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Krog AH, Sahba M, Pettersen EM, et al. Vasc Health Risk Manag. 2016;12:371–378.On page 371, author list, the author “Syed SS Kazmi” should have read “Syed SH Kazmi”.Read the original article

Abstract This research delves into the environmental and energy implications of incorporating autonomous vehicles (AVs) into urban traffic systems, mainly focusing on emissions and fuel efficiency. The study employed PTV VISSIM simulation software to model a four-leg signalized intersection in Balgat, Ankara, under varying levels of AV integration and driving behaviors. A total of 21 scenarios were simulated, assessing the impact of cautious, normal, aggressive, and platooning AV behaviors on emissions of CO, NOx, and VOCs, as well as fuel consumption, across different traffic signal cycle durations. The results indicate that shorter signal cycle times consistently significantly reduce emissions and fuel consumption, irrespective of AV driving behavior. The most notable improvements were observed in platooning scenarios, attributed to their optimized traffic flow. In contrast, longer cycle times increased emissions and fuel consumption, especially with human-driven and cautious AVs, due to more frequent idling and stop-and-go traffic patterns. This study highlights the importance of refining AV driving algorithms and optimizing signal control systems to reduce environmental impacts and improve fuel efficiency in urban settings, providing crucial insights for advancing sustainable urban mobility and traffic management strategies.

Abstract This study explores the interplay between Self-Determination (SDT), relatedness, and teaching presence and CoI’s presence (teaching, cognitive, and social) in the context of online educational settings within China. Specifically, the study employs the Partial Least Squares Structural Equation Modeling (PLS-SEM) to investigate the interaction between SDT (Self-Determination, relatedness, and competence) and the perceived learning outcomes (autonomy, competence, and perceived learning). The underlying structure of the study’s conceptual framework was analyzed through the measurement model and the discriminant validity assessment. The results show that cognitive presence, social presence, and teaching presence are significantly associated with autonomy, competence, relevance, and perceived learning. Moreover, cognitive presence and social presence can potentially augment cognitive processes, amplifying the mediating role of relatedness between cognitive presence and learning outcomes.

Aims: To examine the features of foreign body ingestion and evaluate the effectiveness of endoscopic therapy for foreign body ingestion in Bangladeshi children. Methods: I retrospectively reviewed the medical records of 97 children diagnosed with foreign body ingestion that required endoscopic removal from 2016 to 2023. Results: The children were aged between 3 months and 15 years, with a mean age of 2.9 ​± ​4.9 years, with more than 80 ​% of the patients being under 5 years of age. Foreign body ingestion was observed at a high frequency (71.1 ​%) in children aged one to five years. Coins (67 ​%) and button batteries (5.2 ​%) were the most common foreign bodies swallowed by kids, and the majority of them were accidental (97.9 ​%). The majority of the foreign bodies were blunt (74.3 ​%), but some were sharp (18.6 ​%). Fifty-six percent of esophageal foreign bodies and 94 ​% of gastric foreign bodies were asymptomatic. Around 80 ​% of button batteries and 77.8 ​% of pointed objects were effectively removed from the body within 24 ​h of ingestion. Similarly, food impaction and blunt objects (98.6 ​% and 100 ​%, respectively) were successfully removed after the 24-h period. Endoscopic removal was successful in 99 ​% of cases, with minimal complications. When button batteries and sharp objects were consumed, the severity of erythema, erosion, bleeding, and ulceration increased along with the length of impaction. Conclusions: Foreign body ingestion is a frequent occurrence in children under the age of five. Coin was the most common foreign body, with the majority of asymptomatic presentations. Prompt identification and timely extraction of swallowed foreign bodies may improve clinical outcomes.

Abstract Background The Neurological Fatigue Index (NFI) is the instrument used to evaluate stroke patients’ fatigue. There was no Urdu version of NFI available officially. Objective This study aimed to translate the Neurological Fatigue Index into Urdu and to determine the validity and reliability of Urdu NFI among stroke patients. Methodology It is a cross-cultural validation study. According to international guidelines in phase I, a process of translation was carried out. In phase II, using the sample of 120 participants, validity and reliability of the Urdu version of the Neurological Fatigue Index scale was conducted. The Urdu version’s content validity, convergent/concurrent validity, test-retest reliability, and internal consistency were determined. The latest version of SPSS was used for the data analysis. Results The Urdu version of NFI was drafted after the expert’s review. The content validity index was used to analyze the content validity. The reliability and validity of the Urdu version NFI were evaluated by calculating Cronbach’s alpha (α = 0.86), and intra-class correlation coefficient (ICC = 0.823). Correlations with other scales were the fatigue Severity Scale (FSS) (r = 0.76), Mental Fatigue Scale (MFS) (r = 0.68), Beck Depression Inventory (BDI) (r = 0.53) and Epworth Sleepiness Scale (ESS) (r = 0.47). Conclusion The Urdu Version was linguistically acceptable for the fatigue assessment in post-stroke patients. It showed good content validity, convergent/concurrent validity, internal consistency, and test-retest reliability.

Background: In 2022, the American Association for Thoracic Surgery (AATS) and the European Society of Thoracic Surgeons (ESTS) published joint guidelines regarding the timing, duration, and choice of agent for perioperative venous thromboembolism prophylaxis for thoracic cancer patients. Now, 1 year after their release, we looked to assess practices and general adherence to these recommendations. Methods: We conducted a survey among board-certified/board-eligible thoracic surgeons in the United States, between July and October 2023. Results: A total of 103 board-certified thoracic surgeons responded to the survey. Over half of the surgeons reported using preoperative chemical thromboprophylaxis routinely for lobectomy/sublobar resections (56.3%), pneumonectomy/extended lung resections (64.1%), and esophagectomy (67%). Over two thirds of thoracic surgeons limited the duration of postoperative chemical thromboprophylaxis to the patient’s length of hospital stay and never administered chemoprophylaxis post-discharge. Among surgeons who always continued chemical thromboprophylaxis post-discharge, low-molecular-weight heparin (LMWH) was the most commonly used agent (>70%), followed by direct oral anticoagulants (13.8%-16.7%). Only 33.3% of surgeons prescribing post-discharge chemical thromboprophylaxis after lobectomy/sublobar resections continued prophylaxis up to 4 weeks postoperatively. Conclusions: Contrary to the 2022 joint AATS/ESTS guidelines, the majority of surveyed thoracic surgeons in the United States do not routinely prescribe postoperative thromboprophylaxis after lung and esophageal cancer resections. The dogma of routine extended thromboprophylaxis must be reevaluated as modern minimally invasive thoracic surgery allows for very earlier ambulation and enhanced recovery. There is a need for randomized controlled trials exploring the utility of extended thromboprophylaxis and newer agents such as direct oral anticoagulants.

Objectives: To investigate the effects of myofascial release technique on pain and quality of life (QoL) in patients with fibromyalgia (FM). Methods: A quasi-experimental study was conducted to investigate the effects of myofascial release technique on patients with FM in Shalamar Hospital Lahore, Pakistan. After initial screening, 28 patients aged 25 to 45 years of both genders meeting the predetermined inclusion criteria were selected using convenience sampling. They were divided into two groups. Group A was treated with myofascial release therapy and passive stretching, while group B was treated with passive stretching alone. The McGill pain questionnaire (MPQ) was used to assess the pain, and the revised FM impact questionnaire (FIQR) was used to evaluate QoL. Results: Out of 28 participants, 11(39.3%) were male and 17(60.7%) were females. Pre- and post-treatment mean scores of pain rating index on MPQ were 46.76±10.47 and 23.79±7.43 for the experimental group and 43.36±12.7 and 30.0±9.89 for the control group, respectively (P>0.05). Mean pre- and post-treatment FIQR scores were 52.9±13.6 and 33.02±13.75 for the experimental group and 57.77±23.04 and 46.59±19.37 for the control group, respectively. The difference in the means of post-treatment scores of the two groups for FIQR was significant (P=0.042). Discussion: Compared with passive stretching alone, the myofascial release method for FM did not demonstrate significant improvement in alleviating pain among such patients. However, it is remarkable that myofascial release therapy unveiled a positive impact by improving the overall QoL for FM patients.

