Identification and Epidemiological Analysis of Antibiotic-Resistant Bacteria in the Oral Microbiome of the Population in Pakistan.

Background Antibiotic resistance in the oral microbiome poses serious health risks worldwide, particularly in developing countries like Pakistan. Public health efforts are challenged by the potential of the oral cavity to serve as a reservoir for resistant bacteria due to its frequent exposure to antibiotics. Objective This study aimed to identify and analyze the prevalence and epidemiology of antibiotic-resistant bacteria within the oral microbiome of the Pakistani population. Methodology A cross-sectional study was conducted at Akhtar Saeed Medical and Dental College, Lahore, and Gomal Medical College, Dera Ismail Khan, from January 2023 to December 2023. A total of 290 participants, aged 18 years or older, were recruited based on specific inclusion and exclusion criteria. Oral swabs were collected and analyzed using conventional culture methods. All descriptive and inferential statistical analyses were performed using SPSS version 25 (IBM Corp., Armonk, NY), with a significance level set at p <0.05. Results The most common antibiotic-resistant bacteria identified were Enterococcus faecalis (24.48%, n = 71), Staphylococcus aureus (27.24%, n = 79), and Streptococcus mutans (35.86%, n = 104). The most frequent resistances were to penicillin (32.14%, n = 93), tetracycline (23.45%, n = 68), and erythromycin (22.07%, n = 64). Recent antibiotic use was significantly associated with higher rates of resistance (p = 0.01), with 75.19% of individuals (n = 97) who had used antibiotics within the past three to six months showing resistance. Conclusion The study reveals a high prevalence of antibiotic-resistant bacteria, particularly to penicillin and tetracycline, in the oral microbiome of the Pakistani population.

Regional integration and export performance of Pakistan: Empirical evidence from the Shanghai Cooperation Organization (SCO).

The study examines export impact of Pakistan's integration into Shanghai Cooperation Organization (SCO) on its export's performance. We apply Poisson Pseudo-Maximum Likelihood (PPML) on augmented gravity model to estimate trade data from the period before and after permanent membership with Shanghai Cooperation Organization in 2017. The study aims to explore changes in exports volume and analyze the key mechanism through which Shanghai Cooperation Organization promotes exports. The study assesses that after integration which key exports sector such as agriculture or manufacturing sectors are affected more significantly. The initial findings suggest that SCO integration positively affect and provide access to Central Asian markets, leading to modest but noticeable promotion in exports promotion. In heterogeneity analysis we find that exports of Pakistan are more significant with low and middle-income level countries compared to higher-income level countries. Additionally, exports in the manufacturing sector benefited more than in the agriculture sector. The significant and positive findings of mechanism analysis indicate that the belt and road (B&R) initiative and bilateral trade agreements are the key factors to enhanced exports. The overall impact remains moderated by structural changes in Pakistan economy, such as poor infrastructure, deficiency in energy sector and limited trade relations with its neighbors India and Iran. The study concludes that although the SCO integration has positively promoted exports of Pakistan however, it requires to address domestic economic constraints and capitalize more effectively the benefits of SCO membership through regional cooperation mechanism. For more potential benefits in the region SCO needs to expand B&R connectivity, encourage more trade agreements, and adopt favorable environment to attract high income countries in the organization. The study provides the base for future research in depth analysis of long-term impact of SCO integration on Pakistan exports.

A comprehensive review of covalent organic frameworks (COFs) and their derivatives in environmental pollution control.

Covalent organic frameworks (COFs) have gained considerable attention due to their design possibilities as the molecular organic building blocks that can stack in an atomically precise spatial arrangement. Since the inception of COFs in 2005, there has been a continuous expansion in the product range of COFs and their derivatives. This expansion has led to the evolution of three-dimensional structures and various synthetic routes, propelling the field towards large-scale preparation of COFs and their derivatives. This review will offer a holistic analysis and comparison of the spatial structure and synthesis techniques of COFs and their derivatives. The conventional methods of COF synthesis (i.e., ultrasonic chemical, microwave, and solvothermal) are discussed alongside the synthesis strategies of new COFs and their derivatives. Furthermore, the applications of COFs and their derived materials are demonstrated in air, water, and soil pollution management such as gas capture, catalytic conversion, adsorption, and pollutant removal. Finally, this review highlights the current challenges and prospects for large-scale preparation and application of new COFs and the derived materials. In line with the United Nations Sustainable Development Goals (SDGs) and the needs of digital-enabled technologies (AI and machine learning), this review will encompass the future technical trends for COFs in environmental pollution control.

