Frequency of psychosocial stress and its relationship to safety attitude towards nurse's performance at tertiary care hospitals.

Background & Objectives: Psychosocial stress has a detrimental effect on nurses' work performance. A safe working environment is significant in providing nurses with safe and satisfactory care. The objective of study was to assess the frequency of psychosocial stress of nurses and determine the relationship between psychosocial stress of nurses and safety attitude towards nurses' performances at Tertiary Care Hospital, Karachi. Methods: Analytical cross-sectional study was conducted at Dr. Ruth KM Pfau Civil Hospital, Karachi, and Dow University Hospital Karachi for six months, from December 2020 to May 2021.A total 260 participants were approached by a non-probability purposive sampling. Pearson's correlation was used to establish the relationship between the psychosocial stress of nurses and different parameters of their safety attitude. The Chi-square test was applied for the association between demographic factors of nurses with their psychosocial stress levels. A p-value of ≤0.05 was considered as significant. Results: The majority of nurses, 180 (69.2%), described poor health, while 54 (20.8%) had good health, and only 10% (26) of nurses reported their best health status. Three parameters were negatively correlated and statistically significant with psychosocial stress, namely: teamwork (r-0.13<0.002), job satisfaction (r-0.15<0.028), and perception of management (r-0.34<0.000). The result of the study indicated that gender (P-value<0.000), marital status (P-value<0.0037), and institution (P-value <0.005) were significantly associated with safety attitude score. Conclusion: Most of the nurses had poor health, which was significantly related to teamwork, job satisfaction and perception of management, and stress recognition.

A comprehensive neurological perspective on tick-borne flaviviruses, with emphasis on Powassan virus.

Powassan virus (POWV), a tick-borne flavivirus transmitted primarily by Ixodes ticks, poses a significant threat as it can lead to severe neuroinvasive illness. This review delves into the nuanced clinical presentation of Powassan infection, a challenge in diagnosis exacerbated by the absence of an available vaccine. Over the past decade, the prevalence of POWV has surged in North America, necessitating a thorough examination of its neurological manifestations alongside tick-borne encephalitis virus (TBEV). A comprehensive literature search conducted up to January 2024 revealed 135 cases of neurological symptoms associated with either Powassan or TBEV infection. Notably, severe occipital headache emerged as the most prevalent symptom (22.75%), followed by meningoencephalitis (10.34%), seizures (8.27%), and flaccid paresis (6.8%). Additional manifestations included poor balance, wide gait, dysarthria, facial nerve palsy, seizure, slurred speech, and absent deep tendon reflexes. Tragically, nine cases resulted in fatal outcomes attributed to POWV infection. This analysis highlights the intricate spectrum of neurological symptoms associated with Powassan infection and underscores the necessity for heightened awareness among medical practitioners, particularly in regions with a higher prevalence of the virus. The complexity of symptoms emphasizes the need for further research to unravel the factors contributing to this diversity. Additionally, exploring potential treatment avenues and vaccine development is crucial in addressing the rising threat posed by POWV, ultimately enhancing our ability to manage and prevent severe neurological outcomes.

Frequency, management and impact of adverse events on treatment outcomes in patients with multidrug resistant tuberculosis in Balochistan, Pakistan.

Background: Early detection, monitoring, and managing adverse events (AEs) are crucial in optimising treatment for multidrug-resistant tuberculosis (MDR-TB) patients. Objectives: To investigate the incidence, factors, management, and impact of AEs on treatment outcomes in MDR-TB patients. Methods: This study reviewed the medical records of 275 MDR-TB patients at Fatimah Jinnah Institute of Chest Diseases in Quetta, Pakistan. Patient information was collected using a designed data collection form. Mann-Whitney U and Kruskal-Wallis tests examined the difference in AEs occurrences based on patients' characteristics. Multiple binary logistic regression identified factors associated with unsuccessful outcomes, with statistical significance set at a p-value < 0.05. Results: Almost all patients (99.6%) experienced at-least one AE (median = 4/patient, interquartile range:3-6). The most common were GI disturbance (95.3%), arthralgia (80.4%), body pain and headache (61.8%), ototoxicity (61.4%), psychiatric disturbance (44%), hypokalaemia (40.4%), dermatological reactions (26.2%) and hypothyroidism (21.5%). AEs led to treatment modification in 7.3% patients. Educated patients, those with a history of TB treatment, previous use and resistance to any second-line drug had significantly higher number of AEs. A total of 64.0% were declared cured, 3.6% completed treatment, 19.6% died and 12.7.9% were lost to follow-up. Patients' age of 41-60(OR = 9.225) and >60 years(OR = 23.481), baseline body weight of 31-60 kg(OR = 0.180), urban residence(OR = 0.296), and experiencing ototoxicity (OR = 0.258) and hypothyroidism (OR = 0.136) were significantly associated with unsuccessful treatment outcomes. Conclusion: AEs were highly prevalent but did not negatively impact treatment outcomes. Patients at higher risk of developing AEs and unsuccessful outcomes should receive special attention for its early management.

