Synthesis and characterization of X (X = Ni or Fe) modified BaTiO3 for effective degradation of Reactive Red 120 dye under UV-A light and its biological activity.

For the sustainable advancement of industrial expansion that is environmentally conscious, harmful dyes must be removed from wastewater. Untreated effluents containing colors have the potential to harm the ecosystem and pose major health risks to people, animals, and aquatic life. Here, we have fabricated Ni or Fe modified with BaTiO3 materials and effectively utilized them for Reactive Red 120 (RR 120) dye degradation under UV-A light. The synthesized materials were characterized, and their structural, and photo-physical properties were reported. Phase segregation was not present in the XRD pattern, as evidenced by the absence of secondary phase peaks linked to iron, nickel, or oxides. Low metal ion concentrations may be the cause of this, and the presence of those elements was confirmed by XPS measurements. The Raman spectra of the BaTiO3/Ni and BaTiO3/Fe samples show a widened peak at 500 cm-1, which suggests that Ni or Fe are efficiently loaded onto the BaTiO3. RR 120 dye photodegradation under UV light conditions was effectively catalyzed by BaTiO3/Fe, as evidenced by its superior performance in the UV irradiation technique over both BaTiO3 and BaTiO3/Ni. Compared to bare BaTiO3, both metal-modified materials efficiently degraded the RR 120 dye. Acidic pH facilitated the degradation process, which makes sense given that the heterogeneous photo-Fenton reaction was the mechanism of degradation along with BaTiO3 sensitization. High-acidity sewage can be dangerous and carcinogenic, and conventional biological treatment methods are not appropriate for managing it. In the current investigation, it may be used to treat color effluents with extremely low pH levels. Additionally, the ability of the produced nanocomposites to inhibit the growth of twenty pathogens was examined, along with two fungi, fifteen Gram-negative Bacilli (GNB), one Gram-positive Bacilli (GPB), and two Gram-positive Cocci (GBC).

Responses of soil enzymatic activities and microbial biomass phosphorus to improve nutrient accumulation abilities in leguminous species.

Fertilizers application are widely used to get a higher yield in agricultural fields. Nutrient management can be improved by cultivating leguminous species in order to obtain a better understanding of the mechanisms that increase the amount of available phosphorus (P) and potassium (K) through fertilizer treatments. A pot experiment was conducted to identify the leguminous species (i.e., chickpea and pea) under various fertilizer treatments. Experimental design is as follows: T0 (control: no fertilizer was applied), T1: P applied at the level of (90 kg ha-1), T2: (K applied at the level of 90 kg ha-1), and T3: (PK applied both at 90 kg ha-1). All fertilizer treatments significantly (p < 0.05) improved the nutrient accumulation abilities and enzymes activities. The T3 treatment showed highest N uptake in chickpea was 37.0%, compared to T0. While T3 developed greater N uptake in pea by 151.4% than the control. However, T3 treatment also increased microbial biomass phosphorus in both species i.e., 95.7% and 81.5% in chickpeas and peas, respectively, compared to T0 treatment. In chickpeas, T1 treatment stimulated NAGase activities by 52.4%, and T2 developed URase activities by 50.1% higher than control. In contrast, T3 treatment enhanced both BGase and Phase enzyme activities, i.e., 55.8% and 33.9%, respectively, compared to the T0 treatment. Only the T3 treatment improved the activities of enzymes in the pea species (i.e., BGase was 149.7%, URase was 111.9%, Phase was 81.1%, and NAGase was 70.0%) compared to the control. Therefore, adding combined P and K fertilizer applications to the soil can increase the activity of enzymes in both legume species, and changes in microbial biomass P and soil nutrient availability make it easier for plants to uptake the nutrients.

Preparation and Spectrochemical characterization of Ni-doped ZnS nanocomposite for effective removal of emerging contaminants and hydrogen Production: Reaction Kinetics, mechanistic insights.