Computational insights of double perovskite Na2CaCdH6 hydride alloy for hydrogen storage applications: a DFT investigation.

Prospective use of perovskite hydride materials in H storage a crucial element of clean energy systems has drawn a lot of attention. The structural, electrical, mechanical, thermodynamic, and H storage qualities of Na2CaCdH6 hydride alloys were examined in this work using DFT. According to the structural properties, Na2CaCdH6 has space group 225 (Fm3m), and optimized lattice parameters and volume of Na2CaCdH6 are 3.3485 Å and 593.764 Å3. The measured gravimetric H storage capacity of Na2CaCdH6 hydrides is 2.956 wt%. The hydrides under research are semiconductors, as indicated by the computed electronic characteristics. Elastic constants, Pugh's ratio, modulus, Poisson's ratio, anisotropic, and microhardness of Na2CaCdH6 are calculated under mechanical properties. The hydrides are dynamically stable, as indicated by the phonon dispersion curves, but mechanically stable according to the Born criterion for elastic constant (Cij). The Cauchy's pressure (C″ = 7.836) revealed the ductile behavior. The electronic and mechanical characteristics imply that Na2CaCdH6 hydride can conduct electricity and is also mechanically stable. Our findings shed light on the possibilities of Na2CaCdH6 perovskite hydride material for H storage utilization.

Regularity and wave study of an advection-diffusion-reaction equation.

In this paper, we investigate the optimal conditions to the boundaries where the unique existence of the solutions to an advection-diffusion-reaction equation is secured by applying the contraction mapping theorem from the study of fixed points. Also, we extract, traveling wave solutions of the underlying equation. To this purpose, a new extended direct algebraic method with traveling wave transformation has been used. Achieved soliton solutions are different functions which are hyperbolic, trigonometric, exponential, and some mixed trigonometric functions. These functions show the nature of solitons. Two and three-dimensional plots are drawn using different values of parameters and coefficients for the comparison and behavior of solitons as combined bright-dark, dark, and bright solitons.

16S rRNA gene amplicon sequencing data from the gut microbiota of adolescent Afghan refugees.

The gut microbiota residing in the distal ileum and colon is the most complex, diverse, and densest microbial ecosystem in the human body. Despite its known role in human health and disease, gut microbiome diversity and function are rarely explored in vulnerable populations such as refugees. The current study aimed to explore gut microbiota diversity and sources of variation among adolescent Afghan refugees residing in Peshawar, Pakistan. Stool samples were collected from 10 - 18 years old, healthy adolescents (n=205) for 16S rRNA gene sequence (V4-V5 hypervariable region) analysis on isolated faecal DNA. Bioinformatics analyses were performed using Kraken2, Bracken and Phyloseq. The data presented here will allow researchers to profile the gut microbiota of this rarely explored, vulnerable population who are at high risk of food insecurity and malnutrition. The data can be used to provide insight on the impact of demographic characteristics, dietary intake, nutritional status, and health on gut microbiome diversity, and enables a comparative analysis with similar data sets from other population groups of relevance. The amplicon sequencing data are deposited in the NCBI Sequence Read Archive as BioProject PRJNA1105775.

Technoeconomic analysis of solar PV electrification to remote areas of Dera Ghazi Khan: A case study.

With the increase in population at an immense rate, electricity demand is growing exponentially. Researchers and policymakers are seeking alternating means of power generation to meet the load demand. These resources should be cost-effective, environmentally friendly and least carbon emissions. To mitigate the load demand Renewable Energy Sources (RES) are integrated into electrical networks. In this work, an off-grid solar photovoltaic (PV) system is designed for rural areas of Dera Ghazi Khan (DG Khan), Pakistan. These areas often lack access to reliable grid power. Installing PV systems in these areas can help provide a reliable source of electricity, reduce reliance on fossil fuels, and improve living conditions. This case study is simulated using PVsyst 7.2. of Roonghan village such as hospitals, shops, and residential houses for techno-economic analysis of off-grid solar PV. The economic viability shows that installing off-grid solar PV in DG Khan is much cheaper. The electricity taken from the grid that's almost 80.01%is expensive. This case study helps other researchers and policymakers to mitigate the electricity requirement of remote areas located far away from the national grid. To install a transmission line, having cost $26.98 corer but using an off-grid to provide electricity to the same area is $2.16 corer. Additionally, it integrates Battery Energy Storage (BES) with Renewable Energy Sources (RES) to achieve a 5 % annual energy cost reduction and enhanced self-sufficiency, filling a gap in existing literature.