Assessment of health-related quality of life among Afghan refugees in Quetta, Pakistan.

The study aims to assess the health-related Quality of Life (HRQOL) and its association with socio-demographic factors among the Afghan refugees residing in Quetta, Pakistan. For this purpose, a cross-sectional, descriptive study design by adopting Euro QOL five dimensions questionnaire (EQ-5D) for the assessment of HRQOL was conducted by approaching Afghan refugees from the camp and other areas of Quetta, Pakistan. Furthermore, this study also involved descriptive analysis to expound participant's demographic characteristics while inferential statistics (Kruskal-Wallis and Mann-Whitney test, P < 0.05) were used to compare EQ-5D scale scores. All analyses were performed using SPSS v 20. Herein, a total of 729 participants were enrolled and were subsequently (n = 246, 33.7%) categorized based on their age of 22-31 years (31.30 ± 15.40). The results of mean EQ-5D descriptive score (0.85 ± 0.20) and EQ-VAS score (78.60 ± 11.10) indicated better HRQOL in the current study respondents as compared to studies conducted in other refugee camps around the globe. In addition, demographic characteristics including age, marital status, locality, years of living as refugees, life as a refugee residing out of Pakistan, place of residence in Afghanistan, educational qualification, occupation, and arrested for crime were the statistically significant predictors (P < 0.05) of EQ-5D index scores. However, gender, living status, monthly income, preferred place of treatment were non-significant predictors (P > 0.05). The results of current study provided evidence for a model that correlated with participant's socio-demographic information and HRQOL. Moreover, this study also revealed a baseline assessment for the health status of Afghan refugees, interestingly, these results could be applied for improving HRQOL of the given participants. In conclusion, the HRQOL of Afghan refugees residing in Quetta, Pakistan can largely be improved by providing adequate healthcare facilities, education and employment opportunities, mental and social support, and providing adequate housing and basic necessities of life.

Enhancing systematic tolerance in Bermuda grass (Cynodon dactylon L.) through amplified alkB gene expression and bacterial-driven hydrocarbon degradation.

This study aimed to access the impact of soil polluted with petroleum (5, 10 g petroleum kg-1 soil) on Bermuda grass (Cynodon dactylon L.) with and without applied bacterial inoculants (Arthrobacter oxydans ITRH49 and Pseudomonas sp. MixRI75). Both soil and seed were given bacterial inoculation. The evaluated morphological parameters of Bermuda grass were fresh and dry weight. The results demonstrated that applied bacterial inoculants enhanced 5.4%, 20%, 28% and 6.4%, 21%, and 29% shoot and root fresh/dry weights in Bermuda grass under controlled environment. The biochemical analysis of shoot and root was affected deleteriously by the 10 g petroleum kg-1 soil pollution. Microbial inoculants enhanced the activities of enzymatic (catalase, peroxidase, glutathione reductase, ascorbate peroxidase, superoxide dismutase) and non-enzymatic (ɑ-tocopherols, proline, reduced glutathione, ascorbic acid) antioxidant to mitigate the toxic effects of ROS (H2O2) under hydrocarbon stressed condition. The maximum hydrocarbon degradation (75%) was recorded by Bermuda grass at 5 g petroleum kg-1 soil contamination. Moreover, bacterial persistence and alkane hydroxylase gene (alkB) abundance and expression were observed more in the root interior than in the rhizosphere and shoot interior of Bermuda grass. Subsequently, the microbe used a biological tool to propose that the application of plant growth-promoting bacteria would be the most favorable choice in petroleum hydrocarbon polluted soil to conquer the abiotic stress in plants and the effective removal of polyaromatic hydrocarbons in polluted soil.

