Vegetation-edaphic correlation and importance value index in himalayan 'ecotone' temperate conifer forest using the multivariate technique

Himalayan 'Ecotone' temperate conifer forest is the cradle of life for human survival and wildlife existence. In spite of the importance of these areas, they have not been studied in depth. This study aimed to quantify the floristic structure, important value index (IVI), topographic and edaphic variables between 2019 and 2020 utilizing circular quadrant method (10 m x 10 m). The upper-storey layer consisted of 17 tree species belongs to 12 families and 9 orders. Middle-storey shrubs comprised of 23 species representing 14 families and 12 orders. A total of 43 species of herbs, grasses, and ferns were identified from the ground-storey layer, representing 25 families and 21 orders. Upper-storey vegetation structure was dominated by Pinus roxburghii (22.45 %) and middle-storey by Dodonaea viscosa (7.69 %). However, the ground layer vegetation was diverse in species composition (43 species) and distribution. The floral vegetation structure was encompassing of three floral communities which were diverse in IVI, such as, in Piro-Aial (Group 2), Pinus roxburghii (54.46 x 15.94) had the highest IVI value, followed by Pinus wallichiana (45.21 x 14.85) in Piwa-Quin (Group 3) and Ailanthus altissima (22.84 x 19.25) in Aial-Qugal (Group 1). However, the IVI values for Aesculus indica, Celtis australis, and Quercus incana in Aial-Qugal (Group 1) were not determined due to low detection rate. Nevertheless, eleven of these species showed 0 IVI values in Piro-Aial (Group 2) and Piwa-Quin (Group 3). CCA ordination biplot illustrated the significant differences among floral communities and its distribution, which impacted by temperature, rainfall, soil pH, altitude, and topographic features. Ward's agglomerative clustering finding reflected 'Ecotone' temperate conifer forest is rich and diverse floristic structure.

Handling 'carbon footprint' in orthopaedics

INTRODUCTION

The National Health Service contributes 4%-5% of England and Wales' greenhouse gases and a quarter of all public sector waste. Between 20% and 33% of healthcare waste originates from a hospital's operating room, and up to 90% of waste is sent for costly and unneeded hazardous waste processing. The goal of this study was to quantify the amount and type of waste produced during a selection of common trauma and elective orthopaedic operations, and to calculate the carbon footprint of processing the waste.

METHODS

Waste generated for both elective and trauma procedures was separated primarily into clean and contaminated, paper or plastic, and then weighed. The annual carbon footprint for each operation at each site was subsequently calculated.

RESULTS

Elective procedures can generate up to 16.5kg of plastic waste per procedure. Practices such as double-draping the patient contribute to increasing the quantity of waste. Over the procedures analysed, the mean total plastic waste at the hospital sites varied from 6 to 12kg. One hospital site undertook a pilot of switching disposable gowns for reusable ones with a subsequent reduction of 66% in the carbon footprint and a cost saving of £13,483.89.

CONCLUSIONS

This study sheds new light on the environmental impact of waste produced during trauma and elective orthopaedic procedures. Mitigating the environmental impact of the operating room requires a collective drive for a culture change to sustainability and social responsibility. Each clinician can have an impact upon the carbon footprint of their operating theatre.

Patterns of Change in Nucleotide Diversity Over Gene Length

Nucleotide diversity at a site is influenced by the relative strengths of neutral and selective population genetic processes. Therefore, attempts to estimate Effective population size based on the diversity of synonymous sites demand a better understanding of their selective constraints. The nucleotide diversity of a gene was previously found to correlate with its length. In this work, I measure nucleotide diversity at synonymous sites and uncover a pattern of low diversity towards the translation initiation site of a gene. The degree of reduction in diversity at the translation initiation site and the length of this region of reduced diversity can be quantified as "Effect Size" and "Effect Length" respectively, using parameters of an asymptotic regression model. Estimates of Effect Length across bacteria covaried with recombination rates as well as with a multitude of translation-associated traits such as the avoidance of mRNA secondary structure around translation initiation site, the number of rRNAs, and relative codon usage of ribosomal genes. Evolutionary simulations under purifying selection reproduce the observed patterns and diversity-length correlation and highlight that selective constraints on the 5'-region of a gene may be more extensive than previously believed. These results have implications for the estimation of effective population size, and relative mutation rates, and for genome scans of genes under positive selection based on "silent-site" diversity.

The carbon footprint of arthroscopic procedures

INTRODUCTION

The healthcare sector contributes the equivalent of 4.4% of global net emissions to the climate carbon footprint; between 20% and 70% of healthcare waste originates from a hospital's operating theatre and up to 90% of waste is sent for costly and unneeded hazardous waste processing. This study aimed to quantify the amount and type of waste produced during an arthroscopic anterior cruciate ligament reconstruction (ACLR) and an arthroscopic rotator cuff repair (RCR), calculate the carbon footprint and assess the cost of the waste disposal.

METHODS

The amount of waste generated from ACLR and RCR procedures was calculated across a range of hospital sites. The waste was separated primarily into clean and contaminated, paper or plastic. Both carbon footprint and cost of disposal across the hospital sites was subsequently calculated.

RESULTS

RCR generated 3.3-15.5kg of plastic waste and 0.9-2.3kg of paper waste. ACLR generated 2.4-9.6kg of plastic waste and 1.1-1.6kg of paper waste. The cost to process waste varies widely between hospital sites, waste disposal contractors and method of waste disposal. The annual burden of the included hospital sites for the arthroscopic procedures undertaken was 6.2 tonnes of carbon dioxide.

CONCLUSIONS

The data collected demonstrated a significant variability in waste production and cost for waste disposal between hospital sites. At a national level, consideration should be given to the procurement of appropriate products such that waste can be efficiently recycled or disposed of by environmentally sustainable methods.

Tracing probiotic producing bacterial species from gut of buffalo (Bubalus bubalis), South-East-Asia

Abstract Due to extensive application of antibiotics as growth promoters in animal feed, antimicrobial resistance has been increased. To overcome this challenge, rumen microbiologists search for new probiotics to improve the rate of livestock production. The present study was aimed to isolate and evaluate breed-specific lactic acid bacteria (LAB) as potential animal probiotics. The current study was conducted during 10 months from July 2020 to April 2021, in which a total of n=12 strains were isolated from different samples including milk, rumen, and feces of Nilli Ravi Buffaloes. These isolates were evaluated for their antimicrobial potential against common animal pathogens (Bacillus spp., E. coli, Staphylococcus aureus, Salmonella spp., Listeria spp.). All the isolates were identified using 16S rRNA gene sequencing and the phylogenetic analyses inferred that these strains showed close relations to the species of various genera; Enterococcus lactis, Pediococcus pentosaceus, Bacillus subtilis Weissella cibaria, Weissella soli, Bacillus tequilensis, Weissella bombi, Bacillus licheniformis, Lactococcus lactis, Bacillus megaterium, Lactobacillus ruminis, and Lactococcus lactis. NMCC-Ru2 has exhibited the enormous potential of antimicrobial activity, 28 mm, for Salmonella typhimurium;23 mm for Listeria monocytogenes 21 mm for E.coil. Highest resistance was seen in NMCC-Ru2 agasint test antbiotic, like 25.5 mm for Tetracycline. Overall results revesl that the probiotic profile of isolates was achieved using standard criteria, particularly with animal probiotic properties

A rare concurrent incidence of adult-onset acute disseminated encephalomyelitis and antiphospholipid antibody syndrome: A case report

INTRODUCTION

Acute disseminated encephalomyelitis (ADEM) is a demyelinating immune-mediated condition of the central nervous system, whereas antiphospholipid antibody syndrome (APLA) is an autoimmune disorder accompanied by thrombosis and pregnancy-related problems. We present a unique case of a 30-year-old female with ADEM coexisting with APLA, highlighting the importance of early identification and specialized care.

PRESENTATION OF CASE

We present a case of a 30-year-old woman with a history of hypertension, multiple miscarriages, and non-compliance with medication, who presented with altered consciousness and weakness in all four limbs. Laboratory tests revealed positive anti-cardiolipin and lupus anticoagulant antibodies, confirming APLA. A neurological examination revealed increased limb tone, heightened reflexes, and extensor plantar responses. MRI revealed confluent white matter lesions that were consistent with ADEM. The patient received prompt treatment with intravenous methylprednisolone and then received oral prednisone, leading to a rapid improvement in neurological status.