In this study, we report the successful synthesis of Ni-doped ZnS nanocomposite via a green route using ethanolic crude extract of Avena fatua. The as-synthesized nanocomposite was comprehensively characterized using Dynamic light scattering (DLS), Zeta potential, scanning electron microscopy (SEM), Transmission electron microscopy (TEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Fourier transform infrared spectroscopy (FTIR), and Atomic force microscopy (AFM). These analyses provided detailed insights into the size, morphology, composition, surface properties, and structural characteristics of the nanocomposite. Subsequently, the synthesized nanocomposite was evaluated for their photocatalytic performance against the organic dye Methyl orange. Remarkably, the nanocomposite exhibited rapid and efficient degradation of Methyl orange, achieving 90 % degradation within only 30 min of irradiation under UV light. Moreover, the photocatalyst demonstrated an exceptional hydrogen production rate, reaching 167.73 µmolg-1h-1, which is approximately 4.5 times higher than that of its pristine counterparts. These findings highlight the significant potential of Ni-doped ZnS nanocomposite as highly efficient photocatalysts for wastewater treatment and hydrogen production applications.

Nutrient Uptake Potential of Nonleguminous Species and Its Interaction with Soil Characteristics and Enzyme Activities in the Agro-ecosystem.

The potential nutrient uptake abilities of a plant are essential for improving the yield and quality. Green manures can take up a huge amount of macronutrients from the soil. The mechanisms underlying the differences in nutrient uptake capacity among different nonlegume species remain unclear. The plot experiments were conducted to investigate the performance of nonlegume species including forage radish (Raphanus raphanistrum subsp. sativus), oil radish (Raphanus sativus var. Longipinnatus), February orchid (Orychophragmus violaceus L), and rapeseed (Baricca napus), while a ryegrass (Lolium perenne L.) species was used as a control. The study results showed that forage radish had the highest nutrient uptake (N and P), i.e., 322 and 101% in Hunan and 277 and 469% in the Sichuan site, respectively, compared with the control. While the greatest K uptake was found in forage radish, i.e., 123%, and February orchid, 243%, in the Hunan and Sichuan sites. Forage radish also presented higher phosphorus use efficiency in both experimental areas: Hunan by 301% and Sichuan by 633% compared to the control. Significant modifications were found in nutrient availability and enzyme activities after the cultivation of various species. The oil radish enhanced the ß-glucosidase (BG) and leucine-aminopeptidase enzyme activities by 324 and 367%, respectively, while forage radish developed the highest phosphatase (Phase) and N-acetyl-glucosaminidase (NAG) activities compared to the ryegrass in Hunan. In the Sichuan site, the oil radish promotes enzyme activities such as Phase (126%), BG (19%), and NAG (17%), compared to the control. It is concluded that forage radish, oil radish, and February orchid can easily improve soil nutrient quality in green manuring practices and provide valuable nutrient management systems.

Fabrication and characterization of binary composite MgO/CuO nanostructures for the efficient photocatalytic ability to eliminate organic contaminants: A detailed spectroscopic analysis.

Design and eco-friendly fabrication of affordable and sustainable materials for the treatment of wastewater consisting of dyes, antibiotics, and other harmful substances has always been demanding. Untreated wastewater being released from industries imposes serious threats to our ecosystem, seeking convenient approaches to diminish this alarming issue. Here in this work, we synthesized MgO/CuO nanocomposites from a plant extract of Ammi visnaga L. and then employed these nanocomposites for the treatment of organic dye (methylene blue). We characterized the synthesized nanocomposites by dynamic light scattering (DLS), zeta potential, scanning electron microscopy (SEM), atomic force microscopy (AFM), transmission electron microscopy (TEM), x-ray diffraction (XRD), and X-ray photoelectron microscopy (XPS). DLS presented information about the explicit size of nanocomposites, while the surface charge was examined by zeta potential. XRD provided detailed information about the crystalline behavior and the information regarding surface morphology and size was extracted by SEM, TEM, and AFM. Moreover, the fabricated nanocomposites were used as a photocatalyst in the treatment of methylene blue. The overall catalytic reaction took an hour to complete, and the value of percentage degradation was 98 %. Substantially, a detailed account of the kinetics, rate of reaction, and mechanism is also fostered in the context. The presented study can assist scientists and researchers around the world to reproduce the results and use them to apply them on a broader scale.

Electrochemical detection and removal of brilliant blue dye via photocatalytic degradation and adsorption using phyto-synthesized nanoparticles.

