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Abstract Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by cognitive decline, memory impairment, and behavioral alterations. The N-methyl-D-aspartate (NMDA) receptor has emerged as a promising target for AD pharmacotherapy due to its role in the disease’s pathogenesis. This study leverages advanced computational methods to screen 80 active constituents of Withania somnifera (Ashwagandha), a traditional herb known for its neuroprotective effects, against the NMDA receptor, using FDA-approved Ifenprodil as a reference. Our blind virtual screening results demonstrated that all tested compounds could bind to various domains of the NMDA receptor, with binding energies ranging from − 4.1 to -11.9 kcal/mol, compared to Ifenprodil’s -7.8 kcal/mol. Binding preference analysis revealed 7 compounds bound to the A-chain, 37 to the B-chain, 7 to the C-chain, and 29 to the D-chain of the receptor. Notable binding was observed predominantly at the Amino Terminal Domain (ATD) core site, some at the ATD-Ligand Binding Domain (LBD) interface, and a few at the Transmembrane Domain (TMD). Particularly, 17alpha-hydroxywithanolide D, with a binding energy of -11.9 kcal/mol, emerged as a prime candidate for further investigation. Molecular dynamics simulations of this compound revealed key interactions, including direct hydrogen bonding with residues ASP165, ARG431, THR433, LYS466, and TYR476 on the D-chain, as well as additional hydrophobic and water-bridging interactions. These simulations highlighted the compound’s influence on dynamic conformational states of the GluN1b-GluN2B receptor complex, modulating interactions between GluN1b Lys178 and GluN2B Asn184. Furthermore, the compound affected the distance between LBD heterodimers and the tension within the LBD-M30 linker, demonstrating its potential to modulate NMDA receptor activity. This comprehensive study not only underscores the therapeutic promise of Withania somnifera derivatives for AD but also provides a detailed molecular basis for their efficacy, offering valuable insights for targeted drug development and innovative therapeutic strategies against Alzheimer’s disease.

Abstract Background Liver disease is the third leading cause of premature death in the UK. Transplantation is the only successful treatment for end-stage liver disease but is limited by a shortage of suitable donor organs. As a result, up to 20% of patients on liver transplant waiting lists die before receiving a transplant. A third of donated livers are not suitable for transplant, often due to steatosis. Hepatic steatosis, which affects 33% of the UK population, is strongly associated with obesity, an increasing problem in the potential donor pool. We have recently tested defatting interventions during normothermic machine perfusion (NMP) in discarded steatotic human livers that were not transplanted. A combination of therapies including forskolin (NKH477) and L-carnitine to defat liver cells and lipoprotein apheresis filtration were investigated. These interventions resulted in functional improvement during perfusion and reduced the intrahepatocellular triglyceride (IHTG) content. We hypothesise that defatting during NMP will allow more steatotic livers to be transplanted with improved outcomes. Methods In the proposed multi-centre clinical trial, we will randomly assign 60 livers from donors with a high-risk of hepatic steatosis to either NMP alone or NMP with defatting interventions. We aim to test the safety and feasibility of the defatting intervention and will explore efficacy by comparing ex-situ and post-reperfusion liver function between the groups. The primary endpoint will be the proportion of livers that achieve predefined functional criteria during perfusion which indicate potential suitability for transplantation. These criteria reflect hepatic metabolism and injury and include lactate clearance, perfusate pH, glucose metabolism, bile composition, vascular flows and transaminase levels. Clinical secondary endpoints will include proportion of livers transplanted in the two arms, graft function; cell-free DNA (cfDNA) at follow-up visits; patient and graft survival; hospital and ITU stay; evidence of ischemia-reperfusion injury (IRI); non-anastomotic biliary strictures and recurrence of steatosis (determined on MRI at 6 months). Discussion This study explores ex-situ pharmacological optimisation of steatotic donor livers during NMP. If the intervention proves effective, it will allow the safe transplantation of livers that are currently very likely to be discarded, thereby reducing waiting list deaths. Trial registration ISRCTN ISRCTN14957538. Registered in October 2022.

Background: Literature has suggested that there is evidence regarding the impact of nutritional status on the overall oral health of children and adolescents. The study objectives were to investigate oral health and nutritional status in children in terms of dietary intake, and to determine the anthropometric measures and correlate the oral health & nutritional status in urban and sub-urban children. Method: An analytical cross-sectional study was conducted from September 2022 to March 2023. Total 267 children from Urban and sub-urban regions age 12-18 years were included using the convenience sampling technique. Urban data was collected from Dow University's dental OPD and private schools in Karachi, while suburban data was gathered from Long Khoso village near Hyderabad. Non-clinical data as well as clinical data which included oral examinations like dental caries status, oral hygiene status, periodontal condition, fluorosis malocclusion, and anthropometric measurements were gathered. SPSS v.21 was used to analyze data. Chi-square and correlation were applied between oral health status and anthropometric measurements. P-value ≤0.05 was considered statistically significant. Results: Area of residence was found to be significantly associated with habits, milk intake, oral hygiene practices, dental caries, and oral hygiene index (p-value < 0.001). A significant relationship was found between the area of residence and height (p-value 0.001). It was seen that anthropometric scores were low in suburban children. Conclusion: This study highlights a positive oral health status among all, with a high prevalence of healthy periodontal tissue and low caries severity reported in Urban as compared to suburban children.

The emergence of 6G networks promises ultra-high data rates and unprecedented connectivity. However, the effective utilization of the millimeter-wave (mmWave) as a critical enabler of foreseen potential in 6G, poses significant challenges due to its unique propagation characteristics and security concerns. Deep learning (DL)/machine learning (ML) based approaches emerged as potential solutions; however, DL/ML contains centralization and data privacy issues. Therefore, federated learning (FL), an innovative decentralized DL/ML paradigm, offers a promising avenue to tackle these challenges by enabling collaborative model training across distributed devices while preserving data privacy. After a comprehensive exploration of FL enabled 6G networks, this review identifies the specific applications of mmWave communications in the context of FL enabled 6G networks. Thereby, this article discusses particular challenges faced in the adaption of FL enabled mmWave communication in 6G; including bandwidth consumption, power consumption and synchronization requirements. In view of the identified challenges, this study proposed a way forward called Federated Energy-Aware Dynamic Synchronization with Bandwidth-Optimization (FEADSBO). Moreover, this review highlights pertinent open research issues by synthesizing current advancements and research efforts. Through this review, we provide a roadmap to harness the synergies between FL and mmWave, offering insights to reshape the landscape of 6G networks.

Background: Early in the COVID-19 pandemic, positive COVID-19 status often disqualified potential organ donors due to perceived risks, despite limited evidence. Subsequent studies have clarified that the COVID-19 status of donors, particularly when incidental and not the cause of death, does not adversely affect non-lung transplant outcomes. This study quantifies the potential loss of eligible organ donors and the corresponding impact on organ availability during the initial phase of the pandemic. Methods: In this retrospective analysis, we examined deceased donor referrals to a major organ procurement organization from June 2020 to January 2022. Referrals were categorized as All Referrals, Medically Ruled Out (MRO), or Procured Donors (PD). We used Chi-square tests for categorical comparisons and logistic regression to model additional donors and organs, contrasting COVID-negative and positive cases within age-matched cohorts. Results: Among 9478 referrals, 23.4 % (2221) were COVID-positive. Notably, COVID-positive referrals had a substantially higher MRO rate (80.6 % vs. 29.6 %, p

This proposed framework aims to mitigate global terrorist threats, suspicious activities, and legal violations by introducing an innovative system that monitors encrypted short-text messages across instant messaging programs. In the current landscape, criminals, terrorists, and clandestine entities extensively employ encrypted messages for illicit endeavours on a global scale. Despite the escalating use of encrypted messages on social media platforms, a comprehensive solution for combating online crime is notably absent.The outlined framework addresses this gap by employing a cryptographic system that integrates semantic web ontology, a Predefined Dataset, and machine learning technology for encryption, decryption, and cryptanalysis. A key feature is the framework's ability to predict potential crimes by analyzing blogs for suspicious terminology conveyed through coded information. The identified information is then promptly communicated to law enforcement agencies, thereby alleviating the burden on numerous security entities and offering an efficient strategy against global crime.What sets this proposed framework apart is its unique utilization of encrypted text, a dimension that has remained unexplored in previous studies. The cohesive integration of its components expedites the process of anticipating crime types and significantly reduces the incidence of encrypted crimes on a global scale.

