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The underrepresentation of non-Europeans in human genetic studies so far has limited the diversity of individuals in genomic datasets and led to reduced medical relevance for a large proportion of the world's population. Population-specific reference genome datasets as well as genome-wide association studies in diverse populations are needed to address this issue. Here we describe the pilot phase of the GenomeAsia 100K Project. This includes a whole-genome sequencing reference dataset from 1,739 individuals of 219 population groups and 64 countries across Asia. We catalogue genetic variation, population structure, disease associations and founder effects. We also explore the use of this dataset in imputation, to facilitate genetic studies in populations across Asia and worldwide.

Objectives: Surgery through a single port may be less painful because access is supplied by 1 intercostal nerve or more painful because multiple instruments are used in 1 port. We analyzed data collected from the video-assisted thoracoscopic surgery group of a randomized controlled trial to compare differences in pain up to 1 year. Methods: Groups were compared in a prespecified exploratory analysis using direct (regression) and indirect comparison (difference with respect to thoracotomy). In-hospital visual analogue scale pain scores were used, and analgesic ratios were calculated. After discharge, pain was evaluated using European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Core 30 scores up to 1 year. Results: From July 2015 to February 2019, we randomized 503 participants. After excluding 50 participants who did not receive lobectomy, surgery was performed using a single port in 42 participants (predominately by a single surgeon), multiple ports in 166 participants, and thoracotomy in 245 participants. No differences were observed in-hospital between single- and multiple-port video-assisted thoracoscopic surgery when modeled using a direct comparison, mean difference of −0.24 (95% CI, −1.06 to 0.58) or indirect comparison, mean difference of −0.33 (−1.16 to 0.51). Mean analgesic ratio (single/multiple port) was 0.75 (0.64 to 0.87) for direct comparison and 0.90 (0.64 to 1.25) for indirect comparison. After discharge, pain for single-port video-assisted thoracoscopic surgery was lower than for multiple-port video-assisted thoracoscopic surgery (first 3 months), and corresponding physical function was higher up to 12 months. Conclusions: There were no consistent differences for in-hospital pain when lobectomy was undertaken using 1 or multiple ports. However, better pain scores and physical function were observed for single-port surgery after discharge.

Objective: To compare the antiemetic effects of Metoclopramide and Ondansetron in female patients undergoing laparoscopic cholecystectomy. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital Rawalpindi, Pakistan, Feb to Jul 2022. Methodology: Female patients aged between 15-80 years, American Society of Anesthesiologists Grade I or II planned for laparoscopic cholecystectomy were included in the study. Using non-probability consecutive sampling technique 66 patients were assigned to two Groups with 33 participants in each Group i.e., Group-A (Metoclopramide) and Group-B (Ondansetron) Group. Patients from Group-A received 10mg Metoclopramide while patients from Group-B received Ondansetron 4mg as a part of premedication. Recorded variables were nausea, vomiting and requirement of antiemetic medication at recovery, during the first 06 hours and during 06-24 hours post-operatively. Results: Mean age of the patients was 44.61±12.74 years. ASA distribution of the patients in our study revealed 28(84.8%) patients from Group-A and 26(78.8%) patients from Group-B belonged to ASA I while 05(15.2%) and 07(21.2%) were from ASA II in Group-A and Group-B respectively. Both Metoclopramide and Ondansetron were effective, however results were significant only for nausea and the requirement of antiemetic medication in post-anesthesia care unit. Conclusion: Metoclopramide and Ondansetron both are effective in reducing nausea and vomiting after laparoscopic cholecystectomy in female patients. Ondansetron is superior to Metoclopramide in the reduction of nausea postoperatively however in case of vomiting there is no significant relationship between the two drugs.