Herein, we report a sensitive electrochemical platform prepared by modifying the electrode surface with copper-doped zinc oxide nanoparticles; these nanoparticles were prepared via a green synthetic approach using the extract of Cassia fistula leaves and multiwalled carbon nanotubes (MWCNTs). For the best response of the electrode modifier, a number of experimental conditions were optimized to obtain the most intense signal of the target analyte Coomassie brilliant blue using a rapid analysis technique square wave voltammetry. The designed sensor displayed remarkable sensitivity for Coomassie brilliant blue with a detection limit of 0.1 nM under the optimized conditions. Moreover, the repeatability, specificity and reproducibility of the designed sensor demonstrated its potential for practical applications. The sensing platform was also used for monitoring the degradation kinetics of the Coomassie brilliant blue dye. Catalytic degradation of the dye was performed using the synergistic effect of Cu-ZnO NPs together with Fenton reagent. The dye degraded by 96% in 60 minutes under neutral conditions, which is one of the main achievements of this work that has never been reported. The photocatalytic breakdown of Coomassie brilliant blue was also monitored using UV-visible spectroscopy. The degradation kinetics results of both techniques agreed well. The adsorption of Coomassie brilliant blue using ZnO NPs was monitored spectrophotometrically. The adsorption data were fitted in a pseudo-second order kinetic model by following the Langmuir isotherm at lower concentration and Freundlich isotherm at higher concentration.

Outcomes and comparison of dosimetric parameters between intracavitary (Fletcher) and combined intracavitary/interstitial (Utrecht) brachytherapy in locally advanced cervical cancer.

OBJECTIVE: To report outcomes of combined intracavitary/interstitial (IC/IS) image-guided brachytherapy (IGBT) in locally advanced cervical cancer, and to compare its dosimetric parameters with intracavitary-only (IC) brachytherapy in a first-in-country experience. METHODS AND MATERIALS: Between January 2021 and September 2022, a total of 160 insertions were done in 40 patients with FIGO IB3-IVA cervical cancer undergoing IGBT using a hybrid (Utrecht) applicator. Corresponding treatment plans for IC brachytherapy were generated during treatment, and optimized. A preplanned comparison of dosimetric parameters, defined in GEC-ESTRO was conducted. RESULTS: The clinical use of a hybrid IC/IS applicator was feasible in all insertions. An average of 14 needles were inserted in each patient over four fractions. Mean HR-CTV D90 and D98 was 86 (SD 1.9) Gy and 75.7 (SD 2.3) Gy using hybrid applicator, and 80 (SD 5.4) Gy and 69.8 (SD 5.2) Gy using IC applicator, with a mean dose gain of 6.0 (SD 5.0) Gy and 5.9 (SD 4.7) Gy (p <0.001), respectively. Likewise, mean D2cc for bladder and sigmoid were significantly lower in the hybrid technique. Mean contribution of brachytherapy to total HR-CTV D90 (in absolute EQD2 Gy) was 41.7 Gy using IC/IS applicator while 35.7 Gy for IC-only applicator (p = 0.027). Clinical response at 12 weeks showed an overall response rate (ORR) and complete response (CR) rates of 92.5% and 77.5%, respectively. CONCLUSIONS: IGBT using a hybrid IC/IS applicator showed excellent tolerability and yielded favorable results, resulting in significant dosimetric improvement in terms of primary target dose, and sparing OARs.

Negative Chronotropic Cardiovascular Changes in Lumbar Spine Surgery: A Potential Spinal-Cardiac Reflex?

