Rotavirus gastroenteritis in Pakistan, 2018: updated disease burden.

OBJECTIVE: Rotavirus A (RVA) is a significant cause of severe diarrheal illness and one of the common causes of death in children under the age of five. This study was aimed at detecting the prevalence of RVA in Pakistan after rotavirus vaccines were introduced. Fecal samples were obtained from 813 children from different hospitals in Rawalpindi and Islamabad, Pakistan, from January 2018 to December 2018. To obtain additional information from the parents / guardians of the children, a standard questionnaire was used. RESULTS: Using an enzyme-linked immunosorbent assay kit (ELISA), rotavirus antigen was detected and ELISA positive samples were subjected to reverse transcription PCR (RT-PCR). The findings showed 22% prevalence of RVA in children with acute gastroenteritis (AGE) via ELISA and 21% prevalence via RT-PCR in children with AGE. There was no statistically significant difference between gender, age and RVA infections. The winter, spring and fall/autumn seasons were statistically significant for RVA prevalence. CONCLUSION: The present study will provide post vaccine prevalence data for the health policy makers. The implementation of rotavirus vaccines, along with adequate nutrition for babies, clean water supply and maternal hygienic activities during infant feeding, is recommended. Furthermore, continuous surveillance is mandatory in the whole country to calculate the disease burden caused by RVA.

Sciatic Nerve Variants in Patients Diagnosed With Sciatica: Is There a Correlation?

PURPOSE: Compression of the sciatic nerve in its path along the piriformis muscle can produce sciatica-like symptoms. There are 6 predominant types of sciatic nerve variations with type 1 being the most common (84.2%), followed by type 2 (13.9%). However, there is scarce literature on the prevalence of sciatic nerve variation in those diagnosed with sciatica. MATERIALS AND METHODS: The charts of 95 patients clinically diagnosed with sciatica who had a magnetic resonance imaging of the pelvis/hip were retrospectively studied. All patients had T1-weighted axial, coronal, and sagittal images. Magnetic resonance imagings were interpreted separately by 2 board-certified fellowship-trained musculoskeletal radiologists to identify the sciatic nerve variant. RESULTS: Seven cases were excluded because of inadequate imaging. Of the remaining 88 patients, 5 had bilateral sciatica resulting in a sample size of 93 limbs. Fifty-two (55.9%) had type 1 sciatic nerve anatomy, 39 (41.9%) had type 2, and 2 (2.2%) had type 3. The proportions of type 1 and 2 variations were significantly different from the normal distribution (P < 0.001), whereas type 3, 4, 5, and 6 variants were not (P = 1.00). CONCLUSIONS: There is strong statistical significance regarding the relationship between sciatic nerve variation and the clinical diagnosis of sciatica. Preoperative magnetic resonance imaging can be considered in sciatica patients to prevent iatrogenic injury in pelvic surgery.

PI4KIII inhibitor enviroxime impedes the replication of the hepatitis C virus by inhibiting PI3 kinases.

Objectives: Many positive-stranded RNA viruses, including HCV, drastically remodel intracellular membranes to generate specialized environments for RNA replication. Phosphatidylinositol 4-kinase III (PI4KIII)α plays an essential role in the formation of HCV replication complexes and has therefore been explored as a potential drug target. Here, we characterized the anti-HCV activity of the PI4KIII inhibitors enviroxime and BF738735 and elucidated their mechanism of action. Methods: Antiviral assays were performed using HCV subgenomic replicons and infectious HCV. Enviroxime- and BF738735-resistant HCV replicons were generated by long-term culture with increasing compound concentrations. Intracellular localization of phosphatidylinositol 4-phosphate (PI4P) lipids was analysed by confocal microscopy. Results: HCV subgenomic replicons resistant to either enviroxime or BF738735 proved cross-resistant and carried mutations in the NS3, NS4B and NS5A genes. Knockdown of PI4KIIIß by small interfering RNA (siRNA) did not affect the replication of the HCV subgenomic replicon in this study. Furthermore, the compounds did not affect PI4P lipid levels at the replication complexes nor the phosphorylation status of NS5A, activities attributed to PI4KIIIα. Interestingly, the broad-spectrum phosphoinositide 3-kinase (PI3K) inhibitor LY294002 proved to be 10-fold less effective against the resistant replicons. In addition, enviroxime and BF738735 inhibited several PI3Ks in enzymatic assays. Conclusions: Contrary to assumptions, our data indicate that PI4KIIIα and PI4KIIIß are not the main targets for the anti-HCV activity of enviroxime and BF738735. Instead, we demonstrated that both molecules impede HCV replication at least partially by an inhibitory effect on PI3Ks. Moreover, HCV is able to bypass PI3K inhibition by acquiring mutations in its genome.