Exogenous application of glutathione enhanced growth, nutritional orchestration and physiochemical characteristics of Brassica oleracea L. under lead stress.

A major obstacle to agricultural production and yield quality is heavy metal contamination of the soil and water, which leads to lower productivity and quality of crops. The situation has significantly worsened as a result of the growing population and subsequent rise in food consumption. The growth of nutrient-rich plants is hampered by lead (Pb) toxicity in the soil. Brassica oleracea L. (broccoli) is a prominent vegetable crop in the Brassicaceae family subjected to a number of biotic and abiotic stresses that dramatically lower crop yields. Seed priming is a novel, practicable, and cost-effective method that can improve various abiotic stress tolerances. Many plant metabolic activities depend on the antioxidant enzyme glutathione (GSH), which also chelates heavy metals. Keeping in view the stress mitigation potential of GSH, current research work was designed to inspect the beneficial role of seed priming with GSH on the growth, morphological and gas exchange attributes of broccoli seedlings under Pb stress. For this purpose, broccoli seeds were primed with 25, 50, and 75 µM L-1 GSH. Plant growth and photosynthetic activity were adversely affected by Pb stress. Furthermore, Pb stress enhanced proline levels along with reduced protein and phenol content. The application of GSH improved growth traits, total soluble proteins, chlorophyll content, mineral content, and gas exchange parameters. The involvement of GSH in reducing Pb concentrations was demonstrated by an improved metal tolerance index and lower Pb levels in broccoli plants. The results of the current study suggest that GSH can be used as a strategy to increase broccoli tolerance to Pb by enhancing nutrient uptake, growth and proline.

Serum HMGB1 is a biomarker for acute myocardial infarction with or without heart failure.

This study measured serum high mobility group box 1 (HMGB1) levels in patients with acute myocardial infarction (AMI) and/or heart failure (HF) and evaluated their relationship with peripheral inflammatory biomarkers and cardiac biomarkers, which have not been reported before. Of the patients, 55 had AMI without HF (AMI-HF ), 42 had AMI with HF (AMI+HF ), and 60 had HF without AMI (HF-AMI ) compared with 50 healthy controls. Blood samples were collected to assess serum HMGB1 levels and blood test-related inflammatory biomarkers (e.g., erythrocyte sedimentation rate [ESR], hs-CRP, uric acid, and white blood cell count) and cardiac biomarkers (e.g., MYO, cTnI, CKMB, CK, NT-proBNP, LDH, aspartate aminotransferase [AST], and alanine aminotransferase [ALT]). Compared to healthy controls, three groups of patients, especially those with AMI+HF , had significantly higher levels of serum HMGB1. All tested inflammatory biomarkers (except uric acid) were significantly positively correlated with HMGB1 in patients with AMI patients but not in patients with non-AMI. In addition, all tested cardiac biomarkers (except NT-proBNP in AMI-HF ) were significantly higher in patients with AMI than in control individuals. The levels of MYO, cTnI, CKMB, CK, AST, and ALT were not significantly changed in patients with HF-AMI compared to control individuals, but were still much lower than those in patients with AMI (except ALT). In all patients, the levels of NT-proBNP, and cTnI were significantly correlated with HMGB1 levels. Except for MYO, LDH, AST, and ALT, all cardiac biomarkers in AMI-HF and AMI+HF showed a significant correlation with HMGB1. Among risk factors, hypertension, diabetes, previous heart disease, and reduced left ventricular ejection fraction showed a significant correlation with HMGB1 in all disease groups.

Foliar spray of stress protective chemicals alleviates cobalt toxicity by improving root antioxidant defense in maize (Zea mays).

