Efficient Nickel and Cobalt Recovery by Metal-Organic Framework-Based Mixed Matrix Membranes (MMM-MOFs).

Green energy transition has supposed to give a huge boost to the electric vehicle rechargeable battery market. This has generated a compelling demand for raw materials, such as cobalt and nickel, which are key common constituents in lithium-ion batteries (LIBs). However, their existing mining protocols and the concentrated localization of such ores have made cobalt and nickel mineral conundrums, and their supplies experience shortages, which threaten to slow the progress of the renewable energy transition. Aiming to contribute to the sustainable recycling of these valuable metals from LIBs and wastewater, in this work, we explore the use of four mixed matrix membranes (MMMs) embedding different metal-organic frameworks (MOFs), i.e., MIL-53(Al), MIL-53(Fe), MIL-101(Fe), and {SrIICuII 6[(S,S)-serimox]3(OH)2(H2O)}·39H2O (SrCu 6 Ser) in polyether sulfone (PES), for the recovery of cobalt(II) and nickel(II) metal cations from mixed cobalt-nickel aqueous solutions containing common interfering ions. Whereas the neat PES membrane slightly contributes to the adsorption of metal ions, showing reduced removal efficiency values of 10.2 and 9.5% for Ni(II) and Co(II), respectively, the inclusion of MOFs in the polymeric matrix substantially improves the adsorption performances. The four MOF@PES MMMs efficiently remove these metals from water, with MIL-53(Al)@PES being the one that presents better performance, with a removal efficiency up to 95% of Ni(II) and Co(II). Remarkably, SrCu 6 Ser@PES exhibits outstanding selectivity toward cobalt(II) cations compared to of nickel(II) ones, with removal efficiencies of 63.7 and 15.1% for Co(II) and Ni(II), respectively. Overall, the remarkable efficiencies, versatility, high environmental robustness, and cost-effective synthesis shown by this family of MOF@PES MMMs situate them among the best adsorbents for the extraction of this kind of contaminants.

Advanced Persistent Threat (APT) and intrusion detection evaluation dataset for linux systems 2024.

The novel dataset called Linux-APT Dataset 2024 captures Advanced Persistent Threat (APT) attacks along with other latest and sophisticated payloads. Existing datasets lacks latest attacker's techniques and procedures, APTs tactics and configuration to capture maximum Linux log sources to observe the working and behaviour of an APT in a detailed manner. The environment which supported us in capturing the logs is composed of Linux machines and a centralized logging system configured appropriately to captures and detect all possible events and logs for an APT and other complex intrusion. Unlike Microsoft Windows, Linux logging system are investigated enough and usually systems relies on limited log sources but for an APT, all possible log sources should be evaluated and added to completely analyse the behaviour, trajectory, and operation of an APT. To keep the dataset up to date and realistic, recent payloads and APTs are emulated in the environment. A well-known cyber-security framework 'MITRE ATT&CK' is utilised to map the behaviour and operation in a generalized manner after capturing the events and logs. This dataset can be used for training and conducting a variety of experiments to build as well as design the solutions for detecting most recent intrusions and APT attacks for Linux System.

State, synthesis, perspective applications, and challenges of Graphdiyne and its analogues: A review of recent research.