PDCD4 deficiency in hepatocytes exacerbates nonalcoholic steatohepatitis through enhanced MHC class II transactivator expression.

Nonalcoholic steatohepatitis (NASH) is a primary cause of liver cirrhosis and hepatocellular carcinoma, presenting a significant and unmet medical challenge. The necessity to investigate the molecular mechanisms underlying NASH is highlighted by the observed decrease in programmed cell death 4 (PDCD4) expression in NASH patients, suggesting that PDCD4 may play a protective role in maintaining liver health. In this study, we identify PDCD4 as a natural inhibitor of NASH development in mice. The absence of PDCD4 leads to the spontaneous progression of NASH. Notably, PDCD4-deficient hepatocytes display elevated major histocompatibility complex class II (MHCII) expression due to CIITA activation, indicating that PCDC4 prevents the abnormal transformation of hepatocytes into antigen-presenting cells (APCs). Cell co-culture experiments reveal that hepatocytes lacking PDCD4, which resemble APCs, can directly activate CD4+ T cells by presenting multiple peptides, resulting in the release of inflammatory factors. Additionally, both cellular and animal studies show that CIITA promotes lipid accumulation in hepatocytes and exacerbates NASH progression. In summary, our findings reveal a novel role of PDCD4 in regulating CIITA and MHCII expression during NASH development, offering new therapeutic approaches for NASH treatment.

Effect of stakeholder pressure on environmental performance: Do virtual CSR, green credit, environmental and social reputation matter?

In today's globalized and interconnected world, businesses operate within an interconnected network with various stakeholders. Among these stakeholders, the pressure from consumers, investors, regulators, and communities for corporations to adopt environmentally responsible practices has intensified significantly. Therefore, this study investigates the relationship between stakeholder pressure and environmental performance (EP) in Pakistan's manufacturing sector while examining the potential moderating roles of environmental reputation, social reputation, virtual CSR, and green credit. Data was gathered by convenience sampling and a cross-sectional research approach. A structural questionnaire was given to 376 employees of manufacturing firms that are listed on the Pakistan Stock Exchange (PSE). The research hypotheses were tested using PLS-SEM techniques, which examined the interactions between these variables. The results reveal that stakeholder pressure significantly influences the environmental performance of manufacturing firms. Environmental reputation and virtual CSR negatively moderate the relationship between stakeholder pressure and EP. Moreover, social reputation and green credit positively moderate the relationship between stakeholder pressure and EP. These results contribute to the existing literature by shedding light on how stakeholder pressure influences firms' environmental behavior. Practical implications include integrating virtual CSR strategies, securing green financing options, and building strong environmental and social reputations to effectively respond to stakeholder demands and improve environmental performance.

A future directions of renal cell carcinoma treatment: combination of immune checkpoint inhibition and carbon ion radiotherapy.

Renal cell carcinoma (RCC) is considered radio- and chemo-resistant. Immune checkpoint inhibitors (ICIs) have demonstrated significant clinical efficacy in advanced RCC. However, the overall response rate of RCC to monotherapy remains limited. Given its immunomodulatory effects, a combination of radiotherapy (RT) with immunotherapy is increasingly used for cancer treatment. Heavy ion radiotherapy, specifically the carbon ion radiotherapy (CIRT), represents an innovative approach to cancer treatment, offering superior physical and biological effectiveness compared to conventional photon radiotherapy and exhibiting obvious advantages in cancer treatment. The combination of CIRT and immunotherapy showed robust effectiveness in preclinical studies of various tumors, thus holds promise for overcoming radiation resistance of RCC and enhancing therapeutic outcomes. Here, we provide a comprehensive review on the biophysical effects of CIRT, the efficacy of combination treatment and the underlying mechanisms involved in, as well as its therapeutic potential specifically within RCC.

