Coronary sinus reducer for the treatment of refractory angina (ORBITA-COSMIC): a randomised, placebo-controlled trial.

BACKGROUND: The coronary sinus reducer (CSR) is proposed to reduce angina in patients with stable coronary artery disease by improving myocardial perfusion. We aimed to measure its efficacy, compared with placebo, on myocardial ischaemia reduction and symptom improvement. METHODS: ORBITA-COSMIC was a double-blind, randomised, placebo-controlled trial conducted at six UK hospitals. Patients aged 18 years or older with angina, stable coronary artery disease, ischaemia, and no further options for treatment were eligible. All patients completed a quantitative adenosine-stress perfusion cardiac magnetic resonance scan, symptom and quality-of-life questionnaires, and a treadmill exercise test before entering a 2-week symptom assessment phase, in which patients reported their angina symptoms using a smartphone application (ORBITA-app). Patients were randomly assigned (1:1) to receive either CSR or placebo. Both participants and investigators were masked to study assignment. After the CSR implantation or placebo procedure, patients entered a 6-month blinded follow-up phase in which they reported their daily symptoms in the ORBITA-app. At 6 months, all assessments were repeated. The primary outcome was myocardial blood flow in segments designated ischaemic at enrolment during the adenosine-stress perfusion cardiac magnetic resonance scan. The primary symptom outcome was the number of daily angina episodes. Analysis was done by intention-to-treat and followed Bayesian methodology. The study is registered with ClinicalTrials.gov, NCT04892537, and completed. FINDINGS: Between May 26, 2021, and June 28, 2023, 61 patients were enrolled, of whom 51 (44 [86%] male; seven [14%] female) were randomly assigned to either the CSR group (n=25) or the placebo group (n=26). Of these, 50 patients were included in the intention-to-treat analysis (24 in the CSR group and 26 in the placebo group). 454 (57%) of 800 imaged cardiac segments were ischaemic at enrolment, with a median stress myocardial blood flow of 1·08 mL/min per g (IQR 0·77-1·41). Myocardial blood flow in ischaemic segments did not improve with CSR compared with placebo (difference 0·06 mL/min per g [95% CrI -0·09 to 0·20]; Pr(Benefit)=78·8%). The number of daily angina episodes was reduced with CSR compared with placebo (OR 1·40 [95% CrI 1·08 to 1·83]; Pr(Benefit)=99·4%). There were two CSR embolisation events in the CSR group, and no acute coronary syndrome events or deaths in either group. INTERPRETATION: ORBITA-COSMIC found no evidence that the CSR improved transmural myocardial perfusion, but the CSR did improve angina compared with placebo. These findings provide evidence for the use of CSR as a further antianginal option for patients with stable coronary artery disease. FUNDING: Medical Research Council, Imperial College Healthcare Charity, National Institute for Health and Care Research Imperial Biomedical Research Centre, St Mary's Coronary Flow Trust, British Heart Foundation.

Real-world experience with caplacizumab in the management of acute TTP.

The cornerstone of life-saving therapy in immune-mediated thrombotic thrombocytopenic purpura (iTTP) has been plasma exchange (PEX) combined with immunomodulatory strategies. Caplacizumab, a novel anti-von Willebrand factor nanobody trialed in 2 multicenter randomized controlled trials (RCTs) leading to European Union and US Food and Drug Administration approval, has been available in the United Kingdom (UK) through a patient access scheme. Data were collected retrospectively from 2018 to 2020 for 85 patients (4 children) receiving caplacizumab from 22 UK hospitals. Patient characteristics and outcomes in the real-world clinical setting were compared with caplacizumab trial end points and historical outcomes in the precaplacizumab era. Eighty-four of 85 patients received steroid and rituximab alongside PEX; 26% required intubation. Median time to platelet count normalization (3 days), duration of PEX (7 days), and hospital stay (12 days) were comparable with RCT data. Median duration of PEX and time from PEX initiation to platelet count normalization were favorable compared with historical outcomes (P < .05). Thrombotic thrombocytopenic purpura (TTP) recurred in 5 of 85 patients; all had persistent ADAMTS13 activity < 5 IU/dL. Of 31 adverse events in 26 patients, 17 of 31 (55%) were bleeding episodes, and 5 of 31 (16%) were thrombotic events (2 unrelated to caplacizumab); mortality was 6% (5/85), with no deaths attributed to caplacizumab. In 4 of 5 deaths, caplacizumab was introduced >48 hours after PEX initiation (3-21 days). This real-world evidence represents the first and largest series of TTP patients, including pediatric patients, receiving caplacizumab outside of clinical trials. Representative of true clinical practice, the findings provide valuable information for clinicians treating TTP globally.