Cardiovascular changes following lumbar spine surgery in a prone position are exceedingly rare. Over the past 20 years, a total of six cases have been published where patients experienced varying degrees of bradycardia, hypotension, and asystole, which could be attributed to intraoperative dural manipulation. As such, there is emerging evidence for a potential neural-mediated spinal-cardiac reflex. The authors report their experience of negative chronotropy during an elective lumbar spine surgery that coincided with dural manipulation and review the available literature. A 34-year-old male presented with a long-standing history of lower back pain recently deteriorating to bilaterally radiating leg pain, with restricted left leg raise, and numbness at the left L5 dermatomal territory. The patient was an athletic police officer with no comorbidities or past medical history. Magnetic resonance imaging lumbosacral spine revealed spinal stenosis most pronounced at L4/L5 and disc bulges at L3/L4 and L5/S1. The patient opted for lumbar decompression surgery. After an unremarkable comprehensive preoperative workup, including cardiac evaluation (electrocardiogram, echocardiogram), the patient was induced general anesthesia in a prone position. A lumbar incision was made from L2 to S1. When the left L4 nerve root was retracted while removing the prolapsed disc at L4/L5, the anesthetist cautioned the surgeon of bradycardia (34 beats per minute [bpm]), and the surgery was immediately stopped. The heart rate improved to 60 bpm within 30 seconds. When the root was later retracted again, a second episode of bradycardia occurred for 4 minutes with heart rate declining to 48 bpm. The surgery was stopped, and after 4 minutes, the anesthetist administered 600 µg of atropine. The heart rate then rose to 73 bpm within 1 minute. Other potential causes for bradycardia were excluded. The total blood loss was estimated to be 100 mL. He remains well at his 6-month follow-up and has returned to work as normal. Akin to previously published cases, each episode of bradycardia coincided with dural manipulation, which may indicate a possible reflex between the spinal dura mater and the cardiovascular system. Such a rare adverse event may occur even in seemingly healthy, young individuals, and anesthetists should caution the operating surgeon of bradycardias to exclude operative manipulation of the dura as the cause. While this phenomenon is only reported in a handful of lumbar spine surgery cases, it provides evidence for a potential spinal-cardiac physiological reflex in the lumbar spine that may be neural mediated and should be investigated further.

Analytical solution for the dynamics and optimization of fractional Klein-Gordon equation: an application to quantum particle.

Klein-Gordon equation characterizes spin-particles through neutral charge field within quantum particle. In this context, fractionalized Klein-Gordon equation is investigated for the comparative analysis of the newly presented fractional differential techniques with non-singularity among kernels. The non-singular and non-local kernels of fractional differentiations have been employed on Klein-Gordon equation for the development of governing equation. The analytical solutions of Klein-Gordon equation have been traced out by fractional techniques by means of Laplace transforms and expressed in terms of series form and gamma function. The data analysis of fractionalized Klein-Gordon equation is observed for Pearson's correlation coefficient, probable error and regression analysis. For the sake of comparative analysis of fractional techniques, 2D sketch, 3D pie chart, contour surface with projection and 3D bar sketch have been depicted on the basis of embedded parameters. Our results suggest that varying frequency has reversal trends for quantum wave and de Broglie wave.

Photocatalytic Degradation of Food and Juices Dyes via Photocatalytic Nanomaterials Synthesized through Green Synthetic Route: A Systematic Review.

The unavailability of non-poisonous and hygienic food substances is the most challenging issue of the modern era. The uncontrolled usage of toxic colorant moieties in cosmetics and food manufacturing units leads to major threats to human life. The selection of environmentally benign approaches for the removal of these toxic dyes has gained the utmost attention from researchers in recent decades. This review article's main aim is the focus on the application of green-synthesized nanoparticles (NPs) for the photocatalytic degradation of toxic food dyes. The use of synthetic dyes in the food industry is a growing concern due to their harmful effects on human health and the environment. In recent years, photocatalytic degradation has emerged as an effective and eco-friendly method for the removal of these dyes from wastewater. This review discusses the various types of green-synthesized NPs that have been used for photocatalytic degradation (without the production of any secondary pollutant), including metal and metal oxide NPs. It also highlights the synthesis methods, characterization techniques, and photocatalytic efficiency of these NPs. Furthermore, the review explores the mechanisms involved in the photocatalytic degradation of toxic food dyes using green-synthesized NPs. Different factors that responsible for the photodegradation, are also highlighted. Advantages and disadvantages, as well as economic cost, are also discussed briefly. This review will be advantageous for the readers because it covers all aspects of dyes photodegradation. The future feature and limitations are also part of this review article. Overall, this review provides valuable insights into the potential of green-synthesized NPs as a promising alternative for the removal of toxic food dyes from wastewater.

Intracerebral hemorrhage as the first symptomatic manifestation of chronic myeloid leukemia (chronic phase): A case report and literature review.

