution, and synergism, in addition, they are non-tox, non-allergen and have a docking score of − 10.83 kcal/mol, implying the best interaction with Pregnane X receptor involved in dysbiosis. The potential of nanosynbiotics to revolutionize treatment strategies through precise targeting and modulation of the gut microbiome for improved health outcomes and disease management is promising. Their transformational influence is projected to be powered by integration with modern technology and customized formulas. Further in-vivo studies are required for the validation of nanosynbiotics as nutraceuticals.

Objective . Congenital hypothyroidism (CH) is a treatable condition with a good outcome if diagnosed promptly. However, neonatal screening programs are not routinely available in developing countries in Pakistan. Method . To highlight the practices of newborn screening in Pakistan, an online survey was conducted. Google forms were circulated to national pediatric societies and hospitals. Results . Out of 341 respondents most were consultant pediatrician (n = 212, 62.17%) followed by residents (n = 80, 23.41%). Majority, (n = 309, 90.6%) believed it was essential to screen all newborns for CH. However, in practice only (n = 141, 41.3%) were offering screening. The most common reasons cited for not screening was the cost of test (n = 110, 32.2%), non-availability of testing services (n = 29, 8.5%) and lack of any implemented screening policies in the hospitals or national guidelines (n = 20, 5.8%). Differences in practice were also observed at provincial levels ( P

Objective: To compare the outcome and comparative efficacy of spinal manipulation and Mulligan sustained natural apophyseal glides in patients with mechanical upper back pain. Study Design: Quasi-experimental study. Place and Duration of Study: Riphah International University, Lahore Pakistan, from June to Dec 2020. Methodology: A sample of 26 patients with upper back pain was included. Subjects were distributed in two Groups: Group-A got spinal manipulation along with central sustained natural apophyseal glides treatment, and Group-B was treated with Mulligan-based central sustained natural apophyseal glides treatment. Faces pain scale, MODI questionnaire, and goniometer were used as data collecting tools. Pre-treatment and post-treatment values after 12 treatment sessions measured. Results: Pain decreased to a greater extent in the treatment of the Spinal Manipulation-Group with a mean value 1.85±1.28 as compared to 5.08±1.04 to Group-B (The p-value was

Iron-nanoparticles (Fe-NPs) are increasingly been utilized in environmental applications due to their efficacy and strong catalytic activities. The novelty of nanoparticle science had attracted many researchers and especially for their green synthesis, which can effectively reuse biological resources during the polymerization reactions. Thus, the synthesis of Fe-NPs utilizing plant extracts could be considered as the eco-friendly, simple, rapid, energy-efficient, sustainable, and cost-effective. The green synthesis route can be recognized as a practical, valuable, and economically effective alternative for large-scale production. During the production process, some biomolecules present in the extracts undergo metal salts reduction, which can serve as both a capping and reducing mechanism, enhancing the reactivity and stability of green-synthesized Fe-NPs. The diversity of species provided a wide range of potential sources for green synthesis of Fe-NPs. With improved understanding of the specific biomolecules involved in the bioreduction and stabilization processes, it will become easier to identify and utilize new, potential plant materials for Fe-NPs synthesis. Newly synthesized Fe-NPs require different characterization techniques such as transmission electron microscope, ultraviolet-visible spectrophotometry, and X-ray absorption fine structure, etc, for the determination of size, composition, and structure. This review described and assessed the recent advancements in understanding green-synthesized Fe-NPs derived from plant-based material. Detailed information on various plant materials suitable of yielding valuable biomolecules with potential diverse applications in environmental safety. Additionally, this review examined the characterization techniques employed to analyze Fe-NPs, their stability, accumulation, mobility, and fate in the environment. Holistically, the review assessed the applications of Fe-NPs in remediating wastewaters, organic residues, and inorganic contaminants. The toxicity of Fe-NPs was also addressed; emphasizing the need to refine the synthesis of green Fe-NPs to ensure safety and environmental friendliness. Moving forward, the future challenges and opportunities associated with the green synthesis of Fe-NPs would motivate novel research about nanoparticles in new directions.

Abstract BackgroundPrimary health care (PHC) is the backbone of universal health coverage, with community health workers (CHWs) being one of its critical pillars in lower-middle-income countries. Most CHW functions require them to be an efficient communicator, but their program development has been deficient in this area. Can IT provide some solutions? Moreover, can some IT-based CHW-delivered innovations help mothers and children in areas not covered by PHC services? We explored these questions during the development and feasibility testing of a digital application designed to improve the communication capacity of CHWs in two underserved areas of Islamabad. ObjectiveThis study aims to explore the perceptions, practices, and related gaps about mother and child health, and child development in an underserved area; develop and deploy a behavior change communication program to address the gaps; and assess the feasibility of the program. MethodsWe carried out a mixed methods study with three steps. First, we conducted 13 in-depth interviews and two focus group discussions with stakeholders to explore the issues faced by mothers living in these underserved areas. To address these barriers, we developed Sehat Ghar, a video-based health education application to demonstrate practices mothers and families needed to adopt. Second, we trained 10 volunteer CHWs from the same community to deliver health education using the application and assessed their pre-post knowledge and skills. Third, these CHWs visited pregnant and lactating mothers in the community with random observation of their work by a supporting supervisor. ResultsInitial exploration revealed a need for health-related knowledge among mothers and suboptimal utilization of public health care. Sehat Ghar used behavior change techniques, including knowledge transfer, enhancing mothers’ self-efficacy, and improving family involvement in mother and child care. Volunteer CHWs were identified from the community, who after the training, showed a significant improvement in mean knowledge score (before: mean 8.00, SD 1.49; after: mean 11.40, SD 1.43; P ConclusionsSehat Ghar is a simple, easy-to-use digital application for CHWs and is acceptable to the community. Mothers appreciate the content and presentation and are ready to incorporate its messages into their daily practices. The real-world effectiveness of the innovation tested on 250 mother-infant pairs will be important for its proof of effectiveness. With its usefulness and adaptability, and the rapidly spreading use of mobile phones and internet technology, this cost-effective innovation can help in delivering health communications at a large scale in a minimum amount of time.