IMMEDIATE PAIN RELIEF BY MICROVASCULAR DECOMPRESSION FOR IDIOPATHIC TRIGEMINAL NEURALGIA.

BACKGROUND: Trigeminal neuralgia is a common entity which is managed by neurosurgeons in day to day practice. Up-till now many treatment options have been adopted for it but micro-vascular decompression is much impressive in terms of pain control and recurrence rate in all of them. The objective of study was known the efficacy of micro vascular decompression for idiopathic trigeminal neuralgia by using muscle patch in terms of immediate pain relief. METHODS: This descriptive study was carried out in Neurosurgery Department lady reading hospital, Peshawar from January 2010 to December 2012. All patients who underwent micro vascular decompression for idiopathic trigeminal neuralgia were included in the study. Patients were assessed 72 hours after the surgery by borrow neurological institute pain scale (BNIP scale) for pain relief and findings were documented on predesigned pro forma. Data was analysed by SPSS-17. RESULTS: Total 52 patients were included in this study. Among these 32 (61.53%) were female and 20 (38.46%) were males having age from 22-76 years (mean 49 years). Right side was involved in 36 (69.23%) and left side in 16 (30.76%) patients. Duration of symptoms ranged from 6 months to 16 years (mean 8 years). History of dental extraction and peripheral neurectomy was present in 20 (38%) and 3 (5.76%) patients while V3 was most commonly involved branch with 28 (57.69%) frequency and combined V2, V3 involvement was 1 (11.53%). Superior cerebellar artery was most common offending vessel in 46 (88.46%) while arachnoid adhesions were in 2 (3.84%) patients. We assessed patient's immediate postoperatively using BNIP pain scale. CONCLUSION: Micro-vascular decompression is most effective mode of treatment for trigeminal neuralgia in terms of immediate pain relief.

In situ nitrogen-doped graphene-TiO2 nano-hybrid as an efficient photocatalyst for pollutant degradation.

To solve environmental-related issues (wastewater remediation, energy conservation and air purification) caused by rapid urbanization and industrialization, synthesis of novel and modified nanostructured photocatalyst has received increasing attention in recent years. We herein report the facile synthesis of in situ nitrogen-doped chemically anchored TiO2 with graphene through sol-gel method. The structural analysis using X-ray diffraction showed that the crystalline nitrogen-doped graphene-titanium dioxide (N-GT) nanocomposite is mainly composed of anatase with minor brookite phase. Raman spectroscopy revealed the graphene characteristic band presence at low intensity level in addition to the main bands of anatase TiO2. X-ray photoelectron spectroscopy analysis disclosed the chemical bonding of TiO2 with graphene via Ti-O-C linkage, also the substitution of nitrogen dopant in both TiO2 lattice and into the skeleton of graphene nanoflakes. UV-Vis absorption spectroscopy analysis established that the modified material can efficiently absorb the longer wavelength range photons due to its narrowed band gap. The N0.06-GT material showed the highest degradation efficiency over methylene blue (MB, ∼98%) under UV and sulfamethoxazole (SMX, ∼ 90.0%) under visible light irradiation. The increased activity of the composite is credited to the synergistic effect of high surface area via greater adsorption capacity, narrowed band gap via increased photon absorption, and reduced e-/h+ recombination via good electron acceptability of graphene nanoflakes and defect sites (Ti3+ and oxygen vacancy (Vo)). The ROS experiments further depict that primarily hydroxyl radicals (OH•) and superoxide anions (O2•-) are responsible for the pollutant degradation in the process redox reactions. In summary, our findings specify new insight into the fabrication of this new material whose efficiency can be further tested in applications like H2 production, CO2 conversion to value-added products, and in energy conservation and storage.

