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In a detailed investigation of lichen diversity in different regions of Pakistan, utilizing molecular and morphological techniques, we identified and reported three species – Dimelaena altissima, Lecanora chlarotera, and Usnea lapponica – as new records for Pakistan. Furthermore, nrITS sequences for Evernia prunastri, Lecanora horiza, L. hybocarpa, Peltigera polydactylon, and P. praetextata were generated for the first time from Pakistan. Detailed morpho-anatomical descriptions, habitat information, distribution data, and results of biochemical analyses are also provided for a better understanding of the lichen diversity and ecology in this region.

Background There is scant data regarding the use of oral disease-modifying treatments (oDMT) in patients with relapsing–remitting multiple sclerosis (PwRRMS) from Saudi Arabia. Objective This study aimed to identify the response rate to oDMT in PwRRMS compared to interferon (IFN) in terms of achieving no evidence of disease activity-3 (NEDA-3). Methods This retrospective study was conducted at a tertiary care hospital in Saudi Arabia and included all adult PwRRMS over a 2-year period who were on oDMTs or IFN for

OBJECTIVES Cerebral venous thrombosis (CVT) is a rare type of stroke. Functional outcome (FOC) in CVT can be affected by different factors, and recanalization is an important determinant. This study aimed to identify the FOC predictors including recanalization in patients with CVT. METHODS This retrospective study reviewed electronic charts of patients with CVT admitted to the King Fahd Hospital of the University, a teaching and referral hospital between January 2012 and March 2023. Demographic and other clinicoradiological characteristics were noted. Factors affecting FOC were investigated using the Chi-square test, odds ratios (ORs), and 95% confidence interval (CI). RESULTS Out of 64 patients, 78% achieved good FOC. Age was significantly higher in patients having poor FOC as compared to those having good FOC (P ≤ 0.001). Women had more likelihood to be functionally independent as compared to men (OR = 1.35, 95% CI = 1.01–1.80, P = 0.02). Altered consciousness (OR = 2.94, 95% CI = 1.23–6.99, P = 0.01), venous hemorrhagic infarction (OR = 3.26, 95% CI = 1.36–7.82, P = 0.008), and nonrecanalization (OR = 1.44, 95% CI = 0.97–2.14, P = 0.02) were significantly associated with poor FOC. Hereditary thrombophilia (OR = 0.60, 95% CI = 0.31–1.12, P = 0.03) and infections (OR = 0.59, 95% CI = 0.31–1.12, P = 0.01) were associated with less likelihood of good FOC. Age ≥50 years (P = 0.01) and illness of more than 1-month duration (P = 0.01) were associated with nonrecanalization. CONCLUSION Older age, male sex, presence of venous hemorrhagic infarction, and nonrecanalization can predict poor FOC in CVT. The recanalization process can be affected by late presentation, and the plausible reason could be a delay in therapeutic anticoagulation. Further prospective and multicenter studies are needed to determine the predictors of FOC and to understand the process of recanalization in CVT.

Background: The mitochondrial DNA (mtDNA) G10398A polymorphism has been associated with bipolar disorder (BD). It leads to an amino acid substitution within NADH dehydrogenase subunit, thereby altering the mitochondrial complex I function. This exploratory case–control study assesses the association of mtDNA G10398A with the risk of BD and its relationship to clinical variables in Indian patients. Methods: Cases met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of BD-I in remission and had a family history of BD or recurrent unipolar disorder in biological relatives. The healthy controls (HC) had no known illness and were screened negative for Family Interview for Genetic Studies. Participants were assessed using Clinical Pro forma, NIMH-Life Chart Method and Alda lithium response scale. The mtDNA G10398A was assessed with real-time polymerase chain reaction using TaqMan assay. Results: A total of 82 participants were recruited across cases and controls, with 42 patients (50% with maternal history) and 40 healthy individuals with similar demographic profiles. The mean age of onset was 25.16 (standard deviation [SD] 7.6) years, with illness for 11.59 years (SD: 7.18). Allele A was found in 50% of cases compared to 32.5% HC (odds ratio = 2.08; 95% confidence interval [CI]: 0.85–5.09). Findings remain non-significant for patients with maternal mood disorders (allele A: 38.9%; 21/42). Cases with allele G had significantly higher body mass index (BMI) (P = 0.008) than those with allele A. Conclusion: The study adds information on mtDNA 10398A amongst Indian patient samples and healthy individuals. No significant group difference was found with respect to mtDNA G10398A. The positive association of allele G with higher BMI has potential clinical relevance that can be further investigated in larger samples.

The prevalence of Internet gaming disorder (IGD) is growing on a global scale, leading to heightened concerns around adolescents’ aggressiveness. The presence of competition and lack of supervision in online gaming might provoke aggressive tendencies. Adolescents might be influenced by competitive games and interactions. Pakistan, a country with advanced technology, has limited investigations on issues related to IGD and aggressiveness. This cross-sectional study examines IGD and aggression in adolescent boys (N = 240) and girls (N = 136) who play online games, recruited via a convenient sampling technique. The study also examines the aggression of gamers (G1) and non-gamers (G2). The results of two-way ANOVA show that adolescent boys and girls differ in IGD and Aggression scores with the evidence of the significance of the main effect for the assessment of IGD with F(1.374) = [6.362], p = .014. In addition, results indicated evidence of the significance of the main effect for the assessing aggression with F(1.374) = [6.645], p = .010. Further results of mixed factorial ANOVA indicated significant differences in the aggression of G1 and G2, male and female participants with the significant main effect of aggression with F(1.374) = [49.530], p < .001. The findings emphasize the importance of monitoring and regulating adolescents’ gaming behaviors, especially excessive gaming. Parents, educators, and healthcare professionals can help identify adolescents at risk of IGD and provide appropriate support and therapies. Promoting appropriate gaming habits and preventing the detrimental effects of excessive gaming in adolescents is essential.

Abstract Enhancing efficiency and productivity in countries’ healthcare systems is a global challenge. The Chinese government invested huge resources to improve the efficiency and productivity of the healthcare system across the country. To assess the success of the mission above, this research utilized DEA-SBM Meta frontier analysis alongside the Malmquist Productivity Index. These methodologies were employed to gauge Efficiency, production technology heterogeneity, and productivity of healthcare systems change across 31 mainland Chinese provinces and four distinct geographical regions throughout the study period spanning from 1997 to 2022. Results revealed that the mean efficiency score of China’s healthcare system is 0.7672. It indicates a growth potential of 23.28 percent in the operational efficiency of healthcare systems. The eastern region’s efficiency level (0.86917) is higher among all four regions. Zhejiang, Shandong, and Guangdong are the top three healthcare-efficiency performers. The technology gap ratio indicates that eastern regions witnessed a high TGR (0.9909), showing the country’s attainment of superior healthcare technologies. Beijing, Guangdong, Shanghai, Tianjin, and Zhejiang witnessed higher TGR values among all 31 mainland Chinese provinces. The total factor productivity index of the healthcare system witnessed a slight growth of 0.33%, with an average MI score of 1.0033. Efficiency change (EC) was found to be the main determinant of TFPC as technology change TC is less than EC. Moreover, the MI score of the Western region (1.033) is higher than the corresponding Eastern, northeastern, and central regions. Guizhou, Anhui, and Yunnan were found to be the top three performers in TFPC growth. Finally, the Kruskal–Wallis test confirmed the statistically significant difference among 4 Chinese regions for the healthcare system’s efficiency, TFPC, and TGR.