Aims Background: Late-onset Tay-Sachs disease (LOTS) is an autosomal recessive lysosomal storage disease due to a variety of mutations in the hexosaminidase-A gene which leads to accumulation of GM2 ganglioside in the brain. It typically presents in late adolescence with a slowly progressive spectrum of neurologic symptoms including lower-extremity weakness with muscle atrophy, dysarthria, incoordination, tremor and mild spasticity and/or dystonia. Psychiatric symptoms including mood disorder, psychosis and neurocognitive symptoms occur in around 50% of cases but are rarely the presenting feature. Methods Case Report: Patient X is a 35 year old man of Irish descent currently detained in an independent hospital locked rehabilitation unit following the breakdown of a care home placement. He first presented to mental health services at the age of 17 with psychomotor agitation, rapidly changeable moods, manic-like symptoms and sexual disinhibition. He was diagnosed with schizoaffective disorder, attention deficit hyperactivity disorder and Asperger's syndrome and he had several compulsory hospital admissions over the next five years before a prolonged period of rehabilitation and discharge to a residential home for people with autistic spectrum disorders. However, he continued to exhibit disruptive behaviour, often triggered by periods of insomnia and had further hospital admissions. When he was 31 his brother was diagnosed with LOTS and this led to him being tested and found to have the same mutation. Results Discussion: There had been no suspicion of a neuropsychiatric disorder prior to the diagnosis of the patient's brother with LOTS and he was treated with conventional psychotropic medication with limited success. However, when the case records were obtained from his first hospital admission there was evidence of dysarthria although the significance of this was not appreciated. With hindsight many of his other symptoms can be seen as indicative of a neuropsychiatric disorder. Conclusion It is important to take a family history and consider a neuropsychiatric condition in families with multiple affected individuals. There are as yet no specific treatments for LOTS, and management is aimed at symptom reduction and enhancing quality of life, but a number of disease modifying strategies are being investigated including enzyme replacement therapy, pharmaceutical chaperone therapy, substrate reduction therapy, gene therapy, and hematopoietic stem cell replacement therapy, making it even more important the condition is recognized early.

Abstract Nitrogen (N) as an inorganic macronutrient is inevitable for plant growth, development, and biomass production. Many external factors and stresses, such as acidity, alkalinity, salinity, temperature, oxygen, and rainfall, affect N uptake and metabolism in plants. The uptake of ammonium (NH4+) and nitrate (NO3−) in plants mainly depends on soil properties. Under the sufficient availability of NO3− (>1 mM), low‐affinity transport system is activated by gene network NRT1, and under low NO3− availability (

As a long-lasting and ongoing economic problem, inflation significantly affects how society views socioeconomic concerns and how people go about living their daily lives. For South Asian economies, inflation is not only a hypothetical economic concept; it is a brutal reality that affects their capacity to pay for necessities. Therefore, this study examines the effects of oil prices, technological advances, and labor market dynamics on inflation using the Panel ARDL on a subset of South Asian countries over the years 1995 to 2022. The Hausman test recommends PMG estimates while the cointegration test verifies the presence of long-run correlations between variables. According to the findings of this study, oil prices contribute to inflation in South Asian economies. Moreover, technological advancements have the ability to lower inflationary pressures. The overall condition of the labor market particularly is reflected in factors like employment rates, which have a signaficant impact on inflation. Tight labor markets can result in short-term demand-pull inflation when workers demand higher wages. On the other hand, cost-push inflation may occur if wages continue to rise steadily over time.

Background: COVID-19 infection has been implicated in millions of deaths worldwide. The respiratory distress occurs with cytokine storm around 2ndweek of symptom onset. Tocilizumab, a humanized monoclonal antibody directed against the interleukin 6(IL-6) receptor has been used at varying extents in suppressing it, however, limited literature exists about the timing of its administration. We contemplated this study with the primary objective to establish whether tocilizumab favourably affected the outcome when given in the early stages of complication. The secondary objectives were to assess the importance of ROX score and the effect of age on outcome. Methods: We conducted a retrospective study in a tertiary care hospital. Patients who received tocilizumab were divided into two groups depending on whether they received the drug in ≤ 10 days (Group 1) or≥ 11 days (Group 2) of onset of symptoms. The patient’s demographic data and co-morbidities, on- admission vitals, ROX score, and laboratory parameters, outcome etc. were collected from the electronic health records. Results: Both groups were comparable with regard to demographic and baseline parameters on admission. The outcome was significantly better in patients of Group-1(P=0.01) with better survival. The outcome was also significantly higher in ages ≤ 50yrs age(P=0.02) who received tocilizumab. Failure to improve ROX score after 24hrs. of administration of tocilizumab was associated with poor outcomes (p=0.001). Conclusion: Tocilizumab when given in the early stages of COVID-19-related complications may be associated with decreasing mortality. Age may be an indicator of favourable effect, and failure to improve ROX score after tocilizumab is associated with poor outcomes

This study investigated the potential of blockchain technology to transform Electronic Health Record (EHR) administration, integrity, and security. EHRs store vital health information such as medical history, diagnosis, prescriptions, and imaging findings, which may be shared with healthcare professionals to improve patient care. The existing EHR systems have a centralized framework. These centralized systems have a single point of failure, data management, integrity, and security concerns. Blockchain technology provides a solution to these problems by delivering benefits such as safety, privacy, secrecy, and decentralization. This study presents a framework for adopting blockchain technology in EHR systems, providing a comprehensive, modular, and straightforward approach. Our proposed framework addresses the constraints of existing EHR systems by providing a platform for connected and interoperable EHRs. The proposed blockchain-based patient health records management framework demonstrates the potential to address the limitations of current centralized health records systems. It offers benefits such as data privacy and security, interoperability, audibility, decentralization, and automation through the use of smart contracts. The proposed framework is implemented in Ethereum. The evaluation, i.e., cost and performance results, show that this solution is reasonable and may be used on any blockchain network, whether it is permissioned or permissionless.

Background The purpose of this study is to make it easier to counsel the general public on how to promote their psychological health and better lifestyle by boosting their physical activity in the event of more devastating future waves of coronavirus disease 2019. Coronavirus disease is a viral infection first reported in Wuhan, China, which led to a worldwide pandemic and lockdown. In addition to physical health, the uncertainty of situation and fear of infection have further affected the mental health of the individuals. Lockdown has also halted the physical activity of people further adding into the stress and anxiety.

Traditional herbal medicines and health supplements have been empirically used to treat various disorders but most of them are not standardized and have not been experimentally validated for safety and efficacy. In the present study, various dosage forms of traditional herbal medicines prescribed for specific diseases were collected from local practitioners at different districts of Khyber Pakhtunkhwa, Pakistan. The collected samples were analyzed for heavy metal, trace elements, and minerals using atomic absorption spectroscopy. All the tested samples contained heavy metals, trace elements and minerals in different concentrations. All the samples were tested positive for the presence of toxic heavy metals such as arsenic (As), cadmium (Cd) and lead (Pb). The trace elements like cobalt (Co), iron (Fe), zinc (Zn) and chromium (Cr) were also detected in acceptable range. Similarly, the samples analyzed were rich in some of the essential minerals such as sodium (Na), magnesium (Mg) and calcium (Ca) which are necessary for the proper functioning of the body. The hazard quotient (HQ) values were measured for toxic heavy metals to determine their safe ranges for human body. The HQ values were above the permissible range for arsenic (As) in all detected samples while for cadmium (Cd) and lead (Pb), the values ware above in 50 % of the analyzed samples. The detection of toxic metals and their HQ values beyond the permissible limits in different dosage forms raised questions about their quality. This study suggests that evaluation of traditional herbal remedies for the metals contents and their standardization are strongly recommended for quality assurance and protection of public health.