Background: Preemptive analgesia is a method of administration of drugs prior to surgery involving blocking noxious stimuli across the perioperative period. It involves blocking the pain pathway preemptively before injury-induced hypersensitivity manifests. Objective: To compare the analgesic efficacy of duloxetine with pregabalin as preemptive analgesic in lumbar spine surgeries. Design: Randomised, double-blinded, prospective study. Methods: Fifty patients of both sexes between 18-55yrs undergoing elective lumbar spine surgery were randomly allocated into two groups, group P and group D of twenty-five patients each. Group P received 75 mg pregabalin once daily for three days, followed by 150 mg pregabalin daily for the next four days till the day of surgery. Group D received 20 mg duloxetine once daily for three days, followed by 40 mg duloxetine twice daily for the next four days till the day of surgery. Outcome Measure: Both the groups were primarily evaluated in terms of time for request of 1st rescue analgesic and total intraoperative analgesic requirement in terms of fentanyl boluses required; among other parameters. Results: The time for request of 1st rescue analgesic postoperatively was significantly longer in the pregabalin group (396 ± 267.77 min) than in the duloxetine group (218.4 ± 96.9 min), P = 0.003. Pregabalin recipients required considerably less rescue analgesics in terms of dosage, P = 0.006. Also, pregabalin exhibited better postoperative pain control than duloxetine as reflected by NRS comparative scores. No statistical difference was appreciated in terms of intraoperative fentanyl requirement, intraoperative hemodynamic control; nausea and sleepiness. Conclusion: Pregabalin is more efficacious as a preemptive analgesic than duloxetine in lumbar spine surgery.

One of the main issues confronting humanity in the twenty-first century is the lack of potable water availability. Around half of the world’s consumers face drinking water scarcity. Industrially rich areas have a high population and high-water contamination risk factors. Modern technologies that are quite effective for water purification, present economical limitations that impede their usefulness in developing countries. Conventional methods involving low energy, low chemical demand, and prevention of water-borne disease are therefore significant for water purification in developing countries like Pakistan. These limitations have led to improvising the conventional method for facile water purification. Herein we report the water purification assembly based on allow sand filtration; involving the raw materials grass, clay, sand, silt, pebbles, gravel and coal/ fly ash carbon to obtain clean and quality-controlled water treatment. Ground water samples collected from various areas of Sargodha city were subjected to the developed design Hybrid Multi-Layer Slow Sand Filter (HMLSSF). Based on pre- and post-treatment water analysis, it was determined that the filtration assembly was quite effective at reducing pH, turbidity, dissolved and suspended solids, hardness, and heavy metals percent removal by 87%, 77.7%, 91.3%, 95.4%, 84.4%, and to promising levels, respectively. Moreover, 99 % biological contamination such as total coliform was also removed by this method.

TWBs are being well formed by a simple, highly innovative method known as Incremental Sheet Forming (ISF). Both aluminum and steel sheets welded through friction stir welding (FSW), laser beam welding (LBW) or electron beam welding (EBW) have been explored, extensively, by researchers. However, no research is available on the formability characterization of selected steel sheets having thickness and strength differential, manually welded using Tungsten Inert Gas (TIG) welding technique and formed through Single Point Incremental Forming (SPIF). The same is addressed in this study. Variable wall angle truncated pyramid was used as test geometry. Tensile testing, microhardness and scanning electron microscope (SEM)/Energy Dispersive X-ray (EDX) analysis were performed before forming. Material selected for the study included deep drawing quality (DDQ) steel (DC06) and stainless steel (SS) (AISI 201). Because of huge difference in both strength and hardness values of DDQ steel and SS, low formability was achieved in case of strength differential with minimum and maximum forming depths of 1.8 mm and 3.6 mm, respectively. Whereas formability achieved in case of thickness differential was quite high with minimum and maximum values of forming depths of 27.8 mm and 36.6 mm, respectively since strength and hardness values were not varied much. Percentage thinning was used to assess formability achieved. Final thicknesses achieved during forming were verified by cosine law also. Research investigations may be applied in similar fashion for precise study of material characterization of various kinds of TWBs being used in multiple industries including automotive, vessel, medical, etc.

Smart agro-practices over the years have revolutionized the agriculture sector and promoted the concept of sustainable agriculture. One such practice is use of agro-waste biochar in agricultural, environmental, and climatic operations. The viability of using a biochar-based nanocomposite as a support fertilizer for the gradual release of nitrogen, potassium, and phosphorus in various media is examined in this study. The banana peel biochar (BPBC) and its nanocomposite (BNF) were prepared using a simple yet comprehensive chemical process. Synthesized materials were evaluated using FT-IR and SEM/EDX. Physical attributes as well as fertilizer basic characteristics were determined and prepared nanocomposite demonstrated noticeably better water absorbance ratio (68%), equilibrium water content (78.97%), and swelling ratio (3.64 g g−1) than biochar, which is advantageous for preserving soil water levels. The salt index values (0.087mmhos/cc) of the created nanocomposite performed better when compared to the conventional fertilizers due to their safer application. Long-term availability of all doped minerals to the plants, during experimental cycle, was revealed by slow-release nutrient studies in water and soil, which is ideal for promoting germination and growth. The findings of this research revealed that prepared BNF showed improved germination parameters i.e., time for 50% germination (3.4, 3.3, 4.4 days), germination index (3.1, 3.5, 2.4), final germination percentage (91.7, 100, 83.3%), mean germination time (4.0, 3.9, 4.9 days), for cucumber, broccoli and okra, respectively. In addition to that the prepared BNF facilitated enhanced shoot and root length in all the three vegetables as compared to conventional fertilizers. The dose optimization studies depicted that best results of germination as well as plant growth parameters are facilitated by BNF (37.5 kg/ha) owing to enhancement in soil quality by supplying additional organic matter in addition to provision of nutrients on slow-release.

Background: Craniosynostosis has a prevalence of 1 in 2000 to 2500 live births. We report on a case of craniosynostosis managed surgically. Method: A 2-year old male, case of craniosynostosis which presented to Ziauddin Hospital North Nazimabad OPD. This child had a history of multiple falls since the past 4 months for which sutures were required twice. His head circumference was above 95 percentile for his age. He was diagnosed as a case of trigonocephaly based on the findings of the 3D CT scan. He underwent surgical remodelling Result: Patient was discharged after an unremarkable post-operative period.