Background: Chronic myeloid leukemia (CML) is mostly asymptomatic at diagnosis. Intracerebral hemorrhage (ICH), as the first presentation of CML in its chronic phase (CP) has only once been reported in the literature. In addition, CML (CP) patients developing ICH are equally rare, with only eight cases reported. ICH is more commonly associated with CML progressing to its end stage (accelerated phase [AP] and blast crisis [BC]). The pathophysiology of ICH in CML-CP is postulated to be due to leukostasis, unlike in the CML-AP/BC, where thrombocytopenia and coagulopathy are the underlying mechanisms. This case adds to the scarce literature on a rare and challenging complication of ICH in CML-CP, especially as these patients tend to rebleed and management is uncertain. Case Description: A 22-year-old male presented with a 2-week history of headaches and vomiting, associated with a 1-week history of the left-sided weakness. Initial blood work revealed hyperleukocytosis. The patient was investigated for CML with intracranial involvement. During his stay, his Glasgow coma score (GCS) dropped (from 14 to 11), prompting an urgent CT scan which revealed a large resolving ICH with perifocal edema and midline shift. A decompressive hemicraniectomy with expansion duraplasty was performed to alleviate the mass effect and reduce intracranial pressure. Three hours postoperatively, the patient developed an extradural hematoma which needed prompt evacuation. A postoperative CT revealed an improved midline shift, and after 7 days, his GCS improved to 15, and he began oncological treatment. Neurological symptoms were experienced by our patient at presentation with hyperleukocytosis on full blood count, which may implicate leukostasis as an underlying mechanism. Conclusion: Even in the CP, CML patients presenting with mild neurological symptoms should be investigated to exclude intracranial bleeds. As these patients tend to rebleed, they should be conservatively managed unless there is a need to alleviate intracranial pressure.

Spermatic cord leiomyosarcoma in a young male: A case report and literature review.

Spermatic cord Leiomyosarcoma is an extremely rare intrascrotal tumour. Owing to its rarity, no definitive management guidelines have been formulated as yet. The majority of published literature comprises of case reports or case series and show varying outcomes depending upon multiple patient- and disease-related factors. Almost all cases are older adults with majority in the sixth or seventh decades of life. It is commonly labelled as an indolent curable tumour if treated Spermatic cord Leiomyosarcoma is an extremely rare intrascrotal tumour. Owing to its rarity, no definitive management guidelines have been formulated as yet. The majority of published literature comprises of case reports or case series and show varying outcomes depending upon multiple patient- and disease-related factors. Almost all cases are older adults with majority in the sixth or seventh decades of life. It is commonly labelled as an indolent curable tumour if treated early by radical orchiectomy. The role of lymphadenectomy, adjuvant radiotherapy or chemotherapy is unclear. This case report concerns a young 38-year-old man who suffered from a painless firm left hemiscrotal mass for the past two years. Ultrasonography showed an intrascrotal paratesticular mass. Metastatic workup was negative. Left radical orchiectomy was performed and histopathology of the surgical specimen revealed leiomyosarcoma of the spermatic cord. The patient is on post-surgery follow-up and disease-free for six months. A literature review is also presented.

Nitrogen fertilizer application rates and ratios promote the biochemical and physiological attributes of winter wheat.

Improper optimization of the rates and ratios of nitrogen application reduces grain yields and increases the nitrogen loss, thereby affecting environmental quality. In addition, scarcer evidence exists on the integrative approach of nitrogen, which could have effects on the biochemical and physiological characteristics of wheat. Treatments were arranged as nitrogen (N) rates of 00, 75, 150, 225, and 300 kg ha-1 in the main plots, and different nitrogen ratios were organized in subplots at 5:5:0:0 and 6:4:0:0, which were applied at the sowing, jointing, flowering, and grain filling stages. The results revealed that 225 kg N ha-1 significantly enhanced the stomatal conductance (G s), photosynthetic rate (P n), intercellular CO2 (C i), transpiration rate (T r), and total chlorophyll by 28.5%, 42.3%, 10.0%, 15.2%, and 50%, receptively, at the jointing stage in comparison to the control (0 kg N ha-1). Nitrogen application of 225 kg ha-1 increased the soil-plant analysis development (SPAD) value and the chlorophyll a, chlorophyll b, and carotenoid contents of winter wheat under the 6:4:0:0 ratio. The trend of the photosynthetic characteristics was observed to be greater at the 6:4:0:0 fertilization ratio compared to that at 5:5:0:0. The photosynthetic rate was significantly associated with the biochemical and physiological characteristics of winter wheat. In conclusion, the nitrogen dose of 225 kg ha-1 and the ratio of 6:4:0:0 (quantity applied at the sowing, jointing, flowering, and grain filling stages) effectively promoted the photosynthetic and other physiological characteristics of winter wheat.