Synthesis, characterization and antifungal potential of titanium dioxide nanoparticles against fungal disease (Ustilago tritici) of wheat (Triticum aestivum L.).

Nanoparticles (NPs) preparation using a green as well as environmentally acceptable processes has achieved a lot of attention in recent decade. The current study compared the synthesis of titania (TiO2) nanoparticles synthesized from leaf extracts of two plant species (Trianthema portulacastrum, Chenopodium quinoa) and traditional approach by chemical preparation. The effects of no calcination on the physical characteristics of TiO2 NPs as well as their antifungal effects were examined and compared with the already reported calcinated TiO2 NPs. The produced TiO2 NPs were evaluated using high-tech techniques such as X-ray diffraction (XRD), scanning electron microscope, energy dispersive spectroscopy (EDX), and elemental mapping. TiO2 NPs prepared by sol-gel technique (T1) and prepared from extractions from leaves of T. portulacastrum (T2), and C. quinoa (T3) were either calcinated or non calcinated and tested against fungal disease (Ustilago tritici) of wheat for antifungal efficacy. The -peak (2θ) at 25.3 was confirmed by XRD to be connected with the anatase (101) form in both cases but before calcination, NPs were lacking the rutile and brookite peaks. The results showed that all types of TiO2 NPs examined had good antifungal activity against U. tritici, but those made from C. quinoa plant extract have good antifungal activity against disease. TiO2 NPs which are produced by the green methods (T2, T3) have the highest antifungal activity (58%, 57% respectively), while minimal activity (19%) was recorded when NPs were synthesized using the sol-gel method (T1) with 25 µl/mL. Non calcinated TiO2 NPs have less antifungal potential than calcined TiO2 NPs. It can be concluded that calcination may be preferred for efficient antifungal activity when using titania nanoparticles. The green technology may be used on a larger scale with less damaging TiO2 NP production and can be utilized against fungal disease on wheat crop to reduce crop losses worldwide.

Cadmium accumulation by Phragmites australis and Iris pseudacorus from stormwater in floating treatment wetlands microcosms: Insights into plant tolerance and utility for phytoremediation.

Environmentally sustainable remediation is needed to protect freshwater resources which are deteriorating due to severe industrial, mining, and agricultural activities. Treatment by floating wetlands could be a sustainable solution to remediate water bodies. The study aimed to examine the effects of Cd on Phragmites australis and Iris pseudacorus growth (height, biomass, root length and chlorophyll contents), anatomy, Cd accumulation in their biomass and their ability to remove Cd, N and P. Seedlings of both plants were grown in a greenhouse for 50 days in artificially prepared stormwater amended with Cd, N, and P. The treatments were: control (Cd _0), Cd_1, Cd_2, and Cd_4 mg L-1. N and P contents were 4 mg L-1 and 1.8 mg L-1, respectively. In the case of P. australis, the maximum plant height, root length, and total dry biomass production was increased in medium dose (Cd_2) treatment while the chlorophyll index (CCI) increased in high dose (Cd_4) treatment as compared to all treatments. For I. pseudacorus, the maximum plant height and total dry biomass production, root length and CCI values were improved in low dose (Cd_1) and high dose (Cd_4) treatments, respectively among all treatments. Results showed that P. australis accumulated 10.94-1821.59 µg · (0.05 m2)-1 in roots and 2.45-334.65 µg · (0.05 m2)-1 in shoots under Cd_0, Cd_1 and Cd_4 treatments. I. pseudacorus accumulated the highest Cd in roots up to 5.84-4900 µg · (0.05 m2)-1 and 3.40-609 µg · (0.05 m2)-1 in shoots under Cd_0, Cd_1 and Cd_4 treatments. The translocation factor was observed as <1 and the bioconcentration factor >1 for both species, which indicates their phytostabilization potential. Results demonstrate that P. australis and I. pseudacorus are suitable for use in floating wetlands to remediate contaminated sites.

