RESUMO
This paper introduces a refined and broadened version of decision-theoretic rough sets (DTRSs) named Generalized Sequential Decision-Theoretic Rough Set (GSeq-DTRS), which integrates the three-way decision (3WD) methodology. Operating through multiple levels, this iterative approach aims to comprehensively explore the boundary region. It introduces the concept of generalized granulation, departing from conventional equivalence-relation-based structures to incorporate similarity/tolerance relations. GSeq-DTRS addresses the limitations encountered by its predecessor, Seq-DTRS, particularly in managing sequential procedures and integrating new attributes. A notable advancement is its seamless handling of continuous-scale datasets through a defined Generalized Granular Structure (GGS), enabling classification across multiple levels without necessitating reduction of attributes. A refined version of conditional probability (CP), aligned with tolerance classes, enhances the approach, supported by a meticulously designed algorithm. Extensive experimental analysis conducted on two datasets sourced from https://www.kaggle.com demonstrates the efficacy of the procedure for both continuous and discrete datasets, effectively classifying probable elements into POS or NEG regions based on their membership. Unlike traditional Seq-DTRS, it does not require reduction of attributes at each new level. Additionally, the algorithm exhibits lower sensitivity to parametric values and yields results in fewer iterations. Thus, its potential impact on decision-making processes is readily apparent.
RESUMO
Overexposure of sewage workers to bioaerosol released from wastewater treatment plants (WWTPs) can cause serious infections, but practical method for controlling their health risk is lacking. In this study, reverse quantitative microbial risk assessment was used to estimate the daily critical exposure time (CET) of sewage workers exposing to Staphylococcus aureus bioaerosol emitted by three emission sources facilities in a WWTP based on either U.S. EPA or WHO benchmark, and sensitivity analysis was conducted to analyze the influence of various parameters on the outcomes of CET. The results showed that the CET of females was always 1.12-1.29 times that of males. In addition, the CET after wearing face masks was 28.28-52.37 times as long as before. The working time can be determined based on the CET results of male workers wearing face masks exposed to the inverted-umbrella aeration tank (14.73-550.98 min for U.S. EPA benchmark and 55.07-1972.24 min for WHO benchmark). In each scenario, the variable parameter exposure concentration (ec) always showed the most influence on the CET results. After wearing the face masks, the removal fraction by employing face masks also had a significant effect on the results, only second to ec. Therefore, the wearing of face mask is the most convenient and effective measure to prolong the CET. Furthermore, practical methods to reducing bioaerosol concentration in WWTPs exposure are also necessary to extend CET and safeguard worker health. This study enriches the application range of reverse quantitative microbial risk assessment framework and provides theoretical support for stakeholders to establish reasonable working time threshold guidelines, and practical method and novel perspective to protect the on-site health risks of sewage workers exposing to various facilities.
RESUMO
Background Renal calculi therapy has advanced significantly in recent years, with mini-percutaneous nephrolithotomy (PCNL) emerging as a minimally invasive treatment modality. Mini-PCNL has been subjected to several modifications to achieve the best possible outcomes and reduce morbidity. This study aimed to compare the efficacy and safety of Swiss LithoClast Trilogy™ and pneumatic Swiss LithoClast™ in managing renal stones with mini-PCNL. Methodology This descriptive retrospective study was conducted at the Department of Urology, Lady Reading Hospital, from January 1, 2023, to December 31, 2023. A record of male and female patients aged more than 18 years who underwent mini-PCNL for renal stones was retrieved. The following two groups of patients were created: group A (n = 25) mini-PCNL with Swiss LithoClast Trilogy™ and group B (n = 26) mini-PCNL with pneumatic Swiss LithoClast™. The efficacy and safety profile of both groups was compared. Results A total of 51 patients were enrolled, with 25 in group A and 26 in group B. Groups A and B had mean ages of 45.2 and 47.5 years, respectively. Male participants outnumbered females in both groups, 72% (n = 18) in group A and 77% (n = 20) in group B. Group A had a mean stone size of 15.8 mm, and group B had a mean stone size of 16.5 mm. Stone-free rate on postoperative day one was 88% (n = 22) in group A and 84.6% (n = 22) in group B, with no statistically significant difference (p > 0.05). At the end of three months, 96% of participants in group A and 84.6% of patients in group B were found to be free of stones, and the difference between the two groups was not statistically significant (p > 0.05). Intraoperative hemorrhage occurred in 12% (n = 3) of group A and 15.4% (n = 4) of group B patients, with no significant difference (p > 0.05). Conclusions There were no significant differences in stone-free rates, complication rates, or intraoperative/postoperative complications between mini-PCNL with Swiss LithoClast Trilogy™ or Pneumatic Swiss LithoClast™.