Iran's convoluted geopolitical status, its centrality to locale-specific wars, plus the shifting balance of the global order make cyber security a key issue worldwide in addition to traditional security challenges. Iran is an appealing target for cyber enemies due to its numerous security vulnerabilities, which include ransomware infection, scams, as well as complicated malware. Iran has taken a flexible stance, via collaboration, authorized, and intellectual tactics to counter these concerns. Forming cyber security teams, utilizing the latest innovations, and hiring competent employees are all examples of efforts in cyber defense. Legislative structures are essential for bringing criminals before the law and discouraging unlawful behaviour, but the dynamic nature of cyber threats makes it difficult to update rules. The goal is to keep information security and safety measures under check. The identification and mitigation of cyber dangers necessitate collaboration with various nations, global organizations, and corporations. Iran's cyberspace involvement shapes societal sentiment and upholds the will of the people, with both advantageous and hazardous repercussions. To bolster its application and balance its powerful adversaries, it employs cyber assaults in conjunction with conventional asymmetrical combat strategies. What is Iran's main cyber security concerns and challenges, and how is Iran addressing as well as tackling them, is the question that this study aims to answer.

Abstract Background The electronic transitions between two fine levels depend on the transition probability. The transition probability depends on spectral line strength and oscillator strength. The oscillator strength depends on the number of oscillators and their energies. In this research, we will find the oscillator strengths of hyperfine multiplets of the Tantalum atom. The oscillator strength of hyperfine multiplet investigation aims to enhance our understanding of Tantalum's spectral characteristics. This work provides valuable information in the spectroscopy of material, atomic/molecular, and astrophysics. Result Fourier transform spectra from ultraviolet to far infrared regions have been obtained from TUGRAZ. Fourier transform spectra give the most reliable position of the wavelength of hyperfine multiplets. The Fourier transform spectra of Tantalum contain thousands of Tantalum I and II spectral lines. Each spectral line can be characterized by its upper and lower levels and corresponding angular momenta and hyperfine constants. These properties of the spectral lines were collected from the literature. Hyperfine multiplets for each fine structure were calculated, and they revealed their spectroscopic behavior with high precision. Conclusion In this study, Tantalum's hyperfine multiplet oscillator strength was calculated using advanced computational techniques to address its atomic structure. The fine structure “gf” values were obtained from literature, and intensities of the multiplets were determined. They combined with the gf values to calculate the oscillator strengths of the hyperfine multiplets.

Dependence on the depleting fossil fuels, particularly in the transportation sector, calls for sustainable, green solutions such as electrification, which address the challenges of providing alternate sources of power at low emissions. Electric vehicles are the centerpiece of the transportation electrification sector. Reducing the time for charging from hours to a few minutes gives an extra sheen to the prospect of transportation electrification. However, massive upscaling of the electric power infrastructure is required to accommodate the demands of large-scale transportation electrification. This article explores a sustainable strategy involving distributed energy resources to meet the elevated power and energy demand due to DC fast charging and ultra-fast charging EV load on the electric power distribution network. The mixed integer quadratic optimization model developed ensures seamless integration of the renewable resources, the EV load, and the distribution grid while adhering to the power quality constraints. This paper demonstrates that it is possible to serve a 155 kW aggregated (peak power load) DC fast charging load with a 100 kW interconnect. Similarly for an ultrafast -charging station a peak reduction factor of 9.11 compared to unmanaged charging is achieved at the interconnection point. The methodology is developed, and results are compared against a rule-based system for multiple scenarios. Additionally, validation based on OPAL RT RT-4500 for a sample scenario is presented.

Transient lower esophageal sphincter relaxation (TLESR) is frequently associated with reflux events and terminates with a primary or secondary peristaltic wave. However, it is unclear whether the presence and properties of the refluxate affect TLESR-termination events. The aims of this study were to determine the pattern of terminating esophageal motor activity after TLESR in healthy subjects and factors affecting the type of terminating motor event. Fifteen healthy subjects (7 men, age 18-56) were studied. High-resolution manometry and impedance/pH monitoring were performed simultaneously in supine position for 2 h after subjects took a 1,000-kcal meal (Awake Study). This procedure was repeated during the night under polysomnographic recording for 6-8 h after consuming a 1,000-kcal meal (Sleep Study). We categorized three types of TLESR-terminating motor events, primary peristalsis (PP), full secondary contraction (FSC), which propagated the entire esophagus, and partial secondary contractions (PSC), which started distal to the upper esophageal sphincter. Overall, 289 TLESR events were found. The percentages of TLESR events terminated by PP, FSC, and PSC were 22%, 14%, and 64%, respectively. TLESR events terminated by PP were less likely to be accompanied by reflux events. TLESR events terminated by FSC were significantly more likely to have evidence for proximal esophageal reflux and esophago-pharyngeal reflux. Findings were similar in awake and sleep states. We concluded that, in healthy recumbent subjects, the most common TLESR-termination event is a secondary contraction, rather than PP. Presence and distribution of the refluxate is a major influence on the type of terminating contraction. impedance/pH; lower esophageal sphincter; peristalsis; transient lower esophageal sphincter relaxation