Green Synergy: Interplay of corporate social responsibility, green intellectual capital, and green ambidextrous innovation for sustainable performance in the industry 4.0 era.

This study delves into the interconnections among corporate social responsibility, green intellectual capital, green ambidextrous innovation, and sustainable performance, particularly in the context of Industry 4.0 and sustainability. A questionnaire-based survey was conducted, and a sample of 317 small and medium enterprises was collected. Using Partial Least Squares Structural Equation Modeling in Smart-PLS v4, the findings reveal a significant relationship between corporate social responsibility and sustainable performance, with green intellectual capital and green ambidextrous innovation serving as mediating factors. Moreover, the study highlights the moderating role of Industry 4.0 among green intellectual capital and green ambidextrous innovation with sustainable performance. These findings may guide the managers in designing and implementing CSR strategies beyond compliance and contributing to competitive advantage through green intellectual capital and green ambidextrous innovation for business success in the era of Industry 4.0.

Computational investigation on physical properties of lead based perovskite RPbBr3 (R = Cs, Hg, and Ga) materials for photovoltaic applications.

In the modern era, the major problem is solving energy production and consumption. For this purpose, perovskite materials meet these issues and fulfill energy production at a low cost. Density functional theory and the Cambridge Serial Total Energy Package (CASTEP) are used to examine the characteristics of the cubic inorganic perovskites RPbBr3 (R = Cs, Hg, and Ga). In the context of the generalized gradient approximation (GGA), the ultrasoft pseudo-potential plane wave technique and the Perdew-Burke-Ernzerhof exchange-correlation functional are used for investigations. Structural, mechanical, electronics, and optical properties are investigated using CASTEP code. According to structural properties, compounds have a cubic nature with space 221 (Pm3m). Compounds formation energy (- 3.46, - 2.21, and - 3.14 eV)of (CsPbBr3, HgPbBr3, and GaPbBr3) and phonon calculations are studied and find that compounds are stable. The results of our investigation show that the compounds have narrow bandgaps of direct kind, with 1.85 eV for CsPbBr3, 1.56 eV for HgPbBr3, and 1.71 eV for GaPbBr3, respectively, indicating that they may be used to improve conductivity. Additionally, anisotropy (2.135, 3.651, 10.602), Pugh's ratio (1.87, 2.25, 2.14), and Poison's ratio (0.27, 0.31, 0.29) are traits that the compounds (CsPbBr3, HgPbBr3, GaPbBr3) display a ductile nature. The CsPbBr3 compound showed significant optical conductivity and absorption in terms of their optical properties, especially in the visible region, which makes them suitable for use in solar cell applications as well as for LED applications.

Gender-based differences in the representation and experiences of academic leaders in medicine and dentistry: a mixed method study from Pakistan.

BACKGROUND: Research evidence suggests gender-based differences in the extent and experiences of academic leaders across the globe even in developed countries like USA, UK, and Canada. The under-representation is particularly common in higher education organizations, including medical and dental schools. The current study aimed to investigate gender-based distribution and explore leaders' experiences in the medical and dental institutes in a developing country, Pakistan. METHODS: A mixed-method approach was used. Gender-based distribution data of academic leaders in 28 colleges including 18 medical and 10 dental colleges of Khyber Pakhtunkhwa, Pakistan were collected. Qualitative data regarding the experiences of academic leaders (n = 10) was collected through semi-structured interviews followed by transcription and thematic analysis using standard procedures. RESULTS: Gender-based disparities exist across all institutes with the greatest differences among the top-rank leadership level (principals/deans) where 84.5% of the positions were occupied by males. The gender gap was relatively narrow at mid-level leadership positions reaching up to as high as > 40% of female leaders in medical/dental education. The qualitative analysis found gender-based differences in the experiences under four themes: leadership attributes, leadership journey, challenges, and support. CONCLUSIONS: The study showed that women are not only significantly under-represented in leadership positions in medical and dental colleges in Pakistan, they also face gender-based discrimination and struggling to maintain a decent work life balance. These findings are critical and can have important implications for government, organizations, human resource managers, and policymakers in terms of enacting laws, proposing regulations, and establishing support mechanisms to improve gender-based balance and help current and aspiring leaders in their leadership journey.