Dietary supplementations modulate the physiological parameters, fatty acids profile and the growth of red claw crayfish (Cherax quadricarinatus).

An optimal diet is an important factor for the proper growth and health of crustaceans. However, the regulation of antioxidant activity and non-specific immunity related to the consumption of feed additives has not been studied in RC-crayfish. Triplicate groups of 20 crayfish/tank (36.72 ± 0.70 g) fed with a basal diet and sixteen experimental diets that contained five feed additives with four grade levels (40, 160, 240 and 320 mg/kg vitamin E, 2, 4, 6 and 8 g/kg nucleotides, 2, 4, 6 and 8 g/kg Haematococcus pluvialis, 5, 10, 15 and 20 g/kg arachidonic acid and 2.5, 5, 10 and 15 g/kg yeast extract) on physiological parameters, fatty acids profile and growth of Cherax quadricarinatus for a period of 70 days by using orthogonal array method (L16 45 ). The results showed that the antioxidants activity in the haemolymph and hepatopancreas were both higher in crayfish fed with diets NO. 9 to 12 than others. Also, all the diets except diets NO. 13 to 16 showed lower free radicals contents than the control group. Similarly, significantly higher non-specific immune parameters were observed in the hepatopancreas of crayfish supplementations than those fed a control diet. Biochemical parameters related to protein profile in haemolymph increased in diets NO. 9 to 12 and then decreased in control and diets NO. 13 to 16, while the highest biochemical parameters related to lipid profile except HDL-c contents in haemolymph were observed in crayfish fed the control diet. Fatty acid composition in the hepatopancreas, muscle and ovary of RC-crayfish was significantly influenced by using the combination of Vit E, NT, H. pluvialis and YP compared to the control group. Compared to all treatments, RC-crayfish fed with diets NO. 2 and 12 had significantly stimulated higher growth performance and feed utilisation. Overall, our results suggest that diets supplemented with Vit E level of 240 mg/kg, in combination with 8 g/kg NT, 4 g/kg, H. pluvialis, 5 g/kg ARA and 10 g/kg YP are the promising treatments to increase antioxidants activity, non-specific immune response, fatty acids composition and growth of RC-crayfish. However, high dietary supplementations level can reduce antioxidants activity, immunity and inhibit growth.

A generalized procedure for joint monitoring and probabilistic quantification of extreme climate events at regional level.

Droughts and heat waves are currently recognized as two of the most serious threats associated with climate changes. Drought is characterized by prolonged dry periods, low precipitation, and high temperature, while heat wave refers to an extended period of exceptionally high temperature, surpassing the region's average for that time of year. There is a close relationship between droughts and heat waves, as both are often caused by similar weather patterns and can exacerbate each other's impacts. Therefore, it is crucial to monitor and quantify both droughts and heat waves jointly at a regional level in order to develop sustainable policies and effectively manage water resources. This article develops a new index, the standardized composite index for climate extremes (SCICE), for joint monitoring and probabilistic quantification of extreme climate events at regional level. The procedure of SCICE is mainly based on the joint standardization of standardized precipitation index (SPI) and standardized temperature index (STI). In the application of SCICE, results reveal that the long-term probabilities of the joint occurrence of dry and hot events are significantly greater than those of wet and cold events. Furthermore, the outcomes of the comparative assessment support the validity of using SCICE as a compact statistical approach in regional drought analysis. In summation, the study demonstrates the capability of SCICE to effectively characterize and assess the joint monitoring of drought and heat waves at a regional level, providing a comprehensive approach to understanding the joint impact of climate extremes.