Minimum wage standard adjustment and employment: Heterogeneity effects on the human capital investment.

Considerable debate has arisen around the potential effects of increasing the minimum wage on employment. This study aims to analyze the impact of changes in China's minimum wage standard on employment. The research utilises the canonical model method and constructs a regression model based on standard labor economics theory. The analysis is conducted using sample data from Chinese industrial enterprises between 2000 and 2007. Regression analysis is performed by categorizing enterprises based on their level of human capital investment. The findings indicate that minimum wage increases have a non-linear impact on employment, when seen from the standpoint of human capital investment. When the level of human capital investment is low, an increase in the minimum wage standard leads to a decrease in employment; when the level of human capital investment is high, an increase in the minimum wage standard leads to an increase in employment. According to the findings, the reason for this is that, investments in human capital can improve business profitability, increase worker marginal productivity, and increase labor demand. Similarly, the employment effect of a change in the minimum wage is positive in regions with high levels of human capital investment due to the externality effect of human capital. Adjustments to the minimum wage have a negative impact on employment in areas of the country with low levels of human capital investment. This demonstrates that changing the minimum wage does not result in a simple increase or decrease in total employment. The level of investment in human capital within the organization and the region is an important factor in determining the type and magnitude of the impact.

Dynamic impact of demographic features, FDI, and technological innovations on ecological footprint: evidence from European emerging economies.

Climate change effect mitigation is a critical priority for top leaders and communities around the globe. Human-induced environmental issues are affecting humankind's standard of living and development potential and the planetary boundaries. Sustainability objectives aim to enhance environmental quality and ensure sustainable development for all by eliminating social inequalities. This study examines the complex relationships between demographic features, foreign direct investment, technological innovation, and ecological footprint, emphasizing the relevance of population aging, population density, and urbanization in this context. The research uses a selection of emerging European economies during 1995-2018. The reasons for countries' selection are related to the increasing rate of population aging in European countries, the attractiveness for foreign direct investment, the economic growth, and the technological advancement potential these emerging countries possess. In order to investigate the long-run relationship between the selected variables, the study tests the cross-section dependence, homogeneity, and cointegration and uses Konya tests to determine panel causality. Based on Konya methodology, differences between countries in the panel are evidenced and discussed accordingly. Our findings confirm the long-run relationship between environment, technological innovation, population aging, and FDI. The results of this research are highly relevant for policymakers in selected countries for identifying the set of correlations and the relevance of various variables in such national economies. Demographic features such as population aging and population density are critical for Europe, and the results show the impact on the ecological footprint.

A novel variant in the FLNB gene associated with spondylocarpotarsal synostosis syndrome.

OBJECTIVES: Genetic disorders involved in skeleton system arise due to the disturbance in skeletal development, growth and homeostasis. Filamin B is an actin binding protein which is large dimeric protein which cross link actin cytoskeleton filaments into dynamic structure. A single nucleotide changes in the FLNB gene causes spondylocarpotarsal synostosis syndrome, a rare bone disorder due to which the fusion of carpels and tarsals synostosis occurred along with fused vertebrae. In the current study we investigated a family residing in north-western areas of Pakistan. METHODS: The whole exome sequencing of proband was performed followed by Sanger sequencing of all family members of the subject to validate the variant segregation within the family. Bioinformatics tools were utilized to assess the pathogenicity of the variant. RESULTS: Whole Exome Sequencing revealed a novel variant (NM_001457: c.209C>T and p.Pro70Leu) in the FLNB gene which was homozygous missense mutation in the FLNB gene. The variant was further validated and visualized by Sanger sequencing and protein structure studies respectively as mentioned before. CONCLUSIONS: The findings have highlighted the importance of the molecular diagnosis in SCT (spondylocarpotarsal synostosis syndrome) for genetic risk counselling in consanguineous families.

The effect of technological progress and income per capita on carbon dioxide emission: the moderating role of economic freedom.