RESUMO
The escalating production and improper disposal of petrochemical-based plastics have led to a global pollution issue with microplastics (MPs), which pose a significant ecological threat. Biobased and biodegradable plastics are believed to mitigate plastic pollution. However, their environmental fate and toxicity remain poorly understood. This study compares the in vivo effects of different types of MPs, poly(butylene adipate-co-terephthalate) as a biodegradable plastic, polylactic acid (PLA) as a biobased plastic, ß-cyclodextrin-grafted PLA as a modified biobased plastic, and low density polyethylene as the reference petrochemical-based plastic, on the key aquatic primary consumer Diaphanosoma celebensis. Exposure to MPs resulted in significant reproductive decline, with comparable effects observed irrespective of MP type or concentration. Exposure to MPs induced distinct responses in redox stress, with transcriptional profiling revealing differential gene expression patterns that indicate varied cellular responses to different types of MPs. ATP-binding cassette transporter activity assays demonstrated altered efflux activity, mainly in response to modified biobased and biodegradable MPs. Overall, this study highlights the comparable in vivo and in vitro effects of biobased, biodegradable, and petrochemical-based MPs on aquatic primary consumers, highlighting their potential ecological implications.
Assuntos
Microplásticos , Poluentes Químicos da Água , Microplásticos/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Plásticos Biodegradáveis , Cladocera/efeitos dos fármacos , PoliésteresRESUMO
Mercury is a hazardous heavy metal that is distributed worldwide in aquatic ecosystems. Methylmercury (MeHg) poses significant toxicity risks to aquatic organisms, primarily through bioaccumulation and biomagnification, due to its strong affinity for protein thiol groups, which results in negative effects even at low concentrations. MeHg exposure can cause various physiological changes, oxidative stress, neurotoxicity, metabolic disorders, genetic damage, and immunotoxicity. To assess the risks of MeHg contamination in actual aquatic ecosystems, it is important to understand how MeHg interacts with environmental factors such as temperature, pH, dissolved organic matter, salinity, and other pollutants such as microplastics and organic compounds. Complex environmental conditions can cause potential toxicity, such as synergistic, antagonistic, and unchanged effects, of MeHg in aquatic organisms. This review focuses on demonstrating the toxic effects of single MeHg exposure and the interactive relationships between MeHg and surrounding environmental factors or pollutants on aquatic organisms. Our review also recommends further research on biological and molecular responses in aquatic organisms to better understand the potential toxicity of combinational exposure.
Assuntos
Organismos Aquáticos , Compostos de Metilmercúrio , Poluentes Químicos da Água , Compostos de Metilmercúrio/toxicidade , Organismos Aquáticos/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Animais , Monitoramento AmbientalRESUMO
All inorganic lead halide perovskites exhibit fascinating optical and optoelectronic characteristics for on-chip lasing, but the lack of precise control of wafer-scale fabrication for perovskite microstructure arrays restricts their potential applications in on-chip-integrated devices. In this work, a microstructure-template assisted crystallization method is demonstrated via a designed chemical vapor deposition process, achieving the controllable fabrication of homogeneous perovskite micro-hemispheroid (PeMH) arrays spanning the entire surface area of a 4-inch wafer. Benefiting from the low-loss whispering gallery resonance and plasmon-enhanced light-matter interactions in well-confined hybrid cavities, this CsPbX3/Ag (X = Cl, Br) plasmonic microlasers exhibit quite low thresholds below 10 µJ cm-2. Interestingly, these thresholds can be efficiently modulated through the manipulation of plasmonic resonance and electromagnetic field mode in PeMHs owning various diameters. This strategy not only provides a valuable methodology for the large-scale fabrication of perovskite microstructures but also endorses the potential of all-inorganic perovskite nanostructures as promising candidates for on-chip-integrated light sources.