Abstract The GUSTO clinical trial (Gene expression subtypes of Urothelial carcinoma: Stratified Treatment and Oncological outcomes) uses molecular subtypes to guide neoadjuvant therapies in participants with muscle‐invasive bladder cancer (MIBC). Before commencing the GUSTO trial, we needed to determine the reliability of a commercial subtyping platform (Decipher Bladder; Veracyte) when performed in an external trial laboratory as this has not been done previously. Here, we report our pre‐trial verification of the TCGA molecular subtyping model using gene expression profiling. Formalin‐fixed paraffin‐embedded tissue blocks of MIBC were used for gene expression subtyping by gene expression microarrays. Intra‐ and inter‐laboratory technical reproducibilities, together with quality control of laboratory and bioinformatics processes, were assessed. Eighteen samples underwent analysis. RNA of sufficient quality and quantity was successfully extracted from all samples. All subtypes were represented in the cohort. Each sample was subtyped twice in our laboratory and once in a separate reference laboratory. No clinically significant discordance in subtype occurred between intra‐ or inter‐laboratory replicates. Examination of sample histopathology showed variability of morphological appearances within and between subtypes. Overall, these results show that molecular subtyping by gene expression profiling is reproducible, robust and suitable for use in the GUSTO clinical trial.

Introduction: In renal transplantation, donor hepatitis C virus (HCV) status is crucial to consider when selecting a recipient given the high likelihood of transmission. We analyzed the effect of donor HCV status on post-renal transplant rejection and virologic infectious outcomes using electronic health record data from multiple US health care organizations. Methods: Using real world data from electronic health records of renal transplant recipients, a propensity score-matched case-control study of one-year renal transplant outcomes was conducted on cohorts of HCV-negative recipients who received an organ from an HCV-positive donor (HCV D+/R-) versus from an HCV-negative donor (HCV D-/R-). Donor HCV positivity was defined as new recipient HCV positivity within 30 days post-transplant. Cohorts were matched by major risk factors for rejection including age, gender, race, etiologies of end-stage renal disease, dialysis dependence, donor type, induction immunosuppression, and virologic lab studies. The primary outcome was one-year incidence of rejection. Secondary outcomes included longitudinal measures of liver and kidney function, incidence of non-HCV viremia, and DAA treatment pathways and responses. Results: Data from 900 renal transplant recipients were analyzed, 450 subjects per group (D+/R-, D-/R-). Mean age at transplant was 57.1 ± 11.9 years, 60 % were male, and 38 % were African American. Kaplan-Meier analysis showed a significantly increased incidence of one-year rejection for HCV D-/R- compared to HCV D+/R- (16.6% vs 22.8 %, p = 0.02). This difference did not persist on a sub-analysis excluding subjects with delayed graft function (DGF) (16.3% vs 19.2 %, p = 0.25). Although mean eGFR was initially higher in HCV D+/R-, there were no significant differences in liver or kidney allograft function at 12 months. There was no significant difference for composite viremia (CMV/EBV/BK; 37.66% vs 31.60 %, p = 0.07). The most common DAA regimen was glecaprevir/pibrentasvir (52.8 %). DAA treatment responses were excellent, with most subjects having a negative viral load by 90 days (mean: 1.7 ± 1.9 log units/mL). Conclusion: Donor HCV positivity did not negatively impact one-year rejection outcomes post-renal transplantation. Importantly, this effect was not biased by age. Anti-HCV treatment was effective and liver and kidney function were excellent at one-year post-transplant. These data support the continued expansion of the donor pool by utilizing organs from HCV-positive donors in the era of anti-HCV direct-acting antiviral therapies.

Abstract Background Maintaining the quality of life is the main objective of managing type 2 diabetes (T2DM) (QoL). Since it is a key factor in patient motivation and adherence, treatment-related QoL has always been considered when choosing glucose-lowering medicines. The objective of the study was to evaluate the quality of life besides glycemic control among type 2 diabetes mellitus patients receiving Treviamet® & Treviamet XR® (Sitagliptin with Metformin) in routine care. Methods It was a prospective, open-label, non-randomized clinical trial including T2DM patients uncontrolled on Metformin therapy. All patients received Treviamet® & Treviamet XR® for six months. Sequential changes in QoL, fasting plasma glucose, HbA1c, body weight, and blood pressure were monitored from baseline to 3 consecutive follow-up visits. The frequency of adverse events (AEs) was also noted throughout the study. Results A total of 504 patients were screened; 188 completed all three follow-ups. The mean QoL score significantly declined from 57.09% at baseline to 33.64% at the 3rd follow-up visit (p

This comprehensive article explores the massive MIMO (M-MIMO) design and its associated concepts, focusing on the seamless integration requirements for Beyond 5G (B5G) and 6G networks. Addressing critical aspects such as RF chain reduction, pilot contamination, cell-free MIMO, and security considerations, this article delves into the intricacies of M-MIMO in the evolving landscape of B5G. Moreover, the emerging MIMO concepts in this article include AI-enabled M-MIMO three-dimensional beamforming, reconfigurable intelligent surfaces, visible light communication, and THz spectrum utilization. This review highlights the challenges and open research issues, including Narrow Aperture Antenna Nodes, Plasmonic Antenna Arrays, Integrated Sensing with M-MIMO, and the application of federated learning in M-MIMO systems. By examining these cutting-edge developments, this article aims to advance knowledge in the field and inspire future research directions in the exciting realm of B5G and 6G networks.

[This corrects the article DOI: 10.1371/journal.pone.0293477.].

Background: Readily accessible to the public, community pharmacies (CPs) were placed under increased pressure during the COVID-19 pandemic. In England, dispensing volume increased by 25% between February and March 2020. This followed a decade of stagnant government funding, which has been attributed to CP closures. If another pandemic emerged, the reduced number of CPs may face increased pressures. Objective: To explore CP service provision in England throughout the COVID-19 pandemic from the perspectives of providers and policy makers, including what can be learned in preparation for any future pandemic. Methods: CP providers (n = 10) and policy makers (n = 6) were interviewed via telephone between June and September 2021. Interviews were transcribed and then analysed thematically using NVivo. Results: Pandemic specific pressures were identified, as well as long-term issues which preceded the pandemic. Increased workload was recognised by both providers and policy makers due to changes in prescribing habits and was exacerbated by staff shortages. CP staff safety was a major concern, with limited personal protective equipment provided despite being open to the public. General Practitioner (GP) surgeries received more protective equipment than CP and still referred patients to pharmacy e.g., for a blood pressure check. Conclusions: The pandemic re-confirmed CPs role of providing accessible healthcare, particularly medicines provision, but also highlighted the demand for in-person clinical services. Improved communication channels between CP and GP surgeries are required, as is pandemic prescribing guidance to ensure appropriate prescribing to safeguard the medicines supply chain. To ensure the health of all providers is fairly protected, activities which require in-person contact or can be undertaken remotely by CP, GP surgeries and other providers should be reviewed. For pandemic preparation, legislative changes are required which empower pharmacy to fully contribute to patient care. A review of pharmacy funding and staffing is also needed to ensure services are sustainable.

Against the backdrop of global warming and increased rainfall, the hazards and potential risks of landslides are increasing. The rapid generation of a landslide inventory is of great significance for landslide disaster prevention and reduction. Deep learning has been widely applied in landslide identification due to its advantages in terms of its deeper model structure, high efficiency, and high accuracy. This article first provides an overview of deep learning technology and its basic principles, as well as the current status of landslide remote sensing databases. Then, classic landslide deep learning recognition models such as AlexNet, ResNet, YOLO, Mask R-CNN, U-Net, Transformer, EfficientNet, DeeplabV3+ and PSPNet were introduced, and the advantages and limitations of each model were extensively analyzed. Finally, the current constraints of deep learning in landslide identification were summarized, and the development direction of deep learning in landslide identification was analyzed. The purpose of this article is to promote the in-depth development of landslide identification research in order to provide academic references for the prevention and mitigation of landslide disasters and post-disaster rescue work. The research results indicate that deep learning methods have the characteristics of high efficiency and accuracy in automatic landslide recognition, and more attention should be paid to the development of emerging deep learning models in landslide recognition in the future.