DISCUSSION

The intricate interaction between ADEM and APLA remains enigmatic. The plausible connection between "molecular mimicry" and weakened blood-brain barrier, substantiated by antiphospholipid antibodies, may help explain their concurrent occurrence.

CONCLUSION

This case highlights the significance of early diagnosis and management of the rare and complex coexistence of ADEM and APLA to attain optimal outcomes, as well as the significance of careful examination for simultaneous autoimmune markers in individuals presenting with neurological disturbances.

Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report

Myasthenia in the infancy and toddler age group is rare and often presents a challenge to treating pediatric neurologists. Our report addresses the challenges encountered when distinguishing myasthenia in infants and toddlers from similar illnesses, as well as the differentiation between congenital myasthenia, transient myasthenia, and autoimmune myasthenia. We present four cases of myasthenia between the ages of 10 and 30 months. The diagnosis and management of these cases were challenging due to the variability in clinical presentation. Four cases of myasthenia were diagnosed, with three having autoimmune myasthenia and one having congenital myasthenic syndrome. One patient initially tested negative for acetylcholine receptor antibodies, but later tested positive after 4 months and had a rare facial diplegia finding. The patient with congenital myasthenic syndrome had a novel genetic mutation, DPAGT1 homozygous variants, and also had false positive acetylcholine receptor antibodies. These cases highlight the importance of genetic testing for all infants and toddlers suspected of having myasthenia.

The divergence of mutation rates and spectra across the Tree of Life

Owing to advances in genome sequencing, genome stability has become one of the most scrutinized cellular traits across the Tree of Life. Despite its centrality to all things biological, the mutation rate (per nucleotide site per generation) ranges over three orders of magnitude among species and several-fold within individual phylogenetic lineages. Within all major organismal groups, mutation rates scale negatively with the effective population size of a species and with the amount of functional DNA in the genome. This relationship is most parsimoniously explained by the drift-barrier hypothesis, which postulates that natural selection typically operates to reduce mutation rates until further improvement is thwarted by the power of random genetic drift. Despite this constraint, the molecular mechanisms underlying DNA replication fidelity and repair are free to wander, provided the performance of the entire system is maintained at the prevailing level. The evolutionary flexibility of the mutation rate bears on the resolution of several prior conundrums in phylogenetic and population-genetic analysis and raises challenges for future applications in these areas.

Benzimidazole-Based Schiff Base Hybrid Scaffolds: A Promising Approach to Develop Multi-Target Drugs for Alzheimer's Disease

A series of benzimidazole-based Schiff base derivatives (1-18) were synthesized and structurally elucidated through 1H NMR, 13C NMR and HREI-MS analysis. Subsequently, these synthetic derivatives were subjected to evaluation for their inhibitory capabilities against acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). All these derivatives showed significant inhibition against AChE with an IC50 value in the range of 123.9 ± 10.20 to 342.60 ± 10.60 µM and BuChE in the range of 131.30 ± 9.70 to 375.80 ± 12.80 µM in comparison with standard Donepezil, which has IC50 values of 243.76 ± 5.70 µM (AChE) and 276.60 ± 6.50 µM (BuChE), respectively. Compounds 3, 5 and 9 exhibited potent inhibition against both AChE and BuChE. Molecular docking studies were used to validate and establish the structure-activity relationship of the synthesized derivatives.

Patterns of change in nucleotide diversity over gene length

Nucleotide diversity at a site is influenced by the relative strengths of neutral and selective population genetic processes. Therefore, attempts to identify sites under positive selection require an understanding of the expected diversity in its absence. The nucleotide diversity of a gene was previously found to correlate with its length. In this work, I measure nucleotide diversity at synonymous sites and uncover a pattern of low diversity towards the translation initiation site (TIS) of a gene. The degree of reduction in diversity at the TIS and the length of this region of reduced diversity can be quantified as "Effect Size" and "Effect Length" respectively, using parameters of an asymptotic regression model. Estimates of Effect Length across bacteria covaried with recombination rates as well as with a multitude of fast-growth adaptations such as the avoidance of mRNA secondary structure around TIS, the number of rRNAs, and relative codon usage of ribosomal genes. Thus, the dependence of nucleotide diversity on gene length is governed by a combination of selective and non-selective processes. These results have implications for the estimation of effective population size and relative mutation rates based on "silent-site" diversity, and for pN/pS-based prediction of genes under selection.

Darcy Forchheimer flow of CMC-water based hybrid nanofluid due to a rotating stretchable disk

The flow of fluid over a spinning disk has a broad scope of numerous applications. It is employed in various things, including medical equipment, the braking system of cars, gas turbines, plastic films, and glass production. As a result of these applications, we considered the phenomena of Darcy Forchheimer's three-dimensional flow on TiO2-Fe3O4 nanoparticles suspended in based CMC-water fluid. The influence of thermal radiation and convective conditions is studied. Moreover, the Buongiorno model is utilized to compute the Brownian motion and the thermophoretic effect. To generate the non-dimensionalized governing equations, suitable alterations are put into use. These equations are then utilized with Matlab BVP4c. Graphs are used to analyze the behavior of velocity distributions, and thermal and concentration profiles at different parameter values. In addition, the solutions to the flow problem have been analyzed in terms of several other physical variables on velocity, temperature, concentration, drag force, heat, and mass transfer. According to the findings, it is clear that an escalates in the value of the rotation parameter leads to an increase in the radial velocity and axial velocity. In contrast, an opposite pattern is followed in the Forchheimer number. Finally, some engineering quantities are evaluated numerically and presented in tabular forms.

Numerical analysis of magnetohydrodynamics Casson nanofluid flow with activation energy, Hall current and thermal radiation

In this study we analyzed the flow, heat and mass transfer behavior of Casson nanofluid past an exponentially stretching surface under the impact of activation energy, Hall current, thermal radiation, heat source/sink, Brownian motion and thermophoresis. Transverse magnetic field with the assumption of small Reynolds number is implemented vertically. The governing partial nonlinear differential equations of the flow, heat and mass transfer are transformed into ordinary differential equations by using similarity transformation and solved numerically by using Matlab bvp4c package. The impact of each of the Hall current parameter, thermal radiation parameter, heat source/sink parameter, Brownian motion parameter, Prandtl number, thermophoresis parameter and magnetic parameter on velocity, concentration and temperature, is discussed through graphs. The skin friction coefficient along the x-and z-directions, the local Nusselt number and the Sherwood number are calculated numerically to look into the inside behavior of the emerging parameters. It is witnessed that the flow velocity is a diminishing function of the thermal radiation parameter and the behavior has observed in the case of Hall parameter. Moreover, mounting values of Brownian motion parameter reduce the nanoparticle concentration profile.

Analysis of mitochondrial DNA mutations in Pakistani population diagnosed with cardiovascular diseases

Heart and blood vessel disorders, such as coronary heart disease, brain vessel disease, rheumatic heart disease, and others, are together referred to as cardiovascular disease (CVD). In this study, we sought to determine how mitochondrial Leucine Transfer RNA genes and CVDs are related (MT-L1 and MT-L2). From CVD patients in Peshawar, a total of 27 saliva samples were taken. Leu-tRNA genes expressed by mitochondria were amplified using polymerase chain reaction after DNA was removed. Ten samples were sent for sequencing after PCR and gene cleaning. We obtained all of the sequenced results, which were subsequently aligned and evaluated against the mitochondrial revised Cambridge Reference Sequence (rCRS). However, in our sequenced samples, Leu-tRNA MT-L1 and MT-L2 genes were determined to be unaltered. Thus, it is suggested that a large population be taken into account while screening for mutations in the mitochondrial encoded Leu-tRNA MT-L1 and MT-L2 genes of cardiac patients in areas of Pakistan. Additionally, it is recommended that patients with cardiac problems should also have other mitochondrial encoded genes checked for potential mutations. This could result in the identification of genetic markers that could be used for early CVD screening in Pakistan.