The ability of selected fungal strains to produce carboxylesterase enzymes for biodegradation and use of bifenthrin insecticide as carbon source: in vitro and in silico approaches.

Bifenthrin (BF) is a broad-spectrum type I pyrethroid insecticide that acts on insects by impairing the nervous system and inhibiting ATPase activity, and it has toxic effects on non-target organisms and high persistence in the environment. This study aimed to determine the potential of six different fungi, including Pseudozyma hubeiensis PA, Trichoderma reesei PF, Trichoderma koningiopsis PD, Purpureocillium lilacinum ACE3, Talaromyces pinophilus ACE4, and Aspergillus niger AJ-F3, to degrade BF. Three different concentrations of BF, including 0.1%, 0.2%, and 0.3% w/v, were used in the sensitivity testing that revealed a significant (p ≤ 0.01) impact of BF on fungal growth. Enzymatic assays demonstrated that both intracellular and extracellular carboxylesterases hydrolyzed BF with the enzymatic activity of up to 175 ± 3 U (µmol/min) and 45 ± 1 U, respectively. All tested fungi were capable of utilizing BF as a sole carbon source producing 0.06 ± 0.01 to 0.45 ± 0.01 mg dry biomass per mg BF. Moreover, the presence of PytH was determined in the fungi using bioinformatics tools and was found in A. niger, T. pinophilus, T. reesei, and P. lilacinum. 3D structures of the PytH homologs were predicted using AlphaFold2, and their intermolecular interactions with pyrethroids were determined using MOE. All the homologs interacted with different pyrethroids with a binding energy of lesser than - 10 kcal/mol. Based on the study, it was concluded that the investigated fungi have a greater potential for the biodegradation of BF.

Model simplification and sensitivity analysis of chemical species for oxidation behavior in multi route complex chemical mechanism.

This study employs a Model Reduction Technique (MRT) to simplify the four-step catalytic carbon monoxide (CO) oxidation reaction. The C-matrix method identifies key elements, key/non key components, and key reactions, while the Intrinsic Low-Dimensional Manifold (ILDM) pinpoints a Slow-Invariant Manifold (SIM) important for understanding key species behavior. Sensitivity analysis can be considered for measuring the efficiency of the chemical species in detailed mechanism. This systematic approach contributes to optimizing and controlling complex reactions offering broad application potential. In addition to the mathematical proof, the validation of the given chemical model is rectified. The comparison between the slow invariant manifold of both reaction routes is reported and the computational based results performed in this study are obtained through MATLAB.

Recurrent Infection in a Young Female Patient Recently Diagnosed With Primary Evans Syndrome Without Neutropenia.

Evans syndrome (ES) is a rare autoimmune condition of unknown etiology that occurs in a small subset of patients diagnosed, either sequentially or concomitantly, with immune thrombocytopenia (ITP) or warm autoimmune hemolytic anemia (AIHA). Neutropenia is present occasionally. Diagnosis is based on exclusion with a median age of 52 years of age. Here we have a case of a young patient with ES presenting with recurrent infection. ES should be included in differential diagnoses for patients presenting with AIHA, ITP, cytopenias or recurrent infection as the prognosis is more favorable when diagnosis is made early and symptoms are still mild.

Patient satisfaction with Saudi community pharmacy services (Wasfaty System).

Introduction: The healthcare system in KSA has been substantially transformed as part of Vision 2030, including implementation of an electronic prescribing system, called Wasfaty, to enable patients to receive their prescriptions from community pharmacies (CPs). This study assessed patient satisfaction with CPs and the Wasfaty system. Methods: This cross-sectional observational study used existing data from the Saudi Ministry of Health's patient experience program. Data were collected from patients (≥15 years of age) visiting governmental primary care clinics in 2022. Summary statistics were determined and multivariable logistic regression analyses were conducted. Results: The sample included 66,541 patients. More than 70% of patients were satisfied with the services of the CPs and the Wasfaty system. Being older and being female consistently showed a positive association with satisfaction across several services. Whereas patients in preventive clinics had higher odds of satisfaction with medication availability (OR: 1.19, 95% CI: 1.03-1.37) and waiting time (OR: 1.23; 95% CI: 1.03-1.47), patients in chronic disease clinics had lower satisfaction with medication availability (OR: 0.92, 95% CI: 0.85-0.99). Saudi patients had lower odds of being satisfied with multiple services. Conclusions: The overall high satisfaction among patients suggested the success of the Wasfaty system in meeting patient needs and expectations. However, areas for improvement exist to increase patient satisfaction, such as addressing medication shortages and ensuring clear patient-pharmacist communication. The results highlight the importance of continued monitoring and evaluation to support the patient experience with pharmacy services, and to improve patients' journeys, medication adherence, and overall healthcare outcomes.