Advances in sustainable approaches utilizing orange peel waste to produce highly value-added bioproducts.

Orange peel waste (OPW), a discarded part of orange fruit, is a rich source of essential constituents that can be transformed into highly value-added bioproducts. OPW is being generated in million tonnes globally and returns to the environment without complete benefit. Thus, a high volume of annually produced OPW in the industry requires effective valorization. In this regard, limited data is available that summarizes the broader spectrum for the sustainable fate of OPW to produce value-added bioproducts. The main objective of this treatise is to explore the sustainable production of bioproducts from OPW. Therefore, this review covers all the aspects of OPW, from its production to complete valorization. The review encompasses the extraction technologies employed for extracting different valuable bioactive compounds, such as: essential oil (EO), pectin, and carotenoids, from OPW. Furthermore, the suitability of bioconversion technologies (digestion/fermentation) in transforming OPW to other useful bioproducts, such as: biochemicals (lactic acid and succinic acid), biopolysaccharides (xanthan and curdlan gum), and bioenergy (biomethane and bioethanol) is discussed. Also, it includes the concept of OPW-based biorefineries and their development that shall play a definite role in future to cover demands for: food, chemicals, materials, fuels, power, and heat. Lastly, this review focuses on OPW-supplemented functional food products such as: beverages, yogurts, and extruded products. In conclusion, insights provided in this review maximize the potential of OPW for commercial purposes, leading to a safe, and waste-free environment.

Independent validation and clinical implications of the risk prediction model for long QT syndrome (1-2-3-LQTS-Risk).

AIMS: Risk stratification of patients with long QT syndrome (LQTS) represents a difficult task. In 2018, we proposed a granular estimate of the baseline 5-year risk of life-threatening arrhythmias (LAE) for patients with LQTS, based on the genotype (long QT syndrome Type 1, long QT syndrome Type 2, and long QT syndrome Type 3) and the duration of the QTc interval. We sought to externally validate a novel risk score model (1-2-3-LQTS-Risk model) in a geographically diverse cohort from the USA and to evaluate its performance and assess potential clinical implication of this novel model. METHODS AND RESULTS: The prognostic model (1-2-3-LQTS-Risk model) was derived using data from a prospective, single-centre longitudinal cohort study published in 2018 (discovery cohort) and was validated using an independent cohort of 1689 patients enrolled in the International LQTS Registry (Rochester NY, USA). The validation study revealed a C-index of 0.69 [95% confidence interval (CI): 0.61-0.77] in the validation cohort, when compared with C-index of 0.79 (95% CI: 0.70-0.88) in the discovery cohort. Adopting a 5-year risk ≥5%, as suggested by the ROC curve analysis as the most balanced threshold for implantable cardioverter-defibrillator (ICD) implantation, would result in a number needed to treat (NNT) of nine (NNT = 9; 95% CI: 6.3-13.6). CONCLUSION: The 1-2-3-LQTS-Risk model, the first validated 5-year risk score model for patients with LQTS, can be used to aid clinicians to identify patients at the highest risk of LAE who could benefit most from an ICD implant and avoid unnecessary implants.

Recent analytical tools to mitigate carbon-based pollution: New insights by using wavelet coherence for a sustainable environment.

Anthropogenic activities are a ubiquitous source of carbon-based pollution. A sustainable environment is endangered due to inefficiently regulated pollution policies, and the rise in world population further enhances the severity of this formidable challenge. This study has investigated the impact of the annual CO2 emissions in Pakistan on electricity production from different sectors, GDP, and the population by focusing on the control of carbon-based pollution. This research study intends to fill the gap in previous studies by providing significant measures to link the control of carbon-based pollution, increased GDP, and Pakistan's population, using data from 1990 to 2020. A set of 15 variables are mainly used to investigate all of these relations. Carbon pollution drastically impacts both the external and internal environment. The graphical analysis undertaken in this study finds an upward trend and significant positive correlation among the variables. It demonstrates that Pakistan shows minimal contribution in CO2 emission compared to other Asian economies, but in recent decades, an increasing growth rate has been noticeable and needs to be controlled. The ECM and ARDL approaches confirm that all the variables positively affect CO2 emission both in the long- and short-term, except for electricity production from gas and hydro in the long term, which shows negative relation. The long-term shifts also indicate that high CO2 emissions can be recovered from by adjusting these variables. The study also suggests that the government should convert high carbon use to low carbon energy use to control CO2 emissions in Pakistan.