Irreversibility analysis with hybrid cross nanofluid of stagnation point and radiative flow (TiO2+CuO) based on engine oil past a stretchable sheet

The present study addressed the physical significance of the entropy generation for the mixed convection time-dependent flow of cross-hybrid nanoliquid due to the stretched surface at a stagnation point. The Plot for heat transport is discoursed by applying the role of thermal radiation under convective conditions. For hybrid nanofluid, engine oil is used as a base liquid with copper (II) oxide C u O and titanium dioxide T i O 2 nanoparticles. The existing model is framed in the highly partial differential equation system. The governing equations have been transformed into a set of ODS's using a similar scaling operation. Following this, the resulting ODEs are solved numerically through the BVP4c. The primary goal of this research is to analyze the results of varying the stretching ratio parameter ( λ ), Weissenberg parameter ( W e ), thermal radiation ( R d ), and Biot number ( B i ) for both pure T i O 2 and CuO +  T i O 2 / E O hybrid nanofluid, on the velocity, temperature, drag force, heat transfer as well as entropy generation, and Bejan number was studied. A drop in velocity is observed with increasing values of the W e and upsurge in velocity for rising value of unsteady parameter ( A ), while increasing values of both of these parameters are associated with rising temperatures. Copper and titanium oxide nanoparticles are used to increase Engine oil (EO) thermal enactment, making it a more useful base fluid. Further, some significant industrial and engineering applications are related to the present problem discourse.

Irreversibility analysis of radiative flow of Prandtl nanofluid over a stretched surface in Darcy-Forchheimer medium with activation energy and chemical reaction

This communication elaborates the irreversibility analysis of the flow of Prandtl nanofluid along with thermal radiation past a permeable stretched surface embedded in a Darcy-Forchheimer medium. The activation and chemical impressions along with effects of thermophoretic and Brownian motion are as well examined. The flow symmetry of the problem is modeled mathematically and leading equations are rehabilitated into nonlinear ordinary differential equations (ODEs) through the assistance of suitable similarity variables. The Keller-box technique in MATLAB is employed to draw the impacts of the contributing elements on the velocity field, temperature distribution, and concentration. The impact of the Prandtl fluid parameter has mounting performance for the velocity whereas conflicting behavior is examined in the temperature profile. The achieved numerical results are matched correspondingly with the present symmetrical solutions in restrictive cases and fantastic agreement is scrutinized. In addition, the entropy generation uplifts for the growing values of the Prandtl fluid parameter, thermal radiation, and Brinkman number and decreases for growing numbers of the inertia coefficient parameter. It is also discovered that the coefficient of friction decreases for all parameters involved in the momentum equation. Features of nanofluids can be found in a variety of real-world fields, including microfluidics, industry, transportation, the military, and medicine.

Simulation of Prandtl Nanofluid in the Mixed Convective Flow of Activation Energy with Gyrotactic Microorganisms: Numerical Outlook Features of Micro-Machines

The physiological systems and biological applications that have arisen during the past 15 years depend heavily on the microscale and nanoscale fluxes. Microchannels have been utilized to develop new diagnostic assays, examine cell adhesion and molecular transport, and replicate the fluid flow microenvironment of the circulatory system. The various uses of MHD boundary flow in engineering and technology are extensive, ranging from MHD power generators and the polymer industry to MHD flow meters and pumps and the spinning of filaments. In this investigation, the (Magnetohydrodynamic) MHD flow of Prandtl nanofluid is investigated along with mixed convection, energy activation, microorganism, and chemical reaction. The flow model is considered through partial differential equations in dimensionless form which is then integrated numerically via considering the Bvp4c technique. The outcome is numerous emerging physical parameters over velocity profile, temperature, mass concentration, and microorganism with the separate pertinent quantities such as the Prandtl fluid parameter, elastic fluid parameter, magnetic field, mixed convection parameter, activation energy, chemical reaction, Brownian motion, thermophoretic force, Prandtl number, and Schmidt number. The friction factor, rate of heat transfer and Sherwood number, and density of microbes are revealed numerically and graphically. The outcomes indicate that the Prandtl fluid parameter and elastic fluid parameter tend to enhance the velocity profile. It is also noted that the Prandtl fluid parameter depreciates the thermal rate with the addition of the concentration profile while the opposite trend is recorded for activation energy. Obtained numerical outcomes are correspondingly compared with the current statistics in limiting cases and a close match is obtained.

Scrutinization of second law analysis and viscous dissipation on Reiner-RivlinNanofluid with the effect of bioconvection over a rotating disk

In comparison to Newtonian fluids, non-Newtonian fluids have fascinating features in heat transportation. Here, newly type of Reiner-Rivlinnanoliquid flow over the revolving disk for viscous dissipation (VD) is being explored in a multiple-slip effect. The inclusion of gyrotactic microorganisms in the nanoliquid enhances the tendency of the nanoparticles. The idea of the intended model is enhanced by considering in the impact of activation energy, thermal radiative, heated convective conditions and entropy minimization. The system of nonlinear PDE is constructed into nonlinear ODE's by applying the von-Karman similarity method and later solved numerically using the BVP4c solver which is considered to study the complicated ordinary differential equations. TheInfluence of various parameters is elaborated and plotted physically through the graphical illustration. By contrasting the reported data in the restricted form to a previously published article, the accuracy of the current model has examined. The impact of a non-Newtonian fluid parameter over the velocity field appeared to showdpreciation in it. The results elucidate that when the wall slip coefficient is larger more torque is needed to maintain constant disk revaluation. Surface heat transmission and wall skin friction are computed for a wide variety of factors. These flows have several real world-applications, including modeling cases that occur in oceanography and geophysics, various industrial fields (such as lumber production).

Comprehensive Analysis of Feature Extraction Methods for Emotion Recognition from Multichannel EEG Recordings

Advances in signal processing and machine learning have expedited electroencephalogram (EEG)-based emotion recognition research, and numerous EEG signal features have been investigated to detect or characterize human emotions. However, most studies in this area have used relatively small monocentric data and focused on a limited range of EEG features, making it difficult to compare the utility of different sets of EEG features for emotion recognition. This study addressed that by comparing the classification accuracy (performance) of a comprehensive range of EEG feature sets for identifying emotional states, in terms of valence and arousal. The classification accuracy of five EEG feature sets were investigated, including statistical features, fractal dimension (FD), Hjorth parameters, higher order spectra (HOS), and those derived using wavelet analysis. Performance was evaluated using two classifier methods, support vector machine (SVM) and classification and regression tree (CART), across five independent and publicly available datasets linking EEG to emotional states: MAHNOB-HCI, DEAP, SEED, AMIGOS, and DREAMER. The FD-CART feature-classification method attained the best mean classification accuracy for valence (85.06%) and arousal (84.55%) across the five datasets. The stability of these findings across the five different datasets also indicate that FD features derived from EEG data are reliable for emotion recognition. The results may lead to the possible development of an online feature extraction framework, thereby enabling the development of an EEG-based emotion recognition system in real time.

Development of MoS2-ZnO heterostructures: an efficient bifunctional catalyst for the detection of glucose and degradation of toxic organic dyes

The heterostructure catalyst MoS2-ZnO possesses binary properties and provides a novel platform for the remediation of environmental as well as health issues.

Genome-wide dissection of changes in maize root system architecture during modern breeding

Appropriate root system architecture (RSA) can improve maize yields in densely planted fields, but little is known about its genetic basis in maize. Here we performed root phenotyping of 14,301 field-grown plants from an association mapping panel to study the genetic architecture of maize RSA. A genome-wide association study identified 81 high-confidence RSA-associated candidate genes and revealed that 28 (24.3%) of known root-related genes were selected during maize domestication and improvement. We found that modern maize breeding has selected for a steeply angled root system. Favourable alleles related to steep root system angle have continuously accumulated over the course of modern breeding, and our data pinpoint the root-related genes that have been selected in different breeding eras. We confirm that two auxin-related genes, ZmRSA3.1 and ZmRSA3.2, contribute to the regulation of root angle and depth in maize. Our genome-wide identification of RSA-associated genes provides new strategies and genetic resources for breeding maize suitable for high-density planting.