Climate change in context of environmental issues is pushing most of the countries to set the goals in order to achieve carbon neutrality and sustainable development. The recognition of Sustainable Development Goal (SDG) thirteen (13) is aided by the objective of this study which is to take an urgent action to combat climate change. In this context, this study investigates the effect of technological progress, income, and foreign direct investment on carbon dioxide emission by taking into consideration the moderating effect of economic freedom in 165 global countries from 2000 to 2020. The study employed ordinary least squares (OLS), fixed effects (FE), and two-step system generalized method of moments for analysis. The findings reveal that economic freedom, income per capita, foreign direct investment, and industry increase carbon dioxide emission while technological progress reduces emission in global countries. Surprisingly, economic freedom indirectly increases the level of carbon emissions by technological progress; however, economic freedom indirectly decreases the level of carbon emissions by income per capita. In this regard, this study favors clean eco-friendly technologies and seeks methods for development without harming the environment. Furthermore, the findings of this study have considerable policy suggestions for the sample countries.

The relationship between renewable energy consumption, technological innovations, and carbon dioxide emission: evidence from two-step system GMM.

Large amount of energy use for rising economic growth leads to high carbon dioxide discharge that worsens environmental quality which is a challenge for countries in achieving sustainable development. Improved level of technological innovations and renewable energy consumption might overcome the issue of environmental degradation and achieving sustainable development. This study examines the effect of technological innovations on renewable energy consumption and carbon dioxide emission in the belt and road initiative countries for the period of 1995 to 2019. Two-step difference and two-step system GMM models were employed for analysis where the results indicate that technological innovations increase renewable energy consumption and carbon dioxide emission. The effect of renewable energy consumption and trademark applications on carbon dioxide is negatively significant that raises environmental quality. Furthermore, this study confirms the validity of Environmental Kuznets curve hypothesis in the sample countries. The findings of this study have considerable policy implication for the sample countries on rising technological innovations and renewable energy consumption in achieving environmental sustainability.

The effect of institutions and urbanization on environmental quality: evidence from the Belt and Road Initiative countries using dynamic panel models.

Increased globalization in urban areas raise energy consumption that leads to high carbon dioxide discharge and degrade environmental quality. Other economic activities also produce emission; however, a well-established institutional framework can overcome the issues of environmental degradation and minimize the effect of harmful factors on the environment. In this regard, this study investigates the effect of urbanization, energy consumption, and industrialization on carbon dioxide emission by taking into consideration the role of institutional quality in the Belt and Road Initiative (BRI) countries for the period of 2002 to 2019. Employing dynamic panel techniques, the results are in line with theories which show that increased urbanization, energy consumption, industrialization, and economic growth raise carbon dioxide emission and lead to environmental degradation. The study also found that international trade and political stability reduce emission; however, institutional quality as a whole positively affects carbon dioxide emission. The study also found a U-shape relationship between urbanization and carbon dioxide emission. The interaction term between institutional quality and urbanization significantly mitigates carbon dioxide emission and raise environmental sustainability. The findings of this study have considerable policy suggestions for the sample countries.

The effect of political stability, carbon dioxide emission and economic growth on income inequality: evidence from developing, high income and Belt Road initiative countries.

The reduction of income inequality and environmental frailty are important factors which can help achieve sustainable development. In this context, it is important to investigate the nexus between income inequality and carbon dioxide emission by considering the role of political stability. This paper examines the effect of political stability, economic growth, financial development, and carbon dioxide on income inequality in developing countries, high-income countries, and the Belt Road initiative (BRI) countries from 2002 to 2019. By employing a two-step generalized method of moments and panel quantile regression, the findings show that carbon dioxide emission, financial development, and political stability rise income inequality while economic growth significantly reduces income inequality in developing countries. In the case of high-income countries, political stability and carbon dioxide negatively affect income inequality while financial development rise income inequality. In the case of BRI countries, political stability, economic growth, and carbon dioxide emission significantly reduce income inequality. Our findings have considerable policy implications regarding reducing income inequality in the sample countries.

Exploring the nexus between energy consumption, income inequality and poverty, economic growth, and carbon dioxide emission: evidence from two step system generalized method of moments.