This study produced nanofluids via a two-step method by dispersing copper–nickel–zinc (CuNiZnFe2O4) ferrite nanocomposites in transformer and kerosene oils. A sol–gel auto-combustion approach was adopted to synthesize ferrite nanoparticles. The prepared nanoparticles were analyzed through scanning electron microscopy, photoluminescence spectroscopy, and x-ray diffraction. The measured crystallite size varied between 11 and 13 nm. The SEM images show that the structures of the developed CuNiZn nanoparticles are irregular. The photoluminescence results give a bandgap of 1.91 eV and the emission lines of the nanoparticles. Transient hot wire analysis was performed to determine the thermal conductivity of the base fluid and the prepared nanofluids. It is observed that nanoparticles in the nanofluid enhance the heat transfer rate. It has been proven that CuNiZn/kerosene-based nanofluids have greater thermal conductivity than CuNiZn/transformer oil-based nanofluids. The viscosity of transformer oil-based nanofluids at room temperature is 12.53 mm2 s−1, which decreases to 12.49 mm2 s−1 at 40 °C. Similarly, the viscosity of kerosene-based nanofluids is 1.49 mm2 s−1 at room temperature and 1.16 mm2 s−1 at 40 °C. The sedimentation method revealed that CuNiZn/transformer oil-based nanofluids have greater stability than CuNiZn/kerosene-based nanofluids.

In the current studies two naproxen derivatives (NPD) were evaluated for analgesic and anti-inflammatory properties. The acetic acid and hot plate animal models were used to screen the compounds for analgesic potential. While the anti-inflammatory potential was evaluated through animal paw edema, induced by several inflammatory mediators (carrageenan, bradykinin, and prostaglandin E2), the xylene-induced ear edema was also used as an inflammatory model. Both NPDs showed significant (p

Natural contamination of agricultural products like crops (red chilies, peanuts, pistachio, walnut, rice, corn, cottonseed, and wheat) by various fungi and their metabolites, may occur at pre and post-harvest levels. Ten thousand Mycotoxins have been known that are produced by various fungi but the metabolites of the genus Aspergillus called aflatoxins are well known due to their most toxic potential. Among the twenty identified types of aflatoxins four types B1 (AFB1), B2 (AFB2), G1 (AFG1), and G2 (AFG2) are well known due to carcinogenic potential. It is a very difficult task to inhibit their growth from food and feed products to get rid from the exposure of aflatoxins. The process of inhibition was employed for this purpose and natural materials with their modified surface was used as antifungal agents. This method was found to be very beneficial and effective for the inhibition of Aflatoxogenic A. flavus from agricultural commodities. This method of inhibition of growth of A. flavus being cost effective and economical to preserved food and feed products before its consumption. In this research work, Fe/Mg nanoparticles was prepared by using leaf extract of Azadirachta indica. Optimum conditions for efficient inhibition of A. flavus was initial concentration 5 mg/mL while dose rate for both of these was 15 and 20 mg/mL. For the characterization of synthesized Fe/Mg nanoparticles Ultraviolet spectroscopy, Scanning electron microscopy, energy-dispersive X-ray spectroscopy and Fourier-transform infrared spectroscopy were used. Statistical analysis was done by calculating standards errors at 0.05 level of significance.

Objective: To examine the clinical spectrum of breast cancer, its symptoms, presentation, histologic types and different types of its genetic aberrations in the women of reproductive age. Methodology: This Retrospective study was conducted at the Heavy Industries Taxila (HIT) Hospital, Taxila Cantt, from March 2022 to December 2022. The Temporal sampling technique was used to collect the data. We looked at the data of patients with breast cancer that were treated at the HIT hospital Taxila. The retrospective data was collected from the files of the patients who visited HIT Hospital, dated back from January 2011 to December 2020. The study included women of reproductive age with breast cancer symptoms, regardless of whether they had a family history of the disease. The women with metastatic breast lesions and breast trauma were excluded from the study. Age, hormone receptor status, axillary lymph node status, histologic grade and subtype, tumor size margin status, menopausal status, human epidermal growth factor receptor-2 (HER2)/neu status, and the entire genetic spectrum were all included in the charts. The clinical spectrum, staging, and genetic spectrum are all described in tables. Results: The disease's genetic makeup was found to be quite diverse, with abnormalities in genes; ATM, BARD1, CDH1, and BRCA2 making up 2 (3%) each, 3 (4%) breast cancer gene 1 (BRCA1) and BRCA2 abnormalities making up 48 (67%) of the cases. Twelve (16%) of the patients had TP53 mutations, while two (2%) of the patients had NF1 and RECQL gene alterations. Conclusions: This study identifies multiple genes that contribute to the development of breast cancer, including BRCA1, BRCA2, TP53, BARD1 and Cadherin 1 (CDH1) genes.

Background: The study was conducted with the aim to investigate the VRSA isolates in terms of their susceptibility to routinely used biocides influenced by the co-occurrence of biocide resistant gene (BRGs) and efflux pumps genes. Methodology: Frequently touched surfaces within intensive care unit (ICU) of cardiac hospital were classified into three primary sites i.e., structure, machines and miscellaneous. Over a period of six months (January 2021 to July 2021) twenty three swabs samples were collected from these sites. Subsequently, these samples underwent both phenotypic and molecular methods for VRSA isolation and identification. Susceptibility and efficacy testing of biocides (benzalkonium chloride (BAC), cetrimide (CET) and chlorhexidine gluconate (CHG)) were evaluated using microdilution broth and suspension method. Furthermore, specific primers were used for singleplex PCR targeting BRGs (cepA, qacA, and qacE) and efflux pump (norA, norB, norC, sepA, mepA and mdeA) associated genes. Results: We found that 72.2 % S. aureus demonstrate the presence of vanA or vanB genes with no significant difference among three sites (p > 0.05). cepA is the most dominant BRGs followed by qacA and qacE from structure site as compared to other sites (p

This study is devoted to the preparation of barium doped bismuth ferrites by sol–gel auto combustion method using different concentrations of barium nitrates Bi1-xBaxFeO3 (x = 0, 0.10, 0.20, 0.30). The Electrical, structural properties, and crystallite size of all samples had been studied. The electrical properties, of the samples, showed compromising results to use in electrical applications. The X-ray diffraction analysis of the samples showed the rhombohedra shape of the samples. The crystallite size were measured and noted to be 24 nm with the enhancement of Ba concentration. The electrical conductivity and resistivity are measured by the mean of two probe methods and results showed an increase in conductivity with the addition of barium. The activation energy were also calculated and recorded to be a 2.07 eV. The magnetic susceptibility of all samples was measured and the response was enhanced by the increase of the Ba concentration. SEM study revealed the morphology of the all prepared samples. The nanoparticles have average particle sizes of 15 and 75 nm, were observed by using image software. The FTIR analysis of all samples resulted the transmittance and the functional group of the all samples.