Potential Therapeutic Effects of Morin Hydrate in Folic Acid-Induced Acute Kidney Injury

Introduction/Objective

Acute kidney injury (AKI) causes significant morbidity and mortality and, if left unmanaged, can progress to chronic kidney disease. Despite the advances in our understanding of the pathogenesis of AKI, there are no available therapeutics to combat it effectively. Folic acid (FA)-induced AKI is a well established rat model characterized by acute renal injury due to the disturbance of the antioxidant system with subsequent renal fibrosis. Morin hydrate, a well-known bioactive flavonoid, has been proven to alleviate oxidative stress and exhibits anti- inflammatory, anti-apoptotic and neuroprotective activity.

Methods/Case Report

We investigated the potential protective and therapeutic effects of morin hydrate on FA-induced AKI. Thirty-five rats were divided randomly into 5 groups (6 rats/ group) as follows: control group received a vehicle for 10 days, FA group received a vehicle for 10 days with an intraperitoneal (IP) injection of a single dose (SD) of FA (250 mg/kg) on the 7thday, FA-Withdrawal group injected with a SD of FA (250 mg/kg IP) on the 1st day with a vehicle for 10 days, morin-pretreated group received morin hydrate (40 mg/kg orally) for 7 days, followed by a SD of FA (250 mg/kg, i.p), and morin-treated group injected with a SD of FA (250 mg/kg IP), then treated with morin hydrate (40 mg/kg orally) for 7 consecutive days. All animals were sacrificed after 10 days and then, blood samples and kidneys were collected for biochemical and histopathological examination.

Results (if a Case Study enter NA)

FA group showed extensive structural damage in renal tubules and glomeruli with no significant improvement in withdrawal and morin-pretreated groups. Morin treatment significantly attenuated histopathological changes and reduced FA-induced increase in serum creatinine, albumin and urea levels. This therapeutic role of morin was associated with suppression of inflammation, oxidative stress, and apoptosis.

Conclusion

These findings suggest that morin hydrate constitutes a potential natural therapeutic product for treating AKI.

Acute dysphagia: A rare initial symptom of lateral medullary syndrome: A case report

Introduction and importance

A unique etiology of stroke, lateral medullary syndrome (LMS), is a consequence of posterior inferior cerebellar artery or vertebral artery thromboembolic conditions. LMS patients present particularly with ipsilateral hyperalgesia, ipsilateral ataxia, and Horner's syndrome. Our case signifies that neurogenic origin should always be considered in the absence of local causes of dysphagia. Early diagnosis could prevent LMS complications, including neurological disabilities. A scarcity of research related to dysphagia in LMS, and its outcomes exists. Therefore, the objective is to investigate the clinical course in a patient afflicted with severe dysphagia following a diagnosis of (LMS). This would encourage further research, thus improving management and treatment strategies.

Case presentation

We report a case of a 45-year-old male, a smoker for 20 years, who presented with a single, unique complaint of acute dysphagia for 9 days. According to our knowledge, this is among very few reported cases of LMS with dysphagia being the rare initial complaint. The neurological issues associated with dysphagia gradually improved with the administration of antiplatelet; clopidogrel and lipid-lowering drug; rosuvastatin and the patient was discharged. Atypical presentation in LMS could be supported by the presence of lateral medullary infarct which was confirmed by MRI (Magnetic Resonance Imaging).

Clinical discussion

Dysphagia is a common complaint in multiple gastrointestinal (GI) settings. However, in cases where the GI causes are excluded, as described here, diagnosis of LMS becomes tough.

Conclusion

The diagnosis of LMS was queried owing to the presentation of the single most important common symptom, with no other characteristic manifestations of LMS.

Activity of a direct VTA to ventral pallidum GABA pathway encodes unconditioned reward value and sustains motivation for reward

Dopamine signaling from the ventral tegmental area (VTA) plays critical roles in reward-related behaviors, but less is known about the functions of neighboring VTA GABAergic neurons. We show here that a primary target of VTA GABA projection neurons is the ventral pallidum (VP). Activity of VTA-to-VP-projecting GABA neurons correlates consistently with size and palatability of the reward and does not change following cue learning, providing a direct measure of reward value. Chemogenetic stimulation of this GABA projection increased activity of a subset of VP neurons that were active while mice were seeking reward. Optogenetic stimulation of this pathway improved performance in a cue-reward task and maintained motivation to work for reward over days. This VTA GABA projection provides information about reward value directly to the VP, likely distinct from the prediction error signal carried by VTA dopamine neurons.

Numerical Computation for Gyrotactic Microorganisms in MHD Radiative Eyring-Powell Nanomaterial Flow by a Static/Moving Wedge with Darcy-Forchheimer Relation

The intention of this study is to carry out a numerical investigation of time-dependent magneto-hydro-dynamics (MHD) Eyring-Powell liquid by taking a moving/static wedge with Darcy-Forchheimer relation. Thermal radiation was taken into account for upcoming solar radiation, and the idea of bioconvection is also considered for regulating the unsystematic exertion of floating nanoparticles. The novel idea of this work was to stabilized nanoparticles through the bioconvection phenomena. Brownian motion and thermophoresis effects are combined in the most current revision of the nanofluid model. Fluid viscosity and thermal conductivity that depend on temperature are predominant. The extremely nonlinear system of equations comprising partial differential equations (PDEs) with the boundary conditions are converted into ordinary differential equations (ODEs) through an appropriate suitable approach. The reformed equations are then operated numerically with the use of the well-known Lobatto IIIa formula. The variations of different variables on velocity, concentration, temperature and motile microorganism graphs are discussed as well as force friction, the Nusselt, Sherwood, and the motile density organism numbers. It is observed that Forchheimer number Fr decline the velocity field in the case of static and moving wedge. Furthermore, the motile density profiles are deprecated by higher values of the bio convective Lewis number and Peclet number. Current results have been related to the literature indicated aforementioned and are found to be great achievement.

Efficacy Of Alpha-Adrenergic Receptor Antagonists In The Treatment Of Distal Ureteric Stones: A Paediatric Study

BACKGROUND

European association of urology (EAU) recommended α- blockers for managing distal ureteric stones in the paediatric population. This paper will help to understand the efficacy of Silodosin as a medical expulsive agent for distal ureteric stones in children, along with the required time duration of stone expulsion.

METHODS

Forty participants were enrolled and evaluated for complaints, pain severity, associated symptoms, and ultrasound was done to confirm the position and size of the distal stone. Follow-ups were scheduled after every 7 days (1 week) for redo ultrasound and assessment of the stone position. Data was entered and analyzed in the SPSS version 23. To evaluate the significance of data chi-square test was performed, p-value <0.005 was considered significant.

RESULTS

The minimum and maximum age limits recorded are 3 years and 18 years respectively with a mean age of 9.5±4.5 years and mean stone size was measured as 0.6±0.1 cm. Distribution of stone size indicated the minimum size of 0.4 cm and maximum of 1.0 cm stone in study subjects. Maximum stone expulsion was reported within 14 days or an initial 2 follow-up scans.

CONCLUSIONS

The efficacy of Silodosin and medical expulsive therapy evaluated the effect on pain management as pain episodes declined with Silodosin treatment and spontaneous passage of stones were increased within the first 14 days of treatment. This study will be a beneficial contribution in literature especially in a developing country population where paediatric urolithiasis is on expansion and ongoing.

A misdiagnosis of choledochal cyst type IB and recommendation to use gold-standard imaging techniques: A case report

A choledochal cyst (CC) is a rare congenital dilation of the biliary ductal system that can cause troublesome complications when left untreated. CC in children classically manifests as a rare triad of the right upper quadrant mass, jaundice, and abdominal pain. Here, we report the case of an eight-year-old boy seen in Paediatric Unit I of Dr Ruth K. M. Pfau Civil Hospital Karachi, Pakistan, on October 9, 2019, who was initially misdiagnosed for liver abscess due to the non-specific symptoms and managed appropriately with antibiotics, which failed to improve the symptoms. Moreover, a hydatid cyst was considered based on ultrasonography (USG) which was later ruled out by the negative serology. A definitive diagnosis of CC was established on magnetic resonance cholangiopancreatography (MRCP). In resource-limited countries, USG is always the first line screening tool for biliary duct abnormalities which in some cases is comprehensibly enough for the diagnosis of a rare entity like CC, thus requiring a highly specific imaging test like MRCP to be performed to devise an effective treatment and surgical plan.