Abstract Background Unplanned admission after surgery at an ambulatory surgery center (ASC) is an established measure of the quality of care and can affect the patient’s experience. Previous studies on this topic are generally dated, focused on a single specialty, or studied 30-day admissions after ambulatory surgery. Few studies have reported admission within 24 h after surgery at an ASC which is a different but important measure of the quality of anesthetic and surgical care. Understanding admissions within 24 h of surgery can identify opportunities for improvement immediately after surgery. Therefore, our study was designed to assess the incidence and risk factors for unplanned hospital admissions within 24 h after surgery performed at a hospital ASC. Methods After Institutional Review Board approval, a retrospective analysis was performed on all adult patients who underwent surgery at a US ASC between January 1, 2016, and December 31, 2022. Data were obtained from the hospital’s electronic medical record. The study sample was divided into two groups: those with an unplanned hospital admission within 24 h after surgery and those without an unplanned hospital admission. To evaluate risk factors for unplanned hospital admissions, univariate analyses with p value

Objective: Although national efforts have aimed to improve the safety of inpatient operations, income-based inequities in surgical outcomes persist, and the evolution of such disparities has not been examined in the contemporary setting. We sought to examine the association of community-level household income with acute outcomes of cardiac procedures over the past decade. Methods: All adult hospitalizations for elective coronary artery bypass grafting/valve operations were tabulated from the 2010-2020 Nationwide Readmissions Database. Patients were stratified into quartiles of income, with records in the 76th to 100th percentile designated as highest and those in the 0 to 25th percentile as lowest. To evaluate the change in adjusted risk of in-hospital mortality, complications, and readmission over the study period, estimates were generated for each income level and year. Results: Of approximately 1,848,755 hospitalizations, 406,216 patients (22.0%) were classified as highest income and 451,988 patients (24.4%) were classified as lowest income. After risk adjustment, lowest income remained associated with greater likelihood of in-hospital mortality (adjusted odds ratio, 1.61, 95% CI, 1.51-1.72), any postoperative complication (adjusted odds ratio, 1.19, CI, 1.15-1.22), and nonelective readmission within 30 days (adjusted odds ratio, 1.07, CI, 1.05-1.10). Overall adjusted risk of mortality, complications, and nonelective readmission decreased for both groups from 2010 to 2020 (P

Background: Recent randomized trials have suggested non-operative management to be a safe alternative to appendectomy for acute uncomplicated appendicitis. Yet, there remains significant variability in treatment approach. This study sought to characterize center-level variation in non-operative management within a national cohort of adults presenting with appendicitis. Methods: The 2016–2020 Nationwide Readmissions Database was queried to identify all adult (≥18 years) hospitalizations for acute uncomplicated appendicitis. Hierarchical, mixed-effects models were developed to ascertain factors linked with non-operative management. Bayesian methodology was applied to predict random effects, which were then used to rank centers by increasing hospital-attributed rate of non-operative management. Institutions with high center-specific rates of non-operative management (>90th percentile) were considered low-operating hospitals (LOH). Results: Of an estimated 447,500 patients, 52,523 (11.7 %) were managed non-operatively. Compared to those undergoing appendectomy, the non-operative cohort was older, more commonly male, and of a higher comorbidity burden. Approximately 30 % in the variability of non-operative management was attributable to hospital effects, with absolute, risk-adjusted rates ranging from 0.5 to 22.5 %. Centers with non-operative management rates ≥90th percentile were considered LOH.Following risk adjustment, among patients undergoing appendectomy, care at LOH was linked with greater odds of postoperative infection, resource utilization, and non-elective readmission. Conclusions: We identified significant interhospital variation in the utilization of non-operative management for acute uncomplicated appendicitis. Further, we found LOH to be associated with inferior outcomes following surgical management. Future work is needed to assess the care pathways that contribute to increased utilization of non-operative strategies, and disseminate best practices across institutions.

Abstract Parkinson’s disease (PD) is a common neurodegenerative disorder with a significant risk proportion driven by genetics. While much progress has been made, most of the heritability remains unknown. This is in-part because previous genetic studies have focused on the contribution of single nucleotide variants. More complex forms of variation, such as structural variants and tandem repeats, are already associated with several synucleinopathies. However, because more sophisticated sequencing methods are usually required to detect these regions, little is understood regarding their contribution to PD. One example is a polymorphic CT-rich region in intron 4 of the SNCA gene. This haplotype has been suggested to be associated with risk of Lewy Body (LB) pathology in Alzheimer’s Disease and SNCA gene expression, but is yet to be investigated in PD. Here, we attempt to resolve this CT-rich haplotype and investigate its role in PD. We performed targeted PacBio HiFi sequencing of the region in 1375 PD cases and 959 controls. We replicate the previously reported associations and a novel association between two PD risk SNVs (rs356182 and rs5019538) and haplotype 4, the largest haplotype. Through quantitative trait locus analyzes we identify a significant haplotype 4 association with alternative CAGE transcriptional start site usage, not leading to significant differential SNCA gene expression in post-mortem frontal cortex brain tissue. Therefore, disease association in this locus might not be biologically driven by this CT-rich repeat region. Our data demonstrates the complexity of this SNCA region and highlights that further follow up functional studies are warranted.

Abstract Introduction The rising worldwide concern of Non-Communicable Diseases (NCD) is alarming as it is associated with 80% of annual global mortality. NCD threat is rising due to, among others, the increasing ageing population, thus putting the efforts to promote health ageing at the forefront of many countries’ health agenda. Physical activity has been recognised as one of the significant factors in the pursuit of healthy ageing. Nevertheless, approximately one third of individuals in Malaysia are physically inactive. The aim of this study is to determine the prevalence of physical inactivity and its associated factors among pre-retirement government healthcare workers. Methods This cross-sectional study was conducted from May to June 2023 among pre-retirement government healthcare workers in Kuala Lumpur, Malaysia. The sample size required was 233 and proportionate random sampling was used to recruit potential respondents who answered self-administered online questionnaires. Global Physical Activity Questionnaire (GPAQ) was used to measure the level of physical activity and data analysis was performed using SPSS version 29. Results A total of 214 complete responses were received from the 233 questionnaires distributed, giving a response rate of 91.8%. The prevalence of physical inactivity among pre-retirement healthcare workers was 39.7% as compare only 29.9% in general population. Significant predictors for physical inactivity included higher education levels (SPM, STPM, or certificate holders) (AOR = 13.4, 95% CI: 2.47–72.65), non-Malay ethinicity (AOR = 4.7, 95% CI: 1.23–18.38), personal barriers (AOR = 1.6, 95% CI:1.35–1.79), social barriers (AOR = 1.21, 95% CI: 1.06–1.39), and physical environment barriers (AOR = 1.468, 95% CI: 1.221–1.765). Conclusion This study shows a worrying prevalence of physical inactivity among pre-retirement healthcare workers that is even higher than the general population in Malaysia. The findings highlight the importance of focusing the preventive strategies among non-Malay workers and those with lower education levels. It is also vital to address all the physical, social, and environmental barriers towards physical inactivity. By prioritising these factors, employers and stakeholders will be able to establish better workplace health promotion and address the issue of physical inactivity more efficiently.