Abstract The Himalayas, globally acknowledged as one of the four biodiversity hotspots, underscore their ecological significance, boasting abundant flora and fauna. Among these, a diverse array of wild fruits such as Aegle marmelos, Artocarpus lakoocha, Baccaurea spp., Carissa spp., and others provide essential nutrition for local populations. These fruits, rich in bioactive compounds, offer nutraceutical potential, contributing to health aspects like antidiabetic, anti-inflammatory, and anticancer properties. The integration of Himalayan wild fruits into circular practices supports sustainable livelihoods. The responsible harvesting, efficient processing, and value addition of these fruits align with circular principles, striking a balance between conservation and progress. Technologies such as anaerobic digestion, waste-to-energy conversion, and composting can harness waste generated during cultivation and processing, contributing to a circular economy and rural Himalayan community development. Preserving, accessing, and commercializing underutilized fruits can significantly enhance economic prosperity and the quality of life for inhabitants. However, integrating these fruits into agriculture faces multifaceted challenges, spanning social, economic, environmental, agronomic, and political dimensions. Addressing these challenges is crucial for sustainable development, aiming to eradicate poverty, malnutrition, and hidden hunger. Moreover, addressing these challenges is not only vital for sustainable development in the Himalayan region but also for mitigating carbon footprints and tackling issues like poverty, malnutrition, hidden hunger, and climate change. The exploration of these concepts within the Himalayan context holds immense promise for sustainable development and ecological conservation. Graphical Abstract

Globally, diabetes mellitus (DM) and stroke are two common chronic illnesses that have a substantial impact on rates of morbidity and mortality. There is significant evidence linking diabetes to an increased risk of stroke in terms of incidence, severity, and mortality. This extensive review looks at shared risk factors, underlying pathophysiological mechanisms, epidemiological trends, and evidence-based therapy approaches to give a thorough analysis of the causal relationship between diabetes mellitus and stroke. Studies using epidemiological data regularly show that people with diabetes have a higher incidence of stroke than people without the disease. Furthermore, diabetes is linked to a less favorable outcome following a stroke, as well as an elevated chance of stroke recurrence. Determining the pathophysiological pathways that connect diabetes and stroke is essential to understanding their relationship. Key pathophysiological processes associated with these disorders include endothelial dysfunction, inflammation, oxidative stress, hyperglycemia, and dyslipidemia. Due to microvascular complications, these mechanisms raise the risk of hemorrhagic stroke and predispose diabetics to an increased risk of ischemic stroke by creating a prothrombotic and atherosclerotic milieu. Diabetes and stroke are linked due to shared risk factors like smoking, obesity, dyslipidemia, hypertension, and poor glycemic control. Lifestyle changes, blood pressure control, lipid-lowering therapy, antiplatelet medicines, and a nutritious diet are essential for stroke risk reduction. Reducing the risk of stroke in people with diabetes requires the implementation of management techniques that focus on both diabetes control and stroke prevention. Optimizing results and lowering the frequency of stroke-related complications in diabetics requires multidisciplinary care. The intricate interactions between diabetes mellitus and stroke are highlighted in this review’s conclusion, which also highlights the value of patient education, risk factor treatment, the effect of antidiabetic therapy on stroke, and integrated care in lowering the incidence of stroke in people with diabetes.

Abstract Introduction The present study evaluated the psychometric properties of the Arabic translation of the Mukbang Addiction Scale (MAS) among Arabic-speaking adults from the general population. Specifically, it aimed to assess the factorial structure through a confirmatory factor analysis, determine the composite reliability through Cronbach alpha and McDonald’s omega scores, assess gender invariance, and evaluate the convergent validity by examining its correlation to eating addiction and psychological distress. Methods A total of 370 individuals with a mean age of 21.94 ± 2.29 years participated in this study, which was conducted using an online platform. The participants were surveyed on demographic information, mukbang addiction, food addiction, and psychological distress. Translation was conducted using the forward and backward technique. Results The findings demonstrated excellent internal consistency of the Arabic MAS (McDonald’s omega coefficient = 0.93). Confirmatory factor analyses validated the one-factor structure of the scale, while establishing measurement invariance across sex at the configural, metric, and scalar levels. No sex differences were observed in the Mukbang addiction levels. Lastly, the MAS scores were significantly and positively correlated with food addiction and psychological distress, supporting their convergent validity. Conclusion The current research provides evidence supporting the reliability and validity of the Arabic version of the MAS as a self-report method for assessing addictive Mukbang watching. While further validations are needed to corroborate the present findings, this measure can be effectively utilized across different fields, including schools, mental health centers, and researchers aiming to understand this global phenomenon. Plain English Summary Mukbang refers to individuals or hosts consuming large quantities of food while interacting with their audiences through recorded video or a live stream. The Mukbang phenomenon has gained substantial popularity among young individuals over the past years, rising concerns about its potential impact on their eating habits and health, especially when overconsumed. Overconsumption of mukbang content, or Mukbang addiction, aligns with the core features of addiction, including compulsive engagement, tolerance, and withdrawal symptoms, making it comparable to other addictive behaviors. Mukbang addiction can lead to detrimental effects on mental and physical health, including neglect of balanced nutrition, disordered eating habits, obesity, feelings of guilt, shame, poor self-esteem, distorted self-images, body dissatisfaction, heightened anxiety or depression, and social isolation. Given these significant impacts, valid and reliable tools are crucial to enable an accurate assessment of Mukbang addiction. This study proposes to translate, adapt and examine the psychometric properties of the Mukbang Addiction Scale (MAS) in a sample of Arabic-speaking individuals from the general population. Findings showed that the six MAS items loaded on a single factor with strong internal consistency and good convergent validity, preliminarily indicating its potential validity and reliability for assessing addictive mukbang-watching among Arabic-speaking individuals.

Fig fruit (Ficus carica L.) drink is a source of healthy minerals, vitamins, and bioactive ingredients however to improve the shelf-life of functional drink naturally, moringa leaf extract was compared with optimized concentration of potassium metabisulphite (synthetic preservative). Purposely, fig fruit drink, without preservatives was considered as negative control whereas, 0.2 % potassium metabisulphite-based fig fruit drink was taken as positive control. Further, ultrasound assisted extracts of moringa at varied levels; 5, 10, 15, and 20 % were incorporated in the fig fruit drink as natural preservative to test antioxidant, storage, and sensory quality against control samples. Resultantly, the maximum loss in antioxidant activity (18–38 %) and functional ingredients (24–56 %) was observed in negative control sample, in response to high microbial expansion till the termination of the study. Additionally, acceptability score for negative control sample was maximum at Day 1, that afterwards faced significant decline at 30th Day (6.6 ± 0.3). In contrast, positive control sample demonstrated minimum loss of free radical scavenging ability (7–22 %), polyphenols (11 %) and flavonoids (7 %) thus indicated maximum control on microbes i.e. 61–63 % as compared to negative control. Further, positive control sample indicated optimum consumer preference (7.0 ± 0.3) that remained stable throughout storage. Further, as the concentration of moringa exceeded from 5 to 20 %, the loss of functional ingredients reduced from 13 to 24 to 6–11 % and deterioration in antioxidant capacity suppressed from 14 to 26 to 8–20 %, correspondingly however, the sensory acceptability showed a declining trend, and 20 % moringa based sample portrayed poor consumer response (5.0 ± 0.2). Lastly, it was deduced that control on microbes was directly proportional to the concentration of moringa extract in fig fruit drink, that was poor in 5 % moringa extract concentration; 32–54 %. Conclusively, customer preference was reasonable (6 ± 0) at 15 % moringa extract concentration so this level should be employed in fig fruit drink for realistic control on bacterial (57 %) and fungal (47 %) activities.

Background No Arabic validated scale is available to date to measure AI literacy. The current study aimed to evaluate the psychometric properties of a first Arabic translation of the Artificial Intelligence Literacy Scale (AILS) among university students from four Arab countries (i.e. Lebanon, Saudi Arabia, Morocco and Palestine).Methods Online cross-sectional data collection took place in July 2023 among university students (N = 1849, mean age of 21.37 ± 3.84 years, 74.3% females).Results The Arabic version replicated the original four-factor structure of the AILS. Internal consistency reliability coefficients were excellent (Cronbach α = .92). Moreover, scalar, metric and configural invariance was supported across sex and country. Finally, concurrent validity was established through significant negative correlations of the AILS scores with levels of fear of autonomous robots and artificial intelligence.Conclusion Making an Arabic version of the AILS available can guide course designs and development at the higher education system, to include AI in both curricula and assessment settings.