The concern of environmental degradation, poverty, and income inequality remains a priority in achieving sustainable development goals. Countries are trying to reduce income inequality, alleviate poverty, and reduce environmental degradation which needs special attention. Consequently, this study explores the effect of income inequality, poverty, and energy consumption on carbon dioxide emission in the Belt and Road Initiative countries from 1996 to 2018. By employing the generalized method of moments, the findings show that income inequality, poverty, and energy consumption significantly increase carbon dioxide emission and lead to environmental degradation, while access to electricity significantly raises environmental quality. Economic growth positively affects carbon dioxide emission; however, the environmental Kuznets curve is valid. Income inequality exerts a moderating effect on carbon dioxide emission via per capita economic growth that reduces environmental degradation in the Belt and Road Initiative countries. The results of this study give important policy implications for the Belt and Road Initiative countries.

The nexus between natural resources, renewable energy consumption, economic growth, and carbon dioxide emission in BRI countries.

This study investigates the nexus between natural resources, renewable energy consumption, economic growth, and carbon emission in 35 belt and road initiative (BRI) countries from 1985 to 2019. By employing OLS, fixed effect, generalized method of moments, and seemingly unrelated regression models, the results show that carbon dioxide and renewable energy are the driver factors of economic growth while natural resources reduce economic growth. The effect of economic growth and natural resources on carbon dioxide is positive; however, renewable energy consumption significantly reduces carbon emission. Economic growth rise renewable energy consumption while carbon dioxide and natural resources reduce it. The findings of this study have considerable policy implications for the belt and road countries that how natural resources and income inequality influence the interlinkage of renewable energy consumption, economic growth, and carbon dioxide emission.

Urbanization, renewable energy production, and carbon dioxide emission in BSEC member states: implications for climate change mitigation and energy markets.

As the world's population grows, the energy demand continues to rise due to advancements in technology and the impact of globalization. The finite nature of traditional energy sources has accelerated the shift toward renewable energy, particularly in developing countries where environmental degradation and declining quality of life are significant concerns. This study delves into the interplay between urbanization, carbon dioxide emissions, economic growth, and renewable energy production in Organization of the Black Sea Economic Cooperation member states, providing new insights into the energy market. By using annual data from 1995 to 2020 and advanced panel cointegration tests, this study provides a comprehensive analysis of the determinants of renewable energy for developing countries. The findings show a substantial and long-term relationship between urbanization, emissions, growth, and renewable energy production. These findings have important implications for policymakers and underscore the critical role of renewable energy in mitigating climate change in developing countries.

Multiple Bony Mallet Finger Injuries in One Hand of a 14-Year-Old Boy.

Bony mallet finger injuries, commonly seen as isolated incidents, typically occur in active individuals. We report a rare case of simultaneous avulsion fractures at the distal phalangeal bases of the second, third, and fourth fingers on the right hand of a 14-year-old boy following a forced passive flexion injury during a football game. The patient initially received conservative management with a finger extension splint for the distal interphalangeal (DIP) joints. However, one week after the injury, we performed surgical fixation on all affected digits using the K-wire extension block method due to multiple fractures and the patient's intolerance for the mallet finger splint. After six weeks, all K-wires were removed, and physiotherapy sessions began. Three months post-injury, the second and fourth DIP joints demonstrated an "Excellent" outcome, and the third DIP joint demonstrated a "Good" outcome based on Crawford's criteria for outcome assessment of mallet finger injury after management. This case highlights the importance of early detection and appropriate management of concomitant mallet finger injuries in pediatric patients to prevent potential complications that could impair hand function and quality of life.

Dose institutional quality influences the relationship between urbanization and CO2 emissions?

As a result of rapid economic expansion, increased energy use, and urbanization, global warming and climate change have become serious challenges in recent decades. Institutional quality can be the remedy to impede the harmful effect of factors on environmental quality. This study investigates the impact that urbanization and institutional quality on environmental quality in in the Belt and Road Initiative (BRI) countries from 2002 to 2019. By using two step generalized method of moment, the findings shows that urbanization leads to an increase in carbon dioxide emissions and a decline in environmental quality. On the other hand, the square term of urbanization indicates that an increase in urbanization leads to a reduction in emissions at a later stage after reach a certain level. Education, on the other hand, has the reverse impact of increasing carbon emissions; economic growth, foreign direct investment, and government effectiveness all boost carbon emissions. In a similar vein, the interaction between urbanization and the effectiveness of the government is unfavorable, underscoring the transformative role that the effectiveness of the government plays in leading to environmental sustainability. Finally, the findings of this study have considerable policy implication for the sample countries.