Recent Development of Heat and Mass Transport in the Presence of Hall, Ion Slip and Thermo Diffusion in Radiative Second Grade Material: Application of Micromachines

This article describes the incompressible two-dimensional heat and mass transfer of an electrically conducting second-grade fluid flow in a porous medium with Hall and ion slip effects, diffusion thermal effects, and radiation absorption effects. It is assumed that the fluid is a gray, absorbing-emitting but non-scattering medium and the Rosseland approximation is used to describe the radiative heat flux in the energy equation. It is assumed that the liquid is opaque and absorbs and emits radiation in a manner that does not result in scattering. It is considered an unsteady laminar MHD convective rotating flow of heat-producing or absorbing second-grade fluid across a semi-infinite vertical moving permeable surface. The profiles of velocity components, temperature distribution, and concentration are studied to apply the regular perturbation technique. These profiles are shown as graphs for various fluid and geometric parameters such as Hall and ion slip parameters, radiation absorption, diffusion thermo, Prandtl number, Schmidt number, and chemical reaction rate. On the other hand, the skin friction coefficient and the Nusselt number are determined by numerical evaluation and provided in tables. These tables are then analysed and debated for various values of the flow parameters that regulate it. It may be deduced that an increase in the parameters of radiation absorption, Hall, and ion slip over the fluid region increases the velocity produced. The resulting momentum continually grows to a very high level, with contributions from the thermal and solutal buoyancy forces. The temperature distribution may be more concentrated by raising both the heat source parameter and the quantity of radiation. When one of the parameters for the chemical reaction is increased, the whole fluid area will experience a fall in concentration. Skin friction may be decreased by manipulating the rotation parameter, but the Hall effect and ion slip effect can worsen it. When the parameter for the chemical reaction increases, there is a concomitant rise in the mass transfer rate.

Cattaneo-Christov Double Diffusion (CCDD) on Sutterby Nanofluid with Irreversibility Analysis and Motile Microbes Due to a RIGA Plate

In this article, a Riga plate is exhibited with an electric magnetization actuator consisting of permanent magnets and electrodes assembled alternatively. This Riga plate creates an electric and magnetic field, where a transverse Lorentz force is generated that contributes to the flow along the plate. A new study field has been created by Sutterby nanofluid flows down the Riga plate, which is crucial to the creation of several industrial advancements, including thermal nuclear reactors, flow metres, and nuclear reactor design. This article addresses the second law analysis of MHD Sutter by nanofluid over a stretching sheet with the Riga plate. The Cattaneo-Christov Double Diffusion heat and mass flux have been created to examine the behaviour of relaxation time. The bioconvection of motile microorganisms and chemical reactions are taken into consideration. Similarity transformations are used to make the governing equations non-dimensional ordinary differential equations (ODE's) that are subsequently solved through an efficient and powerful analytic technique, the homotopy analysis method (HAM). The effect of pertained variables on velocity, temperature, concentration, and motile microorganism distributions are elaborated through the plot in detail. Further, the velocity distribution enhances and reduces for greater value Deborah number and Reynold number for the two cases of pseudoplastic and dilatant flow. Microorganism distribution decreases with the augmented magnitude of Peclet number (Pe), Bioconvection Lewis number (Lb), and microorganism concentration difference number (ϖ). The entropy production distribution is increased for the greater estimations of the Reynolds number (ReL) and Brinkman parameter (Br). Two sets of graphical outputs are presented for the Sutterby fluid parameter. Finally, for the justification of these outcomes, tables of comparison are made with various variables.

974 Fragility Fractures of the Hip: A Matched Cohort Study of Acetabular Fractures and Neck of Femur Fractures

Aim

Due to an ageing population, acetabular fractures in the elderly are on the rise. Management of this group of patients remains controversial, especially as it is associated with high morbidity and mortality. With an ageing population, there will be an increasing trend in low energy associated acetabular fractures. We present the largest cohort of operatively treated acetabular geriatric patients in the UK, comparing complications and mortality, and also comparing them to patients with neck of femur fractures.

Method

A review of a prospectively collected acetabular database was conducted. All patients over the age of 60 that had an operative fixation for an acetabular fracture from 2015 to 2020 were identified. Demographic data, operative details and complications were recorded. We cohort-matched these patients with neck of femur fractures during the same period to compare patient outcomes and cohort demographics.

Results

204 patients were included in the study. The mean age was 76. The most common mechanism of injury was a fall from less than 1 metre (64%). The mean length of stay for acetabular fractures was 25 days. In-hospital mortality was 3% and 10% for acetabular fractures and neck of femur fractures respectively.

Conclusion

There is little difference in demographic information between geriatric acetabular fractures and neck of femur fractures. Operatively treated geriatric acetabular fractures are associated with greater length of stay than neck of femur fractures.

AB0629 Glomerulonephritis associated with ANCA after COVID-19 vaccine: a systematic review

Background

The COVID-19 pandemic has led to widespread vaccination with effective results and a great safety profile. However, as the vaccination rate has increased, more cases of autoimmune diseases after the COVID-19 vaccine have been described. We present a systematic review of ANCA-associated glomerulonephritis after the COVID-19 vaccine.

Objectives

To summarize the existing evidence on ANCA-associated glomerulonephritis after the COVID-19 vaccine.

Methods

We searched all studies from inception till January 27, 2022, that described ANCA-associated biopsy-proven glomerulonephritis after COVID-19 vaccine through Embase and Medline. Methodological quality was evaluated with the 4 domains tool. We included 13 patients from 2 case series and 9 case reports. We extracted demographics, history, lab results, outcomes. We then applied descriptive statistics.

Results

46% of the patients were males and 54% were females. The median age was 74 years. 54% developed symptoms after the second dose of the 2-dose vaccine. The median interval between the vaccine and the symptom onset was 10.5 days. 85% had anti-MPO antibodies, and the rest – anti-PR3 antibodies. 31% of patients had persistent creatinine (Cr) elevation on follow-up, and 3 patients were requiring hemodialysis. Of those 3 patients, 1 patient had normal renal function prior to presentation, and the rest had chronic kidney disease. The summary of the cases is presented in Table 1.

Table 1.Gender, ageDe novo (1) or relapse (2)AZD1222 (1), or mRNA-1273 (2), or BNT162b2 (3)OutcomeM, 75121HemodialysisM, 74121Improved CrF, 82212Improved CrF, 70312Improved CrF, 78413Improved CrF, 79513RemissionF, 54613Improved CrF, 78623HemodialysisM, 58712RemissionM, 63811Improved CrF, 29913RemissionM, 521012HemodialysisM, 841113Worsened Cr

Conclusion

Although the causality cannot be established on current evidence, the COVID-19 vaccine can probably trigger glomerulonephritis associated with ANCA, primarily anti-MPO type. We need a bigger cohort to identify patients predisposed for disease development or relapse after the COVID-19 vaccine.

References

[1]David R, Hanna P, Lee K, et al. Relapsed ANCA associated vasculitis following Oxford AstraZeneca ChAdOx1-S COVID-19 vaccination: A case series of two patients. Nephrol. 2021;27(1):109-110.

[2]Klomjit N, Alexander MP, Fervenza FC, et al. COVID-19 Vaccination and Glomerulonephritis. Kidney Int Rep. 2021;6(12):2969-2978.

[3]Chen C-C, Chen H-Y, Lu C-C, et al. Case Report: Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Acute Renal Failure and Pulmonary Hemorrhage May Occur After COVID-19 Vaccination. Front Med. 2021;8.

[4]Shakoor MT, Birkenbach MP, Lynch M. ANCA-Associated Vasculitis Following Pfizer-BioNTech COVID-19 Vaccine. Am J Kidney Dis. 2021;78(4):611-613.

[5]Hakroush S, Tampe B. Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination. Front Immunol. 2021;12.

[6]Davidovic T, Schimpf J, Sprenger-Mahr H, et al. De Novo and Relapsing Glomerulonephritis following SARS-CoV-2 mRNA Vaccination in Microscopic Polyangiitis. Case Reports Nephrol. 2021.

[7]Feghali EJ, Zafar M, Abid S, et al. De-novo Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Following the mRNA-1273 (Moderna) Vaccine for COVID-19. Cureus. 2021;13(11).