Development of CRISPR-CAS9 based RNA drugs against Eimeria tenella infection.

Parasitic diseases are major trouble in many parts of the world. We consider that if a chemical can break a DNA barcode sequence, it might be used to develop a species-specific anti-parasitic agent. To examine this hypothesis, we constructed sgRNAs that target both the control (5.8S rDNA) and a DNA barcode (ITS) sequence in Eimeria tenella. In vitro experiment showed that Cas9 mRNA combined with sgRNAs could reduce the sporulation percentage of oocysts and the survival rate of sporulated oocysts and sporozoites. Quantitative real-time PCR showed that the DNAs of parasites exposed to Cas9 mRNA and sgRNAs were significantly affected, regardless of whether they were exposed to a combination of two sgRNAs or just a single sgRNA. The DNA sequencing also indicated that the experimental group exposed to two sgRNAs mixed with Cas9-induced deletion of large parts and a single sgRNA mixed with Cas9-induced mutation at sgRNA targeted fragments. In vivo trial, the effect of sgRNA and Cas9 RNA on the pathogenicity of E. tenella in chicken showed less lesion score and oocysts score (P < 0.05) in experimental groups than control groups. The results and concepts presented in this research can lead to discovering novel nucleic acid therapeutic drugs for Eimeriasis and other parasitic infections, which provide insights into the development of species-specific anti-parasitic agents.

Characterization of Two-Component System CitB Family in Salmonella Pullorum.

Salmonella enterica, serovar Gallinarum, biovar Pullorum, is an avian-specific pathogen which has caused considerable economic losses to the poultry industry worldwide. Two-component systems (TCSs) play an essential role in obtaining nutrients, detecting the presence of neighboring bacteria and regulating the expression of virulence factors. The genome analysis of S. Pullorum strain S06004 suggesting the carriage of 22 pairs of TCSs, which belong to five families named CitB, OmpR, NarL, Chemotaxis and LuxR. In the CitB family, three pairs of TCSs, namely CitA-CitB, DcuS-DcuR and DpiB-DpiA, remain unaddressed in S. Pullorum. To systematically investigate the function of the CitB family in S. Pullorum, four mutants, ΔcitAB (abbreviated as Δcit), ΔdcuSR (Δdcu), ΔdpiBA (Δdpi) and ΔcitABΔdcuSRΔdpiBA (Δ3), were made using the CRISPR/Cas9 system. The results demonstrated that the CitB family did not affect the growth of bacteria, the results of biochemical tests, invasion and proliferation in chicken macrophage HD-11 cells and the expression of fimbrial protein. But the mutants showed thicker biofilm formation, higher resistance to antimicrobial agents, enhanced tolerance to inhibition by egg albumen and increased virulence in chicken embryos. Moreover, the deletion of Dpi TCS was detrimental to survival after exposure to hyperosmotic and oxidative environments, as well as the long-term colonization of the small intestine of chickens. Collectively, we provided new knowledge regarding the possible role of the CitB family involved in the pathogenic processes of S. Pullorum.

Dynamical analysis of coronavirus disease with crowding effect, and vaccination: a study of third strain.