Improving Winter Wheat Photosynthesis, Nitrogen Use Efficiency, and Yield by Optimizing Nitrogen Fertilization.

Wheat is the third most producing crop in China after maize and rice. In order to enhance the nitrogen use efficiency (NUE) and grain yield of winter wheat, a two-year field experiment was conducted to investigate the effect of different nitrogen ratios and doses at various development stages of winter wheat (Triticum aestivum L.). A total of five N doses (0, N75, N150, N225, and N300 kg ha-1) as main plots and two N ratios were applied in split doses (50%:50% and 60%:40%, referring to 50% at sowing time and 50% at jointing stage, 50% at sowing time + 50% at flowering stage, 50% at sowing time + 50% at grain filling stage, and 60% + 40% N ratio applied as a 60% at sowing time and 40% at jointing stage, 60% at sowing time and 40% at flowering stage, and 60% at sowing time and 40% at grain filling stage in subplots). The results of this study revealed that a nitrogen dose of 225 kg ha-1 significantly augmented the plant height by 27% and above ground biomass (ABG) by 24% at the grain filling stage, and the leaf area was enhanced by 149% at the flowering stage under 60 + 40% ratios. Furthermore, the N225 kg ha-1 significantly prompted the photosynthetic rate by 47% at the jointing and flowering stages followed by grain filling stage compared to the control. The correlation analysis exhibited the positive relationship between nitrogen uptake and nitrogen content, chlorophyll, and dry biomass, revealing that NUE enhanced and ultimately increased the winter wheat yield. In conclusion, our results depicted that optimizing the nitrogen dose (N225 kg/ha-1) with a 60% + 40% ratio at jointing stage increased the grain yield and nitrogen utilization rate.

Integrated management of charcoal rot disease in susceptible genotypes of mungbean with soil application of micronutrient zinc and green manure (prickly sesban).

Charcoal rot disease is incited by the soil-borne fungus Macrophomina phaseolina (Tassi). Goid is a challenging disease due to long-term persistence of fungus sclerotia in the soil. This study assessed the potential of zinc (Zn: 1.25, 2.44, and 5 mg/kg) and green manure (GM: 1 and 2%) in solitary and bilateral combinations to alleviate infection stress incited by M. phaseolina on disease, growth, physiology, and yield attributes in mungbean. A completely randomized design experiment was conducted in potted soil, artificially inoculated with the pathogen, and sown with surface-sterilized seeds of mungbean genotypes (susceptible: MNUYT-107 and highly susceptible: MNUYT-105). Concealment of plant resistance by M. phaseolina in both genotypes resulted in 53-55% disease incidence and 40-50% plant mortality, which contributed in causing a significant reduction of 30-90% in attributes of growth, biomass, yield, photosynthetic pigment, and total protein content with an imbalance of production of antioxidant enzymes (polyphenol oxidase, superoxide dismutase, catalase, and peroxidase). Soil application with Zn-based fertilizer (ZnSO4: 33%) in combination with GM significantly managed up to 80% of the charcoal rot disease, hence improving growth (50-100%) and physiochemical (30-100%) attributes and sustainably enhancing grain average yield (300-600%), biological yield (100-200%), and harvest index (100-200%) in mungbean plants. The heat map and principal component analyses based on 19 measured attributes with 16 treatments separated Zn (2.44 or 5 mg/kg) combined with 2% GM as the best treatments for alleviating charcoal rot disease stress by improving growth, yield, and biological attributes to an extent to profitable farming in terms of harvest index (HI) and benefit-cost ratio (BCR).

Analysis of the Characteristics of Colonoscopy Perforation and Risk Factors for Failure of Endoscopic Treatment.