Globally, 50% of people consume rice (Oryza sativa), which is among the most abundant and extensively ingested cereal grains. Rice bran is a by-product of the cereal industry and is also considered a beneficial waste product of the rice processing industry. Rice bran oil (RBO) is created from rice bran (20–25 wt% in rice bran), which is the outermost layer of the rice kernel; has a lipid content of up to 25%; and is a considerable source of a plethora of bioactive components. The main components of RBO include high levels of fiber and phytochemicals, including vitamins, oryzanols, fatty acids, and phenolic compounds, which are beneficial to human health and well-being. This article summarizes the stabilization and extraction processes of rice bran oil from rice bran using different techniques (including solvent extraction, microwaving, ohmic heating, supercritical fluid extraction, and ultrasonication). Some studies have elaborated the various biological activities linked with RBO, such as antioxidant, anti-platelet, analgesic, anti-inflammatory, anti-thrombotic, anti-mutagenic, aphrodisiac, anti-depressant, anti-emetic, fibrinolytic, and cytotoxic activities. Due to the broad spectrum of biological activities and economic benefits of RBO, the current review article focuses on the extraction process of RBO, its bioactive components, and the potential health benefits of RBO. Furthermore, the limitations of existing studies are highlighted, and suggestions are provided for future applications of RBO as a functional food ingredient.

Objectives: Hepatitis C virus (HCV) and bacterial vaginosis (BV) coinfection generate sustained inflammation with bulk production of reactive oxygen species. They have the potency to cause hepatocellular carcinoma, vaginal apoptosis, disturb pregnancy, and influence drug treatment and follow-up. This case-control study aimed to compare the redox status in HCV and BV coinfection with respect to BV mono-infection among pregnant females (PFs). Methods: Blood samples and vaginal secretions were drawn from 75 PFs divided into three groups: coinfection (n = 25), monoinfection (n = 25), and control PFs (n = 25) who are presumed healthy subjects. Blood samples were analyzed for HCV detection based on conserved 5’ untranslated region via real-time polymerase chain reaction and hematological parameters. Markers of oxidative stress (malondialdehyde and peroxidase) and antioxidants (catalase and superoxide dismutase) were checked in plasma as well as vaginal secretions of patients among all three groups. Results: Hematological analysis reveals that hemoglobin levels, platelets, and lymphocytes decreased significantly (p < 0.050) among the coinfection followed by mono-infection group compared to the control group. Moreover, the higher isolation frequency of pathogenic bacteria (Acinetobacter spp.) and Nugent score trend was observed among the coinfection group. Antioxidant levels were significantly lower (p < 0.050) among the vaginal secretions and blood plasma of patients having coinfection with respect to the mono-infection and control groups. While oxidative stress marker was significantly highest (p < 0.050) among vaginal secretions and blood plasma of coinfection followed by mono-infection and control group. These results validate that overall redox severity was more among the coinfection compared to the mono-infection and control groups. Conclusions: Redox indexes should be considered in early diagnosis and treatment of HCV and BV coinfection which may also facilitate the better treatment of hepatocellular carcinoma and vaginal apoptosis.

Abstract In the current study, a novel method was used to synthesize silver nanoparticles (AgNPs) by utilizing Quercus baloot aqueous extract as a reducing agent. The biosynthesized AgNPs were then subjected to various physicochemical characterizations to assess their effectiveness against microbial familiarity. The characterization techniques included ultraviolet‐visible spectro‐photometry (UV‐Vis), scanning electron microscopy (SEM), transmission electron microscopy (TEM), X‐ray diffractometer (XRD), and Fourier‐transform infrared spectroscopy (FTIR). The UV‐Vis analysis revealed a distinctive spectral peak at 420 nm, indicating the presence of silver nanoparticles. SEM imaging displayed the nanoparticle size range of about 100 nm at a magnification of 30,000x, while TEM demonstrated that the nanoparticles had a spherical morphology with a size of approximately 100 nm. Moreover, the crystalline structure of the silver nanoparticles was confirmed by XRD analysis, further validating their successful synthesis. Additionally, FTIR analysis provided evidence of the presence of phytochemicals involved in synthesizing the AgNPs. the biosynthesized silver nanoparticles (AgNPs) were evaluated for antibacterial and antifungal activities. The AgNPs displayed substantial efficacy against common bacterial strains, including Staphylococcus aureus (71%), Escherichia coli (59%), and Klebsiella pneumoniae (64%). Furthermore, they demonstrated significant antifungal activity against plant pathogenic fungi, namely Aspergillus niger (65%), Aspergillus flavus (70%) and Fusarium oxysporum (61%).

Background: Narcissism is a personality disorder that has an impact on interpersonal relationship with friends, family and colleagues. These individuals can be more shy, arrogant or over-sensitive. These traits are also present among normal individual. A lot of features of behaviour are still unknown. Objective: To observe the narcissism score among medical and allied health students and the association of narcissism with their academic performance. Study type, settings & duration: This cross-sectional study was conducted at Fatima Memorial College of Medicine & Dentistry, Lahore from March 2019 to October 2019. Methodology: In this cross-sectional study of six months duration the “Narcissistic Personality Inventory (NPI-40)” tool was administrated on 385 medical and allied health undergraduate students. NPI scores were calculated. Comparative analysis was carried out. Multiple linear regression was also performed to observe the dependence of NPI score on demographic variables. Results: NPI score of males were found to be higher (18.27) than females scores (14.66). The odds for NPI were 21.98 times higher in males as compared to females. Similarly, hostilities were 3.42 times at more risk of narcissism. Last exam percentage was significantly associated with narcissism score (0.024). Conclusion: Students of Allied health sciences exhibit more narcissistic traits than MBBS undergraduates. Institutes should encourage student counseling & mentoring sessions and they should have taught to overcome negative personality characteristics.