OBJECTIVES To study the prevalence of polycystic ovary syndrome, its associated conditions and complications in the low socio-economic population of Sikandrabad, Karachi. METHODOLOGY This cross-sectional study was conducted in a primary health care centre of Ziauddin University, Sikandrabad-Karachi, Pakistan, from January-June 2021. The ethical committee of the university approved this study. All female patients with gynaecological complaints having an age between 18 to 49 years were included. Females with a history of unilateral oophorectomy, uterine abnormality and abnormal karyotype or known malignancies were excluded from the study. A sample size of 118 was calculated using open-epi software. A performed questionnaire was used to collect data from females with gynaecological complaints. PCOS was diagnosed using Rotterdam criteria. Routine examination tests were done at the Primary Health Care Clinic (PHCC) of Ziauddin Hospital, and obesity was labelled through BMI calculation. RESULTS Of 118 females in the reproductive age group screened, 55.93% reported PCOS as a major gynaecological problem, followed by endometriosis at 16.94%, uterine fibroid at 14.46% and urinary tract infections at 9.32% respectively. Patients had infertility as a major complaint, with 54.54% cases followed by menstrual abnormalities at 21.21%, obesity at 16.66% and others at 7.57%. Most patients (38%) were obese, and 34% were overweight. CONCLUSION PCOS is a prevalent complicated endocrine disorder in women in the reproductive age group, and it presents with varying gynaecological complications like infertility, menstrual disturbances, hirsutism, and acne. Obesity, hormonal imbalance and poor dietary intake affect the disease outcomes further. More multi-centred studies are needed to know the exact prevalence and causal relations.

The proposed framework aims to prevent global crimes, specifically terrorist attacks, bomb blasts, and drone attacks, by using the Suspicious Cryptographic Message Detection (SCMD) system to detect and decrypt suspicious messages. Terrorists often use encrypted messages to communicate with their teammates in different parts of the world, making it difficult for authorities to monitor their activities. The framework addresses this issue by detecting with gradient boosting algorithm and cryptanalyzing by using Simple Substitution Cipher techniques to decrypt suspicious messages and predict potential criminal activity. The framework utilizes various emerging trends in information technology, including machine learning techniques, pre-defined decision rules, wordnet, and semantic web ontology, to predict the type of crime, the criminal's name and location, and other criminal details. It comprises multiple components, including Semantic web Ontology, Suspicious Database, and machine learning techniques, to facilitate the detection and reporting of criminal activity. When the server receives a suspicious encrypted message, the framework detect and decrypts it and predicts the type of crime based on microblogs before it can be executed by the criminals. The details of the criminals are then alerted to the cybercrime department, reducing the burden on security departments and enhancing public safety. In summary, the framework provides a comprehensive solution to the challenges posed by encrypted messages in criminal activities. It uses advanced technologies to identify and predict potential criminal activities, enabling law enforcement agencies to take preemptive actions to prevent major and minor attacks, including terrorist attacks.

Background: Due to widespread availability, low cost, safety, and little side effects, herbal medications are now more often used than ever before. Medicinal plants with various pharmacological effects may be found in a variety of places in nature. An herbaceous, perennial tropical plant known as Maranta arundinacea L. offers a number of built-in medical benefits, including efficacy as an antioxidant and an antibacterial. Objectives: This plant's rhizome extracts were tested for phytochemical analysis, antioxidant capacity and antibacterial efficacy against some Gram-negative bacteria. Methodology: In the current work, phytochemical analysis of M. arundinacea rhizome’s various extracts was done by standard methods and its free radicals scavenge activity was assessed by using the well-known (in-vitro) model of DPPH while antibacterial activity was estimated by the disc diffusion method. Results: Phenols, flavonoids, saponins, tannins, alkaloids, glycosides and steroids were found in the M. arundinacea rhizome extracts after a preliminary phytochemical screening, which may be the source of the plant's antioxidant and antibacterial action. The percentage inhibition (DPPH) of its water extract (80.11±3.2%) was higher than methanol extract (70.20±2.5%) followed by chloroform (37.50±1.8%) and petroleum ether extract (20.40±1.4%) at concentration 1mg/ml. The minimum inhibition zone developed against Enterobacter aerogene was (16±0.01mm), Salmonella typhimurium (19±0.03mm), Pseudomonas aeruginosa (18±0.02mm) and Escherichia coli (24±0.04mm), in methanolic extract, while the inhibition zone developed against E. aerogene was (18.5±0.02mm), S. typhimurium (19.5±0.03mm), P. aeruginosa (20±0.03mm) and E. coli (29±0.05mm), in water extract and no inhibition zone was developed in petroleum ether and chloroform extract. Conclusion: It was concluded that M. arundinacea rhizome water and methanol extracts posses a strong antioxidant and antibacterial activity due to its phytochemicals which may offer an option for the treatment of illnesses linked to oxidative stress and for pathogens that are resistant to a number of drugs.

The outright aim of Beyond Fifth Generation (B5G) communication is to bring a revolution in Quality of Service (QoS) through enhanced Mobile Broadband (eMBB), Ultra-Reliable Low Latency Communication (URLLC), and massive Machine Type Communication (mMTC). Thereby, due to this massive expansion in the communication paradigm, interference is bound to surface unexpected challenges in the wireless domain. Thus, interference mitigation is a foundational aim in the research paraphernalia of B5G communication. Presently, Software Defined Networking (SDN) is emerging to empower wireless communication with centralized routing-based interference mitigation. With this premise, we aim to present a focused review on SDN-based interference mitigation in wireless communication. Initially, we discuss current research horizon in the subject domain and briefly explore literature for routing-based interference mitigation. Thereby, we analyze the potential of SDN through evaluation of existing solutions for interference mitigation in B5G communication. We conclude our survey by highlighting prominent future research directions in SDN-based interference mitigation.

Ti6Al4V is regarded as the “workhorse” in aerospace industry for its wide applications at high temperatures. Unique attributes are high strength to density ratio and outstanding material properties at high thermal conditions. This present-day work involves the pre-slotting on Ti6Al4V surface with the help of fibre Laser, followed by the operation of micro-milling on respective Laser engraved slots. Localized melting due to Laser ablation leads to the decrease in the surface contact between milling tool and material surface. Micro-milling in return helps to remove the Heat affected zones (HAZ) created during Laser engraving process. ANOVA helps to point out the contributing factors for burr width and height on both milling sides. Main effect plots generated during process optimization, help to point out optimal combination of input parameters for minimized burr width and height. Higher frequency of Laser helps to generate consistent slots. Lower rotational speeds are responsible for high values of burr width and height. Whereas high rotational speed leads to efficient chip removal, resulting in decreased burr width and height.

Background: It is emphasized in medical education that assessment drives learning. In 2020, during the first COVID-19 lockdown, University College of Medicine and Dentistry made a shift towards Computer Based Assessments (CBAs) in order to facilitate learning. Objective: To determine undergraduate medical student’s perception for computer based assessment environment in medical school Methods: The cross-sectional descriptive study was conducted at the University of Lahore, Pakistan, from May 2022 to September 2022, and included undergraduate medical students who were requested to complete the Assessment Environment Questionnaire. Students' individual perception scores were calculated and the means of individual domains and global scores were compared in different academic years. SPSS version 23 was used for statistical analysis. Results: Of 574 participants, 20% of the participants were from 1st year, 20.7% were from second year, 20% from 3rd year, 19.9% from 4thyear and 19.3% from final year. Generally, the students perceived their assessment environment positive resulting in a global mean score of 67.6±13.7 out of the maximum 80. First year students scored significantly higher (P

Since African Swine Fever (ASF) was detected in the Dominican Republic in July 2021, it has negatively impacted the country’s swine industry. Assessing the epidemiological situation is crucial to helping local authorities and industry stakeholders control the disease. Here, data on 155 reported outbreaks in the Dominican Republic from November 2022 to June 2023 were evaluated. Descriptive spatiotemporal analysis was performed to characterize disease distribution and spread, and between-herd R0 was calculated for the study period. The Knox test and a space–time permutation model were used to evaluate clustering. Data on clinical presentation, biosecurity measures, and suspected reasons for introduction were categorized and summarized. The majority (78%) of outbreaks occurred on backyard farms which generally had low biosecurity. Across farm types, the majority of pigs were still alive at the time of depopulation. Spatiotemporal findings and R0 estimates suggest an endemic pattern of disease geographically located centrally within the country. Clustering was detected even at small temporal and spatial distances due to outbreaks amongst neighboring backyard farms. These results provide critical information on the current state of the ASF epidemic in the Dominican Republic and will aid government officials and swine industry leaders in developing effective ASF control strategies.