[8]Villa M, Diaz-Crespo F, Perez de Jose A, et al. A case of ANCA-associated vasculitis after AZD1222 (Oxford–AstraZeneca) SARS-CoV-2 vaccination: casualty or causality? Kidney Int. 2021;100(4):937-938.

[9]Dube GK, Benvenuto L, Batal I. Antineutrophil Cytoplasmic Autoantibody-Associated Glomerulonephritis Following the Pfizer-BioNTech COVID-19 Vaccine. Kidney Int Rep. 2021;6(12):3087-3089.

[10]Sekar A, Campbell R, Tabbara J, et al. ANCA glomerulonephritis after the Moderna COVID-19 vaccination. Kidney Int. 2021;100(2):473-474.

[11]Obata S, Hidaka S, Yamano M, et al. MPO-ANCA-associated vasculitis after the Pfizer/BioNTech SARS-CoV-2 vaccination. Clin Kidney J. 2021.

Disclosure of Interests

None declared

POS0867 COMORBIDITY AND COMPLICATIONS PRIOR TO SYSTEMIC SCLEROSIS DIAGNOSIS: A RETROSPECTIVE COHORT ANALYSIS

Background

Systemic sclerosis (SSc) is a rare autoimmune disease characterized by progressive microvascular damage, collagen deposition and subsequent fibrosis of the skin and internal organs which contributes to substantial morbidity and premature death.1-2

Objectives

The objective was to evaluate the disease burden of SSc patients prior to their SSc diagnosis.

Methods

Patients with SSc were identified in a claims dataset (IBM MarketScan Commercial Database, 2015-2019) using ICD 10 diagnosis codes for SSc. Eligible subjects were required to have > 1 inpatient or >2 outpatient/office claims with a scleroderma diagnosis code on separate days and > 24 months of continuous health plan enrollment without a SSc diagnosis before the first SSc claim (‘index date’) and > 12 months of enrollment after the index date. Overall comorbid disease burden was assessed via the Charlson Comorbidity Index (CCI) 13-24 and 12 months before and 12 months after index date. The prevalence of SSc-related complications for atherosclerosis, pulmonary arterial hypertension (PAH), pulmonary fibrosis (PF), Raynaud’s Phenomenon (RP), and gastrointestinal (GI) complications (e.g., GERD, dysphagia, etc.) were identified using ICD codes and reported as percentages for the aforementioned time intervals relative to patients’ index dates.

Results

902 eligible SSc patients were identified for analysis. The mean age at index SSc diagnosis was 54.3 years and 84.7% of patients were female. Mean CCI scores 13-24 months before, 12 months before, and 12 months after index SSc diagnosis were 0.84, 1.13 and 1.30, respectively. From the time points 13-24 months before, 12 months before, and 12 months after index SSc diagnosis, increasing rates were also observed of atherosclerosis, PAH, PF, RP, and GI complications (Table 1).

Table 1.

Charlson Comorbidity Index (CCI) and systemic sclerosis-related complications by time-interval

Clinical characteristic13-24 months before Index12 months before Index12 months after IndexMean CCI (std dev)0.84 (1.58)1.13 (1.71)1.30 (1.75)Systemic sclerosis-related complicationsAtherosclerosis7%9%14%Pulmonary arterial hypertension (PAH)1%4%12%Pulmonary fibrosis (PF)5%8%16%Raynaud’s Phenomenon (RP)13%29%43%GI complications23%32%46%

Conclusion

Results from this analysis suggests that SSc-related sequalae are present at least two years prior to SSc diagnosis and rates of these complications increased markedly over time. Patients’ overall comorbid disease burden also worsened substantially over this period, likely because of these complications. The internal organ involvement is likely under reported due to requirements to link each diagnosis with an ICD-10 code. These data indicate the significant burden of SSc, prior to and after diagnosis, highlighting the need for awareness, prompt diagnosis, and effective therapies for SSc and its related complications.

References

[1]Cutolo M, et al. Expert Rev Clin Immunol. 2019;15(7):753-764.

[2]Steen VD, Medsger TA. Ann Rheum Dis. 2007;66(7):940-944.

Disclosure of Interests

Dinesh Khanna Consultant of: Horizon Therapeutics, Daniel Furst Consultant of: Horizon Therapeutics, Justin W. Li Grant/research support from: Horizon Therapeutics, Saloni Shah Grant/research support from: Horizon Therapeutics, Tamara Lesperance Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Farah Ali Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephanie Taylor Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics

POS0933 IMPACT OF SACROILIAC JOINT STEROID INJECTION IN AXIAL SpA PATIENTS WITH BONE MARROW EDEMA ON DIFFERENT DISEASE OUTCOME MEASURES: A RANDOMIZED CONTROLLED TRIAL

Background

Sacroiliac joint injection in axial spondyloarthritis (SpA) patients with steroid was controversial. A well designed randomized clinical trial testing its effect on different disease outcome measures particularly bone marrow edema was missing [1].

Objectives

To test the effect of steroid injection in the sacroiliac joint of axial SpA patients on different disease outcome measures.

Methods

N = 43 were registered. They were randomly assigned into 2 groups; Group I (23 cases) received sacroiliac joint injection lidocaine hydrochloride mixed with triamcinolone, whereas Group II (22 cases) received subcutaneous saline injections. All participants fulfilled the ASAS criteria for axial SPA and they all had bone marrow edema at baseline. Outcomes measures were: Visual Analogue Scale (VAS), ASDAS, BASFI, and SPARCC scores. Participants were assessed at baseline (before and after sacroiliac joint injection) and after 3 months.

Results

There was a significant difference between both groups regarding pain, spine mobility, SPARCC and ASDAS scores in favor of group I. Spine mobility showed the earliest improvement, followed by pain whilst SPARCC and ASDAS scores showed improvement after 3 months. Higher disease activity, younger age, and shorter disease duration all were associated with better outcomes. Bilateral hip involvement was a predictor of poor response

Conclusion

Sacroiliac joint injection of lidocaine and triamcinolone in axial SpA patients is effective in controlling pain, improving function, disease activity scores, and bone marrow edema with acceptable complications and relatively sustained effect.

References

[1]Elsaman, A., A. Hamed, and A. Radwan, Ultrasound-guided epidural block in axial spondyloarthritis patients with limited spine mobility: a randomized controlled trial. The Korean journal of pain, 2021. 34(1): p. 114.

Table 1.

Comparison between the two study groups

Group I (N=24)Group II (N=23)P value*Age35.4±6.233.5±6.70.354SexMale17(77.3%)16(76.2%)1.000Female5(22.7%)5(23.8%)VASBefore injection (0)7.95±0.847.86±0.730.688After injection (1)3.55±1.446.95±1.02<0.00112 weeks later (2)4.82±1.377.19±0.81<0.001P value 0 vs 1**<0.0010.003-P value 0 vs 2**<0.0010.001-P value 1 vs 2**<0.0010.397-ASDASBefore injection2.69±0.442.60±0.370.45112 weeks later1.51±0.442.40±0.46<0.001P value **<0.0010.022BASFIBefore injection61.91±9.7062.95±11.710.75212 weeks later57.50±8.1361.24±0.530.199P value **<0.0010.081-SPARCCBefore injection34.73±9.1433.48±8.930.65212 weeks later15.68±6.6030.95±7.85<0.001P value **<0.0010.024-Finger to floorBefore injection (0)27.68±9.9426.90±11.620.815After injection (1)17.09±7.0025.48±11.230.00512 weeks later (2)19.64±7.8326.76±11.790.024P value 0 vs 1**<0.0010.001-P value 0 vs 2**<0.0010.791-P value 1 vs 2**0.0010.072-Lateral bendingBefore injection (0)21.64±5.9122.29±4.510.688After injection (1)25.50±6.1322.57±3.430.06012 weeks later (2)24.55±4.9522.24±2.950.071P value 0 vs 1**<0.0010.649-P value 0 vs 2**0.0030.947-P value 1 vs 2**0.0870.426-

* p values were calculated using Independent t test, except for the sex, where Fisher Exact test was used.

** p values for paired data was calculated using paired t test, to compare the baseline values (0) with either immediate post-injection (1) or 12 weeks later (2) values.