Eco-innovations, green growth, and environmental taxes in EU countries: a panel quantile regression approach.

The purpose of this study is to examine how environmental taxation, green growth, and eco-innovations contribute to a more sustainable environment. This study examines the influence of green growth, environmental taxes, and eco-innovations on carbon dioxide emissions in 26 environmentally responsive European Union (EU) countries from 2000 to 2020. The analysis was conducted using the second-generation panel unit root test, cross-sectional dependence, panel cointegration, and panel quantile regression. Theoretical and empirical research has demonstrated that both linear and non-linear green growth strategies are effective in reducing CO2 emissions. There is evidence that CO2 emissions can be reduced through the implementation of environmental taxes, eco-innovations, the use of renewable energy sources, and enhanced energy efficiency. In contrast, economic growth has a positive effect on carbon emissions, and its square term verifies the environmental Kuznets curve. Nevertheless, our research findings provide empirical support for the hypothesis that sustainable development contributes to the maintenance of stringent environmental standards. For the sampled countries, the study's findings have significant policy implications. These results encourage governments to prioritize green growth over traditional economic growth and to encourage eco-innovations in renewable energy technology.

Income inequality, economic growth, renewable energy usage, and environmental degradation in the Belt and Road initiative countries: dynamic panel estimation.

This study investigates the effect of income inequality, carbon dioxide emissions, renewable energy consumption, and economic growth on each other's in the Belt and Road initiative countries from 2002 to 2019. By using OLS, fixed effect, difference GMM, system GMM, and seemingly unrelated regression (SUR) models, the results show that income inequality and renewable energy consumption are reduced while economic growth, foreign direct investment, and financial development have an increasing effect on carbon emissions. The effect of carbon emissions and renewable energy consumption is negative, while economic growth is positive and negative for income inequality across different models. Income inequality, carbon dioxide emissions, economic growth, and foreign direct investment are negatives for renewable energy consumption. Income inequality is positive, while carbon dioxide and financial development negatively affect economic growth. The findings have considerable policy implications for the sample countries regarding income distribution, energy use, environmental quality, and enhancing economic growth. The countries should focus on acquiring renewable energy sources to increase economic growth and reduce environmental pollution.

Dynamic risk spillover effect and path of risk transmission across industrial sectors in China during COVID-19 epidemic.

Understanding the dynamic link between the development of COVID-19 pandemic and industry sector risk spillovers is crucial to explore the underlying mechanisms by which major public health events affect economic systems. This paper applies ElasticNet method proposed by Diebold and Yilmaz (2009, 2012, 2014) to estimate the dynamic risk spillover indicators of 20 industrial sectors in China from 2016 to 2022, and systematically examines the impact of industry risk network fluctuations and the transmission path caused by COVID-19 shock. The findings reveal that risk spillovers of Chinese industries show a dynamic change of "decline-fluctuation-rebound" with the three phases of COVID-19 epidemic. At the beginning of the epidemic, machinery and equipment, paper and printing, tourism and hotels, media and information services, and agriculture were the exporters of epidemic risk, while materials, transportation equipment, commercial trade, health care, and environmental protection were the importers of epidemic risk; However, as the epidemic developed further, the direction and effect of risk transmission in the industry was reversed. Examining the network characteristics of the pair sectors, we found that under the epidemic shock, the positive risk spillover from tourism and hotels, culture, education and sports to consumer goods, finance, and energy industries was significantly increased, and finance and real estate industries were affected by the risk impact of more industries, while the number of industries affected by information technology and computer industry was significantly reduced. This paper shows that there is inter-industry risk transmission of the COVID-19 epidemic shock, and the risk transmission feeds back in a cycle between industries as the epidemic develops, driving the economy into a vicious circle. The role of the service sector in blocking the spread of negative shocks from the epidemic should be emphasized and brought into play to avoid increasing the overall economic vulnerability. This study will help to deepen the understanding of scholars and policy makers on the network transmission effects of the epidemic.