RESUMO
Magnesium hydride (MgH2) is a promising hydrogen storage candidate due to its large capacity; however, high dehydrogenation temperature and slow kinetic rates are the main bottlenecks. Herein, we proposed a strategy for designing nitrogen-doped graphene-supported Ni nanoparticles (NPs) (Ni@NC) to tackle these problems. The results showed that the MgH2 + 15 wt % Ni@NC nanocomposite reduced the on-set dehydrogenation temperature to 195 °C, which was 175 °C lower than pristine MgH2. In addition, MgH2 + 15 wt % Ni@NC achieved 1.7 and 6.5 wt % desorption capacities at 225 and 300 °C, respectively, while absorbing 5.5 wt % hydrogen at 100 °C. The MgH2 + 15 wt % Ni@NC nanocomposite showed high cyclic stability, achieving 98.0% capacity retention after 100 cycles at 270 °C with negligible loss in capacity. This remarkable hydrogen storage performance can be attributed to the homogeneous distribution of Ni NPs on N-doped graphene layers, in situ formed Mg2NiH2 NPs, and multiphasic regions, promoting the nucleation and growth process during hydrogenation/dehydrogenation, which stabilized and improved the cyclic stability. This strategy paves the way to developing high-performance MgH2 for large-scale applications.
RESUMO
BACKGROUND: Educating health professionals on patient safety can potentially reduce healthcare-associated harm. Patient safety courses have been incorporated into medical and nursing curricula in many high-income countries and their impact has been demonstrated in the literature through objective assessments. This study aimed to explore student perceptions about a patient safety course to assess its influence on aspiring health professionals at a personal level as well as to explore differences in areas of focus between medical and nursing students. METHODS: A dedicated patient safety course was introduced for year III medical and year II and IV nursing students at the Aga Khan University (2021-2022). As part of a post-course assessment, 577 participating students (184 medical and 393 nursing) wrote reflections on the course, detailing its influence on them. These free-text responses were thematically analyzed using NVivo. RESULTS: The findings revealed five major themes: acquired skills (clinical, interpersonal), understanding of medical errors (increased awareness, prevention and reduction, responding to errors), personal experiences with patient safety issues, impact of course (changed perceptions, professional integrity, need for similar sessions, importance of the topic) and course feedback (format, preparation for clinical years, suggestions). Students reported a lack of baseline awareness regarding the frequency and consequences of medical errors. After the course, medical students reported a perceptional shift in favor of systems thinking regarding error causality, and nursing students focused on human factors and error prevention. The interactive course format involving scenario-based learning was deemed beneficial in terms of increasing awareness, imparting relevant clinical and interpersonal skills, and changing perspectives on patient safety. CONCLUSIONS: Student perspectives illustrate the benefits of an early introduction of dedicated courses in imparting patient safety education to aspiring health professionals. Students reported a lack of baseline awareness of essential patient safety concepts, highlighting gaps in the existing curricula. This study can help provide an impetus for incorporating patient safety as a core component in medical and nursing curricula nationally and across the region. Additionally, patient safety courses can be tailored to emphasize areas identified as gaps among each professional group, and interprofessional education can be employed for shared learning. The authors further recommend conducting longitudinal studies to assess the long-term impact of such courses.
Assuntos
Currículo , Segurança do Paciente , Pesquisa Qualitativa , Estudantes de Medicina , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Estudantes de Medicina/psicologia , Masculino , Feminino , Erros Médicos/prevenção & controle , Atitude do Pessoal de Saúde , Arábia Saudita , Competência ClínicaRESUMO
The basic reproduction number, R0, is a well-known quantifier of epidemic spread. However, a class of existing methods for estimating R0 from incidence data early in the epidemic can lead to an over-estimation of this quantity. In particular, when fitting deterministic models to estimate the rate of spread, we do not account for the stochastic nature of epidemics and that, given the same system, some outbreaks may lead to epidemics and some may not. Typically, an observed epidemic that we wish to control is a major outbreak. This amounts to implicit selection for major outbreaks which leads to the over-estimation problem. We formally characterised the split between major and minor outbreaks by using Otsu's method which provides us with a working definition. We show that by conditioning a 'deterministic' model on major outbreaks, we can more reliably estimate the basic reproduction number from an observed epidemic trajectory.