Objective: To determine the aetiologies and outcomes which would help reduce preventable deaths from acute kidney injury. Study Design: Prospective longitudinal study. Place and Duration of Study: Paediatric Nephrology unit at University of Child Health Sciences, The Children’s Hospital Lahore Pakistan, from Aug 2021 to Jul 2022. Methodology: A total of 149 children who fulfilled the selection criteria were included in the study. Kidney Disease: Improving Global Outcomes guidelines were used for defining and staging acute kidney injury. The aetiology for each case of acute kidney injury was determined using standard workup/protocol and classified as pre-renal, renal and post-renal. Outcome parameters were recovery, improvement, death and progression to chronic kidney disease. Results: The mean age of children was 61.79±52.26 months, predominantly boys (68.5%). The most common etiological group was renal (73,49%), followed by pre-renal (53,35.6%) and post-renal (23,15.4%). It was observed that the majority of children had stage-3 AKI (63.8%), with kidney replacement therapy (KRT) given in 92(61.7%) cases. Mortality was seen in 30.9%, while recovery, improvement and death occurred in 69(46.3%), 44(29.5%) and 36(24.2%), respectively, at the time of discharge. At three months of follow-up, recovery, progression to chronic kidney disease, and death occurred in 73(49.0%), 20(13.4%) and 10(6.7%) children, respectively. Conclusion: Intrinsic renal disease was the most common etiological group occurring primarily in the form of AGN, and sepsis was found to be the most common underlying aetiology. Most patients presented in Stage 3 of acute kidney injury, and recovery was seen in many patients.

Objective: To estimate the frequency of attention deficit hyperactivity disorder and its relationship with screen time and sociodemographic characteristics among children. Method: The cross-sectional study was conducted at the National Institute of Child Health, Karachi, in June-July 2022, and comprised children of either gender aged 5-10 years visiting the paediatric outpatient department. Screen time was measured using a pretested questionnaire, while attention deficit hyperactivity disorder rating scale IV. The relationship of sociodemographic characteristics and screen time with the disorder was explored through multiple linear regression analysis. Data was analysed using SPSS 20. Results: Of the 247 participants, 126(51%) were boys and 121(49%) were girls. The overall mean age was 7.84 ±1.87 years. The were 149(60.3%) children at the primary level of education, while 76(30.8%) had no formal education. There were 139(56.3%) children having screen time >2 hours/day with a mean of 3.36±3.14 hours. There were 15(6.1%) children with attention deficit hyperactivity disorder score >26 with a mean of 11.58±9.27. Boys were more frequently affected by attention deficit hyperactivity disorder compared to girls (p=0.026), and there was a significant positive correlation between screen time and attention deficit hyperactivity disorder (p

Great saphenous vein insufficiency is linked to 80% of all remarkable lower limb varicosities. A total of 30 patients were enrolled from OPD fulfilling the inclusion criteria after the approval of the hospital’s ethical committee. Patients had compression dressing for seven days after surgery. The patients were divided into two groups—Group-A (Compression dressing for two days) and Group-B (Compression dressing for seven days). Stratification of pain score was done against age, gender, and grades of varicose veins, and after dividing into groups t- test was put into use. A p-value 0.05 was contemplated to be remarkable. Thirty patients with primary varicose vein were enrolled in this study. The mean age of patients was 35.4±9.9 years. Mean pain score in these patients was 2.9±0.8 years. ---Continue

Enhancing the environmental perception of autonomous vehicles (AVs) in intelligent transportation systems requires computer vision technology to be effective in detecting objects and obstacles, particularly in adverse weather conditions. Adverse weather circumstances present serious difficulties for object-detecting systems, which are essential to contemporary safety procedures, infrastructure for monitoring, and intelligent transportation. AVs primarily depend on image processing algorithms that utilize a wide range of onboard visual sensors for guidance and decisionmaking. Ensuring the consistent identification of critical elements such as vehicles, pedestrians, and road lanes, even in adverse weather, is a paramount objective. This paper not only provides a comprehensive review of the literature on object detection (OD) under adverse weather conditions but also delves into the ever-evolving realm of the architecture of AVs, challenges for automated vehicles in adverse weather, the basic structure of OD, and explores the landscape of traditional and deep learning (DL) approaches for OD within the realm of AVs. These approaches are essential for advancing the capabilities of AVs in recognizing and responding to objects in their surroundings. This paper further investigates previous research that has employed both traditional and DL methodologies for the detection of vehicles, pedestrians, and road lanes, effectively linking these approaches with the evolving field of AVs. Moreover, this paper offers an in-depth analysis of the datasets commonly employed in AV research, with a specific focus on the detection of key elements in various environmental conditions, and then summarizes the evaluation matrix. We expect that this review paper will help scholars to gain a better understanding of this area of research.

In smart cities, effective traffic congestion management hinges on adept pedestrian and vehicle detection. Unmanned Aerial Vehicles (UAVs) offer a solution with mobility, cost-effectiveness, and a wide field of view, and yet, optimizing recognition models is crucial to surmounting challenges posed by small and occluded objects. To address these issues, we utilize the YOLOv8s model and a Swin Transformer block and introduce the PVswin-YOLOv8s model for pedestrian and vehicle detection based on UAVs. Firstly, the backbone network of YOLOv8s incorporates the Swin Transformer model for global feature extraction for small object detection. Secondly, to address the challenge of missed detections, we opt to integrate the CBAM into the neck of the YOLOv8. Both the channel and the spatial attention modules are used in this addition because of how well they extract feature information flow across the network. Finally, we employ Soft-NMS to improve the accuracy of pedestrian and vehicle detection in occlusion situations. Soft-NMS increases performance and manages overlapped boundary boxes well. The proposed network reduced the fraction of small objects overlooked and enhanced model detection performance. Performance comparisons with different YOLO versions ( for example YOLOv3 extremely small, YOLOv5, YOLOv6, and YOLOv7), YOLOv8 variants (YOLOv8n, YOLOv8s, YOLOv8m, and YOLOv8l), and classical object detectors (Faster-RCNN, Cascade R-CNN, RetinaNet, and CenterNet) were used to validate the superiority of the proposed PVswin-YOLOv8s model. The efficiency of the PVswin-YOLOv8s model was confirmed by the experimental findings, which showed a 4.8% increase in average detection accuracy (mAP) compared to YOLOv8s on the VisDrone2019 dataset.