Coating materials play a crucial role in prolonging the shelf life of fruits by establishing a protective barrier against microbial growth and preserving their freshness. In this investigation, we formulated an edible composite coating solution comprising chitosan (CS), tannic acid (TA), and beeswax (BW) in the following proportions: 0.5 % chitosan, 0.5 % tannic acid, and 2 % beeswax. The solution was created by blending equal volumes (1:1) of 1 % CS and 1 % TA solutions. Subsequently, 2 % solid BW was dissolved through gentle heating, with the addition of 0.2 % glycerol and 0.2 % Tween80. This solution exhibited outstanding antioxidant activity, registering a percentage inhibition of 87.64±1.4 %. Moreover, the solution demonstrated antibacterial effectiveness against Escherichia coli and Bacillus subtilis, with an efficiency of 46–48 %, compared to the standard antibiotic Kanamycin. To assess its efficacy in preserving fruits, we applied the solution to peach surfaces using cotton swabs and observed them at room temperature over several days. It became evident that untreated samples began to spoil and exhibited signs of microbial growth within just 3, 4 days, whereas treated samples remained preserved even after 9, 10 days. Additionally, after 6 days, the treated samples showed slightly less weight loss at 9.10±0.63 %, compared to the control samples at 10.31±0.21 %. The fruit firmness of the treated samples was 4.453±0.59 N, while the control samples measured 3.707±1.98 N. The control samples showed a greater decrease in titrable acidity, with a difference of 0.03 % from day 0 to day 9, compared to a difference of 0.024 % in the treated samples. This study underscores the potential of the CS/TA/BW solution as an innovative edible fruit coating, emphasizing its remarkable antioxidant and antibacterial properties.

South Africa has been rated as having the most severe HIV epidemic in the world since it has one of the largest populations of people living with HIV (PLHIV). KwaZulu-Natal (KZN) is the epicentre of the HIV epidemic. The HIV test and treat services in the public health sector are critical to managing the epidemic and responding to the increase in HIV infections. The KwaZulu-Natal Department of Health (DOH) commissioned a review of the provision of HIV testing services in the province and aimed to investigate its impact on the HIV positivity rate over a ten-year period. The study was an ecological study design using data extracted from the Department’s District Health Information System (DHIS). Descriptive analysis was conducted in addition to ANOVA and multiple regression analysis. The results of this study have shown that the total number of HIV tests conducted over the ten-year period in the province has increased with the highest number of HIV tests being conducted in the 2018/2019 MTEF year. ANOVA analysis indicates that there was a statistically significant difference in the total number of HIV tests conducted and the number of HIV tests per 100 000 population across the province’s 11 districts (p

Background Each year world-wide about 65 million people sustain a mild traumatic brain injury (mTBI). Fatigue is a common and distressing symptom after mTBI. We examine the effect of tranexamic acid (TXA) on fatigue in patients with mTBI using data from the CRASH-3 trial. Methods The CRASH-3 trial randomised 9,202 patients with traumatic brain injury and no significant extracranial bleeding to receive TXA or placebo within 3 hours of injury. The primary outcome was death from head injury within 28 days of injury. The methods and results are presented elsewhere. Fatigue was recorded as “None”, “Moderate” or “Extreme.” This study examines the effect of TXA on extreme fatigue in the 2,632 patients with mTBI (Glasgow Coma Scale [GCS] score≥13). Our analyses were not prespecified. Results Our study primary outcome, extreme fatigue, was reported for 10 (0.8%) of 1,328 patients receiving TXA and 19 (1.5%) of 1,288 patients receiving placebo (risk ratio [RR]=0.51, 95% confidence interval [CI] 0.24-1.09). Death within 28 days of injury was reported for 34 (2.6%) of 1,328 patients receiving TXA versus 47 (3.6%) of 1,288 patients receiving placebo (RR=0.70, 95% CI 0.45-1.08). Among patients allocated to TXA, 44 (3.3%) patients either died or reported extreme fatigue versus 66 (5.1%) patients among those allocated to placebo (RR=0.65, 95% CI 0.44-0.94). This composite outcome is disproportionately influenced by deaths which account for 74% (81 from 110) of events. Conclusions We found no evidence that tranexamic acid reduces fatigue in patients with mTBI. Given, 1) our analyses were not prespecified, 2) our outcome measure is not based on a validated fatigue severity scale, and 3) TBI patients can suffer from hospital-induced delirium, which hinders clinician assessment, these results need to be replicated in another study. Registration ISRCTN (ISRCTN15088122, 19/07/2011), ClinicalTrials.gov (NCT01402882, 26/07/2011), EudraCT (2011-003669-14, 25/07/2011), Pan African Clinical Trial Registry (PACTR20121000441277, 30/10/2012).

Summary: Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.4% of young (

BACKGROUND: Literature on the frequency, response to treatment, and outcomes of acute ischemic stroke (AIS) due to intracranial atherostenosis (ICAS)-related intracranial large artery occlusion (ILAO) from Saudi Arabia is scarce. The aim of this study was to identify the percentage, describe the characteristics, and observe the treatment response in patients with AIS attributed to ICAS-related ILAO. MATERIALS AND METHODS: This cross-sectional study included all adult patients from 2017-2021 who fulfilled the inclusion criteria for the diagnosis of ICAS-related AIS. Patients were dichotomized based on ILAO. Mortality and functional outcomes (FOCs) based on 90 days’ dependence level were compared between the two groups. The association between ILAO and other variables was assessed using the Chi-squared test, odds ratios (OR), and 95% confidence interval (CI). RESULTS: ILAO was found in 38.7% of patients with ICAS-related AIS. Men comprised three-fourths of the cohort and were more frequent in the ILAO group. Smoking was associated with increased (P = 0.04) likelihood of ILAO. Patients with ILAO had more severe strokes (P ≤ 0.001) than patients without. Middle cerebral artery was the most common occluded vessel (52%). Functional dependence (P = 0.003, OR = 2.87, CI = 1.42–5.77), malignant transformation (P = 0.001, OR = 8.0, CI = 1.82–35.9), and mortality (P ≤ 0.001, OR = 7.67, CI = 2.40–24.5) were significantly higher among ILAO group. Patients with ILAO with unfavorable FOC were older than those who achieved better FOC (P ≤ 0.001). Thrombolysis (P = 0.02, OR = 2.50, CI = 1.15–5.41) and mechanical thrombectomy (MT) improved FOC in patients with ILAO (P = 0.04, OR = 2.33, CI = 1.10–4.92). CONCLUSION: ILAO is common in patients with ICAS-related AIS. Timely hyperacute stroke treatment can help improve the FOC of otherwise disabling stroke due to ILAO. Raising awareness of the community about stroke is needed, so that a higher number of patients can arrive at hospital within the golden hours. Further data from the region are required to recognize the efficacy of MT in ICAS-related ILAO.

Abstract Background Depression, anxiety, and stress are the commonly encountered mental health conditions among medical students. Overseas environment may add additional burden to the existing environment. However, comparison of the rate and associated factors of depression, anxiety, stress among domestic and overseas students has not been attempted in Bangladesh. We aimed to assess the rate and associated factors of depression, anxiety, stress among domestic and overseas medical students in the country. Methods This cross‐sectional study was conducted among 360 undergraduate medical students in 2021. Data were collected by self‐reporting instruments by a stratified random sampling method by the Depression, Anxiety, and Stress Scale‐21 scale. Bivariable and multivariable binary logistic regression analyses were done by computing crude odds ratio and adjusted odds ratio with 95% confidence interval to identify the associated factors. Results Among the 360 undergraduate medical students, 181 were domestic and 179 overseas ones. 44.8% of domestic students reported depressive symptoms, 45.3% reported anxiety symptoms, and 33.1% reported stress. On the other hand, half of overseas students experienced depression (50.3%) and anxiety (52.5%), and 41.3% experienced stress. Female medical students were found vulnerable for developing depression, anxiety, and stress than males. Conclusions The study revealed higher rates of depression, anxiety, and stress among overseas undergraduate medical students enrolled in a private medical school of Bangladesh. Private medical college authorities could consider special services for overseas students to ensure adequate psychosocial support.