RESUMO
Alpine lakes are aquatic ecosystems that maintain and regulate water supply for the downstream streams, rivers, and other reservoirs. This study examined the water characteristics of various alpine lakes in Gilgit-Baltistan, Northern Pakistan. For this purpose, water was sampled and investigated for basic parameters, anions, and cations using the multi-parameter analyzers and atomic absorption spectrophotometer. Physicochemical parameters of alpine lakes were noted under the World Health Organization water guidelines, except for fluoride (F-) and turbidity in 4.3% and 36% of samples, respectively. Water quality index (WQI) classified samples (93%) as excellent and good quality (7%). Results showed maximum chronic daily intake values (0.14 ± 0.01 mg/kg-day) for nitrate (NO3-) and hazard quotient (0.80 ± 0.24) for F- in children via water intake from Upper Kachura and Shausar Lakes, respectively. Statistical analyses of Piper and Gibbs's plots revealed that the water quality is mainly characterized by bedrock geology.
Assuntos
Ecossistema , Qualidade da Água , Criança , Humanos , Lagos , Abastecimento de Água , FluoretosRESUMO
Objective The objective of this study is to measure renal function improvement after endopyelotomy for secondary pelvi-ureteric junction (PUJ) obstruction using technetium-99m diethylene-triamine-pentaacetate (DTPA) renal scintigraphy. Material and methods This descriptive study was carried out at the Department of Urology, Institute of Kidney Diseases, Peshawar, Pakistan from June 1, 2021, to May 31, 2023. The study included 118 secondary PUJ blockage patients who underwent endopyelotomy. Patient demographics, clinical history, and preoperative imaging findings were obtained. DTPA renal scintigraphy assessed renal function improvement postoperatively at intervals to determine the efficacy of endopyelotomy. Results The majority of the patients included in the study were male (n=65, 55.1%). The average age of the patients was 45.2 years, with the majority falling within the age range of 46-60 years (n=42, 35.6%). All patients had ultrasonography and computed tomography imaging done, and preoperative renal functions were obtained. Comorbidities included hypertension in 32 (27.12%) and diabetes in 18 (15.25%). DTPA renal scintigraphy showed improved renal function in 81.35% of patients at three months, 88.13% at six months, and 83.05% at 12 months; 15.3% of patients needed further treatments, and 5.1% had PUJ blockage recurrence. Conclusion This study offers significant insights into the results and complexities of endopyelotomy in patients suffering from PUJ blockage. The findings indicate that the technique efficiently enhances kidney function and alleviates symptoms in most patients. However, the study also emphasizes the need to monitor patients undergoing this procedure.
RESUMO
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) pose a significant risk to critically ill patients, particularly in intensive care units (ICU), and are a significant cause of hospital-acquired infections. We investigated whether implementation of a multifaceted intervention was associated with reduced incidence of CLABSIs. METHODS: This was a prospective cohort study over nine years. We implemented a bundled intervention approach to prevent CLABSIs, consisting of a comprehensive unit-based safety program (CUSP). The program was implemented in the Neonatal ICU, Medical ICU, and Surgical ICU departments at the Aga Khan University Hospital in Pakistan. RESULTS: The three intervention ICUs combined were associated with an overall 36% reduction in CLABSI rates and a sustained reduction in CLABSI rates for > a year (5 quarters). The Neonatal ICU experienced a decrease of 77% in CLABSI rates lasting â¼1 year (4 quarters). An attendance rate above 88% across all stakeholder groups in each CUSP meeting correlated with a better and more sustained infection reduction. CONCLUSIONS: Our multifaceted approach using the CUSP model was associated with reduced CLABSI-associated morbidity and mortality in resource-limited settings. Our findings suggest that a higher attendance rate (>85%) at meetings may be necessary to achieve sustained effects post-intervention.