Background: The correlation of adiponectin and serum tumor necrosis factor alpha (TNFα) with glucometabolic parameters in diabetes mellitus (DM) needs further studies. We aimed in this study to evaluate the relationship between adiponectin and TNFα with glucometabolic parameters in patients with type 2 DM (T2DM). Methods: We conducted a cross-sectional study in the Department of Physiology, College of Medicine, King Saud University, Saudi Arabia. The sample size was 117 from the diabetes clinic of King Abdul-Aziz University hospital through the convenience sampling technique. Subjects were grouped into control (healthy) subjects (53) with no chronic diseases and the diabetic group (64) with confirmed T2DM. Socio-demographic data were collected along with the serum blood sample to analyze the variables. Results: Adiponectin was significantly high in healthy subjects compared to the diabetic group (control: 14.4 ± 4.3, T2DM: 11.0 ± 4.1, P = 0.000), while TNFα was higher in the T2DM group (7.8 ± 2.7) than in the control group (6.6 ± 2.9, P = 0.024). TNFα was negatively correlated with adiponectin in the control group (-0.279) and in diabetic subjects (-0.311) and positively correlated with HbA1c in the diabetic group (0.319) and triglycerides (0.252). Adiponectin was positively correlated with HDL in the control group (0.252) and in diabetic subjects (0.326). There was an inverse correlation between TNFα and adiponectin. Conclusion: Adiponectin is higher in healthy subjects than in diabetic patients, while TNFα is higher in diabetic patients. In addition, adiponectin is positively correlated with HDL in healthy as well as diabetic patients. TNFα is positively correlated with HbA1c and triglycerides.

Abstract Background The Stroke Self-Efficacy Questionnaire (SSEQ) measures the self-confidence of the individual in functional activities after a stroke. The SSEQ is a self-report scale with 13 items that assess self-efficacy after a stroke in several functional domains. Objective The purpose was to translate the Stroke Self-Efficacy Questionnaire into Urdu Language and to find out the validity and reliability of Urdu SSEQ among stroke patients. Methods The cross-cultural validation study design was used. Following COSMIN guidelines, forward and backward translation protocols were adopted. After pilot testing on 10 stroke patients, the final Urdu version was drafted. A sample of 110 stroke patients was used to evaluate the validity and reliability of the SSEQ-U. Content and Concurrent validity were determined. The intraclass correlation coefficient and Cronbach’s alpha were used to measure internal consistency and test-retest reliability. Data analysis was performed using SPSS 25. Results The final version was drafted after application on 10 stroke patients. Content validity was analyzed by a content validity index ranging from 0.87 to 1. The internal consistency was calculated by Cronbach’s alpha (α > 0.80). Test-retest reliability was determined by the Intra-class correlation coefficient (ICC2,1=0.956). Concurrent validity was determined by correlations with other scales by using the Spearman correlation coefficient; moderate to strong correlations (positive and negative) were found with the Functional Independence Measure (r = 0.76), Beck Depression Inventory (r=-0.54), Short Form of 12-item Scale (r = 0.68) and Fall Efficacy Scale (r = 0.82) with p

Abstract Background Good Samaritan Laws are a harm reduction policy intended to facilitate a reduction in fatal opioid overdoses by enabling bystanders, first responders, and health care providers to assist individuals experiencing an overdose without facing civil or criminal liability. However, Good Samaritan Laws may not be reaching their full impact in many communities due to a lack of knowledge of protections under these laws, distrust in law enforcement, and fear of legal consequences among potential bystanders. The purpose of this study was to develop a systems-level understanding of the factors influencing bystander responses to opioid overdose in the context of Connecticut’s Good Samaritan Laws and identify high-leverage policies for improving opioid-related outcomes and implementation of these laws in Connecticut (CT). Methods We conducted six group model building (GMB) workshops that engaged a diverse set of participants with medical and community expertise and lived bystander experience. Through an iterative, stakeholder-engaged process, we developed, refined, and validated a qualitative system dynamics (SD) model in the form of a causal loop diagram (CLD). Results Our resulting qualitative SD model captures our GMB participants’ collective understanding of the dynamics driving bystander behavior and other factors influencing the effectiveness of Good Samaritan Laws in the state of CT. In this model, we identified seven balancing (B) and eight reinforcing (R) feedback loops within four narrative domains: Narrative 1 - Overdose, Calling 911, and First Responder Burnout; Narrative 2 - Naloxone Use, Acceptability, and Linking Patients to Services; Narrative 3 - Drug Arrests, Belief in Good Samaritan Laws, and Community Trust in Police; and Narrative 4 - Bystander Naloxone Use, Community Participation in Harm Reduction, and Cultural Change Towards Carrying Naloxone. Conclusions Our qualitative SD model brings a nuanced systems perspective to the literature on bystander behavior in the context of Good Samaritan Laws. Our model, grounded in local knowledge and experience, shows how the hypothesized non-linear interdependencies of the social, structural, and policy determinants of bystander behavior collectively form endogenous feedback loops that can be leveraged to design policies to advance and sustain systems change.

Abstract Coronary artery disease is a leading cause of morbidity and mortality worldwide. It occurs due to a combination of genetics, lifestyle, and environmental factors. Premature coronary artery disease (PCAD) is a neglected clinical entity despite the rising number of cases worldwide. This study aimed to investigate the risk factors of premature coronary artery disease. In this study, we searched articles that had studied the risk factors of premature coronary artery diseases from January 2000 to July 2022 in Saudi Arabia in Web of Science, Pub Med, Scopus, Springer, and Wiley databases. The final analysis is based on seven articles. The smoking prevalence was 39%, diabetes mellitus 41%, hypertension 33%, overweight and obesity 18%, family history of coronary artery disease (CAD) 19%, dyslipidemia 37%, and the prevalence range of low-density lipoprotein cholesterol was 33.8–55.0%. The results revealed a mortality prevalence of 4% ranging from 2 to 8% which is similar to the prevalence in older patients which was 2–10%. Smoking, diabetes mellitus, hypertension, family history of CAD, dyslipidemia, and overweight/obesity are significantly and positively associated with premature coronary artery diseases. The health authorities should design and implement an intensive and effective prophylactic plan to minimize the subsequent impact of PCAD on the young population. In addition, early diagnosis of PCAD has great value in providing timely treatment, managing the patients, and minimizing the burden of the disease.

Purpose – This study evaluated the determinants of augmented reality (AR) adoption in Malaysia's travel and tour operator sectors through an integrated technology-organization-environmental (TOE) and diffusion of innovation (DOI) model. Design/methodology/approach – The TOE and DOI were considered the primary theoretical models but are combined and extended by including few additional variables. Data were collected from 220 respondents of travel and tour operating businesses in Malaysia and analyzed by applying PLS structural equation model technique. Findings – The empirical results established that perceived cost, relative advantages, complexity and compatibility, observability, competitor pressure, value alignment, customer pressure, and trialability are positively connected with the behavioral intention except for external support. The results reveal that value alignment partially mediates the association between relative advantages and behavioral intention, complexity and behavioral intention, compatibility and behavioral intention, perceived cost and behavioral intention except in between trialability and observability. Originality/value – This research is unique as the value alignment construct is included in the model, and thus it fulfills the literature gap by adding the mediation construct. This study contributes to enhancing AR's understanding of the Malaysian travel and tour operator industry through the lenses of owners or managers. It offers an integrated model that combines the TOE and DOI models, rare in this sector, and can be replicated or extended with validated scales.