Background and Objective: The essential goal of any medical school is to train medical graduates to work as independent clinicians. Inadequately prepared doctors put the well-being of patients at a great risk. The objective of the study was to evaluate the preparedness for independent clinical practice of house officers who graduated from medical schools with the traditional discipline-based curriculum, from both public and private sectors, and with high and low merit.Methods: A quantitative correlational study was conducted by using an already validated questionnaire. A total of 241 house officers who graduated from public and private sector medical schools from Lahore, Pakistan, with high and relatively low merit, were selected. The data from the filled responses were analyzed by using Statistical Package for the Social Sciences version 25.0Results: Of the 241 respondents, 152 (55.3%) were females and 89 (32.4%) were males. The mean age of the respondents was 24.19 ± 0.91 years. The difference in mean score between the public and private sectors was significant in the subscales of clinical skills, procedural skills, and patient management. Analysis of free-text responses showed a deficiency in procedural skills, communication skills, time management, and management of acutely ill patients in the emergency department in both classes of medical schools. Many graduates suggested early clinical exposure with hands-on training and the addition of modules of ethics and medical laws in the curriculum.Conclusion: The medical graduates lack pertinent training in professionalism, ethics, medical laws, and communication skills which may hamper their appropriate preparedness before dealing directly with the high turnover of patients during house jobs.

Urease enzyme is an infectious factor that provokes the growth and colonization of virulence pathogenic bacteria in humans. To overcome the deleterious effects of bacterial infections, inhibition of urease enzyme is one of the promising approaches. The current study is designed to synthesize new 1,2-benzothiazine-N-arylacetamide derivatives 5(a-n) that can effectively provide a new drug candidate to avoid bacterial infections by urease inhibition. After structural elucidation by FT-IR, proton and carbon-13 NMR and mass spectroscopy, the synthesized compounds 5(a-n) were investigated to evaluate their inhibitory potential against urease enzyme. In vitro analysis against positive control of thiourea indicated that all the synthesized compounds have strong inhibitory strengths as compared to the reference drug. Compound 5k, being the most potent inhibitor, strongly inhibited the urease enzymes and revealed an IC50 value of 9.8 ± 0.023 µM when compared with the IC50 of thiourea (22.3 ± 0.031 µM)—a far more robust inhibitory potential. Docking studies of 5k within the urease active site revealed various significant interactions such as H-bond, π-alkyl with amino acid residues like Val744, Lys716, Ala16, Glu7452, Ala37 and Asp730.

Abstract Background The population-based serosurveys are essential for estimating Coronavirus Disease-19 (COVID-19) burden and monitoring the progression of this pandemic. We aimed to assess the seroprevalence of SARS-CoV-2 antibodies and potential predictors of seropositivity in the Pakistani population. Methodology This population-based seroprevalence study includes consenting subjects from the workplaces (factories, corporates, restaurants, media houses, schools, banks, and hospitals) located in the urban areas of Karachi, Lahore, Multan, Peshawar, and Quetta. We analyzed each subject's serum sample for SARS-CoV-2-IgM and/or IgG antibodies using UNIPER IgG/IgM Rapid COVID-19 Testing Kit. The subject's demographics, exposure history, and symptoms experienced (in last 7 days) were also obtained. The collected data was analyzed using SPSS version 22.0. Results The overall seroprevalence of SARS-CoV-2 antibodies was 16.0% (2810/17,764). The total antibody seropositivity was higher in males than females (OR 1.22, 95% CI 1.110–1.340). The symptomatic subjects had 2.18 times higher odds of IgG seropositivity while 1.2 times for IgM seropositivity than the asymptomatic subjects. The multivariable logistic regression model showed that the odds of SARS-CoV-2 total antibody seroprevalence were affected by the number of dependents (OR = 1.077; 95% CI 1.054–1.099), apparent symptomology (OR = 1.288; 95% CI 1.011–1.643), close unprotected contact with a confirmed or probable case of COVID-19 (OR 2.470; 95% CI 2.164–2.819), traveling history (last 14 days) (OR = 1.537; 95% CI 1.234–1.914) and proximity with someone who traveled (OR = 1.534; 95% CI 1.241–1.896). Conclusion We found a reasonable seroprevalence of SARS-CoV-2 antibodies in the studied population. Several factors like the number of dependents, apparent symptoms, close unprotected contact with a confirmed or probable case of COVID-19, traveling history, and proximity with someone who traveled are associated with increased odds of SARS-CoV-2 antibody seropositivity.

Introduction: In COVID-19 pandemic, whole of the medical education faced a paradigm shift. Majority of the medical schools shifted their academics online but fair conduction of assessments was still in question. Around the world, many techniques were applied and one was followed at University Medical and Dental College, Lahore (UCMD). Aims & Objectives: To assess the perception of students about modified version of OSPE (displayed on multimedia) so that to implement the same protocol in future by meeting the SOPs without affecting the academics. Place and duration of study: The study was carried out at UCMD, Lahore in year 2021 and was of 6 months duration. Material & Methods:150 students each from first and second year MBBS classes participated in this study. After following the strict SOPs of COVID-19, the students were settled in an auditorium and OSPE was displayed on multimedia screen instead of moving from one station to another as done previously. Feedback was taken from the students after the exam. Results: Response from the students was recorded and percentages were calculated which showed that majority of the students appreciated this modified version of OSPE. Conclusion: This study proved that modified Anatomy OSPE was an effective tool to grade the students without academic disturbance which was imminent in global pandemic and this method can be adapted henceforward.

With a longitudinal (2020–2021) completion, a set of 300 urine samples of individuals suspected of UTI was characterized based on the biochemical analysis and Kirby Bauer's disc diffusion method. Throughout, a total of 167 samples revealed UTI positivity by obtaining bacterial growth. Reporting that E. coli (69.4 %) was the most dominant when compared with Klebsiella (14.3 %), Proteus (5.9 %), S. aureus (4.7 %), P. aeruginosa (3.5 %), and Enterobacter (1.7 %), respectively. Gender-wise discrimination showed that E. coli was highly distributed among female (50.2 %) patients. A prominent percentage of E. coli (41.9 %) was found in the age group between 21-40 years. Isolates of E. coli represented the highest degree of resistance to Amoxicillin and Ceftriaxone (85.3 %), while highly sensitive to Amikacin, and Tazobactam (94.8 %). S. aureus was found highly resistant to Amoxicillin, Levofloxacin, Sulbactam, and Doxycycline (75 %), while highly sensitive to Meropenem, and Cefotaxime (100 %). Proteus spp. was found highly resistant to Sulbactam, and Cefotaxime (100 %), while highly sensitive to Tazobactam (100 %). Enterobacter was found highly resistant to Gentamicin (100 %), while highly sensitive to Aztreonam (100 %). Klebsiella was found highly resistant to Levofloxacin, and Doxycycline (91.6 %), while highly sensitive to Amikacin, Tazobactam, Gentamicin, and Cefoxitin (75 %). P. aeruginosa was found highly resistant to Nalidixic acid (100 %), while highly sensitive to Meropenem, Ceftriaxone, Gentamicin, and Cefotaxime. In conclusion, the Amikacin and Tazobactam were seen to be effective for empirical therapy of UTI.