Disclosure of Interests

None declared

What causes environmental degradation in Pakistan? Embossing the role of fossil fuel energy consumption in the view of ecological footprint

For decades, environmental degradation has become a universal challenge, and for sustainable environment quality, a true and broader proxy is vital. Pakistan is an ecological deficient country in the world, being the sixth-largest economy (population-wise). This study investigates the prime sources of environmental degradation through ecological footprint in Pakistan. The yearly time-series data spanning 1972 to 2020 is utilized for a set of regressors as fossil fuel energy consumption, trade openness, arable land, industrial share to GDP, economic growth, and population growth. We use various econometric techniques, the bounds test, ARDL (short and long run) model, FMOLS, and Granger causality test. Bounds test confirms the existence of cointegration among variables included in our model. The ARDL estimates suggest that fossil fuel energy consumption, trade openness, and population growth are the leading factors affecting the environment. Fossil fuel consumption and population growth significantly damage the environment in the short and long run. Contrasting to that, trade openness is substantial to the environment quality. The FMOLS approves the robustness of the cointegrating findings. Moreover, a unidirectional causal relationship from economic growth to the ecological footprint (GDP → EFP). And also, the ecological footprint of arable land (EFP → AL) is witnessed. At the same time, bidirectional causality is found between growth rate and fossil energy consumption (GDP ↔ FEC). Lastly, we recommend some policy options to improve environmental quality in Pakistan.

Exploring environment sensitivity to fiscal and monetary policies in China: using ecological footprints as a contemporary proxy

This paper is a pioneer attempt using ecological footprints, the latest environment sensitivity proxy to be regressed, contributing to the scarce literature concerning one of the most burning global dilemmas of the era. For econometric analysis, fiscal and monetary tools, green energy consumption, and economic growth have been chosen as a set of regressors data spanning 1990-2020 in China facing the highest total ecological footpaths. And giving priority to the relevancy, reliability, and robustness autoregressive distributed lag (ARDL), fully modified ordinary least squares (FMOLS) and dynamic ordinary least squares (DOLS) have been applied for instant and eternal sensitivities, followed by the widely used stationarity tests (augmented Dicky-Fuller and Phillips-Perron tests) and bounds test. Granger's ordeal has also noticed causal inferences. Cointegrating findings are robust across all techniques, and ARDL results remain consistent regardless of short and prolonged duration. We witness positive and statistically significant (at 10%) responsiveness of ecological footprints (EFP) to China's rapid gross domestic output (GDP) growth per capita fueled by fossil fuels (primarily coal). Contrarily, negative/inverse sensitivity to expansionary fiscal (higher government expenditures, GEx), contractionary monetary policies (higher policy rate, DR), and green energy use (REnC). Besides, EFP demonstrates statistically significant reciprocal interconnection with GDP and REnC but a unidirectional connection with DR (DR → EFP). GDP has effective collaboration with REnC and GEx whereas single-sided relationship DR as (GDP → DR). Finally, some policy choices are endorsed.

Predicting How Well Adolescents Get Along with Peers and Teachers: A Machine Learning Approach

How well adolescents get along with others such as peers and teachers is an important aspect of adolescent development. Current research on adolescent relationship with peers and teachers is limited by classical methods that lack explicit test of predictive performance and cannot efficiently discover complex associations with potential non-linearity and higher-order interactions among a large set of predictors. Here, a transparently reported machine learning approach is utilized to overcome these limitations in concurrently predicting how well adolescents perceive themselves to get along with peers and teachers. The predictors were 99 items from four instruments examining internalizing and externalizing psychopathology, sensation-seeking, peer pressure, and parent-child conflict. The sample consisted of 3232 adolescents (M = 14.0 years, SD = 1.0 year, 49% female). Nonlinear machine learning classifiers predicted with high performance adolescent relationship with peers and teachers unlike classical methods. Using model explainability analyses at the item level, results identified influential predictors related to somatic complaints and attention problems that interacted in nonlinear ways with internalizing behaviors. In many cases, these intrapersonal predictors outcompeted in predictive power many interpersonal predictors. Overall, the results suggest the need to cast a much wider net of variables for understanding and predicting adolescent relationships, and highlight the power of a data-driven machine learning approach with implications on a predictive science of adolescence research.

Green synthesis of gold nanaoparticles using Delphinium Chitralense tuber extracts, their characterization and enzyme inhibitory potential

Green synthesis has been introduced as an alternative to chemical synthesis due to the serious consequences. Metal nanoparticles synthesized through green approach have different pharmaceutical, medical and agricultural applications. The present study followed a green and simple route for the preparation of potentially bioactive gold nanoparticles (Au NPs). Au NPs were prepared via green synthesis approach using crude basic alkaloidal portion of the tuber of Delphinium chitralense. The green synthesized Au NPs were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), X-ray diffraction (XRD) fourier transform infrared (FTIR), and UV-Visible spectrophotometer. Morphological analysis shows that Au NPs have cubic geometry with different sizes. UV-Vis spectroscopic analysis confirmed the synthesis of Au NPs while XRD proved their pure crystalline phase. The Au NPs showed promising dose dependent inhibition of both AChE and BChE as compared to the crude as well as standard drug.

Environmental sustainability assessment of wooden furniture produced in Pakistan

Life cycle assessment was carried out for a conventional wooden furniture set produced in Mardan division of the Khyber Pakhtunkhwa province of Pakistan during 2018-19. Primary data regarding inputs and outputs were collected through questionnaire surveys from 100 conventional wooden furniture set manufacturers, 50 in district Mardan and 50 in district Swabi. In the present study, cradle-to-gate life cycle assessment approach was applied for a functional unit of one conventional wooden furniture set. Production weighted average data were modelled in the environmental impacts modelling software i.e., SimaPro v.8.5. The results showed that textile used in sofa set, wood preservative for polishing and preventing insects attack and petrol used in generator had the highest contribution to all the environmental impact categories evaluated. Total cumulative energy demand for wooden furniture set manufactured was 30,005 MJ with most of the energy acquired from non-renewable fossil fuel resources.

Plasticity of root anatomy during domestication of a maize-teosinte derived population

Maize (Zea mays L.) has undergone profound changes in root anatomy for environmental adaptation during domestication. However, the genetic mechanism of plasticity of maize root anatomy during the domestication process remains unclear. In this study, high-resolution mapping was performed for nine root anatomical traits using a maize-teosinte population (mexicana × Mo17) across three environments. Large genetic variations were detected for different root anatomical traits. The cortex, stele, aerenchyma areas, xylem vessel number, and cortical cell number had large variations across three environments, indicating high plasticity. Sixteen quantitative trait loci (QTL) were identified, including seven QTL with QTL × environment interaction (EIQTL) for high plasticity traits and nine QTL without QTL × environment interaction (SQTL). Most of the root loci were consistent with shoot QTL depicting domestication signals. Combining transcriptome and genome-wide association studies revealed that AUXIN EFFLUX CARRIER PIN-FORMED LIKE 4 (ZmPILS4) serves as a candidate gene underlying a major QTL of xylem traits. The near-isogenic lines (NILs) with lower expression of ZmPILS4 had 18-24% more auxin concentration in the root tips and 8-15% more xylem vessels. Nucleotide diversity values analysis in the promoter region suggested that ZmPILS4 was involved in maize domestication and adaptation. These results revealed the potential genetic basis of root anatomical plasticity during domestication.

The positive impact of COVID-19 on Tuberculosis endemic areas

During a pandemic, we see that the world has controlled covid19 by taking necessary measures. Covid19 and tuberculosis (TB) have mainly the same mode of transmission. The efforts, we took to eliminate covid19, could also be taken to decrease TB. Here, I proposed a strategy that could help to deal with TB suspected cases and to avoid exposure to other people who are coming in hospital setups. Continuous...