Background: Affecting >20million people in the U.S., including 4 % of all hospitalized patients, substance use disorder (SUD) represents a growing public health crisis. Evaluating a national cohort, we aimed to characterize the association of concurrent SUD with perioperative outcomes and resource utilization following elective abdominal operations. Methods: All adult hospitalizations entailing elective colectomy, gastrectomy, esophagectomy, hepatectomy, and pancreatectomy were tabulated from the 2016–2020 National Inpatient Sample. Patients with concurrent substance use disorder, comprising alcohol, opioid, marijuana, sedative, cocaine, inhalant, hallucinogen, or other psychoactive/stimulant use, were considered the SUD cohort (others: nSUD). Multivariable regression models were constructed to evaluate the independent association between SUD and key outcomes. Results: Of ∼1,088,145 patients, 32,865 (3.0 %) comprised the SUD cohort. On average, SUD patients were younger, more commonly male, of lowest quartile income, and of Black race. SUD patients less frequently underwent colectomy, but more often pancreatectomy, relative to nSUD.Following risk adjustment and with nSUD as reference, SUD demonstrated similar likelihood of in-hospital mortality, but remained associated with increased odds of any perioperative complication (Adjusted Odds Ratio [AOR] 1.17, CI 1.09–1.25). Further, SUD was linked with incremental increases in adjusted length of stay (β + 0.90 days, CI +0.68–1.12) and costs (β + $3630, CI +2650–4610), as well as greater likelihood of non-home discharge (AOR 1.54, CI 1.40–1.70). Conclusions: Concurrent substance use disorder was associated with increased complications, resource utilization, and non-home discharge following major elective abdominal operations. Novel interventions are warranted to address increased risk among this vulnerable population and address significant disparities in postoperative outcomes.

Predictive maintenance (PdM) is increasingly pursued to reduce wind farm operation and maintenance costs by accurately predicting the remaining useful life (RUL) and strategically scheduling maintenance. However, the remoteness of wind farms often renders current methodologies ineffective, as they fail to provide a sufficiently reliable advance time window for maintenance planning, limiting PdM's practicality. This study introduces a novel deep learning (DL) methodology for future-RUL forecasting. By employing a multi-parametric attention-based DL approach that bypasses feature engineering, thereby minimizing the risk of human error, two models—ForeNet-2d and ForeNet-3d—are proposed. These models successfully forecast the RUL for seven multifaceted wind turbine (WT) failures with a 2-week forecast window. The most precise forecast deviated by only 10 minutes from the actual RUL, while the least accurate prediction deviated by 1.8 days, with most predictions being off by only a few hours. This methodology offers a substantial time frame to access remote WTs and perform necessary maintenance, thereby enabling the practical implementation of PdM.

Resumo Fundamento O tecido adiposo visceral (TAV) pode ser um contribuinte modificável específico para o comprometimento autonômico relacionado à composição corporal. Objetivos Comparar a variabilidade da frequência cardíaca (VFC) entre grupos estratificados pela classificação de gordura visceral (CGC) e comparar associações entre VFC e métricas de composição corporal. Métodos Um estudo transversal foi realizado em homens saudáveis (n=99, idade=37,8±13,4 anos, índice de massa corporal [IMC]=26,9±4,6 kg/m2). A VFC foi derivada de registros eletrocardiográficos de 5 minutos. A composição corporal (percentual de gordura corporal, CGC e relação entre massa muscular e gordura visceral [RMMCGC]) foi estimada por meio de análise de impedância bioelétrica tetrapolar. Os participantes foram categorizados em grupos de acordo com a CGC: G1 (CGC=1-8); G2 (CGC=9-12); e G3 (CGC>12). Comparações ajustadas por idade foram feitas entre os grupos. Associações independentes foram quantificadas com regressões lineares múltiplas. P

Abstract Objective This study examines the impact of parental migration on the psychological well‐being and development of left‐behind children (LBCs) in Zhejiang, China, within the broader context of the country's rural transformations and urban migration. It investigates how intellectual and relational engagement (RE), autonomy (AUT), competence (COM), and relatedness (RES) contribute to resilience (REL) and post‐traumatic growth (PTG) in these children, reflecting on the shift from viewing parental separation merely as a source of trauma to recognizing its potential to foster significant personal growth. Methods Utilizing a cross‐sectional design, the research was conducted in April and May 2023 with 1348 LBCs from a total sample of 4049 students inZhejiang. A two‐step random, stratified, cluster‐based sampling strategy was employed, and structural equation modeling was used to examine the hypothesized relationships among the constructs. Results The statistical analysis demonstrated significant positive effects of intellectual engagement (IE), AUT, COM, and RE on both REL and PTG (p .60) underscoring their importance. Notably, REL was found to moderate the relationships among RES, COM, and PTG, highlighting its critical role in the psychological adaptation of left‐behind children. Conclusion The study underscores the importance of nurturing intellectual and REs, AUT, and COM to enhance psychological REL and well‐being among LBAs. These elements are crucial for supporting the mental health and developmental needs of children facing the challenges of parental migration. The findings advocate for targeted interventions that can address the unique needs of this vulnerable population, emphasizing the potential for growth and adaptation despite adversities.

Abstract The modulation of the chemical microenvironment surrounding metal nanoparticles (NPs) is an effective means to enhance the selectivity and activity of catalytic reactions. Herein, a post‐synthetic modification strategy is developed to modulate the hydrophobic microenvironment of Ru nanoparticles encapsulated in a metal–organic framework (MOF), MIP‐206, namely Ru@MIP‐Fx (where x represents perfluoroalkyl chain lengths of 3, 5, 7, 11, and 15), in order to systematically explore the effect of the hydrophobic microenvironment on the electrocatalytic activity. The increase of perfluoroalkyl chain length can gradually enhance the hydrophobicity of the catalyst, which effectively suppresses the competitive hydrogen evolution reaction (HER). Moreover, the electrocatalytic production rate of ammonia and the corresponding Faraday efficiency display a volcano‐like pattern with increasing hydrophobicity, with Ru@MIP‐F7 showing the highest activity. Theoretical calculations and experiments jointly show that modification of perfluoroalkyl chains of different lengths on MIP‐206 modulates the electronic state of Ru nanoparticles and reduces the rate‐determining step for the formation of the key intermediate of N2H2*, leading to superior electrocatalytic performance.

Objective: The study was aimed to assess the sex-linked differences in the Blood Pressure Indices (BPI) i.e., Mean Arterial Pressure (MAP) and Pulse Pressure (PP) of COVID patients after 6 Minute Walk Test (6MWT). Study type,settings& duration: This observational study was conducted in the Institute of Basic Medical Sciences,Khyber Medical University, Peshawar from December 2021 to April 2022. Methodology: There were 54 participants (21 Females and 33 Males). Participants with previous COVID-19 infection with a cut off of 3 months post COVID, were included in the study. The participant’s Heart Rate and Blood Pressure were recorded both before and after performing 6MWT. Results: Both pre and post stress comparison of mean difference between post COVID males and females, was significant for MAP (Post-Stress p=0.002 and Pre-Stress p=0.01) only. PP and HR did not show any significant differences between the males vs females in both pre and post stress phase. While, post COVID females had a higher HR than males in both pre and post phase. General Linear regression model was developed while controlling for age and to check the relation between MAP, PP and HR.R squared came out to be 0.648 while MAP was significant with a pvalue = 0.012. Conclusion: This study found a significant difference in Mean Arterial Pressure (MAP) between male and female COVID-19 patients after a 6-minute walk test, suggesting sex-based variations in blood pressure response post-infection. Further research with larger samples is needed to explore the clinical implications of this finding.