Introduction: The COVID-19 pandemic influenced education system worldwide. This change was unusual for both students and anatomists. The present study is conducted to perceive online learning experience of 1st& 2nd year MBBS students in a modular system comparing online SGD & lectures with face to face. Objectives: To assess how medical students of 1st and 2nd year MBBS perceive the experience of learning Anatomy online in an integrated modular system, their attitude towards online small group discussions (SGD) and online Interactive lectures by comparing with face-to-face learning anatomy. Place and duration of study: The study was conducted in the Department of Anatomy at University College of Medicine, University of Lahore during academic year of 2021 over a period of six months from March 2021. Material & Methods: This descriptive cross-sectional study was conducted by using a Questionnaire validated by five medical educationists. The sampling was done by nonprobability convenience technique. For a confidence level of 97%, sample size was 197. A total of 202 students from 1st & 2nd year MBBS, were asked to fill in a Questionnaire with Likert scale of 5, anonymously after taking informed consent, regarding online learning Anatomy through Zoom by comparing online SGD and Interactive lectures with face-to-face learning during COVID-19 pandemic. Data was analyzed using SPSS (version 28) software, p value ?0.05 was considered significant. Results: A total of 202 responses were received of which 197 responses were complete. Of which 56 were from 1styear while 141 were from 2nd Year MBBS. Some students did not answer some questions. Percentages were calculated against student responses, for missing data the percentages were calculated from total number of responses to each question answered. p values calculated were not significant but overall students did not prefer online learning over face to face learning. Conclusion: Our present study concludes that learning anatomy online is challenging. Overall students did not value online learning more than face-to-face learning in terms of flexibility, freedom, interaction with teachers, lack of hands-on practice and concepts, although they enjoyed the leisure of self-study with whole study material available to them at any time.

Background: The use of ultrasonography (USG) to identify fascial layers has led to the development of several newer interfascial techniques for analgesia of the chest and abdominal wall. Two such modalities are the Pectoral nerve block (PEC) and Serratus Anterior Plane (SAP) block. Objective: To compare the duration and quality of analgesia provided by ultrasound-guided SAP block with PEC block II in patients undergoing breast surgeries after induction of general anesthesia. Design: Randomized, double-blinded, prospective study. Methods: Sixty female patients were divided into two groups of 30 each. Patients in Group P received USG guided PEC II block, whereas patients in Group S received USG-guided SAP block after induction. Outcome Measure: The primary objective was to compare the duration of pain relief, whereas the secondary objectives were to compare the degree of pain relief, postoperative analgesic requirement within 24 h after the completion of the surgery, patient satisfaction score and complications if any. Results: The mean time of the first dose of analgesic given was 826 ± 405.24 min. in Group P and 1280 ± 264.29 min. in Group S (P < 0.001). The mean numeric rating scale score at rest at 6 h, on movement at 2 h and 6 h and satisfaction scores in Group P were significantly more than Group S. Conclusion: Ultrasound-guided SAP block provides better postoperative analgesia both in quality and duration over PEC II block.

Background: Adhesive capsulitis is a condition that presents with pain and progressive limitation of both active and passive shoulder movements. It can be primary or secondary, the latter includes causes such as rotator cuff tear, cardiovascular disease, and diabetes mellitus. The American Shoulder and Elbow Surgeons defines that adhesive capsulitis is a condition of uncertain ethology characterized by a significant restriction of both active and passive shoulder motions that occur in the absence of known intrinsic shoulder disorder. Commonly described as: Stage 1 – Freezing stage, with pain and stiffness lasting around 9 months. Stage 2 – Frozen stage, with persistent stiffness lasting 4–12 months. Stage 3 – Thawing stage, with spontaneous recovery lasting 12–42 months. Ultrasonography (USG)-guided hydrodissection is used for adhesive capsulitis of the shoulder due to its cost-effectiveness and acceptance among patients. As adhesive capsulitis is postulated as an i nflammatory and fibrotic disease, easy treatment with intra-articular corticosteroids (CSs) injection may reduce synovitis, limit the development of capsular fibrosis, and alter the natural history of disease. CS injections are effective for shorter duration, but newer agents such as platelet-rich plasma (PRP) are more effective with no serious side effects. Materials and Methods: In this study, 40 patients were taken of adhesive capsulitis of the shoulder and were divided randomly into two groups. One group received injection PRP and the other group received injection CS. The outcome was recorded. Results: There was a statistically significant reduction in numeric rating scale pain scores in both the groups over a time period of 6 weeks, but the PRP injection was observed to be better in reducing the pain scores when compared to the CS injection after the 6th week (P = 0.037). Initially, the CS injection performed better in the 1st week due to anti-inflammatory action. By the 3rd week, both the injections showed a similar effect. However, at the end of the study period (6 weeks), there was a better reduction in the Shoulder Pain and Disability Index (SPADI) pain scores (P = 0.0057) and SPADI disability scores (P = 0.029) of the group PRP. Conclusion: We concluded that USG-guided hydrodissection with PRP is more effective therapy than CS in terms of reduction of pain and improvement in shoulder function in the treatment of adhesive capsulitis of shoulder.

In developing and developed countries, neurological diseases contribute to the major reason for morbidity and mortality. The overall burden is 6.5% globally, of which advanced countries contribute 10 to 11%, whereas progressive countries constitute 4 to 5%. The higher ratio in technologically advanced countries might be due to their advanced system providing complete patient data. Some neurological diseases are common and wellestablished, whereas others occur rarely or are poorly ordered. Schizophrenia affects 45 million people, whereas depression affects 340 million globally. The people living with Alzheimer’s constitute 11 to 45 million people, accounting for 1% of the total disease load. 10% Pakistani community suffer from mental disorders, with 1% Alzheimer’s, 5% depression, 2% epilepsy and 1.5% schizophrenia. Medicinal plants play a vital role in treating several neurological disorders. Due to the upsurge in the cost of the available drugs, the local population is dependent on the use of medicinal plants to treat these neurological disorders. Medicinal plants possess a great therapeutic potential and fewer side effects than synthetic drugs. In Pakistan, research on medicinal plants is increasing day by day. The Pakistani population traditionally depends on herbal medications to treat several neurological disorders. The use is more in rural areas due to easy access and costeffectiveness. In Pakistan, there is a stern gap between the availability of neurological care and a trained neurologist. In this scenario, the use of traditional medicinal plants for aiming to treat neurological disorders is obvious.

The current study was designed to analyze nutritional parameters and to characterize carbapenemase producing-Klebsiella pneumoniae isolates from bovine mastitic cow's milk. Out of 700 milk samples K. pneumoniae was identified by phenotypic and molecular techniques along with their antibiogram analysis and nutritional analysis was performed using the procedure of Association of Official Analytical Chemists. Carbapenemase-producing K. pneumoniae was detected by phenotypic CarbaNP test followed by molecular characterization of their associated resistant genes blaVIM, blaKPC, blaOXA-48, blaNDM, and blaIMP along with insertion sequence common region 1 (ISCR1) and integrons (Int1, Int2, and Int3) genes. Among nutritional parameters, fat content was observed (2.99%) followed by protein (2.78%), lactose (4.32%), and total solid (11.34%), respectively. The prevalence of K. pneumoniae among bovine mastitis was found 25.71%. Antibiogram analysis revealed that more effective antibiotics was ceftazidime (80%) followed by amikacin (72%), while highly resistant antibiotics was Fusidic acid (100%). Distribution of carbapenemase producer K. pneumoniae was found 44.4%. Among carbapenem resistant genes blaKPC was found 11.25%, blaVIM 2.75%, blaNDM 17.5%, and blaOXA-48 7.5%, while blaIMP gene was not detected. Furthermore, distribution of ISCR1 was found 40%, while integron 1 was found 61.2% followed by integron 2 (20%), and integron 3 (5%). In conclusion, the recent scenario of carbapenemase resistant K. pneumoniae isolates responsible for mastitis may affect not only the current treatment regime but also possess a serious threat to public health due to its food borne transmission and zoonotic potential.