An analysis of the effect of agriculture subsidies on technical efficiency: Evidence from rapeseed production in China.

This study was conducted to examine the effects of agricultural subsidies on the technical efficiency of agricultural production technology and on factor input. It utilized a random frontier production function, instrumental variable method, and threshold regression model. The data used for this analysis consisted of 609 field yield measurements from the National Rapeseed Industry Technology System in 2020. The findings indicate that agricultural subsidies have a substantial impacts and it increases the technical efficiency of production process. Specifically, these subsidies encourage the use of land resources while inhibiting the use of chemical fertilizers. However, this does not have a significant effect on the utilization of labor and capital resources. Furthermore, the impact of agricultural subsidies on production technology efficiency varies depending on the scale of the farming operation. The subsidies significantly enhance the production technology efficiency of farmers with a business scale of less than 0.67 ha, but do not significantly improve the production technology efficiency of farmers with a business scale exceeding 0.67 ha. To optimize the effectiveness of agricultural subsidy policy, three methods and recommendations are proposed: increasing the overall amount of subsidies, expanding and diversifying the types of subsidies, and refining the process of disbursing subsidies.

Follicular, luteal dynamics and effect of synchronization methods on reproductive responses in Cholistani cows.

The Cholistani cow is considered one of the milch breeds of Zebu cattle. Despite being heat and tick-resistant, it has not yet gained much popularity among Pakistan dairy farmers due to its long calving interval. This study aimed to understand the basic reproductive physiology of Cholistani cows using sonography and reproductive biotechnologies such as estrus synchronization and timed artificial insemination to improve reproductive efficiency. In experiment 1, six Cholistani cows with mixed parity 3.20 ± 1.30 and weighing 400 kg were selected to monitor ovarian dynamics on alternate days by the same sonographer from the onset of heat through ovulation until the next ovulation. Experiment 2 measured the effect of estrus synchronization methods, controlled internal drug release-gonadotropin-releasing hormone (CIDR-GnRH, n = 31) and Ovsynch (OVS, n = 32) on various reproductive parameters. The mean estrous cycle length was 19.81 ± 0.56 days with two follicular waves. The mean inter-ovulatory interval was 20.80 ± 0.52 days, with a preovulatory follicular size of 13.83 ± 2.37 mm. Estrus response was higher (p > 0.05) in controlled internal drug release (CIDR)-GnRH (93.54%) than in OVS (84.37%) cows. Similarly, ovulation and conception rates were higher in CIDR-GnRH (91.66% vs. 68.42%) than in OVS cows (41.37% vs. 33.33%), respectively. In conclusion, CIDR-GnRH results in a better estrus response, higher ovulation rate, and subsequently greater conception rate than OVS in Bos indicus dairy cows.

Examining the influence of technological self-efficacy, perceived trust, security, and electronic word of mouth on ICT usage in the education sector.

The context of education has changed due to revolutionary developments in the information communication technology (ICT) industry in the post-COVID era. Innovative learning methods were introduced in the education sector to promote quality education. The students find it more convenient to use ICT tools to integrate their knowledge-seeking. China has recently paid more attention to developing and adopting electronic infrastructure. The study assesses the effect of technology self-efficacy (TSE) on ICT acceptance and implementation in China's education sector. It also analyzed the role of perceived trust, perceived security, and electronic word of mouth (eWOM) in integrating digital information sharing and interaction tools. Data is collected from 382 business students at Chinese universities. The results revealed that perceived trust mediates the relationship between TSE and the actual use of ICT tools, intention to use ICT tools for information, and intention to use ICT tools for interaction. Further, perceived security and eWOM significantly moderate the relationship between TSE and perceived trust. The findings indicate that it is essential to offer assistance and instruction to students in the educational sector so they can use ICT technology more frequently. It is also crucial for organizations to establish a supportive culture and provide the necessary technological resources to facilitate the use of ICT.