Abstract The impact of recombinant protein production (RPP) on host cells and the metabolic burden associated with it undermine the efficiency of the production system. This study utilized proteomics to investigate the dynamics of parent and recombinant cells induced at different time points for RPP. The results revealed significant changes in both transcriptional and translational machinery that may have impacted the metabolic burden, growth rate of the culture and the RPP. The timing of protein synthesis induction also played a critical role in the fate of the recombinant protein within the host cell, affecting protein and product yield. The study identified significant differences in the expression of proteins involved in fatty acid and lipid biosynthesis pathways between two E. coli host strains (M15 and DH5⍺), with the E. coli M15 strain demonstrating superior expression characteristics for the recombinant protein. Overall, these findings contribute to the knowledge base for rational strain engineering for optimized recombinant protein production.

Abstract Introduction Coronavirus disease 2019 (COVID-19)-associated tracheal stenosis (COATS) may occur as a result of prolonged intubation during COVID-19 infection. We aimed to investigate patterns of gene expression in the tracheal granulation tissue of patients with COATS, leverage gene expression data to identify dysregulated cellular pathways and processes, and discuss potential therapeutic options based on the identified gene expression profiles. Methods Adult patients (age ≥ 18 years) presenting to clinics for management of severe, recalcitrant COATS were included in this study. RNA sequencing and differential gene expression analysis was performed with transcriptomic data for normal tracheal tissue being used as a control. The top ten most highly upregulated and downregulated genes were identified. For each of these pathologically dysregulated genes, we identified key cellular pathways and processes they are involved in using Gene Ontology (GO) and KEGG (Kyoto Encyclopedia of Genes and Genomes) applied via Database for Annotation, Visualization, and Integrated Discovery (DAVID). Results Two women, aged 36 years and 37 years, were included. The profile of dysregulated genes indicated a cellular response consistent with viral infection (CXCL11, PI15, CCL8, DEFB103A, IFI6, ACOD1, and DEFB4A) and hyperproliferation/hypergranulation (MMP3, CASP14 and HAS1), while downregulated pathways included retinol metabolism (ALDH1A2, RBP1, RBP4, CRABP1 and CRABP2). Conclusion Gene expression changes consistent with persistent viral infection and dysregulated retinol metabolism may promote tracheal hypergranulation and hyperproliferation leading to COATS. Given the presence of existing literature highlighting retinoic acid’s ability to favorably regulate these genes, improve cell-cell adhesion, and decrease overall disease severity in COVID-19, future studies must evaluate its utility for adjunctive management of COATS in animal models and clinical settings.

Abstract Naegleria fowleri, also known as brain-earing amoeba, causes severe and rapidly fatal CNS infection in humans called primary amebic meningoencephalitis (PAM). The DNA from the N. fowleri clinical isolate was sequenced for circular extrachromosomal ribosomal DNA (CERE - rDNA). The CERE contains 18 S, 5.8 S, and 28 S ribosomal subunits separated by internal transcribed spacers, 5 open reading frames (ORFs), and mostly repeat elements comprising 7268 bp out of 15,786 bp (46%). A wide variety of variations and recombination events were observed. Finally, the ORFs that comprised only 4 hypothetical proteins were modeled and screened against Zinc drug-like compounds. Two compounds [ZINC77564275 (ethyl 2-(((4-isopropyl-4 H-1,2,4-triazol-3-yl) methyl) (methyl)amino) oxazole-4-carboxylate) and ZINC15022129 (5-(2-methoxyphenoxy)-[2,2’-bipyrimidine]-4,6(1 H,5 H)-dione)] were finalized as potential druggable compounds based on ADME toxicity analysis. We propose that the compounds showing the least toxicity would be potential drug candidates after laboratory experimental validation is performed.

Background: Carpal tunnel syndrome (CTS) is considered to be one of the most common peripheral nerve disorders with female preponderance which significantly reduces work efficacy and needs further research on its preventable factors, especially obesity. We studied the effects of obesity indices on Phalen’s test duration and median nerve conduction study (NCS) parameters in patients presenting with CTS. Methods: We examined 229 female patients presenting with clinical features of CTS. Clinical examinations including Phalen’s test, median NCSs, and body composition were evaluated. Obesity indices and electrophysiological parameters were compared. Results: There were significant associations of both body mass index (BMI) degrees and body fat percent (BF%) with clinical and NCS parameters with a linear relationship. BF% and BMI were strongly negatively correlated with Phalen’s test duration (BF%; r = -0.334, BMI; r = -0.270 P = 0.001). On the other hand, BF% and BMI were positively correlated with median distal latency (BF%; r = 0.338, BMI; r = 0.372, P value = 0.001), M-latency (BF%; r = 0.264, BMI; r = 0.285, P = 0.001), median motor conduction velocity (MMCV) (BF%; r = 0.119, P = 0.072, BMI; r = 0.173, P = 0.009), median sensory conduction velocity (MSCV) (BF%; r = -0.195, P = 0.003, BMI; r = 0.327, P = 0.001), and sensory nerve action potential (SNAP amplitude) (BF%; r = -.239, BMI; r = -0.350, P = 0.001). Conclusions: Nerve conduction parameters are significantly affected by obesity degree defined by BMI and BF%. Therefore, combining BMI and BF% assessments gives more clinical information regarding CTS severity and management. The true predictive value of these indices needs to be elucidated further.

Abstract A systematic review of literature was conducted to evaluate the effectiveness of passive countermeasures in ameliorating the cardiopulmonary and musculoskeletal effects of gravitational unloading on humans during spaceflight. This systematic review is the third of a series being conducted by the European Space Agency to evaluate the effectiveness of countermeasures to physiologic deconditioning during spaceflight. With future long-duration space missions on the horizon, it is critical to understand the effectiveness of existing countermeasures to promote astronaut health and improve the probability of future mission success. An updated search for studies examining passive countermeasures was conducted in 2021 to supplement results from a broader search conducted in 2017 for all countermeasures. Ground-based analogue and spaceflight studies were included in the search. A total of 647 articles were screened following removal of duplicates, of which 16 were included in this review. Data extraction and analysis, quality assessment of studies, and transferability of reviewed studies to actual spaceflight based on their bed-rest protocol were conducted using dedicated tools created by the Aerospace Medicine Systematic Review Group. Of the 180 examined outcomes across the reviewed studies, only 20 were shown to have a significant positive effect in favour of the intervention group. Lower body negative pressure was seen to significantly maintain orthostatic tolerance (OT) closer to baseline as comparted to control groups. It also was seen to have mixed efficacy with regards to maintaining resting heart rate close to pre-bed rest values. Whole body vibration significantly maintained many balance-related outcome measures close to pre-bed rest values as compared to control. Skin surface cooling and centrifugation both showed efficacy in maintaining OT. Centrifugation also was seen to have mixed efficacy with regards to maintaining VO2max close to pre-bed rest values. Overall, standalone passive countermeasures showed no significant effect in maintaining 159 unique outcome measures close to their pre-bed rest values as compared to control groups. Risk of bias was rated high or unclear in all studies due to poorly detailed methodologies, poor control of confounding variables, and other sources of bias (i.e. inequitable recruitment of participants leading to a higher male:female ratios). The bed-rest transferability (BR) score varied from 2–7, with a median score of 5. Generally, most studies had good BR transferability but underreported on factors such as control of sunlight or radiation exposure, diet, level of exercise and sleep-cycles. We conclude that: (1) Lack of standardisation of outcome measurement and methodologies has led to large heterogeneity amongst studies; (2) Scarcity of literature and high risk of bias amongst existing studies limits the statistical power of results; and (3) Passive countermeasures have little or no efficacy as standalone measures against cardiopulmonary and musculoskeletal deconditioning induced by spaceflight related to physiologic deterioration due to gravity un-loading.