Objective: To study the frequency, clinical presentation, management and outcome of degloving soft-tissue injuries. Study Design: Case series. Place and Duration of Study: Department of Surgery, Federal General Hospital, Islamabad Pakistan, from Jan 2018 to Dec 2019. Methodology: This study included 28 consecutive patients with degloving injuries. Patients with degloving injuries of the soft tissue were included. Initial assessments of all patients were done according to advanced trauma life support. Regular clinical examination for abnormalities such as excessive local pain that was out of line with the intensity of the trauma, extensive ecchymosis or hematomas, and especially, local and regional hypermobility of the skin, capillary refill and perfusion of the area. Results: Out of 28 patients, there were 25 males (9.28%) and three females (10.72%). The mean age was 33.07±9.04 years with a range of 6-50 years. The thigh was the most frequently involved area by degloving injury (25.00%). The back was involved in 17.85% of patients. Leg (10.71%) and foot (10.71%) were involved in 21.42% of patients. From the management point of view, 42.85% of patients had some form of debridement and healing by secondary intention, 17.85% patients were managed conservatively, and 10.71 % of the patients' primary closure was successful. Conclusion: Degloving soft-tissue injury is debilitating and, if not taken care may lead to ischemia necrosis, infection and septicemia of the tissues, which needs extensive debridement, prolonged use of broad-spectrum antibiotics, which result in disability and protracted course of rehabilitation.

Received: 2020/5/3 | Accepted: 2020/11/7The story ofSulaymān and the Queen of Sheba has been narrated in the Noble Qur’an and the Old Testament as one of the profound stories among the thinkers. From the comparison of these two narrations, it is concluded that although both scriptures have recognized the ultimate purpose of the Queen of Sheba was understanding the wisdom of Sulaymān and have confirmed the historical existence of Prophet Sulaymān and the story in terms of establishing social and human relations, lineage, knowledge, and wisdom of Sulaymān and so on, they are different with respect to the quantity and quality of narrating many aspects such as calling Bilqis’ throne, bringing an account by the Hoopoe Bird (Hud Hud), passing the glass surface by Bilqis and so on quoted in the Noble Qur’an with educational purposes whereas they have not been mentioned in the Old Testament. Besides, there are fundamental differences between the reporting method in these two scriptures in issues such as position (kingdom or prophethood), infallibility of Sulaymān from the beginning until the end of his reign, highlighting the process of converting to Islam and the promotion of the Queen of Sheba from idolatry to Tawhid (monotheism) and so on such that the most basic differences between these two narrations refer to their different approach and explanation (in terms of being for guidance or entertainment). Therefore, the comparative display of the differences and similarities as well as the the analysis of this visit in terms of method, structure, and content using a descriptive-analytical approach is considered the main innovative purpose of the present article.

Abstract A multi-layered chiral device manifesting asymmetric transmission (AT) facilitating one-way channeling of electromagnetic (EM) waves, based on the inherent polarization is presented. The designed metasurface depicts a high transmission contrast with an efficiency above 80% for an ultra-wide operational range of 6.3–12.3 GHz, constituting a fractional bandwidth of 64%. As an additional feature, the reported metasurface yields robustness against oblique incidences up to 45 $$^\circ $$ ∘ while maintaining high transmission efficiency. This report also introduces a unique analogy of the AT based communication system with logic-gates by formulating its truth-table and logic circuit. Furthermore, new insights of AT magnitude’s dependence to oblique incidences are presented on the account of surface impedance mismatch due to TE and TM polarization with varying incidence angle. Moreover, avoidance of grating lobes and the associated transmission deterioration through utilization of electrically small periodic metasurface is presented. The results have been numerically and practically validated yielding state-of-the-art features. Operating within C and X band, the reported work is an ideal candidate for practical AT applications.

COVID-19 has yielded serious consequences globally, including severe damages to the economic, social, and health sectors around the world. The ensuing global crisis has made states realize that Non-Traditional Security (NTS) threats such as pandemics and diseases do not discriminate between territorial boundaries. Hence, they cannot be dealt with in isolation but by creating a mutual ground and impetus for coordination and collaboration within the international system. This research paper outlines the revival of global health diplomacy (GHD) as grounds for reforming multilateral global governance institutions under the umbrella of ‘human security’. In doing so, it lists vital GHD initiatives during COVID-19 by state and non-state actors while highlighting the need for continued collaboration in the post-pandemic recovery phase. Additionally, the present study takes the case of Pakistan, a developing state with extremely fragile health and economic infrastructure, to showcase the importance of humanitarian and developmental assistance in ensuing ‘human security.’

The intensive use of chemical fertilizers in arable farming dramatically increased environmental pollution through anthropogenic ammonia (NH3) and greenhouse gaseous emissions. Therefore, there is a need to develop improved fertilizer management practices that can reduce these losses. An experiment was conducted to assess the mitigating effects of sole or combined application of zeolite with biochar on gaseous emissions from arable land. For this purpose, zeolite (clinoptilolite) was mixed with different doses of biochar (produced from Dalbergia Sissoo wood chips) and applied along with the recommended dose of chemical fertilizer (NPK @ 150, 100, and 60 kg ha–1, respectively) on arable land in years 2013–14 and 2014–15. Immediately after application, these were incorporated into the top 10 cm of the soil layer and wheat was sown. Treatments were as follows: C = control, Z = zeolite @ 5 t ha–1, B1Z = biochar @ 3 t ha–1 + zeolite @ 5 t ha–1, B2Z = biochar @ 6 t ha–1 + zeolite @ 5 t ha–1, and B3Z = biochar @ 9 t ha–1 + zeolite @ 5 t ha–1. The experiment was laid out in a randomized complete block design (RCBD) with three replicates. The experimental plot size was 6 m × 4 m. Randomly, ten soil samples from each plot were taken at a depth of 0–15 cm and mixed to get a composite sample. All the samples were immediately stored in a freezer at −18°C until gaseous analysis in order to prevent N transformations. Each soil sample was analyzed for emission of NH3, CO2, and CH4 by using a selected-ion flow-tube mass spectrometer (SIFT-MS). Co-application of zeolite and biochar reduced NH3 and CH4 emissions by an average of 87 and 58% compared to the control, respectively. However, CO2 emission was increased by 104% relative to the control. The NH3 emission was decreased by an average of 61, 78, 90, and 92% by Z, B1Z, B2Z, and B3Z treatments compared to the control. Similarly, the decrement in CH4 emission was 47, 54, 55, and 65%. In contrast, the increment in CO2 emission was 42, 110, and 160% for B1Z, B2Z, and B3Z, respectively, while interestingly, a reduction of 12% was observed in Z treatment. Besides, co-application of zeolite and biochar at the highest dose (B3Z) improved soil chemical properties such as soil EC, OM, total N, as well as available P and K relative to zeolite alone. It is concluded that the combined application of zeolite and biochar can mitigate NH3 and greenhouse emissions and improve soil chemical characteristics, thus enhancing the environmental worth of arable farming.