Countries affected by the coronavirus epidemic have reported many infected cases and deaths based on world health statistics. The crowding factor, which we named "crowding effects," plays a significant role in spreading the diseases. However, the introduction of vaccines marks a turning point in the rate of spread of coronavirus infections. Modeling both effects is vastly essential as it directly impacts the overall population of the studied region. To determine the peak of the infection curve by considering the third strain, we develop a mathematical model (susceptible-infected-vaccinated-recovered) with reported cases from August 01, 2021, till August 29, 2021. The nonlinear incidence rate with the inclusion of both effects is the best approach to analyze the dynamics. The model's positivity, boundedness, existence, uniqueness, and stability (local and global) are addressed with the help of a reproduction number. In addition, the strength number and second derivative Lyapunov analysis are examined, and the model was found to be asymptotically stable. The suggested parameters efficiently control the active cases of the third strain in Pakistan. It was shown that a systematic vaccination program regulates the infection rate. However, the crowding effect reduces the impact of vaccination. The present results show that the model can be applied to other countries' data to predict the infection rate.

Outcomes of preterm neonates with patent ductus arteriosus: A retrospective review from a tertiary care hospital.

The management of patent ductus arteriosus (PDA) in preterm neonates remains controversial. A retrospective review was conducted to determine the outcomes in preterm neonates with PDA. Data of neonates admitted to the Aga Khan University Hospital from January 2012 to December 2016 were retrieved from patient records. Of the 208 neonates included in the study, 143 (68.7%) received no treatment, while 65 (31.2%) underwent pharmacotherapy and/or surgical ligation for PDA closure. PDA closure was spontaneous in 109 (52.4%) neonates. The mean ±SD gestational age (GA) of neonates with spontaneous ductal closure was greater as compared to those who required some form of treatment [33±3.3 vs 29.7±3.1weeks, p=0.001]. Apnoea (OR:4.47; 95% CI:1.21-16.44), sepsis (OR:3.81; 95% CI:1.33-10.87), pulmonary haemorrhage (OR:4.88; 95% CI:1.24-19.19), and lower APGAR (OR:0.69; 95% CI:0.54-0.90) were associated with higher odds of mortality in our cohort. Our findings demonstrate that PDA resolves spontaneously in most preterm neonates and provide evidence that conservative treatment is not associated with mortality.

Increased antioxidative enzyme activity mediates the phytoaccumulation potential of Pb in four agroforestry tree species: a case study under municipal and industrial wastewater irrigation.

Wastewater used as irrigation water is causing heavy metal accumulation in the agro-ecosystems. A greenhouse study was conducted to compare the phytoaccumulation ability of four agroforestry tree species under different wastewater treatments. Three-month-old potted seedlings of Morus alba, Acacia nilotica, Acacia ampliceps, and Azadirachta indica were irrigation with tap water (C), municipal wastewater (MWW), and industrial wastewater (IWW). Results showed that MWW had a positive and IWW had a negative impact on biomass production in all the species. Acacia ampliceps showed the highest increment (65%) and showed the lowest decrease (5%) in total biomass under both MWW and IWW treatment. Pb concentration was also found highest in the leaves, stem and roots of Azadirachta indica (108.5, 46.2, 180.5 mg kg-1, respectively) under IWW. Production of H2O2 was highest in IWW treatment with almost 148% increase observed in Azadirachta indica. Similarly, the production of antioxidative enzymes (Superoxide dismutase, Catalase and Peroxidase) was also highest in Azadirachta indica under IWW. Therefore, results suggest that along with high increment in total biomass, both Acacia ampliceps and Azadirachta indica showed high Pb concentration and an effective antioxidative defense mechanism and thus, can be used for planting in soils irrigated with MWW and IWW.

Assessing the impact of transition from nonrenewable to renewable energy consumption on economic growth-environmental nexus from developing Asian economies.

Greenhouse gasses have adverse effects on global warming and air pollution and need to be optimized by minimizing the contributing factors. This work analyzes the effects of economic growth and energy resources (renewable and nonrenewable) on the emissions of greenhouse gasses (GHG). A 2000-2016 panel data from 25 developing Asian countries is analyzed through a robust Random Effect (RE) approach and Hausman Taylor Regression (HTR). Findings show a positive correlation between economic growth and energy consumption, while a 1% increase in renewable energy consumption results in a 0.193% decrease in carbon emissions. Economic growth and renewable energy are positively correlated in both the short and long term, which implies a valid feedback hypothesis. The findings indicate the significant contribution of nonrenewable energy resources to greenhouse gas emissions and the positive impact of renewable resources on greenhouse gas emissions' control. Furthermore, this study highlights the potential of developing Asian economies to preserve the environment through more robust regional environmental policies and renewable energy resources. In light of this study's findings, policymakers in Asian developing economies should develop policies on Renewable Energy infrastructure (RE) to improve GDP and reduce greenhouse gas emissions.