Abstract Osteopenia is a condition characterized by low bone mineral density (BMD) that increases fracture risk, particularly among postmenopausal women (PMW). This study aimed to determine the effects of Kinect-based VRT on BMD and fracture risk in PMW with osteopenia. The study was a prospective, two-arm, parallel-design, randomized controlled trial. The study enrolled 52 participants, 26 randomly assigned to each group. In the experimental group, Kinect-based VRT was provided thrice weekly for 24 weeks for 45 min/session. Both groups were instructed to engage in a daily 30-min walk outdoors. The fracture risk assessment tool (FRAX) was used to calculate fracture risk, and dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. Both variables were assessed at baseline and 24 weeks afterwards. After 24 weeks of Kinect-based VRT, the experimental group showed significant BMD increases in the right and left femoral necks and lumbar spine (p value

Given the cryptocurrency market boom in recent years, this study aims to identify the factors influencing cryptocurrency pricing and the major gaps for future research. A systematic literature review was undertaken. Three databases, Scopus, Web of Science and EBSCOhost, were used for this review. The final analysis comprised 88 articles that met the eligibility criteria. The influential factors were identified and categorized as supply and demand, technology, economics, market volatility, investors’ attributes and social media. This review provides a comprehensive and consolidated view of cryptocurrency pricing and maps the significant influential factors. This paper is the first to systematically and comprehensively review the relevant literature on cryptocurrency to identify the factors of pricing fluctuation. This research contributes to cryptocurrency research as well as to consumer behaviors and marketing discipline in broad.

Metal-organic frameworks (MOFs) and MXene-based advanced materials have garnered significant interest owing to their distinct characteristics, including well-organized pores and customizable topologies, which render them versatile materials for diverse applications. MOFs are structured porous materials composed of metal ions/clusters bound by organic linkers. In contrast, MXenes are a class of two-dimensional transition-metal carbides, nitrides, and carbonitrides with a layered structure. Integrating MOFs and MXenes into concrete can significantly improve their mechanical strength, durability, thermal stability, and functional properties. The high surface area and porosity of MOFs can improve bonding within the cement matrix, control moisture, and protect against harmful substances. In contrast, the conductivity of MXene enables self-sensing and self-healing capabilities, and its barrier properties can prevent corrosion. This paper presents a comprehensive review of the latest research progress on MOFs and MXene-based composite materials in the construction industry, offering insights into their synthesis methodologies, distinctive properties, and transformative potential. From bolstering structural integrity and enhancing thermal management to revolutionizing energy efficiency and enabling smart functionalities, these composite materials present numerous opportunities for addressing contemporary challenges in modern construction while promoting sustainability and resilience. Furthermore, this paper discusses the challenges and future outlook of cementitious materials reinforced with MOFs and MXenes.

ABSTRACTAim: Cannabis-based medication has recently been made available in the NHS for reducing pain and spasticity in patients with multiple sclerosis (MS). The currently available preparation of Sativex (nabiximols) contains a combination of botanical cannabis extracts with cannabidiol (CBD) and tetrahydrocannabinol (THC) with almost equal amounts in addition to minor cannabinoids and terpenoids and is delivered via an oro-mucosal spray. The present study aims to examine the use and trends in prescribing cannabinoid-based Sativex to control pain in patients diagnosed with MS.Methods: Primary care prescribing data for cannabinoid-based Sativex (2013-2022) from the Prescription Cost Analysis were extracted and analysed. Linear regression analyses were performed to examine prescription trends and prescription costs (average change per year).Results: There was a general increasing trend in the number of prescriptions each year, from 4.42 items dispensed per 100,000 people in 2013 to 5.15 in 2022. Overall, prescription items for cannabinoid-based Sativex increased by 0.34% per year (95% CI:−3.98, 4.67, p = 0.860) on average between 2013 and 2022. On average, a 2.43% (95% CI: −5.78, 0.92, p = 0.133) increase per year was observed for the costs of cannabinoid-based Sativex from 2013 to 2022.Conclusion: The results suggested that cannabinoid-based Sativex should be considered an option due to its effectiveness, acceptable tolerance, and safety profile in the prescribing of Sativex.

AbstractAim This cross-sectional study investigated the association between metabolic syndrome (MetS) and handgrip strength (HGS) with respect to sex and adiposity in Saudi men (n = 287) and women (n = 268).Material and methods Anthropometry, body composition, HGS, and blood biochemistry were measured. The average age of the study population was 57.65 ± 9.3 years (men = 55.1 ± 9.3 years, women = 60.4 ± 9.3 years). We report that HGS/body mass index (BMI), HGS/weight, and HGS/fat (%) were significantly higher in controls than in patients with MetS in men but not in women. According to the ROC analysis, relative HGS (RHGS) was higher than HGS alone in the association with MetS, which was significant for men (p

ABSTRACTAn increasing body of research indicates that immunotherapy has demonstrated substantial effectiveness in the realm of metastatic colorectal cancer(mCRC), especially among patients with deficient mismatch repair (dMMR) or microsatellite instability-high (MSI-H) (dMMR/MSI-H mCRC). This study constitutes the inaugural bibliometric and visual analysis of immunotherapy related to mCRC during the last decade. Between 2013 and the conclusion of 2022, we screened 306 articles from Web of Science and subjected them to analysis using CiteSpace and VOSviewer. The United States stood out as the primary contributor in this area, representing 33.33% of the publications, with China following closely at 24.51%. The most prolific institution has the lowest average citation rate. Sorbonne University were the most highly cited institutions. Notably, Frontiers In Oncology published the largest quantity of articles. Andre, Thierry, and Overman, Michael J. were prominent authors known for their prolific output and the high citation rates of their work. The focus areas in this field encompass “tumor microenvironment,” “liver metastasis,” “tumor-associated macrophages,” “combination therapy” and “gut microbiota.” Some keywords offer promise as potential biomarkers for evaluating the effectiveness of immunotherapeutic interventions.

This research aims to understand current patterns, trends, and gaps in personal finance by conducting a systematic literature review of 20 years. The study collected and analyzed the articles published between 2004 to 2024. The research articles were collected from the Scopus database using the PRISMA framework. The review shows changes in the research area, including behavioural finance, digital financial planning tools, and its impact on individuals' financial literacy and planning. The major limitation of this study is that the literature search for personal financial planning might not have incorporated all publications in this area. Furthermore, there is a possibility of bias in this review concerning the papers selected for review and how the researchers interpreted the results. The findings of this systematic literature review can assist policymakers, financial planners, and practitioners in making more informed financial planning decisions and regulations. Thus, by identifying the trends and gaps in personal financial planning, strategies can be defined to provide individuals and society with the necessary level of support. The research is helpful to existing knowledge in that it presents a critical discussion of the personal financial planning literature evident in the last twenty years. The research is original and provides valuable information for upcoming research and practical application in personal financial planning.

# Background Tripura is hyperendemic for malaria and is one of the few states in India that still fall under Category 3 for malaria elimination (i.e., state annual parasite incidence (API) > 1, i.e., number of malaria cases per thousand inhabitants in a year). Tribal communities in Tripura are largely dependent on Jhum cultivation for their sustenance, and several studies have highlighted Jhum as a major risk factor for malaria. # Methods To assess the relationship between Jhum distribution and malaria in Tripura, Jhum hotspots were identified from Landsat-8 OLI spectral images using the Normalized burn ratio index and compared with secondary data on malaria incidence and the state/district-wise total area under Jhum for the years 2017 and 2019. # Results The study's results show that between 2017 and 2019, the total area under Jhum reduced from 39.56 km2 to 27.4 km2, which was accompanied by a shift in several Jhum hotspots from Dhalai and North Tripura in 2017 to West Tripura in 2019. Malaria cases showed a strong correlation with Jhum production both at the district and state level, which was significant at the 95% confidence interval. Furthermore, a stronger correlation in 2019 indicated that the share of malaria cases in Jhum cultivators may be increasing. # Conclusions The present study presents preliminary evidence based on secondary data analysis on the possible implications of Jhum cultivation for malaria epidemiology in an endemic north-eastern state of India. It is suggested that real-time evidence should be generated on malaria prevalence among Jhum cultivators and their families. Based on the evidence, future intervention strategies for the state should focus on the elimination of malaria risk from Jhum cultivators by minimizing outdoor exposure to malaria vectors and improving access to diagnostics and treatment.