Challenges faced in network security have significantly steered the deployment timeline of Fifth Generation (5G) communication at a global level; therefore, research in Sixth Generation (6G) security analysis is profoundly necessitated. The prerogative of this paper is to present a survey on the emerging 6G cellular communication paradigm to highlight symmetry with legacy security concepts along with asymmetric innovative aspects such Artificial Intelligence (AI), Quantum Computing, Federated Learning, etc. We present a taxonomy of the threat model in 6G communication in five security legacy concepts, including Confidentiality, Integrity, Availability, Authentication and Access control (CIA3). We also suggest categorization of threat-countering techniques specific to 6G communication into three types: cryptographic methods, entity attributes and Intrusion Detection System (IDS). Thus, with this premise, we distributed the authentication techniques in eight types, including handover authentication, mutual authentication, physical layer authentication, deniable authentication, token-based authentication, certificate-based authentication, key agreement-based authentication and multi-factor authentication. We specifically suggested a series of future research directions at the conclusive edge of this survey.

Objective: To compare the mean Sound, Eye and Motor (SEM) score of pre cooling and topical application at injection site in pediatric patients. Study Design: A quasi experimental study. Place and Duration of Study: Fatima Jinnah Dental College and Hospital, Karachi, from Sep to Dec 2017. Methodology: Sixty four paediatric patients aged between 8-12 who needed dental anaesthesia were randomly divided into two groups A and B. Subjects in group A were applied topical anaesthesia at the injection site for one minute before needle penetration and in group B ice pack was applied for the same duration at the injection site. A designed questionnaire based on SEM scale was used to measure the patients‟ reaction. Independent-samples t-test was applied to compare the mean SEM score of both groups by taking p-value ≤0.05 as significant. Results: The mean sound, eye and motor (SEM) score was 5.22 ± 1.718 for group A and 3.28 ± 1.373 for group B; with statistically significant differences between both the groups (p≤0.05). Conclusion: Injection of local anaesthesia at a precooled site results in lesser pain and thus decreased child anxiety levels, more effective analgesia and increased patient comfort.

Background: Transversus abdominis plane (TAP) block is a relatively newer block that provides analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall. Aims: To determine the effectiveness of the TAP block over wound infiltration for hernia repair. Settings and Design: Randomized, double-blinded, prospective study in an academic teaching hospital. Methods: Sixty patients were divided into two groups of 30 each. In Group T, patients received ultrasound-guided TAP block for inguinal hernia repair whereas in Group I, local anesthetic infiltration at the wound site was done. Primary outcome measure was pain relief as assessed by a numeric rating scale (NRS) whereas secondary outcome measures were duration (from the time at which TAP block or local anesthetic infiltration is given to the time at which patient first requests for rescue analgesic) of post-operative analgesia, patient satisfaction score, and complications, if any. Results: Mean NRS score at 0hr for a group I was 0.88±0.74 and for group T was 0.68±0.70 with a p-value of 0.28 and the mean NRS score at 24hr for the group I was 4.47±0.66 and for group T was 4.54±0.62 with a p-value of 0.68 but at 2hr, 6hr and 12hr, the NRS was significantly more in group I (p < 0.05). Mean time of 1st analgesic request in group I was 403.73 minutes as compared to group T where it was 711.33 mins (P

Human beings experience every kind of emotion in their everyday lives. Traditionally, emotions are categorized as negative or positive. People, however, tend to escape, disengage from, or avoid the latter type. Emotions are studied from philosophical, biological, and psychological perspectives. On the other hand, al-Rāzī and Ibn Sina are two Muslim scholars who discussed the grief and sorrow disorders in their philosophy. Comparing their works reveals that al-Rāzī applies Plato's moral philosophy, therefore his main focus is on health and well-being. He considers both physical and psychological aspects. In his view, grief and sorrow are unpleasant. Also, the lack of balance in humors and stability of thoughts are the direct causes of raising such strong emotions. Keeping the balance in humors, anti-negativity, and restoration of stability of thoughts are the treatments al-Rāzī suggests in Kitāb al-Ṭibb al-rūḥānī (Book of Spiritual Medicine). Inspired by Aristotle's moral philosophy, Ibn Sina follows the approach of perfectionism. Treating the disorder of grief and sorrow, he goes beyond bodily health issues and admits that moral and psychological treatments are more effective. Apart from the restoration of stability of thoughts and emotions, he is of the opinion that prayers and pilgrimage play a significant role in coping with grief and sorrow.

Abstract Background Metastatic urothelial cancer (UC) is the eighth most common cause of cancer death in the UK. Standard first-line treatment, for most patients, is cytotoxic chemotherapy. Although UC is initially sensitive to chemotherapy, relapse is almost inevitable and outcomes are poor; median overall survival is 8 months. Therefore, there is an urgent need for novel therapies to improve outcomes for this patient group. Methods ATLANTIS is a randomised phase II umbrella-design screening trial of maintenance therapy in biomarker-defined subgroups of patients with advanced UC. The primary end point is progression-free survival, and the study involves over 30 UK cancer centres. Discussion ATLANTIS is the first study in the UK to employ a precision-medicine approach to patients with UC for maintenance treatment. Agents with a positive efficacy signal will proceed to randomised phase III trials to confirm the activity of novel, biologically stratified therapies in UC. Registration ATLANTIS trial EudraCT number 2015–003249-25. ISRCTN25859465.

The aim of this study is to explore social media marketing activities (SMMAs) and their impact on consumer intentions (continuance, participate, and purchase). This study also analyzes the mediating roles of social identification and satisfaction. The participants in this study were experienced users of two social media platforms Facebook and Instagram in Pakistan. A self-administered questionnaire was used to collect data from respondents. We used an online community to invite Facebook and Instagram users to complete the questionnaire in the designated online questionnaire system. Data were collected from 353 respondents, and structural equation modeling (SEM) was used to analyze the data. Results show that SMMAs have a significant impact on the intentions of users. Furthermore, social identification mediates the relationship between social media activities and satisfaction, and satisfaction mediates the relationship between social media activities and the intentions of users. This will help marketers how to attract customers to develop their intentions. This is the first novel study that used SMMAs to address the user intentions with the role of social identification and satisfaction in the context of Pakistan.

Background: COVID-19 has caused significant disruptions in supply chains. It has increased the demand for products and decreased the supply of raw materials. This has interrupted many production processes. The emerging technologies of Industry 4.0 have the potential to streamline supply chains by improving time-sensitive customized solutions during this emergency. Purpose: The study identifies the core technologies of Industry 4.0 and the role and impact of these technologies in managing the disruption caused by the COVID-19 outbreak in strengthening the supply chain resilience. Design/methodology/approach: An extensive literature review using the “Preferred Reporting Items for Systematic Review and Meta-Analysis” method was carried out on the impact of the COVID-19 pandemic on supply chains and Industry 4.0 technologies. The study was undertaken by selecting keywords validated by experts, and a search was conducted in the Scopus, ProQuest, and Google Scholar databases. Publications from the leading journals on these topics were selected. The bibliographical search resulted in 1484 articles, followed by multiple layers of filtering. Finally, the most pertinent articles were selected for review, and a total of 42 articles were analyzed. Findings: The findings of the study showed that the majority of the articles emphasized the digitalization of supply chain management, acknowledging the fundamentals, applications, and prospects, revealing the drivers and challenges of Industry 4.0 technologies to manage disruptions. Most of the authors identified IoT, big data, cloud computing, additive manufacturing, and blockchain to maintain the supply chain resilience. Originality/value: Existing literature on epidemics lacks the basics and practices of utilizing Industry 4.0 technologies in the supply chain recovery process. To fill this research gap, the study summarizes the potential of Industry 4.0 technologies to lessen supply chain disruptions caused by COVID-19. The study findings are valuable for policymakers and practitioners and contribute to supply chain management studies.