Abstract Background Skeletal dysplasia is a heterogeneous group of disorders. Spondyloepiphyseal dysplasias comprise one subgroup. Deficiency of carbohydrate sulfotransferase 3 has been reported in a small number of patients with recessively inherited spondyloepiphyseal dysplasia with joint dislocation, short stature and scoliosis. We report here molecular and clinical findings of affected individuals in three consanguineous Pakistani families. Affected individuals in all three families had a uniform phenotype including severe short stature, multiple dislocated joints, progressive scoliosis and facial dysmorphism. Methods Clinical evaluation was done for three unrelated families. Radiological survey of bones was completed for patients from two of the families. Whole exome sequencing index patients from each family was performed followed by Sanger sequencing for validation of segregation of identified variants in respective families. In-silico analysis for determining pathogenicity of identified variants and conservation was done. Results Whole-exome sequencing revealed biallelic variants c.590 T > C;p.(Leu197Pro), c.603C > A;p.(Tyr201Ter) and c.661C > T;p.(Arg221Cys) in CHST3 (NM_004273.5) in the three families with eight, five and two affected individuals, respectively. Contrary to previous reports, affected individuals in none of the families exhibited a hearing loss. Conclusion We describe genotypic and phenotypic findings of three unrelated families with spondyloepiphyseal dysplasia. Our study confirms phenotypic variability and adds to the genotypic spectrum of spondyloepiphyseal dysplasia.

Abstract Titanium dioxide (TiO2) nanoparticles (NPs) are one of the topmost widely used metallic oxide nanoparticles. Whether present in naked form or doped with metals or polymers, TiO2 NPs perform immensely important functions. However, the alteration in size and shape by doping results in improving the physical, chemical, and biological behaviour of TiO2 NPs. Hence, the differential effects of various TiO2 nanostructures including nanoflakes, nanoflowers, and nanotubes in various domains of biotechnology have been elucidated by researchers. Recently, the exponential growth of research activities regarding TiO2 NPs has been observed owing to their chemical stability, low toxicity, and multifaceted properties. Because of their enormous abundance, plants, humans, and environment are inevitably exposed to TiO2 NPs. These NPs play a significant role in improving agricultural attributes, removing environmental pollution, and upgrading the domain of nanomedicine. Therefore, the currently ongoing studies about the employment of TiO2 NPs in enhancement of different aspects of agriculture, environment, and medicine have been extensively discussed in this review.

Abstract Background Horner’s syndrome is a rare complication of central venous catheter (CVC) insertion. It comprises a triad of unilateral ptosis, ipsilateral meiosis with a normally reactive pupil, and ipsilateral facial anhidrosis of variable spread. Case presentation A 25-year-old female who underwent CVC insertion developed ptosis, reverse ptosis, meiosis, dilational lag, and enophthalmos after her procedure. The patient was diagnosed with a case of Horner’s syndrome attributed to occulosympathetic damage due to CVC in the catheter, after exclusion of all other sources. The patient was counseled regarding the etiology of the disease and advised monthly follow-up. Conclusions Horner’s syndrome is an uncommon complication that can easily be prevented by corrections in technique and experience. The study emphasizes the establishment of diagnostic and preventive principles for HS.

Dengue fever is one of the most frequent arboviral diseases in the world. Dengue is known to cause myocarditis, hepatitis, and neurological illustrations but one of the established presentations is leakage of plasma resulting in circulatory failure. Spontaneous rupture of the spleen is one of the most infrequent but known outcome of dengue fever which has been reported from time to time in literature. We present, here, the case of a 50-year-old patient who developed this condition during dengue fever and was managed in our department successfully. This complication must be kept in mind while treating any case of dengue fever so that it can be avoided or if not then treated timely. Keywords: Spontaneous splenic rupture, Dengue Fever, Dengue haemorrhagic fever, Haemoperitoneum.

Abstract Background Jarcho-Levin syndrome (JLS) is a genetic condition that constitutes specific vertebral anomalies combined with coastal or thoracic anomalies due to specific gene mutations. Although the condition is associated typically to Puerto-Ricans, we describe the novel case of JLS in a Pakistani family that presented with respiratory distress secondary to the condition. Case presentation The case is a full-term girl that had a webbed neck with an undefined chest deformity. Radiology showed kyphoscoliosis and a crablike chest. Early identification of these high morbidity conditions is key to allow for optimal treatment and improved outcomes. Conclusions We have provided a brief breakdown of the management principles of the condition and more than 80 years after the first case of Jarcho-Levin syndrome was reported, we present the diagnostic criterion for JLS.

A lot of research is being carried out on the Direct Current (DC) servo motor systems due to their excessive applications in various industrial sectors owing to their superior control performance. Parameters of the DC servo motor systems to be used in the simulation software are usually unknown or change with time and have to be determined accurately for obtaining the precise simulation response. In this paper, three different estimation techniques for multi-domain DC servo motor model parameters are discussed namely the Compare Coefficient Method, MATLAB Parameter Estimation Toolbox, and System Identification Toolbox. The paper performs a comparison of these methods to identify the one that gives the most accurate results. Experimental data has been used for the comparison of the estimated response from the techniques. The results show that the parameters obtained from the parameter estimation method give the most accurate simulation results with the least error against the experimental results. The study is significant for guiding researchers to prefer this method for estimation purposes of DC servo motor simulation model parameters. The presented technique, i.e. parameter estimation technique, is relatively less complex and requires less computational cost as compared to other techniques found in the literature.

Tuberculosis remains the leading cause of death from a single pathogen. On the other hand, antimicrobial resistance (AMR) makes it increasingly difficult to deal with this disease. We present the hyperbolic embedding of the Mycobacterium tuberculosis protein interaction network (mtbPIN) of resistant strain (MTB XDR1219) to determine the biological relevance of its latent geometry. In this hypermap, proteins with similar interacting partners occupy close positions. An analysis of the hypermap of available drug targets (DTs) and their direct and intermediate interactors was used to identify potentially useful drug combinations and drug targets. We identify rpsA and rpsL as close DTs targeted by different drugs (pyrazinamide and aminoglycosides, respectively) and propose that the combination of these drugs could have a synergistic effect. We also used the hypermap to explain the effects of drugs that affect multiple DTs, for example, forcing the bacteria to deal with multiple stresses like ethambutol, which affects the synthesis of both arabinogalactan and lipoarabinomannan. Our strategy uncovers novel potential DTs, such as dprE1 and dnaK proteins, which interact with two close DT pairs: arabinosyltransferases (embC and embB), Ser/Thr protein kinase (pknB) and RNA polymerase (rpoB), respectively. Our approach provides mechanistic explanations for existing drugs and suggests new DTs. This strategy can also be applied to the study of other resistant strains.