Background: Oral anticoagulation (OAC) is the mainstay of treatment for the prevention of strokes in patients with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) account for increasing OAC in patients with AF. However, prescribing DOACs for patients with established AF poses various challenges and general practice pharmacists may have an important role in supporting their management. Aim: To investigate the effectiveness of pharmacist-led interventions in general practice in optimising the use of OAC therapies in AF. Design & setting: A retrospective observational study in general practices in Bradford. Method: The data were collected retrospectively from 1 November 2018–31 December 2019 using electronic health record data. The data were analysed: 1) to identify patients with AF not on OAC; 2) to describe inappropriate DOAC prescriptions; and 3) to calculate HAS-BLED scores. Results: Overall, 76.3% (n = 470) of patients with AF received OAC therapy, and of these, 63.4% received DOACs. Pharmacist-led interventions increased DOAC prescribing by 6.0% (P = 0.03). Inappropriate DOAC use was identified in 24.5% of patients with AF, with underdosed and overdosed identified in 9.7% and 14.8%, respectively. Post-intervention, inappropriate prescribing was reduced to 1.7%. The mean HAS-BLED score decreased from 3.00 to 2.22 (P

Abstract Background and Aims We performed a meta‐analysis of randomized controlled trials (RCTs) to summarize the overall effect of intravenous immunoglobulin (IVIG) on mortality outcomes among hospitalized coronavirus disease 2019 (COVID‐19) patients. Methods We systematically searched electronic databases up to June 1, 2023. Pooled odds ratio (OR) of mortality with a 95% confidence interval (CI) was generated using a random‐effects model. The risk of bias was appraised using the Cochrane risk‐of‐bias Version 2 tool for randomized trials. Results Nine RCTs were included: three RCTs had an overall low risk of bias, four RCTs had some concerns in the overall risk of bias, and two RCTs trials had an overall high risk of bias. The use of IVIG indicated a significant reduction in the odds of mortality (pooled OR = 0.69; 95% CI 0.50–0.96) relative to nonuse of IVIG. Subgroup analysis in patients with a severe course of COVID‐19 revealed no significant reduction in the odds of mortality (pooled OR = 0.58; 95% CI 0.29–1.16). Conclusions We suggest exercising caution when interpreting effectiveness of IVIG in reducing mortality among hospitalized patients with COVID‐19. Our findings emphasize for larger trials with rigorous study designs to better understand the impact of IVIG, particularly in those with severe COVID‐19.

Despite the critical role of balanced nutrition in crop productivity, the use of potash (K) and zinc (Zn) is not much practiced by Pakistani farmers. The reduced nutrient uptake and crop productivity together increase the costs associated with fertilization and revisit farmers’ confidence in the efficacy and profitability of fertilizers. To address this problem, a field study was conducted in the research area of the MNS-University of Agriculture, Multan, in collaboration with Engro Fertilizers Limited. The research plan consisted of five treatments, including T1 = control (without N, P, K, and Zn fertilizers), T2 = NP in practice (NP at 32–23–0 kg acre-1), T3 = recommended NP (NP at 48–34.5 kg acre-1), T4 = balanced NPK (NP+K at 48–34.5–30 kg acre-1), and T5 = balanced NPK + Zn (NPK+Zn at 48–34.5–30 + 7.5 kg acre-1). Wheat was used as a test crop, and its growth, yield, and physiological and nutritional parameters were studied. The results indicated that NPK+Zn balanced nutrition increased plant height, spike length, photosynthetic rate, water use efficiency, transpiration rate, stomatal conductance, and grain yield by 13%, 15%, 44%, 60%, 63%, 39%, and 78%, respectively, compared with the control. It was found that the combined application of NP, K, and Zn improved the recovery efficiency of applied nutrients, i.e., nitrogen recovery efficiency (NRE) by 230%, phosphorus recovery efficiency (PRE) by 136%, potassium recovery efficiency (KRE) by 135%, and zinc recovery efficiency (ZnRE) by 136% compared to NP-alone application. Agronomic use efficiency of applied fertilizers, such as potassium agronomic use efficiency (KAUE) by 71%, phosphorus agronomic use efficiency (PAUE) by 72%, nitrogen agronomic use efficiency (NAUE) by 70%, and zinc agronomic use efficiency (ZnAUE) by 72%, was observed compared to NP-alone application. The results showed that NPUE, PPUE, NPUE, and ZnPUE were reduced by 5%, 3%, 3%, and 5%, respectively, compared to NP-alone application. Our findings suggest that K and Zn should be made an essential part of wheat nutrition management for higher yield and better quality of produce.

Business dynamics have undergone a remarkable transformation in recent years, primarily driven by the digital revolution. Micro, Small, and Medium Enterprises (MSMEs) are recognized as the cornerstone of economic growth and development, and their adaptability to this digital era is paramount. This empirical investigation explores the complex relationship between entrepreneurs' awareness, perceptions, and intentions and their influence on the adoption of digitalization, with a focus on the digital initiatives of the Small Industries Development Bank of India (SIDBI), which aims to transform MSMEs digitally. Various constructs, such as entrepreneurs' awareness, perceptions, and intentions, are used to evaluate digital adoption in small businesses. By examining entrepreneurs' levels of awareness, perceptions, and intentions, we aim to uncover the fundamental factors that shape their strategic choices regarding digital adoption. This study employs structural equation Modeling (SEM) through AMOS and adopts an explanatory survey method. It involved engaging Indian MSMEs with a total of 300 participants. Of these, 220 successfully submitted fully filled-out questionnaires through Google Forms. It is noteworthy that the examination of the research model revealed promising results by meeting the thresholds of CFI, RMSEA, and other similar measures. Findings reveal that entrepreneurs' awareness and intention positively influence digital adoption in MSMEs, whereas entrepreneurs' perception has no significant influence on digital adoption in MSMEs. This study has significant practical implications for policy formulation, entrepreneurial decision-making, collaborative efforts, risk mitigation, and future research directions in the context of digitalization within the MSME sector.

The correlation between sports participation and psychological well-being is well-documented, revealing a complex interplay influenced by competition level and cultural context. This is particularly relevant in Korea, where the university sports culture significantly impacts student life. This study evaluates how competitive versus non-competitive sports affect Korean university students' psychological well-being using a quantitative approach with SmartPLS 4 for multi-group analysis. Findings reveal that competitive sports significantly enhance mental toughness and stress management through structured coping mechanisms and robust social support, improving coping strategy effectiveness by 34 % compared to non-competitive sports. Conversely, participants in non-competitive sports experience greater general well-being with a 40 % higher use of informal support. These insights suggest that university sports programs could benefit from targeted interventions incorporating specific coping strategies and social support frameworks tailored to the competitive context. This research underscores the need for precise stress management techniques and resilience-building exercises in sports curricula to optimize psychological well-being across different sports environments in Korean universities.