Efficiently utilizing the energy resources in the agriculture sector to produce more agricultural output with minimum environmental degradation is a shared global challenge. The Chinese government has introduced various policies aimed at enhancing energy efficiency (EE) and total factor energy productivity (TFEP) while addressing regional technological disparities in the agricultural sector. This study utilized DEA Super-SBM, Meta frontier Analysis, and the Malmquist–Luenberger index to assess energy efficiency, changes in total factor energy productivity, and the regional technology gap ratio (TGR) across 30 provinces in mainland China and three distinct regions during the period from 2000 to 2020. The findings reveal that the average EE in China's agricultural sector is 0.8492, indicating that, on average, there is a 15.08 % potential for improvement in EE growth within the sector. Qinghai (1.5828), Shanghai (1.3716), and Hainan (1.3582) are found to be the top 3 performers with the highest EE levels. The Eastern region demonstrates high excellence in EE, with a value of 1.0532. The TGR value of Zhejiang indicates the superior production technology utilized in the agriculture sector to utilize energy resources efficiently. Except for Zhejiang, the TGR of Liaoning, Jiangsu, Shanghai, Guangdong, Ningxia, and Hainan is above 0.96 and near 1, indicating superior production technology in the agriculture sector of China. The Technology Gap Ratio (TGR) of China's eastern region is superior to that of the central and western regions, consistently approaching 1. This suggests that the eastern provinces possess more advanced agricultural technologies, allowing them to optimize resource utilization for maximum output. The Malmquist–Luenberger index (MLI) score of 1.103 indicates a 10.3 % growth in the total factor energy productivity of China's agricultural sector. Further analysis reveals that this growth is primarily driven by technological change (TC), with a TC value of 1.080 surpassing the efficiency change (EC) value of 1.028. Among the three agricultural regions, the eastern region exhibits the highest total factor energy productivity. Specifically, Zhejiang (1.23), Shanghai (1.197), Liaoning (1.184), and Hebei (1.147) are identified as the top performers in total factor energy productivity growth in China's agricultural sector. Additionally, the Kruskal-Wallis test confirmed statistically significant differences in EE and TGR among the three regions.

Many entrepreneurs across the US are the key players in building a greener economy. Their agility and innovative spirit offer a source of potential solutions. This is especially true for small businesses, which can quickly adapt to sustainable practices. Therefore, this research investigated the direct and indirect (mediating) roles of waste management and green innovations in green supply chain management and enviropreneurship performance, which is a transition from environmental to enviropreneurship advocacy. This study used a deductive approach with a quantitative research method. A study of a survey for 835 supply chain professionals in US small and medium enterprises used a Structural Equation Modeling technique to test specific research hypotheses. The findings of this study unveiled a positive and significant effect of exogenous variables on endogenous variables. Besides waste management and green innovation, a significant mediation was found between the relationships between green supply chain management and entrepreneurship performance. This research highlights key strategies to boost entrepreneurial performance. Green practices enhance environmental outcomes, minimize waste, bolster stakeholder relationships, lead to cost savings, and improve brand reputation and regulatory compliance. The study identifies areas needing improvement and supports sustainable development. Adhering to environmental regulations shows a commitment to sustainability and helps avoid legal issues. By following these recommendations, managers can foster a greener future for their organizations. This research presented ''enviropreneurship performance'' as a key factor for businesses implementing green supply chains and practices. It proposes an innovative model that connects green practices to this performance, providing important insights for future studies. The study validated this concept by employing a Resource-based View and testing the hypotheses using structural equation modeling, which enhanced the understanding of enviropreneurship within a developed economy.

Objective Preclinical validation study to assess the feasibility and accuracy of electromagnetic image-guided systems (EM-IGS) in orbital surgery using high-fidelity physical orbital anatomy simulators.Methods EM-IGS platform, clinical software, navigation instruments and reference system (StealthStation S8, Medtronic) were evaluated in a mock operating theatre at the Royal Victoria Eye and Ear Hospital, a tertiary academic hospital in Dublin, Ireland. Five high-resolution 3D-printed model skulls were created using CT scans of five anonymised patients with an orbital tumour that previously had a successful orbital biopsy or excision. The ability of ophthalmic surgeons to achieve satisfactory system registration in each model was assessed. Subsequently, navigational accuracy was recorded using defined anatomical landmarks as ground truth. Qualitative feedback on the system was also attained.Results Three independent surgeons participated in the study, one junior trainee, one fellow and one consultant. Across models, more senior participants were able to achieve a smaller system-generated registration error in a fewer number of attempts. When assessing navigational accuracy, submillimetre accuracy was achieved for the majority of points (16 landmarks per model, per participant). Qualitative surgeon feedback suggested acceptability of the technology, although interference from mobile phones near the operative field was noted.Conclusion This study suggests the feasibility and accuracy of EM-IGS in a preclinical validation study for orbital surgery using patient specific 3D-printed skulls. This preclinical study provides the foundation for clinical studies to explore the safety and effectiveness of this technology.

Abstract Background Given the dire need for health and rehabilitation services internationally, exacerbated during the COVID-19 pandemic, there is a critical need to develop tools to support service delivery. This need is palpable in the Global South where tools developed in Eurocentric contexts are not always adaptable, applicable, or relevant. It is for this reason that the researchers present three case studies of tool development using pilot and feasibility studies in South Africa and share the lessons learned from these studies. Objectives To describe three case studies that developed new tools for health and rehabilitation services using pilot and feasibility studies. To synthesize lessons learned from these case studies on the development of tools. Method The researchers describe three case studies that were developed. The case studies are summarized as follows: aims and objectives, context, problem, study design, findings, and what happened after the study. Thereafter, a qualitative cross-case analysis was conducted by the researchers to generate themes. Findings The case studies are described individually and followed by themes identified through cross-case analysis. Discussion The lessons learned are discussed. It is essential to develop new tools and protocols, motivated by the need for equitable and contextually relevant practices. Partnerships and collaboration with end-users are critical for success. A critical, scientific process is essential in developing new tools. Pilot and feasibility studies are invaluable in developing tools and assessing the feasibility of tools and implementation. The goal is to develop practical, usable tools and protocols. Conclusion Through the lessons learned, the researchers are hopeful that the international health and rehabilitation professions will continue to strengthen the scientific development of contextually relevant tools and resources.

Advancements in unmanned aerial vehicle (UAV) technology, along with indoor hybrid LiFi-WiFi networks (HLWN), promise the development of cost-effective, energy-efficient, adaptable, reliable, rapid, and on-demand HLWN-capable indoor flying networks (IFNs). To achieve this, a unified physical layer (UniPHY) capable of simultaneous control communication, data transfer, and sensing is crucial. However, traditional block-based decoders, designed independently for LiFi and WiFi, perform poorly in complex and hybrid LiFi-WiFi-enabled UniPHY systems. In this study, we propose an end-to-end learning framework based on convolutional neural networks (CNNs) for UniPHY, which can be trained to serve hybrid LiFi-WiFi transmissions to improve error performance and simplify UAV hardware. In this work, the performance of the proposed framework is assessed and compared with that of the conventional independent block-based communication system. Furthermore, a comprehensive summary of optimal hyper-parameters for efficient training of our learning framework has been provided. It is shown that, with optimal hyper-parameters, the proposed CNN-based framework outperforms the conventional block-based approach by providing a signal-to-noise ratio gain of approximately 7 dB for the LiFi channel and 23 dB for the WiFi channel. In addition, we evaluate the complexity and training convergence for loss and accuracy.

Objective: To analyse self-medication practice and its determinants among non-medical adult population of Rawalpindi. Study type, settings & duration: A cross-sectional descriptive study was carried out in Rawalpindi city from April to September 2022. Methodology: The 382 non-medical adults were enrolled through consecutive non-probability sampling. Self-administered structured questionnaire was used to gather the information pertinent to demographics of study subjects, distance from healthcare facility, access to medicines, ways of demanding medicine from pharmacist, reasons/ ailments for self-medication and source of information about drug. The data was analysed by using SPSS version 25.0 and Microsoft Excel 2016. Chi-square test was applied to determine the association of self-medication practice with education and socio-economic status. p < 0.05 was considered significant. Results: Out of 382 study subjects, most (54.2%) were females with mean age of 22.46±0.79 years. About 83% respondents were indulged in self-medication practice and 31.8% of them did self-medication due to quick relief from symptoms while 43.3% of the 65 persons did not indulge in self-medication due to fear of wrong use of drug. Low and middle social class had statistically significant association (p 0.05) with self-medication practice. Almost 61.8% of respondents were urban dwellers and 70% were students. About 40.14% were practicing self-medication in compliance with previous prescription. Conclusion: Female students are more indulged in self-medication practice for getting relief of their symptoms from previously prescribed medications.