BACKGROUND: Many studies have been done regarding perforation after colonoscopy, but few studies analyzed the risk factors of endoscopic treatment failure after colonoscopy perforation. This study aimed to analyze the clinical characteristics and treatment plan of those patients with perforation after colonoscopy diagnosis and the treatment and risk factors of failure to endoscopic treatment. METHOD:  This was a retrospective observational study of patients who underwent colonoscopy examination and treatment at the Affiliated Hospital of Yangzhou University, from 04/2009 to 03/2020. The patients were grouped as perforation, treatment success, or failure (required laparoscopy or laparotomy). RESULTS:  From April 2009 to March 2020, 43,470 patients were examined and treated with colonoscopy. There were 35 cases of intestinal perforation, for an incidence of 0.081%. Four patients had immediate surgical intervention (two patients with laparoscopic surgery and two with laparotomy surgery). Thirty-one (88.57%) patients underwent endoscopic treatment. Endoscopic treatment was successful in 20 patients and failed in 11. Compared with the failure group, the perforation size in the success group was smaller (7.60±4.85 vs. 14.4±7.03 mm, P=0.004), hospital stay was shorter (26.6±13.1 vs. 14.2±3.0, P=0.011), and hospitalization costs were lower (30,208±9506 vs. 23,053±6227 RMB, P=0.002). Multivariable logistic stepwise analysis showed that the absence of abdominal pain after therapeutic colonoscopy was independently associated with the success of endoscopic treatment. CONCLUSIONS:  Endoscopic treatment is logically the preferred modality for perforation management, leading to good recovery, shorter hospital stay, and lower costs of treatment. Postoperative abdominal pain is significantly related to the failure of endoscopic treatment.

Growth, Yield and Photosynthetic Performance of Winter Wheat as Affected by Co-Application of Nitrogen Fertilizer and Organic Manures.

The application of organic manures was found to be beneficial, however, the integrated use of organic manures with chemical nitrogen fertilizers has proven more sustainable in increasing the photosynthetic attributes and grain yield of the winter-wheat crop. A multi-factor split-plot design was adopted, nitrogen and manure fertilizer treatments were set in the sub-plots, including nitrogen-gradient treatment of T1:0 kg N ha-1, T2:100 kg N ha-1, T3:200 kg N ha-1, and T4:300 kg N ha-1 (pure nitrogen -fertilizer application) The 25% reduction in nitrogen combined with the manure-fertilizer application includes T5:75 kg N ha-1 nitrogen and 25 kg N ha-1 manure, T6:150 kg N ha-1 nitrogen and 50 kg N ha-1 manure, and T7:225 kg N ha-1 nitrogen and 75 kg N ha-1 manure. The maximum results of the total chlorophyll content and photosynthetic rate were 5.73 mg/g FW and 68.13 m mol m-2 s-1, observed under T4 in Zhongmai 175, as compared to Jindong 22 at the heading stage. However, the maximum results of intercellular CO2 concentration were 1998.47 µmol mol-1, observed under T3 in Jindong 22, as compared to Zhongmai 175 at the tillering stage. The maximum results of LAI were 5.35 (cm2), observed under T7 in Jindong 22, as compared to Zhongmai 175 at the booting stage. However, the maximum results of Tr and Gs were 6.31 mmol H2O m-2 s-1 and 0.90 H2O mol m-2 s-1, respectively, observed under T7 in Zhongmai 175 as compared to Jindong 22 at the flowering stage. The results revealed that grain yield 8696.93 kg ha-1, grains spike-1 51.33 (g), and 1000-grain weight 39.27 (g) were significantly higher, under T3 in Zhongmai 175, as compared to Jindong 22. Moreover, the spike number plot-1 of 656.67 m2 was significantly higher in Jindong 22, as compared to Zhongmai 175. It was concluded from the study that the combined application of nitrogen and manure fertilizers in winter wheat is significant for enhancing seed at the jointing and flowering stages. For increased grain yield and higher economic return, Zhongmai 175 outperformed the other cultivars examined. This research brings awareness toward the nitrogen-fertilizer-management approach established for farmers' practice, which might be observed as an instruction to increase agricultural management for the winter-wheat-growth season.

Prospective Elective Neurosurgical Theater Utilization Audit in Pakistan: Problems in a Public Tertiary Care Hospital and Proposed Solutions from Lower-Middle-Income Country.