Cardiovascular illnesses (CVDs), particularly Coronary Artery Disease (CAD) and Ischemic Heart Disease (IHD), are major global health burdens, with a growing incidence in Pakistan. The development of PCSK9 inhibitors offers encouraging advantages in lowering LDL cholesterol and lowering cardiovascular risk, even though conservative treatments are still essential. However, access to them is severely hampered by their high cost, especially in environments with little resources. The financial limitations and scarcity of healthcare resources while examining the difficulties in obtaining PCSK9 inhibitors in Pakistan is essential. In order to develop solutions for affordability and fair access, it emphasizes the urgent need for multi-stakeholder collaboration, including governmental action, healthcare sector involvement, and pharmaceutical company engagement. It also emphasizes the need for data-specific research and the use of PCSK9 inhibitors in conventional treatment protocols.

Biochar is increasingly gaining popularity due to its extensive recommendation as a potential solution for addressing the concerns of food security and climate change in agroecosystems, with biochar application for increased carbon sequestration, enhanced soil fertility, improved soil health, and increased crop yield and quality. There have been multiple studies on crop yield utilizing various biochar types and application amounts; however, none have focused on the influence of diverse biochar types at various pyrolysis temperatures with different application amounts and the integration of fertilizer regimes in maize crops. Therefore, a two-year factorial field experiment was designed in a temperate Himalayan region of India (THRI) to evaluate the residual effect of different biochar on maize yield under different pyrolysis temperatures, various application rates and fertilizer regimes. The study included three factors viz., amendment type (factor 1), rate of application (factor 2) and fertilizer regime (factor 3). Amendment type included 7 treatments: No biochar- control (A1), apple biochar @ 400 °C pyrolysis temperature (A2), apple biochar @ 600 °C pyrolysis temperature (A3), apple residue biomass (A4), dal weed biochar @ 400 °C pyrolysis temperature (A5), dal weed biochar @ 600 °C pyrolysis temperatures (A6), and dal weed residue biomass (A7). The rate of application included 3 levels: Low (L- 1 t ha−1), medium (M- 2 t ha−1), and high (H- 3 t ha−1). At the same time, the fertilizer regimes included 2 treatments: No fertilizer (N) and recommended dose of fertilizer (F). The results revealed that among the various amendment type, rate of application and fertilizer regimes, the A3 amendment, H rate of application and F fertilizer regime gave the best maize growth and productivity outcome. Results revealed that among the different pyrolyzed residues used, the A3 amendment had the highest plant height (293.87 cm), most kernels cob−1 (535.75), highest soil plant analysis development (SPAD) value (58.10), greatest cob length (27.36 cm), maximum cob girth (18.18 cm), highest grain cob yield (1.40 Mg ha−1), highest grain yield (4.78 Mg ha−1), higher test weight (305.42 gm), and highest stover yield (2.50 Mg ha−1). The maximum dry weight in maize and the number of cobs plant−1 were recorded with amendments A4 (14.11 Mg ha−1) and A6 (1.77), respectively. The comparatively 2nd year of biochar application than the 1st year, the H level of the rate of application than the L rate and the application and integration of the recommended dose of fertilizer in maize results in significantly higher values of growth and productivity in maize. Overall, these findings suggest that the apple biochar @ 600 °C pyrolysis temperature (A3) at a high application rate with the addition of the recommended dose of fertilizer is the optimal biochar for enhancing the growth and productivity of maize in the THRI.

Technological advancements have significantly progressed and innovated across various industries. However, these advancements have also led to an increase in cyberattacks using malware. Researchers have developed diverse techniques to detect and classify malware, including a visualization-based approach that converts suspicious files into color or grayscale images, eliminating the need for domain-specific expertise. Nonetheless, converting files to color and grayscale images may result in the loss of texture details due to noise, adversely affecting the performance of machine learning models. The aim of this study is to present to assess the texture features and noise contributions of the red, green, and blue channels in color images. We propose a novel method to enhance model performance in terms of accuracy, precision, recall, f1-score, memory utilization, and computing cost during testing and training. This study introduces an approach involves separating color channels into individual red, green, and blue datasets and using various Discrete Wavelet Transform levels to reduce dimensions and remove noise. The extracted texture characteristics are then used as input for machine learning classifiers for training and prediction. Through comprehensive evaluation, we compare the performance of grayscale images with that of the red, green, and blue datasets. The results show that grayscale images significantly lose critical textural artifacts and perform worse than the color channels. Notably, employing extra tree classifiers yielded the best results, achieving an accuracy of 98.37%, precision of 98.64%, recall of 97.60%, and an f1-score of 98.04% with the red channel of color dataset.

The Gradient Descent (GD) paradigm is a foundational principle of modern optimization algorithms. The GD algorithm and its variants, including accelerated optimization algorithms, geodesic optimization, natural gradient, and contraction-based optimization, to name a few, are used in machine learning and the system and control domain. Here, we proposed a new algorithm based on the control theoretical perspective, labeled as the Controlled Gradient Descent (CGD). Specifically, this approach overcomes the challenges of the abovementioned algorithms, which rely on the choice of a suitable geometric structure, particularly in machine learning. The proposed CGD approach visualizes the optimization as a Manifold Stabilization Problem (MSP) through the notion of an invariant manifold and its attractivity. The CGD approach leads to an exponential contraction of trajectories under the influence of a pseudo-Riemannian metric generated through the control procedure as an additional outcome. The efficacy of the CGD is demonstrated with various test objective functions like the benchmark Rosenbrock function, objective function with a lack of flatness, and semi-contracting objective functions often encountered in machine learning applications.

Abstract Solving complex post-disaster reconstruction challenges requires the altruistic involvement of heterogeneous stakeholder groups. However, small, more organized groups, such as government parastatals, private developers, and contractors often exploit large, unorganized groups, such as affected communities, leaving them more vulnerable to future disasters. Based on data collected from a case study in Pakistan, this study proposed a framework to assess, anticipate, and mitigate the exploitation of vulnerable stakeholders in post-disaster reconstruction projects. The framework draws on influential management theories and utilizes reciprocal relationships between stakeholder attributes (power, legitimacy, and urgency), participation, and exploitation. The study also argued for non-binary treatment of stakeholder attributes. The framework will allow practitioners to address issues around the exploitation of stakeholder interests in future post-disaster reconstruction projects.

A low-cost adsorbent developed from unmodified Azadirachta indica leaves was used for adsorptive removal of the Congo Red dye from an aqueous medium. The adsorbent was characterized by the Fourier transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), and scanning electron microscopy (SEM) techniques. For optimization of operational parameters such as dye concentration, solution pH, adsorbent dose, contact time, and temperature, batch adsorption experiments were performed. It was found that for neem leaves powder (NLP), the optimum conditions were as follows: adsorbent dose of 0.8 g, contact time of 100 min having a solution with pH value of 5, adsorbate initial concentration of 40 ppm at temperature 60 °C where maximum amount of dye, i.e., 84%, removal was observed. The process followed pseudo-first-order kinetics, which reveals physical adsorption. According to isothermal investigations, sorption data were best fit with the Freundlich isotherm model. Thermodynamically, the adsorption of the Congo Red dye by the neem leaf powder was exothermic. Furthermore, the mechanistic removal of the Congo Red dye by the NLP has been explored with the help of the surface complex formation (PHREEQC) mechanism. Overall, the results of the study explore the promising nature of NLP for Congo Red dye removal. HIGHLIGHTS Providing clean water to the population is one of humanity's main challenges.; Adsorption is one of the most cost-effective and promising techniques for dye removal from polluted water.; 84% of Congo Red dye removal takes place at optimized conditions.; Isotherm, kinetic, and thermodynamics were studied.; The promising nature of the developed system was checked with tap water.;