Background: Vision challenges are among the most prevalent disabling conditions in childhood, affecting up to 28% of school-age children. These issues can impact the development, learning, and literacy skills of affected children. While vision problems are correctable with timely diagnosis and treatment, insufficient networks can impede children's access to comprehensive, and high-quality care. Objective: The study aims to determine where pediatric vision care network adequacy exists in the state of Arizona and where there are gaps in receiving vision care for children. Methods: This cross-sectional study assessed the adequacy of pediatric vision care networks in Arizona through a “secret shopper” phone survey. Calls were made to practices that accept Arizona's Medicaid program, Arizona Health Care Cost Containment System (AHCCCS) and/or commercial insurance. Providers were contacted following a standardized script to schedule routine appointments on behalf of 10 and 3-year-old patients enrolled in either Medicaid or commercial health insurance plans. The study examined various components of children's access to vision care services, including the reliability of provider directory information, time until the next available appointment, bilingual service offerings, ages served, region of practice and types of care available. Results: A total of 556 practices in Arizona were evaluated through simulations as patients on AHCCCS, and 510 practices were assessed through simulations as patients with commercial health insurance plans. The average wait time for the next available appointment was 13 days for both insurance types. Alarmingly, up to 74% of vision care practices in Arizona do not serve children covered by AHCCCS. Furthermore, only 41% provide services to children 5 years and younger. Conclusions: Our findings underscore the need to improve access to vision care services for children in Arizona, especially racial/ethnic minorities, low-income groups, and rural residents.

Background and Aims: Metabolic dysfunction-associated steatohepatitis is an advanced form of nonalcoholic fatty liver disease and a leading cause of end-stage liver disease and transplantation. Insulin resistance and inflammation underlie the pathogenesis of the disease. Methods: This double-blind, randomized, placebo-controlled, multicenter feasibility clinical trial aimed to determine the safety of oral 8 mg insulin in patients with metabolic dysfunction-associated steatohepatitis and type 2 diabetes mellitus. Patients were treated twice daily for 12 weeks with an 8 mg insulin (n = 21) or placebo (n = 11) capsule. Safety was monitored throughout the study. MRI-proton density fat fraction assessed liver fat content, and Fibroscan® measured liver fibrosis and steatosis levels at screening and after 12 weeks of treatment. Results: No severe drug-related adverse events were reported during the study. After 12 weeks of treatment, mean percent reductions in whole-liver (−11.2% vs −6.5%, respectively) and liver segment 3 (−11.7% vs +0.1%, respectively) fat content was higher in the insulin than in the placebo arm. Patients receiving insulin showed a median −1.2 kPa and −21.0 dB/m reduction from baseline fibrosis and steatosis levels, respectively, while placebo-treated patients showed median increases of 0.3 kPa and 13.0 dB/m, respectively. At Week 12, oral insulin was associated with a mean of 0.27% reduction and placebo with a 0.23% increase from baseline hemoglobin A1c levels. Mean percent changes from baseline alanine aminotransferase, and aspartate aminotransferase levels were −10% and −0.8%, respectively, in the oral insulin and 3.0% and 13.4%, in the placebo arm. Conclusion: The results of this feasibility study support the safety and potential therapeutic effect of orally delivered insulin on liver fibrosis, fat accumulation, and inflammatory processes (NIH Clinical Trials No. NCT04618744).

In this study, a weighted federated learning approach is proposed for electrocardiogram (ECG) arrhythmia classification. The proposed approach considers the heterogeneity of data distribution among multiple clients in federated learning settings. The weight of each client is dynamically adjusted according to its contribution to the global model improvement. Experiments on public ECG datasets show that the proposed approach outperforms traditional federated learning and centralized learning methods in terms of accuracy and robustness. On the client side, the suggested federated learning (FL) approach had an accuracy of 0.93, sensitivity of 0.98, specificity of 0.82, miss classification rate of 0.07, precision of 0.06, FPR of 0.01, and FNR of 0.01. FL has 0.98 accuracy, 0.99 sensitivity, 0.91 specificity, 0.02 miss classification rate, 0.10 precision, 0.01, FPR, and 0.01 FNR on the server. The server-side federated learning approach outperforms the client-side in accuracy, sensitivity, specificity, miss classification rates, and precision. The results indicate that the proposed weighted federated learning approach is a promising solution for ECG arrhythmia classification in a distributed environment. In short, the proposed federated learning approach applied to ECG arrhythmia detection aims to address privacy concerns and improve accuracy, while still maintaining the centralized framework and advanced algorithmic approach.

The efficient management of water resources in Chinese agriculture is crucial for ensuring food security and mitigating environmental consequences such as water scarcity and pollution. Agricultural technological innovation is crucial in optimizing agricultural practices and making them more sustainable. To this end, this study investigates the dynamic relationship between agricultural technological innovation and total-factor agricultural water usage efficiency (TFAWUE) in Chinese provinces from 2000 to 2020. The study utilizes the Data Envelopment Analysis (DEA) Malmquist productivity index approach to measure the overall efficiency of water usage in agriculture, known as total-factor agricultural water usage efficiency (TFAWUE). The findings suggest that the mean TFAWUE score of Chinese provinces is 1.1356, surpassing a value of 1. It illustrates that Chinese provinces witnessed a growth of 13.56 in TFAWUE over the study period. Technological change is the primary determinant of growth in the TFAWUE, as technology change (TC) is higher than efficiency change (EC). Subsequently, by employing a rigorous econometrics series, this study provides valuable insights into the intricate dynamics of agricultural technological innovation and its impact on total-factor agricultural water usage efficiency. The study constructs a composite multidimensional index of agricultural technological development, encompassing various technologies pivotal to the agriculture sector. Analysis shows that agricultural technologies enable farmers to implement water conservation practices effectively to enhance agricultural water usage efficiency. However, the farm scale reduces the efficiency of agricultural water usage. Additionally, sprinkler technology positively enhances water usage efficiency in agriculture. These findings provide valuable insights for policymakers in the agricultural sector, offering guidance on sustainable practices and policies for managing water resources in conjunction with improvements in agricultural technologies.

This study investigates the simultaneous influence of the digital economy, environmental technologies, business activity, and institutional quality on both the environment and economic growth in G7 economies from 1996 to 2020. The study provides an in-depth analysis to investigate the influence of institutional quality, particularly the regulatory environment, on business activity. Employing a rigorous methodology encompassing correlation analysis, long-term examination using Driscoll and regression estimators, and the utilization of various digital economy indicators such as internet usage and cell subscriptions, we uncover significant insights. The findings underscore the substantial impact of digital economies in mitigating carbon emissions and driving economic growth at an accelerated rate. Moreover, the study reveals that certain regulatory constraints on corporate operations can paradoxically facilitate carbon emission management while also fostering economic expansion. The study validates the presence of an inverted U-shaped Environmental Kuznets Curve (EKC) in G7 economies. This suggests that there is a specific point at which economic activities start to contribute more to carbon emissions. Moreover, the study highlights the importance of achieving a balance between economic growth driven by foreign direct investment and the goals of environmental sustainability. Environmental technology is becoming increasingly important in the regulation of emissions. Significantly, the study highlights the need to enhance the quality of implementing institutional regulations. It suggests that G7 economies can improve both environmental quality and economic growth by adopting superior regulatory methods. These findings are relevant for governments seeking economic growth and environmental protection. They suggest the need for specific policy actions to accomplish sustainable development goals.

Prion diseases are a type of neurodegenerative disorder caused by the transmission of specific pathogens containing prion proteins. Due to the unique structural characteristics of Prion proteins (PrP), which differ from other types of proteins, the extended incubation period observed in the transmission of specific Prions can be attributed to these differences, at least in part. Prions are found in several other mammals and animals. Prions are unique among false protein folding abnormalities because these are infections and contain various strains of contagious agents associated with a unique in vivo phenotype. They can be acquired either by inheritance or sporadically. There are two types: classical and typical BSP. The objective of this study was to observe the Bhagnari cattle breed of Balochistan, Pakistan, and compare the PrP gene sequence of the Bhagnari with other reported sequences from Pakistan and other parts of the world. This research collected 40 Bhagnari cattle blood samples from Tali, Bhag Nari, and Sibi district areas. DNA extraction of each sample was performed by inorganic method, and then DNA amplification and sequencing of PRNP Gene was performed. The results of this research work showed different polymorphic variations (SNPs) in 16 samples. In this study, while mutations causing prion diseases in cattle were detected in Italian and German breeds, none were identified in the PRNP gene of the cattle population investigated, despite its association with neurological disorders.