Background In lower-middle-income countries such as Pakistan, public hospitals provide free healthcare but suffer from poor management and misgovernance, negatively impacting service provision. One aspect of this is operating theater time (OTT) utilization. In a 1,600-bed hospital with a 22 million catchment population, we noticed significant delays and inadequate OTT efficiency at the neurosurgery department of Jinnah Hospital, Lahore, Punjab, Pakistan. This audit aimed to analyze the neurosurgical OTT utilization, identify delays, and highlight managerial deficiencies and areas for improvement while comparing our workflow with contemporary international literature. Materials and Methods We prospectively audited OTT utilization at the neurosurgical department. All elective surgeries from January to April 2021 were included to identify delays concerning patient transfer, anesthesia team arrival, preparation and intubation time, operative time, and anesthesia extubation time. Results Fifty-six per cent of OTT was utilized operating. Sources of delay included the delayed arrival of anesthesia team (4.7%) and the delay in transferring patients to OT (9.7%). Anesthesia intubation and preparation time accounted for 23% of OT utilization and was significantly longer than the comparable international studies. Extubation time accounted for 5.7% of OT utilization. The issues surrounding transfer delays and prolonged anesthesia time were discussed, with strategies to address them developed with close vital input from our anesthesia colleagues and ward staff. Conclusion Gross delays relatively simple in nature were identified due to poor management and less than ideal interspecialty coordination. Most delays were avoidable and can be addressed by proper planning, optimization of patient transfer and resources, and, most importantly, improved communication between surgeons, anesthetists, and ward staff. This can ensure optimal use of theater time and benefit all specialties, including ancillary staff, and, most importantly, the patient. A reaudit is warranted to assess the impact of interventions on OTT utilization.

Fast investigative lung cancer pathway and endobronchial ultrasound procedure supported by rapid on-site evaluation.

INTRODUCTION: EBUS is a well-established tool for diagnosis and staging of lung cancer in a fast track investigative pathway. However, impact of ROSE in conjunction with EBUS on reduction of time to treatment decision (TTD) for cancer patients is less well known. AIMS: Our aim was to determine TTD which was defined as the number of working days from EBUS procedure to the discussion at sector lung multidisciplinary team meeting (MDT). Moreover, concordance of ROSE with final diagnosis was evaluated. METHODS: A retrospective analysis was performed of a prospective data collection in a busy teaching hospital over a four months study period (September to December 2018). RESULTS: Data from 112 patients was analyzed. There were 61 (54%) males. Mean age was of 70 years (range 43-91). WHO performance status was 0 in 20 (23%), 1 in 57 (51%), 2 in 22 (20%) and 3 in 7 (6%) patients. In total 522 needle passes were performed from 242 sampling sites. Average working days to discuss at MDT after optimal EBUS sampling was 2.087 (range 0-13 working days). ROSE concordance with final cytological diagnosis was 98.4%. The number of needle passes per site for adequate sample and diagnosis in malignant (4.929) vs non-malignant (2.776) involvement was significantly different (p value <0.0001). There was 100% sample adequacy for preliminary diagnosis, immunohistochemistry and predictive molecular testing. CONCLUSION: ROSE supported fast-investigative pathway by reducing the time to treatment decision (TTD) making at MDT. High concordance with final cytological diagnosis makes it an effective tool to inform meaningful decision making.

Role of copper and alumina for heat transfer in hybrid nanofluid by using Fourier sine transform.

The convection, thermal conductivity, and heat transfer of hybrid nanofluid through nanoparticles has become integral part of several natural and industrial processes. In this manuscript, a new fractionalized model based on hybrid nanofluid is proposed and investigated by employing singular verses and non-singular kernels. The mathematical modeling of hybrid nanofluid is handled via modern fractional definitions of differentiations. The combined Laplace and Fourier Sine transforms have been configurated on the governing equations of hybrid nanofluid. The analytical expression of the governing temperature and velocity equations of hybrid nanofluid have been solved via special functions. For the sake of thermal performance, dimensional analysis of governing equations and suitable boundary conditions based on Mittage-Leffler function have been invoked for the first time in literature. The comparative analysis of heat transfer from hybrid nanofluid has been observed through Caputo-Fabrizio and Atangana-Baleanu differential operators. Finally, our results suggest that volume fraction has the decelerated and accelerated trends of temperature distribution and inclined and declined profile of heat transfer is observed copper and alumina nanoparticles.