Breakdown of a Nonlinear Stochastic Nipah Virus Epidemic Models through Efficient Numerical Methods.

Background: Nipah virus (NiV) is a zoonotic virus (transmitted from animals to humans), which can also be transmitted through contaminated food or directly between people. According to a World Health Organization (WHO) report, the transmission of Nipah virus infection varies from animals to humans or humans to humans. The case fatality rate is estimated at 40% to 75%. The most infected regions include Cambodia, Ghana, Indonesia, Madagascar, the Philippines, and Thailand. The Nipah virus model is categorized into four parts: susceptible (S), exposed (E), infected (I), and recovered (R). Methods: The structural properties such as dynamical consistency, positivity, and boundedness are the considerable requirements of models in these fields. However, existing numerical methods like Euler-Maruyama and Stochastic Runge-Kutta fail to explain the main features of the biological problems. Results: The proposed stochastic non-standard finite difference (NSFD) employs standard and non-standard approaches in the numerical solution of the model, with positivity and boundedness as the characteristic determinants for efficiency and low-cost approximations. While the results from the existing standard stochastic methods converge conditionally or diverge in the long run, the solution by the stochastic NSFD method is stable and convergent over all time steps. Conclusions: The stochastic NSFD is an efficient, cost-effective method that accommodates all the desired feasible properties.

Modeling the relationship between carbon emissions and environmental sustainability during COVID-19: a new evidence from asymmetric ARDL cointegration approach.

The study aims to examine the CO2 emissions by considering the implication of COVID-19 under strict lockdown in India. The nonlinear (asymmetric) relationship is investigated between CO2 emission and COVID-19 with its specific determinants. The positive and negative asymmetries of COVID-19 determinants are also captured by using econometric techniques. The daily data series of CO2 emission, new confirmed cases, confirmed deaths, and lockdown as dummy variables from January 30, 2020, to December 1, 2020, for India is analyzed by employing the nonlinear autoregressive distributed lag model. This research revealed a significant nonlinear relationship between CO2 emission and COVID-19. The bound test and asymmetric coefficients are confirmed by the variables' long- and short-run relationships. The dynamic multiplier graphs present that India's strict lockdown due to the rapid increase in COVID-19 patients significantly reduces toxic gas emissions, especially CO2 emissions. This asymmetric relationship has been proficiently declared that unhealthy public routine, extra traffic, and unhygienic gases released in the air become the reason for environmental destruction. The lockdown is practically imposed for specific periods and reasons, contributing to reducing toxic emissions, but it is not a permanent solution for environmental sustainability. The government of India, policymakers, and environmentalists should make people aware of unhealthy and environmentally envying activities and policies and long-term applicable strategies should be designed to upgrade the environment's quality.

Closure versus non-closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass: a systematic review and meta-analysis.