The trustworthiness of qualitative data has been debatable, yet it has strong support from its supporters. However, the importance and worth of qualitative data cannot be undermined. This paper presents a critical review of the trustworthiness of the qualitative data. The degree of trustworthiness of qualitative research can be measured by ensuring the credibility, transferability, dependability, and conformability of research design, process, and action. The guarantee of trustworthiness in qualitative research is more complex than in quantitative research due to its subjective nature. Many researchers and experts denied the generalizability of qualitative research. However, few researchers, like Guba (1985), developed a widely accepted model and strategies to ensure the trustworthiness and generalizability of qualitative research. Credibility is like internal validity in quantitative analysis and provides the actual data about the phenomenon. Transferability shows the degree of application of the research finding in other exact natures of context, people, groups, and settings. If the findings of one study are replicated in a similar population, condition, or context, then the findings are dependable. Neutrality is the degree of fairness of results consisting of purity of initial responses and bias-free.

Abstract Background Postpartum haemorrhage (PPH) causes about 70,000 maternal deaths every year. Tranexamic acid (TXA) is a life-saving treatment for women with PPH. Intravenous (IV) TXA reduces deaths due to PPH by one-third when given within 3 h of childbirth. Because TXA is more effective when given early and PPH usually occurs soon after childbirth, giving TXA just before childbirth might prevent PPH. Although several randomised trials have examined TXA for PPH prevention, the results are inconclusive. Because PPH only affects a small proportion of births, we need good evidence on the balance of benefits and harms before using TXA to prevent PPH. TXA is usually given by slow IV injection. However, recent research shows that TXA is well tolerated and rapidly absorbed after intramuscular (IM) injection, achieving therapeutic blood levels within minutes of injection. Methods The I’M WOMAN trial is an international, multicentre, three-arm, randomised, double-blind, placebo-controlled trial to assess the effects of IM and IV TXA for the prevention of PPH in women with one or more risk factors for PPH giving birth vaginally or by caesarean section. Discussion The trial will provide evidence of the benefits and harms of TXA for PPH prevention and the effects of the IM and IV routes of administration. The IM route should be as effective as the IV route for preventing bleeding. There may be fewer side effects with IM TXA because peak blood concentrations are lower than with the IV route. IM TXA also has practical advantages as it is quicker and simpler to administer. By avoiding the need for IV line insertion and a slow IV injection, IM administration would free up overstretched midwives and doctors to focus on looking after the mother and baby and expand access to timely TXA treatment. Trial registration ClinicalTrials.gov NCT05562609. Registered on 3 October 2022. ISRCTN Registry ISRCTN12590098. Registered on 20 January 2023. Pan African Clinical Trial Registry PACTR202305473136570. Registered on 18 May 2023.

OECD countries are at the forefront of sustainable development and working in several domains, including energy efficiency, environmental taxes, and the development of green technology. On this premise, the study’s main objective is to examine the impact of green technology , environmental taxes and natural resources on energy efficiency. The study used three dimensions of energy measurement: (i) energy efficiency, (ii) energy productivity, and (iii) energy intensity for OECD. An important feature of the study is the use of the “Rule of Law” to implement tax reforms and green technology. Malmquist–Luenberger and the super SBM-DEA are used to measure energy efficiency and productivity. France, Greece, Italy, Luxemburg, Sweden, Lithuania, Colombia, and Turkey’s energy efficiency range is between 1–1.5. Switzerland’s energy efficiency ranges from 1.5–2.0. The United States of America, Japan, the UK, Australia, Germany, Canada, and South Korea’s energy efficiency ranges are between 0.5–1.0. Beyond that, the higher energy-intensive countries are Canada, Estonia, South Korea, Finland, the USA, the Czech Republic, Australia, and the Slovak Republic. Regression analysis highlighted that the environmental tax and green technology are important drivers for improving energy efficiency and productivity and lowering energy intensity. The impact strength of environmental tax is higher than green technology to boost energy efficiency and limit energy intensity. Increasing rent on natural resources can raise the energy intensity and affects environmental sustainability. The study found that “the rule of law” is important for putting green technologies and tax reform into practice. Due to “the rule of law”, industries must abide by the green principle and pay attention to growth and the environment.

Abstract Studies of genetic factors associated with severe COVID-19 in young adults have been limited in non-Caucasian populations. Here, we clinically characterize a case series of patients with COVID-19, who were otherwise healthy, young adults (N = 55; mean age 34.1 ± SD 5.0 years) from 16 Asian, Middle Eastern, and North African countries. Using whole exome sequencing, we identify rare, likely deleterious variants affecting 16 immune-related genes in 17 out of 55 patients (31%), including 7 patients (41% of all carriers or 12.7% of all patients) who harbored multiple such variants mainly in interferon and toll-like receptor genes. Protein network analysis as well as transcriptomic analysis of nasopharyngeal swabs from an independent COVID-19 cohort (N = 50; 42% Asians and 22% Arabs) revealed that most of the altered genes, as identified by whole exome sequencing, and the associated molecular pathways were significantly altered in COVID-19 patients. Genetic variants tended to be associated with mortality, intensive care admission, and ventilation support. Our clinical cases series, genomic and transcriptomic findings suggest a possible role for interferon pathway genes in severe COVID-19 and highlight the importance of extending genetic studies to diverse populations to better understand the human genetics of disease.

Background: The recent COVID vaccinations have successfully reduced death and severity but did not stop the transmission of viruses by the emerging SARS-CoV-2 strain. There is a need for better and long-lasting dynamic vaccines for numerous prevailing strains and the evolving SARS-CoV-2 virus, necessitating the development of broad-spectrum strains being used to stop infection by reducing the spread rate and re-infection. The spike (S) glycoprotein is one of the proteins expressed commonly in the early phases of SARS-CoV-2 infection. It has been identified as the most immunogenic protein of SARS-CoV-2. Methods: In this study, advanced bioinformatics techniques have been exploited to design the novel multi-epitope vaccine using conserved S protein portions from widespread strains of SARS-CoV-2 to predict B cell and T cell epitopes. These epitopes were selected based on toxicity, antigenicity score and immunogenicity. Epitope combinations were used to construct the maximum potent multi-epitope construct with potential immunogenic features. EAAAK, AAY, and GPGPG were used as linkers to construct epitopes. Results: The developed vaccine has shown positive results. After the chimeric vaccine construct was cloned into the PET28a (+) vector for expression screening in Escherichia coli, the potential expression of the construct was identified. Conclusion: The construct vaccine performed well in computer-based immune response simulation and covered a variety of allelic populations. These computational results are more helpful for further analysis of our contract vaccine, which can finally help control and prevent SARS-CoV-2 infections worldwide.

Jamun plant displays enormous diversity throughout Pakistan, which necessitates its screening, evaluation, and validation to document elite genotypes having better traits for the benefit of the fruit industry and farmers. Surveys were made in natural Jamun habitats across Punjab, Pakistan, and genotypes were marked based on visual diversity of trees and fruits. In total, 60 Jamun genotypes were selected for characterization based on phenotypic and genetic markers. Phenotypic characters related to trees, leaf, and flower along with fruit qualitative traits were assessed in situ. Results revealed significant diversity with high (>25%) coefficient of variance values and the first two components of correspondence analysis exhibited 41.71% variation among genotypes. A strong association was observed among traits like upright tree and round fruit shape (0.74), bluish-colored fruit and pinkish pulp (0.85), and elliptic-shaped fruit with low fruit waxiness (−0.72). Leaves of phenotypically characterized plants were brought to Wheat Biotechnology Lab., University of Agriculture, Faisalabad, Pakistan, where Jamun genotypes were investigated genetically using Random Amplified Polymorphic DNA (RAPD) and Inter Simple Sequence Repeat (ISSR) markers. A total of 132 bands were scored, of which 108 were polymorphic, corresponding to almost 81% polymorphism among collected genotypes. High polymorphism information content values were observed against RAPD (0.389) and ISSR (0.457) markers. Genotypes were compared in relation to genetic markers, which exhibited that almost 86% of genetic variability was attributed to differences among accessions, while 14% of variation was due to differences between collections of different areas. Findings of this study confirmed wide phenotypic and genetic distinctness of Jamun in Pakistan that can aid breeders for marker-assisted selection and germplasm enhancement for future crop improvement programs.