Cobalt (Co2+) is a beneficial microelement for plants but toxic to metabolism in higher amounts. This study determined the influence of sublethal Co2+ level (0.5 mM) on the growth of maize (Zea mays L.) hybrids; Hycorn 11 plus (Co2+ sensitive) and P-1429 (Co2+ tolerant) and its alleviation with foliar spray of pre-optimized levels of stress protective chemicals (SPCs), i.e., salicylic acid (SA, 0.5 mM), thiourea (TU, 1.0 mM), and ascorbic acid (AsA, 0.5 mM) applied at seedling, vegetative, and late vegetative stages. Plants were harvested at early vegetative, late vegetative, and silking stages. Co2+ stress caused a decrease in shoot and root length, dry weight, leaf area, and culm diameter, reduced the activities of enzymatic antioxidants and concentrations of AsA and soluble phenolics more in root than shoot, but P-1429 was more tolerant of Co2+ than Hycorn 11 plus. SPCs spray alleviated oxidative damage by enhancing the antioxidant activity, AsA and soluble phenolics, sulfate-S and nitrate-N contents, which were significantly increased in roots than in shoots; P-1429 displayed better response than Hycorn 11 plus. Principal component analysis and correlation matrix revealed the profound roles of SPCs spray in improving Co2+ resistance in root leading to robust growth of hybrids. AsA was highly promising in reducing Co2+ toxicity while vegetative and silking stages were more sensitive. Results revealed that after translocation to root, the foliar-applied SPCs had individualistic modes of action in mitigating Co2+ toxicity on roots. In crux, the metabolism and phloem transport of the SPCs from shoot to root are plausible mechanism for Co2+ tolerance in maize hybrids.

Reduction of fluid forces for flow past side-by-side cylinders using downstream attached splitter plates.

A two-dimensional numerical simulation is performed to investigate the drag reduction and vortex shedding suppression behind three square cylinders with attached splitter plates in the downstream region at a low Reynolds number (Re = 150). Numerical calculations are carried out using the lattice Boltzmann method. The study is carried out for various values of gap spacing between the cylinders and different splitter plate lengths. The vortices are completely chaotic at very small spacing, as observed. The splitter plates are critical in suppressing shedding and reducing drag on the objects. The splitter plates with lengths greater than two fully control the jet interaction at low spacing values. There is maximum percentage reduction in CDmean for small spacing and the selected largest splitter plate length. Furthermore, systematic investigation reveals that splitter plates significantly suppress the fluctuating lift in addition to drastically reducing the drag.

Impact of climate change on wheat grain composition and quality.

Wheat grain quality, an important determinant for human nutrition, is often overlooked when improving crop production for stressed environments. Climate change makes this task more difficult by imposing combined stresses. The scenarios relevant to climate change include elevated CO2 concentrations (eCO2 ) and extreme climatic events such as drought, heat waves, and salinity stresses. However, data on wheat quality in terms of climate change are limited, with no concerted efforts at the global level to provide an equitable and consistent climate risk assessment for wheat grain quality. Climate change induces changes in the quality and composition of wheat grain, a premier staple food crop globally. Climate-change events, such as eCO2 , heat, drought, salinity stress stresses, heat + drought, eCO2 + drought, and eCO2 + heat stresses, alter wheat grain quality in terms of grain weight, nutrient, anti-nutrient, fiber, and protein content and composition, starch granules, and free amino acid composition. Interestingly, in comparison with other stresses, heat stress and drought stress increase phytate content, which restricts the bioavailability of essential mineral elements. All climatic events, except for eCO2 + heat stress, increase grain gliadin content in different wheat varieties. However, grain quality components depend more on inter-varietal difference, stress type, and exposure time and intensity. The climatic events show differential regulation of protein and starch accumulation, and mineral metabolism in wheat grains. Rapid climate shifting impairs wheat productivity and causes grain quality to deteriorate by interrupting the allocation of essential nutrients and photoassimilates. © 2022 Society of Chemical Industry.

Human health risk estimation of antibiotics transferred from wastewater and soil to crops.

Antibiotics enter into agricultural land, via manure application or wastewater irrigation. The practices of using untreated wastewater in the agricultural system help in the bioaccumulation of antibiotics in vegetables and other crops. Exposure to the bioaccumulated antibiotics poses serious health risks to ecosystem and human. In this study, the prevalence of two fluoroquinolones (levofloxacin and ciprofloxacin), their bioaccumulation in five crops (Daucus carota L., Pisum sativum L., Raphanus raphanistrum L., Lactuca sativa L., Spinacia oleracea L.), and associated human health risks were investigated. Lettuce showed highest bioaccumulation of levofloxacin (LEV) (12.66 µg kg-1) and carrot showed high bioaccumulation of ciprofloxacin (CIP) (13.01 µg kg-1). In roots, bioconcentration factor (BCFroot) was observed to be relatively high in radish (LEV 0.24-0.43, CIP 0.32-0.49) and observed to be lower in spinach (LEV 0.05-0.13, CIP 0.12-0.19). The translocation factor (TF) for LEV and CIP was generally >1 for all five crops under all treatment. The final transfer and distribution of LEV and CIP in the edible parts of the crops were as follows: leaves > shoots > roots for both antibiotics. Risk quotient of both LEV and CIP in current study is found to be in between 0.018 and 0.557 and shows a medium risk (0.1 to 1) to human health due the discharge of untreated wastewater into the fields. However, our study reports that both antibiotics do accumulate in the edible plant parts; therefore, it poses potential risks to human health.