Cytokine storm (CS) refers to the spontaneous dysregulated and hyper-activated inflammatory reaction occurring in various clinical conditions, ranging from microbial infection to end-stage organ failure. Recently the novel coronavirus involved in COVID-19 (Coronavirus disease-19) caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) has been associated with the pathological phenomenon of CS in critically ill patients. Furthermore, critically ill patients suffering from CS are likely to have a grave prognosis and a higher case fatality rate. Pathologically CS is manifested as hyper-immune activation and is clinically manifested as multiple organ failure. An in-depth understanding of the etiology of CS will enable the discovery of not just disease risk factors of CS but also therapeutic approaches to modulate the immune response and improve outcomes in patients with respiratory diseases having CS in the pathogenic pathway. Owing to the grave consequences of CS in various diseases, this phenomenon has attracted the attention of researchers and clinicians throughout the globe. So in the present manuscript, we have attempted to discuss CS and its ramifications in COVID-19 and other respiratory diseases, as well as prospective treatment approaches and biomarkers of the cytokine storm. Furthermore, we have attempted to provide in-depth insight into CS from both a prophylactic and therapeutic point of view. In addition, we have included recent findings of CS in respiratory diseases reported from different parts of the world, which are based on expert opinion, clinical case-control research, experimental research, and a case-controlled cohort approach.

Objective: To compare the efficacy of intravenous phenylephrine infusion versus boluses for blood pressure management in elective caesarean sections. Study Design: Quasi-experimental study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jul 2022. Methodology: Three hundred ninety patients requiring elective caesarean section were divided into an Infusion Group (n=195) and a Bolus Group (n=195). The Infusion Group received phenylephrine with 100 mcg/ml titration immediately after spinal anaesthesia as per weight and height at a 1 ml/minute rate and continued for 5 minutes. Infusion stopped if MAP at 5 minutes was above baseline and restarted if dropped below baseline in subsequent readings. In the case of bradycardia, 600mcg of Glycopyrrolate was administered. Parameters recorded at 1, 5, 10 and 15-minute intervals. In the bolus group, total numbers of 100mcg boluses at the end of fifteen minutes were recorded. Protocol for bradycardia and data record intervals was the same. The primary variables were mean arterial pressure (MAP), heart rate(HR), the total dose of phenylephrine used, and nausea and vomiting. Results: Primary outcome variables showed consistent improvement in maintaining MAP in the Infusion Group versus the Bolus Group (p

Abstract Objective To develop an automated, physiologic metric of immune effector cell‐associated neurotoxicity syndrome among patients undergoing chimeric antigen receptor‐T cell therapy. Methods We conducted a retrospective observational cohort study from 2016 to 2020 at two tertiary care centers among patients receiving chimeric antigen receptor‐T cell therapy with a CD19 or B‐cell maturation antigen ligand. We determined the daily neurotoxicity grade for each patient during EEG monitoring via chart review and extracted clinical variables and outcomes from the electronic health records. Using quantitative EEG features, we developed a machine learning model to detect the presence and severity of neurotoxicity, known as the EEG immune effector cell‐associated neurotoxicity syndrome score. Results The EEG immune effector cell‐associated neurotoxicity syndrome score significantly correlated with the grade of neurotoxicity with a median Spearman's R2 of 0.69 (95% CI of 0.59–0.77). The mean area under receiving operator curve was greater than 0.85 for each binary discrimination level. The score also showed significant correlations with maximum ferritin (R2 0.24, p = 0.008), minimum platelets (R2 –0.29, p = 0.001), and dexamethasone usage (R2 0.42, p