The current study intended to investigate the role of new natural compounds derived from the Sesuvium sesuvioides plant in mitigating symptoms of diabetes and insulin resistance in the diabetic mice model. Anti-advanced glycation activity, insulin, and adiponectin were quantified by enzyme-linked immunosorbent assay (ELISA). Glucose uptake was performed using enzymatic fluorescence assay, and glycogen synthesis was measured using PAS staining. Gene and protein expression was assessed using real time PCR (RT-PCR), and immunoblotting and fluorescent microscopy, respectively. The new flavonoid glycoside eupalitin 3-O-α-L-rhamnopyranosyl-(1→2)-β-D-glucopyranoside 1 isolated from S. sesuvioides exhibited anti-AGE activity by reducing human glycated albumin in liver cells. In a diabetic mouse model treated with compound 1, we observed improved glucose tolerance, increased adiponectin levels, and decreased insulin resistance. We also observed alleviated AGEs induced reduction in glucose uptake and restored glycogen synthesis in the compound 1-treated diabetic mice muscles. Exploring the molecular mechanism of action in skeletal muscle tissue of diabetic mice, we found that 1 reduced AGE-induced reactive oxygen species and the inflammatory gene in the muscle of diabetic mice. Additionally, 1 exhibited these effects by reducing the gene and protein expression of receptor for advanced glycation end products (RAGE) and inhibiting protein kinase C (PKC) delta activation. This further led us to demonstrate that compound 1 reduced serine phosphorylation of IRS-1, thereby restoring insulin sensitivity. We conclude that a new flavonoid glycoside from S. sesuvioides could be a therapeutic target for the treatment of symptoms of insulin resistance and diabetes.

ABSTRACTDamage to body tissue either deeply or superficially causes pain sensation in response to which Inflammation occurs which is a normal protective natural response of the body to a variety of hostile agents. Different treatment options, including conventional and herbal therapies, are available for pain and inflammation. This study was designed to evaluate the polyherbal n-hexane and methanolic extracts and their hydrogel formulations prepared from commonly available medicinal plants for their analgesic and anti-inflammatory potential. Cinnamomum verum J. (bark), Moringa oleifera L. (leaves), Nigella sativa L. (seed), and Trigonella foenum graecum L. (seed) were collected and purchased from the vicinity and local market of Multan Punjab, Pakistan. After drying, extraction was carried out by maceration separately with two different solvents (methanol and n-hexane). An equal quantity of all methanolic and n-hexane extracts was used to formulate polyherbal methanolic and n-hexane extracts separately. Then 1%, 3%, and 5% pH-based hydrogel formulations of methanolic and n-hexane polyherbal extract were prepared. All prepared six formulations were evaluated for pH, rheological study, spreadability, extrudability, stability study, texture, color, and for toxicological study. Then analgesic and anti-inflammatory potential of methanol and n-Hexane polyherbal extracts at (200, 400 and 800.0 mg/kg) in comparison with diclofenac sodium (100 mg/kg) and prepared gel formulations (1%, 3%, and 5%) were also evaluated in comparison to diclofenac sodium 1% gel (standard drug). Both polyherbal extracts and their gel formulations have significant analgesic and anti-inflammatory potential but methanolic extract and its hydrogel have slightly more potential as compared to n-hexane extracts and its prepared hydrogel. Results also revealed that their gel formulations have more significant analgesic and anti-inflammatory potentials as compared to extracts. All pH-based gels have good texture, spreadability, extrudability, stability, and are safe to use. It is concluded that methanolic polyherbal extract and hydrogel prepared from methanolic extract have more analgesic and anti-inflammatory potential as compare to n-Hexane extract and hydrogel prepare from n-Hexane extract.

Nitrogen is one of the key elements in the evolution and formation of stellar objects. Earth's atmosphere contains 21% oxygen and 78% nitrogen; these two gases give rise to aurora when ions of the solar wind in the ionosphere collide with them. Some aerosols made of nitrogen and oxygen are also found in the atmosphere. Nitrogen, hydrogen, carbon, and oxygen are the main contributors to the origin of life on Earth. The spectrum of nitrogen ion (N V) has been studied using Quantum defect theory (QDT) and Numerical Coulombic approximation (NCA). N V has two electrons in the core, with the nucleus, and one electron outside the core. It makes it hydrogen or lithium-like. In the first part, the energies of the ns, np, nd, and nf up to n < 30 were calculated with the help of QDT. In the second part, the wavelengths were calculated using the energies and line strength parameters using NCA. Very little experimental data on lifetime and transition probability are available; however, Biemont et al. have calculated the lifetime of the 48 levels of N V using coulomb approximation. In this study, we calculated the lifetime of 196 multiplets of N V. The results are compared with the available experimental and theoretical lifetimes; an excellent agreement was found between known lifetimes and calculated in this work. The lifetimes of 100 multiplets are presented for the first time. The lifetimes of each of the Rydberg series of N V were fitted, and a third-degree polynomial represents the lifetimes of each series.

Abstract The ability to use blood to predict the outcomes of Parkinson’s disease, including disease progression and cognitive and motor complications, would be of significant clinical value. We undertook bulk RNA sequencing from the caudate and putamen of postmortem Parkinson’s disease (n = 35) and control (n = 40) striatum, and compared molecular profiles with clinical features and bulk RNA sequencing data obtained from antemortem peripheral blood. Cognitive and motor complications of Parkinson’s disease were associated with molecular changes in the caudate (stress response) and putamen (endothelial pathways) respectively. Later and earlier-onset Parkinson’s disease were molecularly distinct, and disease duration was associated with changes in caudate (oligodendrocyte development) and putamen (cellular senescence), respectively. Transcriptome patterns in the postmortem Parkinson’s disease brain were also evident in antemortem peripheral blood, and correlated with clinical features of the disease. Together, these findings identify molecular signatures in Parkinson’s disease patients’ brain and blood of potential pathophysiologic and prognostic importance.

The date palm (Phoenix dactylifera L.) fruit contains variety of bioactive constituents including phenolic compounds. This research aimed to analyze the phenolic constituents and antioxidant potential of crude methanol extract samples from seeds of different date varieties, Aseel (As), Ambar (Am), Ajwa Saudi (AJS), Ajwa Khairpur (AJK), Khipro (KP) and Karblyan (KB). Date seeds are regarded as waste product. However, it contains secondary chemicals of biomedical significance. Colorimetric methods were used for the evaluation of phytochemical and antioxidant capacity. The Folin-Ciocalteu method was used for the assessment of phenolic content. The antioxidant potential was evaluated through phosphomolybdenum test, potassium ferricyanide test, and 2,2-diphenyl-1-picryl-hydrazyl-hydrate scavenging test methods. All samples differ significantly in terms of antioxidant activities and quantity of secondary metabolites (phenolic and flavonoid contents). When all samples were compared, As was shown to have the highest amount of phenolic and flavonoids, while AJ(S) had the lowest content. The KP sample had the highest overall antioxidant and reducing potential, while the AJ(K) and Am samples showed the lowest, respectively. Significant DPPH scavenging capacity has been demonstrated in all samples. In order to extend the shelf life of food products, date seeds may consequently provide ideal material for the bio-functional food industry.

Purpose of the study: The focus area of this paper is Sustainable Consumption linked to Sustainable Development Goal (SDG) 12. It emphasizes Responsible Consumption and Production.One of the most important SDGs for the fashion industry is SDG 12. About 98 million tonnes of non-renewable resources are used by fashion per year and out of this just 12 per cent of the material used in clothing is presently recycled. There is an increasing trend in modern consumers to buy pre-loved apparel which are good looking and affordable too. Design/methodology/approach: A qualitative research method was adopted for this study and 36 consumers were interviewed in-depth to find out the reasons behind it. A purposeful Snowball sampling method is used for this study across India. The interview method is adopted to collect the data. Findings: It is found that modern consumers buy their clothes from second-hand stores both online and offline. They have multiple reasons for this as it is cheap and affordable yet stylish clothing, easy shopping, temptation most of the time, and fast fashion. Originality: This paper is of first of its kind which deals with both buyers and sellers of the second-hand market emphasizing environmental sustainability.