Mulching and nitrogen (N) fertilization are the main drivers for sustainable crop production. The sole use of nitrogen fertilizer threatened both the physiology and production of maize in rain-fed areas. Therefore, we proposed that wheat straw mulching with N fertilization would increase maize yield by improving soil fertility, physiology, and nitrogen use efficiency. A two-year field study evaluated the effects of CK (control), N (nitrogen application at 172 kg ha−1), HS (half wheat straw mulch, 2500 kg ha−1), HS+N (half wheat straw, 2500 kg ha−1 plus 172 kg N ha−1), FS (full wheat straw, 5000 kg ha−1), and FS+N (full wheat straw, 5000 kg ha−1 plus 172 kg N ha−1) on maize growth, physiology, and biochemistry. Compared with the control, the FS+N treatment resulted in the increase of 56% photosynthetic efficiency, 9.6% nitrogen use efficiency, 60% nitrogen uptake, 80% soluble sugar, 59% starches, 48% biomass, and 29% grain yield of maize. In addition, the FS+N regime increased 47%, 42%, and 106% of soil organic carbon and available P and N content in comparison with the control. Maize grain and biomass yields were positively correlated with N uptake, photosynthesis, soil organic carbon, and soil available N and P contents. Conclusively, the use of wheat straw at 5000 kg ha−1, along with 172 kg N ha−1, is a promising option for building a sustainable wheat–maize cropping system to achieve optimal crop yield and improved plant and soil health in a semi-arid region of China.

According to WHO 2019, Hepatocellular carcinoma (HCC) is the fourth highest cause of cancer death worldwide. More precise diagnostic models are needed to enhance early HCC and cirrhosis quick diagnosis, treatment, and survival. Breath biomarkers known as volatile organic compounds (VOCs) in exhaled air can be used to make rapid, precise, and painless diagnoses. Gas chromatography and mass spectrometry (GCMS) are utilized to diagnose HCC and cirrhosis VOCs. In this investigation, metabolically generated VOCs in breath samples (n = 35) of HCC, (n = 35) cirrhotic, and (n = 30) controls were detected via GCMS and SPME. Moreover, this study also aims to identify diagnostic VOCs for distinction among HCC and cirrhosis liver conditions, which are most closely related, and cause misleading during diagnosis. However, using gas chromatography-mass spectrometry (GC-MS) to quantify volatile organic compounds (VOCs) is time-consuming and error-prone since it requires an expert. To verify GC-MS data analysis, we present an in-house R-based array of machine learning models that applies deep learning pattern recognition to automatically discover VOCs from raw data, without human intervention. All-machine learning diagnostic model offers 80% sensitivity, 90% specificity, and 95% accuracy, with an AUC of 0.9586. Our results demonstrated the validity and utility of GCMS-SMPE in combination with innovative ML models for early detection of HCC and cirrhosis-specific VOCs considered as potential diagnostic breath biomarkers and showed differentiation among HCC and cirrhosis. With these useful insights, we can build handheld e-nose sensors to detect HCC and cirrhosis through breath analysis and this unique approach can help in diagnosis by reducing integration time and costs without compromising accuracy or consistency.

The term temporomandibular disorder is used for pain and dysfunction at the temporomandibular joint. Manual therapy or exercise therapy has proven to be an effective measure for pain relief. The purpose of this study was to compare the effectiveness of manual therapy and exercise therapy in temporomandibular disorders. A quasi-experimental study was conducted from June 30, 2020 to December 30, 2020 in Al-Sheikh teaching hospital, Sialkot, Pakistan. A convenient sample of 24 patients was involved in the study. Lottery method was used to randomise the patients in either the Manual Therapy Group or Exercise Therapy Group. The participantswere assessed before and after the intervention through Numeric Pain Rating Scale (NPRS) for pain, Patient-Specific Functional Scale (PSFS) for function, Fonesca Amnestic Index (FAI) for the severity of condition, and MillimetreMouth Opening (MMO) for ranges. ---Continue

Incompetence of the great saphenous vein (GSV) is a global issue and the most prevalent cause of chronic venous disease of the leg. Clinical manifestations range from moderate to severe, including tiredness, heaviness, and irritation, as well as hyperpigmentation and leg ulcers. A study was conducted to address this controversy,(1) i.e. to determine the outcome of compression dressing after varicose vein surgery in terms of postoperative pain, on the Surgical floor, of Mayo Hospital, Lahore, from October 1, 2020, to April 1, 2021. A total of 60 patients with Primary varicose veins were enrolled in this study, fulfilling the inclusion criteria after obtaining approval from the ethical committee of the hospital. The patients were divided in two groups. Group A wore compression dressing for two days after surgery and Group B wore compression dressing for seven days after surgery. All the patients received 1gm Paracetamol I/V eight hourly followed by tablet Paracetamol 500mg P/O eight hourly. Then the outcome of compression dressing was analysed in the form of mean postoperative pain. The mean pain score was assessed on one week. Data were entered in SSPS v23.0. Stratification of pain score was done against age, gender, and grades of varicose veins. A comparison of the two groups was done by applying a t-test. A p-value of 0.05 was considered significant. Prescribing compression stockings for longer than two days after Trendelenburg’s procedure leads to reduced pain and improved physical function during the first week after treatment. Keywords: Trendelenburg’s procedure, Great saphenous vein, Compression stockings.

Cadmium (Cd) is one the leading environmental contaminants. The Cd toxicity and its potential stabilization strategies have been investigated in the recent years. However, the combined effects of biochar and microorganisms on the adsorption of Cd and maize plant physiology, still remained unclear. Therefore, this experiment was conducted to evaluate the combined effects of biochar (BC) pyrolyzed from (maize-straw, cow-manure, and poultry-manure, and microorganisms [Trichoderma harzianum (fungus) and Bacillus subtilis (bacteria)], on plant nutrient uptake under various Cd-stress levels (0, 10, and 30 ppm). The highest level of Cd stress (30 ppm) caused the highest reduction in maize plant biomass, intercellular CO2, transpiration rate, water use efficiency, stomatal conductance, and photosynthesis rate as compared to control Cd0 (0 ppm). The sole application of BC and microorganisms significantly improved plant growth, intercellular CO2, transpiration rate, water use efficiency, stomatal conductance, and photosynthesis rate and caused a significant reduction in root and shoot Cd. However, the co-application of BC and microorganisms was more effective than the sole applications. In this regard, the highest improvement in plant growth and carbon assimilation, and highest reduction in root and shoot Cd was recorded from co-application of cow-manure and combined inoculation of Trichoderma harzianum (fungus) + Bacillus subtilis (bacteria) under Cd stress. However, due to the aging factor and biochar leaching alkalinity, the effectiveness of biochar in removing Cd may diminish over time, necessitating long-term experiments to improve understanding of biochar and microbial efficiency for specific bioremediation aims.