BACKGROUND: The comparative evidence regarding the outcomes of closure versus non-closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass (LRYGB) is poorly understood. We aimed to compare the outcomes of closure versus non-closure of mesenteric defects in LRYGB for morbid obesity. METHODS: We conducted a search of electronic information sources to identify all comparative studies investigating the outcomes of closure versus non-closure of mesenteric defects in patients undergoing LRYGB for morbid obesity. We used the Cochrane risk of bias tool and the ROBINS-I tool to assess the risk of bias of RCTs and observational studies, respectively. Random or fixed effects modelling was applied as appropriate. RESULTS: We included 10,031 patients from six observational studies and 2609 patients from two RCTs. Analysis of observational studies showed closure defects resulted in lower risks of internal hernia (OR 0.28, 95% CI 0.15, 0.54) and reoperation for small bowel obstruction (SBO) (OR 0.30, 95% CI 0.10, 0.83); no difference was found between the two groups in terms of SBO not related to internal hernia (OR 1.19, 95% CI 0.47, 2.99), early SBO (OR 0.74, 95% CI 0.04, 14.38), anastomotic leak (OR 0.84, 95% CI 0.45, 1.57), bleeding (OR 1.08, 95% CI 0.62, 1.89), and anastomotic ulcer (OR 2.08, 95% CI 0.62, 6.94). Analysis of RCTs showed closure of defects resulted in lower risks of internal hernia (OR 0.29, 95% CI 0.19,0.45) and reoperation for SBO (OR 0.51, 95% CI 0.38, 0.69) but higher risks of SBO not related to internal hernia (OR 1.90, 95% CI 1.09, 3.34) and early SBO (OR 2.63, 95% CI 1.16, 5.96); no difference was found between the two groups in terms of anastomotic leak (OR 1.95, 95% CI 0.80, 4.72), bleeding (OR 0.67, 95% CI 0.38, 1.17), and anastomotic ulcer (OR 2.08, 95% CI 0.62, 6.94). CONCLUSIONS: Our results suggest that closure of mesenteric defects in LRYGB may be associated with lower risks of internal herniation and reoperation for SBO compared with non-closure of the defects (moderate certainty). The available evidence is inconclusive regarding the risks of SBO not related to internal hernia and early SBO (low certainty). More RCTs are needed to improve the robustness of the available evidence.

Phytoaccumulation of Zn, Pb, and Cd in Conocarpus lancifolius irrigated with wastewater: does physiological response influence heavy metal uptake?

Conocarpus lancifolius is a fast-growing and drought tolerant tree species with phytoremediation potential in arid environments. The present study was conducted to evaluate the phytoaccumulation potential under wastewater treatment. The experiment was performed in a greenhouse where 3-month-old seedlings were irrigated with industrial wastewater and growth, biomass and physiological parameters were measured. Concentrations of zinc (Zn), lead (Pb), and cadmium (Cd) in leaves, shoots, and roots along with translocation and tolerance index were also determined. The results showed that under wastewater treatment total biomass increased from 24.2 to 31.5 g, net CO2 assimilation rate increased from 9.93 to 13.3 µmol m-2 s-1, and water use efficiency increased from 1.7 to 2.42. Similarly, heavy metals (Zn, Pb, and Cd) accumulation in stem, leaves, and roots increased significantly under wastewater treatment where the highest concentration of Zn, Pb and Cd was found in roots followed by leaves and stem, respectively. Tolerance index was found >1, and translocation factor of all heavy metals was found >1. The study revealed that phytoaccumulation potential of C. lancifolius was mainly driven by improved net CO2 assimilation rate and water use efficiency.

Trilemma among energy, economic and environmental efficiency: Can dilemma of EEE address simultaneously in era of COP 21?

Economic growth is a prerequisite for development while energy is the engine for growth process. In the era of globalization, production cost heavily dependent on energy intensity and efficiency with keeping environmental conditions intact. Therefore, the structuring of a significant environmental index is pre-requisition of the world with energy intensity, energy efficiency. For this objective, this study employs 18-years data set between 2000 and 2018 of Organization for Economic Co-operation and Development (OECD) to form a universal aspect of economics, environmental index, and energy efficiency (EEE). The data envelopment analysis (DEA) and arithmetic mean aggregation in the formation of mathematical aggregation mechanisms are applied for empirical analysis. According to the results, Iceland maintained an overall high rank regarding energy efficiency, energy intensity, and environment followed by Greece, New Zeeland, and Norway. In this investigation, Ireland followed by the UK and the USA are the lowest performer regarding energy and environment. Thus, the study concludes that energy (efficiency & intensity) and environment hold complex relations and needs a special set of policies to address them collectively and it is expected that this study can be used as valuable information for the policymaking process.