A Machine-Learning-Blockchain-Based Authentication Using Smart Contracts for an IoHT System.

Nowadays, finding genetic components and determining the likelihood that treatment would be helpful for patients are the key issues in the medical field. Medical data storage in a centralized system is complex. Data storage, on the other hand, has recently been distributed electronically in a cloud-based system, allowing access to the data at any time through a cloud server or blockchain-based ledger system. The blockchain is essential to managing safe and decentralized transactions in cryptography systems such as bitcoin and Ethereum. The blockchain stores information in different blocks, each of which has a set capacity. Data processing and storage are more effective and better for data management when blockchain and machine learning are integrated. Therefore, we have proposed a machine-learning-blockchain-based smart-contract system that improves security, reduces consumption, and can be trusted for real-time medical applications. The accuracy and computation performance of the IoHT system are safely improved by our system.

Sex differences in the association between blood pressure and atrial fibrillation: A case-control study.

Background: To examine the association of hypertension (HBP) and its control with atrial fibrillation (AF) and how patient sex affects this association. Materials and methods: A case control study of patients admitted to our hospital from 2015 to 2019 was conducted. Patients were divided into subgroups according to their blood pressure (BP) levels and control status, in which odd ratios (OR) by sex for AF was estimated using a logistic regression model and restrictive cubic splines before and after propensity score matching. Results: A total of 3,212 patients with AF and 8,307 without AF were investigated. Compared to patients with normal BP, patients with HBP had more AF [OR = 1.75 (1.52-2.02), OR = 2.66 (2.24-3.15), and OR = 4.30 (3.40-5.44) in patients with grade 1, 2, and 3 HBP, respectively]. In HBP patients with grade 3, the OR of AF was much higher in women than in men (OR = 7.15, 95% CI: 4.43-11.50 vs. OR = 2.48, 95% CI: 1.66-3.72). BP over 133.1/79.9 mmHg in men or 127.1/75.1 mmHg in women was positively associated with AF. In patients with HBP, uncontrolled BP was more associated with AF (OR = 3.00, 95% CI: 2.53-3.56), especially in women (OR = 3.09, 95% CI: 2.27-4.19). BP and prevalence of AF correlated with each other positively in patients admitted to a cardiology ward. Lowering BP to 145.1/85.8 mmHg in men or 140.5/82.5 mmHg in women led to less AF. Conclusion: There is more significant relationship between HBP and AF in female patients. A lower and individualized BP target may be formulated to prevent AF in women.

Knockdown of USP8 inhibits prostate cancer cell growth, proliferation, and metastasis and promotes docetaxel's activity by suppressing the NF-kB signaling pathway.

Ubiquitin-specific protease 8 (USP8) has been recently reported to be involved in tumorigenesis. Prostate cancer (PCa) is the most diagnosed malignancy among men, but USP8's role in PCa is not yet investigated comprehensively. Therefore, the PCa cell lines DU145 and PC3 were transfected with USP8 siRNA or overexpressing vector together with or without docetaxel. The silencing USP8 and docetaxel treatment reduced cell viability and migration and promoted apoptosis. In contrast, USP8 knockdown was found to enhance docetaxel antitumor activity. In contrast, increased cell viability and migration were noticed upon USP8 overexpression, thereby decreasing apoptosis and suppressing docetaxel antitumor activity. Notably, although EGFR, PI3K, and NF-kB were found to be increased in both USP8 overexpression and docetaxel treatment, it significantly attenuated the effects in USP8 silencing followed by with or without docetaxel. Although EGFR silencing decreased PI3K and NF-kB activation, overexpression of USP8 was shown to counteract SiEGFR's effects on NF-kB signaling by increasing PI3K expression. Our findings revealed that USP8 plays an oncogenic role in PCa and can suppress docetaxel activity. Additionally, as EGFR/PI3K/NF-kB was previously reported to develop docetaxel resistance, the combination treatment of USP8 knockdown with docetaxel might be a potential PCa therapeutic.