Background. COVID-19 emerged in Wuhan, China and spread rapidly, becoming a global health pandemic. The condition, apart from its typical respiratory presentation, may also cause neurological complications. Case presentation. A 35-year-old, ex-smoker presented with bilateral lower limb weakness associated with urinary incontinence and constipation following the resolution of a suspected COVID-19 infection. His MRI-Spine showed areas of abnormal densities confirming the diagnosis of transverse myelitis. On the presence of positive SARS-CoV-2 antibodies, COVID-19 was concluded as the pathological trigger for the condition. He was treated using Methylprednisolone and Plasmapheresis with supportive limb physiotherapy which led to a partial recovery of the patient’s disability. Conclusion. This is the first case of TM associated with COVID-19 in Pakistan and considering the current scenario of a global pandemic, COVID-19 needs to be considered as an important differential for not only TM but other neurological manifestations like encephalitis, neuritis etc.

Abstract Background Skeletal dysplasia is a heterogeneous group of disorders resulting from different genetic variants in humans. The current study was designed to identify the genetic causes of skeletal dysplasia and short stature in two consanguineous families from Pakistan, both comprised of multiple affected individuals. Patients in one family had proportionate short stature with reduced head circumference while affected individuals in the other family had disproportionate short stature. Methods Clinical data were obtained and radiological examinations of the index patients were completed. Whole genome sequencing for probands from both families were performed followed by Sanger sequencing to confirm segregation of identified variants in the respective families. In-silico pathogenicity score prediction for identified variant and amino acid conservation analysis was completed. Results Whole Genome Sequencing identified a known biallelic variant c.6176_6189delGTCAGCTGCCGAAG; p.(Gln2060ArgfsTer48) in PCNT gene and a novel biallelic variant c.174delC; p.(Asp60ThrfsTer7) in RAB33B gene respectively in affected members of the two families. Clinical imaging revealed platyspondyly and varus deformity in the legs of the affected members in the first family. Radiographs indicated severe platyspondyly, genu valgus deformity of legs and pectus carinatum for the patients in the second family. Conclusion In this study we report the phenotypes and genetic variants in two unrelated families with two distinct forms of skeletal dysplasia. This study strengthens the previous findings that patients harboring PCNT variants are phenotypically homogeneous and also extends the genotypic spectrum of RAB33B variants.

Cross-cultural exchanges among the locals and the tourists have been beneficial in terms of social value creation and sustainability. The present study has examined the role of cultural tourism and social entrepreneurship on social value creation and environmental sustainability. The study has drawn a sample through a non-probabilistic convenience sampling method for desired data collection, as investigators approached tourists visiting the tourism destinations. The study reports data received with the help of tourists visiting cultural heritage in the Gilgit-Baltistan region of Pakistan. The study has employed the PLS_SEM approach for analysis purposes to draw the results. The findings showed a significant relationship between cultural tourism, environmental sustainability, and social value creation that significantly predicts environmental sustainability. The results revealed a significant positive association between social entrepreneurship, social value creation, and environmental sustainability. Besides, results showed that social value creation mediates the relationship between cultural tourism and environmental sustainability and social entrepreneurship and environmental sustainability. The study’s findings climax the importance of cross-cultural interactions that enriches the cultural understanding and gives new perspectives to the existing cultural traditions. Pursuing environmental sustainability through social value creation requires an excellent combination of the administrative and political collaborative strategy that integrates cultural tourism and social entrepreneurship in tourist destination development and aims to attain improved tourist attractions. Besides, this research identifies a significant effect of cultural tourism on environmental sustainability. However, the relationship between tourism and environmental sustainability is bidirectional. It might provide direction for further study. The findings deliver valuable insight into global cultural tourism and social entrepreneurship activities that provide tourism destinations for community development. This investigation produces a systematic and holistic research framework to help explore the influence of cultural tourism and social value creation on the environmental sustainability at tourism destinations. The generalizability of the findings supplies helpful directions for future research on environmental sustainability related to social entrepreneurship and cultural tourism that leads to social value creation.

Background: Lipase is one of the most important enzymes produced from microbial fermentation. Agricultural wastes are a good source of enzyme production because they are cost-effective and production rates are also higher. Method: In this study, eight lignolitic substrates were screened for lipase production. Results: Out of these substrates, guava leaves showed maximum activity of 9.1 U/mL from Aspergillus niger by using the solid-state fermentation method. Various factors such as temperature, pH, incubation period, moisture content, inoculum size, and substrate size that influence the growth of fungi were optimized by response surface methodology (RSM), and then characterization was performed. When all physical and nutritional parameters were optimized by RSM, the maximum lipase activity obtained was 12.52 U/mL after 4 days of incubation, at pH 8, 40 °C temperature, 3 mL inoculum size, 20% moisture content, and 6 g substrate concentration. The enzyme was partially purified through 70% ammonium sulfate precipitation. After purification, it showed 34.291 U/mg enzyme activity, increasing the purification fold to 1.3. The enzyme was then further purified by dialysis, and the purification fold increased to 1.83 having enzyme activity of 48.03 U/mg. Furthermore, activity was increased to 132.72 U/mg after column chromatography. A purification fold of 5.07 was obtained after all purification steps.

BCR-ABL1 is a fusion protein as a result of a unique chromosomal translocation (producing the so-called Philadelphia chromosome) that serves as a clinical biomarker primarily for chronic myeloid leukemia (CML); the Philadelphia chromosome also occurs, albeit rather rarely, in other types of leukemia. This fusion protein has proven itself to be a promising therapeutic target. Exploiting the natural vitamin E molecule gamma-tocotrienol as a BCR-ABL1 inhibitor with deep learning artificial intelligence (AI) drug design, this study aims to overcome the present toxicity that embodies the currently provided medications for (Ph+) leukemia, especially asciminib. Gamma-tocotrienol was employed in an AI server for drug design to construct three effective de novo drug compounds for the BCR-ABL1 fusion protein. The AIGT’s (Artificial Intelligence Gamma-Tocotrienol) drug-likeliness analysis among the three led to its nomination as a target possibility. The toxicity assessment research comparing AIGT and asciminib demonstrates that AIGT, in addition to being more effective nonetheless, is also hepatoprotective. While almost all CML patients can achieve remission with tyrosine kinase inhibitors (such as asciminib), they are not cured in the strict sense. Hence it is important to develop new avenues to treat CML. We present in this study new formulations of AIGT. The docking of the AIGT with BCR-ABL1 exhibited a binding affinity of −7.486 kcal/mol, highlighting the AIGT’s feasibility as a pharmaceutical option. Since current medical care only exclusively cures a small number of patients of CML with utter toxicity as a pressing consequence, a new possibility to tackle adverse instances is therefore presented in this study by new formulations of natural compounds of vitamin E, gamma-tocotrienol, thoroughly designed by AI. Even though AI-designed AIGT is effective and adequately safe as computed, in vivo testing is mandatory for the verification of the in vitro results.