Introduction: Women's empowerment is crucial for gender equality. This study, utilizing NFHS 4 and 5 data, assesses GBV and women's empowerment, including health indicators in Karnataka and India, aiming to evaluate achievements and challenges impacting women's lives for gender equality. Materials and Methods: This study retrospectively analyzed NFHS 4 (2015–16) and NFHS 5 (2019–21) data for India and Karnataka, covering health, Gender-based Violence, education, economic and social-political empowerment. Data analysis used MS Excel 365 and Datawrapper tools. Results: Karnataka's female population increased by 7% (NFHS4 to NFHS5), surpassing India's 1%. Health indicators improved, including menstrual hygiene, family planning, prenatal and postnatal care, and reduced early marriages. Educational attainment, economic involvement, mobile phone ownership, and women's participation in household decisions increased. However, Karnataka saw a notable rise in GBV cases among young women, with spousal violence at 44.4% and sexual violence at 11% (NFHS5). Conclusion: This study depicts the evolution of women's empowerment and gender-based violence in Karnataka, India. Results show improvements in health, education, economic involvement, and specific empowerment indicators. However, the documented rise in GBV cases in Karnataka highlights the need for targeted interventions. Karnataka's experience can be a blueprint for achieving gender equality and women's empowerment in India.

Objective: To assess the presence of Thrombocytopenia among the neonates born to mothers having pregnancy-induced hypertension and associated socio-demographic factors. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Jun 2021. Methodology: This study was conducted on neonates who were born to mothers who were diagnosed and managed with pregnancy-induced hypertension. Thrombocytopenia was defined as a platelet count of

Objective: To compare various labour parameters in partogram among primiparous women and women with one previous caesarean section scar Study Design: Comparative cross-sectional study Place and Duration of Study: Gynaecology and Obstetrics Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Oct 2021 to Sep 2022. Methodology: This study was conducted on primiparous women and women with one previous scar who were booked cases in our department for antenatal checkups and labour. Patients were divided into two groups for comparison. Group-I were primiparous, while Group-II had one previous scar. All women underwent detailed labour records via conventional partogram in the labour room. Duration of the active phase of labour, duration of the second stage, time to progress by 1 cm and time after the alert line were compared in partograms of both the study groups. Results: A total of 390 women who were either primiparous or had one previous caesarean section were recruited for this study. Of the study participants, 226(42.6%) were primiparous, while 164(57.4%) had one previous caesarean section scar. Statistical analysis revealed that the duration of the active phase of labour, time to progress by 1 cm and time after the alert line were statistically significant (p-value

As environmental awareness takes centre stage in business, entrepreneurship research has established a dedicated subfield for sustainability-driven ventures. The growing emphasis on sustainable business practices has led entrepreneurship research to identify entrepreneurship-related sustainability as a critical subfield. However, the inconsistent terminology used, such as “green entrepreneurship,” “ecopreneurship”, and “entrepreneurship” (ENP), reflects the fragmented nature of research in this area. A Systematic Literature Review on entrepreneurship-related sustainability was conducted to address this, focusing on the term “enviropreneurship” and applying PRISMA guidelines for transparency and methodological standardization. A total of 67 research articles published between 2013 and 2022 were analyzed to identify key themes and subthemes. This analysis resulted in a comprehensive definition of ENP and a cohesive research agenda for the future. The findings revealed significant shortcomings in standardized reporting procedures, highlighting the need for greater methodological openness and harmonization. To address this, the widespread adoption of PRISMA principles adapted to the specific needs of ENP research is advocated to enhance rigour, comparability, and reliability in this multidisciplinary field. Categorizing the research articles provided valuable insights into the research direction and specific focus areas, revealing a shift towards practical application and evaluation alongside conceptual exploration and analysis, which is inherent to any research field.

The stigma among caregivers is significantly creating stress for them, which is ultimately disturbing their well-being and quality of life. The aim of the current study is to translate and validate the Family Stigma Stress Scale (FSSS) in Urdu among caregivers of patients with mental illness in Pakistan. A purposive sample of 421 caregivers above 18 years of age (M=39.43, SD=12.41) participated in the present research, where 42.3% were men and 57.7% were women. All the participants completed FSSS and self-structured demographic sheet. For translating the scale, WHO guidelines were followed. Data were analysed through SPSS version 26 and AMOS version 24. To test the internal consistency of the translated scale, we apply the alpha reliability test. The result indicated that the internal consistency of the overall FSSS is good (α=0.85), while its subscale perceived harm (α=0.90) and perceived coping resources (α=0.87) also showed excellent internal consistency. To check that the translated version confirmed the same items, we applied confirmatory factor analysis (CFA) through AMOS version 24. The results of CFA showed that the model is in the acceptable to good fit range with χ2/df (3.16), CFI (0.98), TLI (0.97), IFI (0.98), NFI (0.97), and RMSEA (0.07). An independent sample t-test was used to check the gender difference and illness differences related to caregiving on subscales of FSSS. Results of t-test showed that significant gender differences were observed only on perceived harm indicating that women caregivers perceived more harm as compared to men caregivers of patients with mental illness. Moreover, we also found that caregivers of patients with psychotic disorders perceived more coping resources than caregivers of patients with neurotic disorders. By integrating the FSSS into routine assessments and screenings in healthcare settings, professionals can identify caregivers experiencing high levels of stigma-related stress accurately. Healthcare professionals can advocate for policies and social programs that reduce stigma surrounding mental illness and provide resources for caregivers. Apart from these implications, there are some limitations in the present research, and this scale may not fully account for cultural sensitivity which potentially impacts the scale’s applicability and generalizability. Participants may provide socially desirable responses, especially when dealing with sensitive topics like family stigma. This response bias can affect the accuracy and validity of the scale. Future researchers should focus on these limitations and try to fill these gaps.

Fabry disease (FD) is an X-linked disorder of glycosphingolipid metabolism caused by mutations in the GLA gene encoding alpha-galactosidase A (α-Gal). Loss of α-Gal activity leads to progressive lysosomal accumulation of α-Gal substrate, predominately globotriaosylceramide (Gb3) and its deacylated derivative globotriaosylsphingosine (lyso-Gb3). FD manifestations include early onset neuropathic pain, gastrointestinal symptoms, and later onset life-threatening renal, cardiovascular and cerebrovascular disorders. Current treatments can preserve kidney function but are not very effective in preventing progression of cardiovascular pathology which remains the most common cause of premature death in FD patients. There is a significant need for a translational model that could be used for testing cardiac efficacy of new drugs. Two mouse models of FD have been developed. The α-Gal A-knockout (GlaKO) model is characterized by progressive tissue accumulation of Gb3 and lyso-Gb3 but does not develop any Fabry pathology besides mild peripheral neuropathy. Reports of minor cardiac function abnormalities in GlaKO model are inconsistent between different studies. Recently, G3Stg/GlaKO was generated by crossbreeding GlaKO with transgenic mice expressing human Gb3 synthase. G3Stg/GlaKO demonstrate higher tissue substrate accumulation and develop cellular and tissue pathologies. Functional renal pathology analogous to that found in early stages of FD has also been described in this model. The objective of this study is to characterize cardiac phenotype in GlaKO and G3Stg/GlaKO mice using echocardiography. Longitudinal assessments of cardiac wall thickness, mass and function were performed in GlaKO and wild-type (WT) littermate controls from 5-13 months of age. G3Stg/GlaKO and WT mice were assessed between 27-28 weeks of age due to their shortened lifespan. Several cardiomyopathy characteristics of early Fabry pathology were found in GlaKO mice, including mild cardiomegaly [up-to-25% increase in left ventricular (LV mass)] with no significant LV wall thickening. The LV internal diameter was significantly wider (up-to-24% increase at 9-months), when compared to the age-matched WT. In addition, there were significant increases in the end-systolic, end-diastolic volumes and stroke volume, suggesting volume overload. Significant reduction in Global longitudinal strain (GLS) measuring local myofiber contractility of the LV was also detected at 13-months. Similar GLS reduction was also reported in FD patients. Parameters such as ejection fraction, fractional shortening and cardiac output were either only slightly affected or were not different from controls. On the other hand, some of the cardiac findings in G3Stg/GlaKO mice were inconsistent with Fabry cardiomyopathy seen in FD patients. This could be potentially an artifact of the Gb3 synthase overexpression under a strong ubiquitous promoter. In conclusion, GlaKO mouse model presents mild cardiomegaly, mild cardiac dysfunction, but significant cardiac volume overload and functional changes in GLS that can be used as translational biomarkers to determine cardiac efficacy of novel treatment modalities. The level of tissue Gb3 accumulation in G3Stg/GlaKO mouse more closely recapitulates the level of substrate accumulation in FD patients and may provide better translatability of the efficacy of new therapeutics in clearing pathological substrates from cardiac tissues. But interpretation of the effect of treatment on cardiac structure and function in this model should be approached with caution.