Plant pathogen-mediated rapid acclimation of a host-specialized aphid to a non-host plant

Polyphagous aphids often consist of host-specialized lineages, which have greater fitness on their native hosts than on others. The underlying causes are important for understanding of the evolution of diet breadth and host shift of aphids. The cotton-melon aphid Aphis gossypii Glover is extremely polyphagous with many strict host-specialized lineages. Whether and how the lineage specialized on the primary host hibiscus shifts to the secondary host cucumber remains elusive. We found that the hibiscus-specialized lineage suffered high mortality and gave birth to very few nymphs developing into yellow dwarfs on fresh cucumber leaves, and did not inflict any damage symptoms on cucumber plants. The poor performance did not improve with prolonged exposure to cucumber; however, it did significantly improve when the cucumber leaves were pre-infected with a biotrophic phytopathogen Pseudoperonospora cubensis. More importantly, the hibiscus-specialized lineage with two-generation feeding experience on pre-infected cucumber leaves performed as well as the cucumber-specialized lineage did on fresh cucumber leaves, and inflicted typical damage symptoms on intact cucumber plants. Electrical penetration graph (EPG) indicated that the hibiscus-specialized lineage did not ingest phloem sap from fresh cucumber leaves but succeeded in ingesting phloem sap from pre-infected cucumber leaves, which explained the performance improvement of the hibiscus-specialized lineage on pre-infected cucumber leaves. This study revealed a new pathway for the hibiscus-specialized lineage to quickly acclimate to cucumber under the assistance of the phytopathogen. We considered that the short feeding experience on pre-infected cucumber may activate expression of effector genes that are related to specific host utilization. We suggest to identify host-specific effectors by comparing proteomes or/and transcriptomes of the hibiscus-specialized lineage before and after acclimating to cucumber.

Cardiac Screening in a Young Adult Male Leading to Discovery of Post-COVID Myocarditis with Asymptomatic Large Apical Left Ventricular Thrombus

•

A unique sequela of COVID-19 is COVID-related ventricular thrombus formation.

•

Diagnosis of a ventricular thrombus can only be confirmed through imaging.

•

COVID-related myocarditis can ultimately lead to ventricular thrombus formation.

•

Post-COVID cardiac screening may reveal sequelae in asymptomatic athletic individuals.

Evaluating paediatric dermatology telephone clinics during COVID-19 from a dual clinician and patient perspective: a prospective study

BACKGROUND

The landscape of dermatology services, already rapidly evolving into an increasingly digital one, has been irretrievably altered by the COVID-19 (SARS-CoV-2) pandemic. Data are needed to assess how best to deliver virtual dermatology services in specific patient subgroups in an era of ongoing social distancing and beyond. Initial studies of teledermatology in paediatric populations suggest that many of the problems experienced in adult telemedicine are more apparent when treating children and come with additional challenges.

AIM

To evaluate the efficacy of a virtual paediatric dermatology telephone clinic in comparison to traditional face-to-face (FTF) clinics, both from the clinician and patient/parental perspective.

METHODS

We carried out a prospective service evaluation examining a single centre cohort of paediatric dermatology patients managed during the COVID-19 pandemic via a telephone clinic supported by images. The study period covered June-September 2020. Data on outcomes were collected from clinicians and a qualitative patient/parental telephone survey was undertaken separately. A five-point Likert scale was used to assess both satisfaction and levels of agreement regarding whether a telephone clinic was more convenient than an FTF clinic.

RESULTS

Of 116 patients included, 24% were new and 76% were follow-up patients, with a mixture of inflammatory dermatoses (75%) and lesions (25%). From the clinician's perspective, most consultations (91%) were successfully completed over the telephone. However, qualitative patient and parent feedback paradoxically illustrated that although nearly all (98%) respondents had no outstanding concerns, 52% felt highly unsatisfied and only 22% agreed that telephone clinics were more convenient. Most (65%) preferred FTF follow-up in the future. Statistical analysis using χ² test showed that among those with established follow-ups, the preference for future consultation type was independent of specific reasons for follow-up.

CONCLUSIONS

Our study demonstrates a clear discrepancy between the practical successes of a virtual service from the clinician's perspective compared with the patient/parental perspective. Parental anxiety appears to be less effectively allayed virtually than with FTF. This raises the question of whether there is a role for virtual paediatric telephone clinics in the postpandemic future, which may be better left to patients/parents to decide on an individual basis.

Environmental friendly sustainable application of plant-based mordants for cotton dyeing using Arjun bark-based natural colorant

Ecofriendly exploration of Arjun bark (Terminalia arjuna) is a herbal natural colorant for cotton dyeing. This is because the demand for natural dyes has been increased worldwide due to their therapeutic usage and other food, textiles, agriculture, engineering, and medical applications. Therefore, this study has been carried out due to the isolation of colorant from Arjun bark in an acidified methanolic medium after exposure to ultrasonic rays up to 60 min. Additionally, using bio-mordants, it has been found that the application of 10% of Zeera (Cuminum cyminum) extract as meta-bio-mordant, 3% of Ilaichi (Elettaria cardamomum) extract as meta-bio-mordant, and10 % of Harmal (Peganum harmala) and Neem (Azadirachta indica) extract as meta-bio-mordants has given excellent color strength. These bio-mordants have not only made the coloration process more eco-friendly, viable, and greener, but also improved color strength with various tonal effects from red to reddish brown shades. Thus, it has been found that ultrasonic treatment as an environment-friendly tool has not only enhanced the color strength of natural colorant isolated from Arjun bark onto the cotton fabric under mild conditions.

Case report of a female child with right nasal chondromyxoid fibroma

Chondromyxoid fibroma is a rare tumour, representing <1% of all primary bone neoplasm. We report the case of a four-year-old female child with a one-year history of nasal obstruction and facial swelling. A large enhanced lesion with amorphous densities spreading into the right cribriform plate and floor of sphenoid sinus, laterally into the right lamina papyracea, inferolaterally into the medial wall of maxillary sinus, posteriorly into the nasopharynx and superior aspect of oropharynx was observed on CT scan. The mass was excised by Caldwell Luc's endoscopic medial maxillectomy via sublabial approach. CMF was confirmed histopathologically.

Orthodontic Assessment of Lip Prominence in Pakistani population

Introduction: Many reference planes are being used to determine prominence of upper and lower lip for orthognathic face profile. E-line and S-line are being used to determine lip position in local popuation of Multan city of Pakistan. Materials and Method: Execution of present study was done in Nishtar Institute of Dentistry, Multan during the period of November 2019-March 2020. 300 (112 Males and 188 Females) subjects were selected for this study from all provinces of Pakistan. Their radiographic records (Lateral cephalograms) were taken from radiographic department of related institution. Acetate matte sheets were used to construct reference planes by using 3H pencil. Steiner’s E-line and Rickett’s S-line were used to find Upper and Lower lip position from these reference lines. SPSS was used to analyze data after applying independent t-test. Result: Mean Upper and lower lip position from E- line was -1.74mm & -0.33mm and from S-line was 0.82mm and 1.47mm Conclusion: Cephalometric lip morphology assessment in Multan, Pakistani adults by using Steiner’s and Rickettsreference planes on lateral cephalogram is slightly different as compare to other populations

Surgical Outcomes of External Dacryocystorhinostomy Under Local Anaesthesia in a Tertiary Care Hospital: A Prospective Cohort Study

Objective: This study was designed to conclude the success rate of external dacryocystorhinostomy surgery, patient concerns about surgical scar mark and their satisfaction with the appearance of surgical scar. Methods: A prospective cohort study was conducted at Department of Ophthalmology, Gujranwala Medical College/ Teaching Hospital. Total 74 operated cases of DCR surgery under local anaesthesia in two year period (2018-19) were included. Mean follow-up was up to 11 months. Surgical success was defined as resolution of complaint of epiphora. Surgical failure was defined as blockage of lacrimal pathway on syringing. Patient concerns about surgical scar mark and their satisfaction with the appearance of surgical scar was also assessed by telephonic interview. Results: Out of 74 patients 61 (82.43%) were female and 13 (17.56%) were male. Mean age of patients was 39.49 ± 14.26 years.10 patients had epiphora at the end of follow-up. Majority of failed cases presented at 3 month. Lacrimal syringing on 1 week follow-up was effective to clear any debris or blood clot. The success rate (86.49%) calculated from those patients (n = 67) who completed the follow-up. 46 (68.65%) were not satisfied with the appearance of their surgical scar mark. Conclusion: External DCR performed in local anesthesia is a safe procedure with a success rate of above 85% at one year follow-up. Lacrimal pathway syringing, on follow-up after DCR surgery, can be effective to wash blood clot or debris. Majority of the patient do not find surgical scar mark cosmetically acceptable.