Assuntos
Infecções Relacionadas a Cateter , Controle de Infecções , Unidades de Terapia Intensiva , Humanos , Infecções Relacionadas a Cateter/prevenção & controle , Infecções Relacionadas a Cateter/epidemiologia , Estudos Prospectivos , Paquistão/epidemiologia , Controle de Infecções/métodos , Cateterismo Venoso Central/efeitos adversos , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/epidemiologia , Incidência , Países em Desenvolvimento , Bacteriemia/prevenção & controle , Bacteriemia/epidemiologia , Sepse/prevenção & controle , Sepse/epidemiologiaRESUMO
Endometrial cancer (EC) is the 6th most common cancer in women around the world. Alone in the United States (US), 66,200 new cases and 13,030 deaths are expected to occur in 2023 which needs the rapid development of potential therapies against EC. Here, a network-based drug-repurposing strategy is developed which led to the identification of 16 FDA-approved drugs potentially repurposable for EC as potential immune checkpoint inhibitors (ICIs). A network of EC-associated immune checkpoint proteins (ICPs)-induced protein interactions (P-ICP) was constructed. As a result of network analysis of P-ICP, top key target genes closely interacting with ICPs were shortlisted followed by network proximity analysis in drug-target interaction (DTI) network and pathway cross-examination which identified 115 distinct pathways of approved drugs as potential immune checkpoint inhibitors. The presented approach predicted 16 drugs to target EC-associated ICPs-induced pathways, three of which have already been used for EC and six of them possess immunomodulatory properties providing evidence of the validity of the strategy. Classification of the predicted pathways indicated that 15 drugs can be divided into two distinct pathway groups, containing 17 immune pathways and 98 metabolic pathways. In addition, drug-drug correlation analysis provided insight into finding useful drug combinations. This fair and verified analysis creates new opportunities for the quick repurposing of FDA-approved medications in clinical trials.
RESUMO
In low and medium income countries (LMIC) drinking water sources (wells and boreholes) often contain a high number of pathogenic microorganisms, that can pose significant human and environmental health risks. In this study, a quantitative microbial risk assessment approach based on existing literature was conducted to evaluate and compare the quantitative health risks associated with different age groups using various drinking water supply systems. Results showed that both community-supply and self-supply modes exhibit similar levels of risk. However, the self-supply water source consistently showed higher risks compared to the community-supply one. Borehole water was found to be a more suitable option than well water, consistently showing between 5 and 8 lower health risks for E. coli and fecal coliform levels, respectively. The sensitivity analysis further showed the importance of prioritizing the reduction of E. coli concentration in well water and fecal coliform concentration in borehole water. This study offers a fresh perception on quantifying the impact of exposure concentration and age groups, shedding light on how they affect environmental health risks. These findings provide valuable insights for stakeholders involved in the management and protection of water sources.
Assuntos
Água Potável , Humanos , Escherichia coli , Abastecimento de Água , Medição de Risco , Microbiologia da ÁguaRESUMO
Fluorescence probe technology holds great promise in the application of trace explosive detection due to its high sensitivity, fast response speed, good selectivity, and low cost. In this work, a designed approach has been employed to prepare the TPE-PA-8 molecule, utilizing the classic aggregation-induced emission (AIE) property of 1,1,2,2-tetraphenylethene (TPE), for the development of self-assembled monolayers (SAMs) targeting the detection of trace nitroaromatic compound (NAC) explosives. The phosphoric acid acts as an anchoring unit, connecting to TPE through an alkyl chain of eight molecules, which has been found to play a crucial role in promoting the aggregation of TPE luminogens, leading to the enhanced light-emission property and sensing performance of SAMs. The SAMs assembled on Al2O3-deposited fiber film exhibit remarkable detection performances, with detection limits of 0.68 ppm, 1.68 ppm, and 2.5 ppm for trinitrotoluene, dinitrotoluene, and nitrobenzene, respectively. This work provides a candidate for the design and fabrication of flexible sensors possessing the high-performance and user-friendly detection of trace NACs.
RESUMO
Castration refers to induced sterility via physical, chemical, or hormonal methods. Chemical castration is an efficient and reliable technique in contrast to other sterilization procedures as it is less painful to physical methods and costeffective to hormonal methods. Azadirachta indica (neem), is a charismatic plant as its leaves possess antiinflammatory, antimicrobial, and antiandrogenic chattels. To abate the escalating human population in South Asia, neem oil and neem leaf extract have been effectively used as a contraceptive agent. The key determinant of the current study was to evaluate Neem as a chemical sterilizing agent, (either necrotic or apoptotic), in dogs injected intratesticular in comparison to a hypertonic saline solution. Pre and postinjection testicular width size and blood samples for serum testosterone levels were collected on alternative days. Results disclosed substantial changes in testicular width size, histopathological profile, and serum testosterone level. A nonsignificant (P > 0.05) preinjection testicular width readings in contrast to a significant increase (P < 0.05) three days postinjection was noted in all the competitive groups. The mean values recorded for testicular width size at the end of the trial study via neem leaf extract, 30% HSS and, control groups were 27.7362 ± 2.3315mm, 30.9594 ± 4.6861mm, and 24.5023 ± 2.5387mm, respectively. A declining trend, regarding serum testosterone level being statistically significant (P < 0.05) was recorded in treated groups (A, B) in contrast to the control group (C) as the values were 1.5357 ± 0.7819ng, 1.2669 ± 0.9095ng, and 2.4517 ± 0.1827ng in groups A, B, and C, respectively. Histopathological findings advocated the presence of apoptotic bodies in the neem treated group whereas the presence of degenerated interstitial cells, necrosed seminiferous tubules, damaged germinal epithelium, and ceased spermatogenesis was also studied in both competitive groups. Thus, the apoptotic effect and antiinflammatory property of neem leaf extract resulted in less painful castration and verified Azadirachta indica as a better substitute for chemical castration in contrast to hypertonic saline solution.(AU)
A castração consiste na indução da esterilidade por meio físico, químico ou hormonal. A castração química é uma técnica eficiente e confiável, em contraste com outros procedimentos de esterilização, pois é menos dolorosa para os métodos físicos e econômicos para os métodos hormonais. Azadirachta indica (neem), é uma planta carismática, pois possui folhas antiinflamatórias, antimicrobianas e antiandrogênicas. Para diminuir a crescente população humana no sul da Ásia, o óleo de nim e o extrato de folhas de nim têm sido efetivamente usados como agente contraceptivo. O principal determinante deste estudo atual foi avaliar o Neem como um agente esterilizante químico (necrótico ou apoptótico) em cães injetados intratesticularmente em comparação com uma solução salina hipertônica. O tamanho da largura testicular pré e pósinjeção e as amostras de sangue para os níveis séricos de testosterona foram colhidas em dias alternados. Os resultados obtidos revelaram alterações substanciais no tamanho da largura testicular, perfil histopatológico e nível sérico de testosterona. Observouse uma leitura não significativa (P> 0,05) da largura testicular da préinjeção, em contraste com um aumento significativo (P <0,05) três dias após a injeção em todos os grupos competitivos.Os valores médios registrados para o tamanho da largura testicular no final do estudo via extrato de folhas de nim,HSS a 30% e grupos controle foram 27,7362 ± 2,3315 mm, 30,9594 ± 4,6861 mm e 24,5023 ± 2,5387 mm, respectivamente.Uma tendência decrescente, com relação ao nível sérico de testosterona sendo estatisticamente significante (P <0,05), foi registrada nos grupos tratados (A, B), em contraste com o grupo controle (C), pois os valores eram 1,5357 ± 0,7819ng, 1,2669 ± 0,9095ng e 2,4517 ± 0,1827ng nos grupos A, B e C, respectivamente. Os achados histopatológicos advogaram a presença de corpos apoptóticos no grupo tratado com nim, enquanto a presença de células intersticiais degeneradas, túbulos seminíferos necrosados, epitélio germinativo danificado e espermatogênese interrompida também foi estudada nos dois grupos competitivos. Assim, o efeito apoptótico e a propriedade antiinflamatória do extrato de folhas de nim resultaram em uma castração menos dolorosa e confirmaram que a Azadirachta indica foi um melhor substituto para a castração química do que a solução salina hipertônica.(AU)