Carbon materials technology provides the possibility of synthesizing low-cost, outstanding performance replacements to noble-metal catalysts for long-term use. Graphdiyne (GDY) is a carbon allotrope with an extremely thin atomic thickness. It consists of carbon elements, that are hybridized with both sp. and sp2, resulting in a multilayered two-dimensional (2D) configuration. Several functional models suggest, that GDY contains spontaneously existing band structure with Dirac poles. This is due to the non-uniform interaction among carbon atoms, which results from various fusions and overlapping of the 2pz subshell. Unlike other carbon allotropes, GDY has Dirac cone arrangements, that in turn give it inimitable physiochemical characteristics. These properties include an adjustable intrinsic energy gap, high speeds charging transport modulation efficiency, and exceptional conductance. Many scientists are interested in such novel, linear, stacked materials, including GDY. As a result, organized synthesis of GDY has been pursued, making it one of the first synthesized GDY materials. There are several methods to manipulate the band structure of GDY, including applying stresses, introducing boron/nitrogen loading, utilizing nanowires, and hydrogenations. The flexibility of GDY can be effectively demonstrated through the formation of nano walls, nanostructures, nanotube patterns, nanorods, or structured striped clusters. GDY, being a carbon material, has a wide range of applications owing to its remarkable structural and electrical characteristics. According to subsequent research, the GDY can be utilized in numerous energy generation processes, such as electrochemical water splitting (ECWS), photoelectrochemical water splitting (PEC WS), nitrogen reduction reaction (NRR), overall water splitting (OWS), oxygen reduction reaction (ORR), energy storage materials, lithium-Ion batteries (LiBs) and solar cell applications. These studies suggested that the use of GDY holds significant potential for the development and implementation of efficient, multimodal, and intelligent catalysts with realistic applications. However, the limitation of GDY and GDY-based composites for forthcoming studies are similarly acknowledged. The objective of these studies is to deliver a comprehensive knowledge of GDY and inspire further advancement and utilization of these unique carbon materials.

(Multivariate)-Metal-Organic Framework for Highly Efficient Antibiotic Capture from Aquatic Environmental Matrices.

Contamination of aquatic environments by pharmaceuticals used by modern societies has become a serious threat to human beings. Among them, antibiotics are of particular concern due to the risk of creating drug-resistant bacteria and, thus, developing efficient protocols for the capture of this particular type of drug is mandatory. Herein, we report a family of three isoreticular MOFs, derived from natural amino acids, that exhibit high efficiency in the removal of a mixture of four distinct families of antibiotics, such as fluoroquinolones, penicillins, lincomycins, and cephalosporins, as solid-phase extraction (SPE) sorbents. In particular, a multivariate (MTV)-MOF, prepared using equal percentages of amino acids l-serine and l-methionine, also exhibits outstanding recyclability, surpassing the benchmark material activated carbon. The good removal performance of the MTV-MOF was rationalized by means of single-crystal X-ray diffraction. These results highlight the situation of MOFs as a real and promising alternative for the capture of antibiotics from environmental matrices, especially wastewater streams.

Electro-Synthesis of Organic Compounds with Heterogeneous Catalysis.

Electro-organic synthesis has attracted a lot of attention in pharmaceutical science, medicinal chemistry, and future industrial applications in energy storage and conversion. To date, there has not been a detailed review on electro-organic synthesis with the strategy of heterogeneous catalysis. In this review, the most recent advances in synthesizing value-added chemicals by heterogeneous catalysis are summarized. An overview of electrocatalytic oxidation and reduction processes as well as paired electrocatalysis is provided, and the anodic oxidation of alcohols (monohydric and polyhydric), aldehydes, and amines are discussed. This review also provides in-depth insight into the cathodic reduction of carboxylates, carbon dioxide, CC, C≡C, and reductive coupling reactions. Moreover, the electrocatalytic paired electro-synthesis methods, including parallel paired, sequential divergent paired, and convergent paired electrolysis, are summarized. Additionally, the strategies developed to achieve high electrosynthesis efficiency and the associated challenges are also addressed. It is believed that electro-organic synthesis is a promising direction of organic electrochemistry, offering numerous opportunities to develop new organic reaction methods.

Genome sequencing and analysis of genomic diversity in the locally transmitted SARS-CoV-2 in Pakistan.

Surveillance of genetic diversity of the SARS-CoV-2 is extremely important to detect the emergence of more infectious and deadly strains of the virus. In this study, we evaluated mutational events in the SARS-CoV-2 genomes through whole genome sequencing. The samples were collected from COVID-19 patients in different major cities of Pakistan during the four waves of the pandemic (May 2020 to July 2021) and subjected to whole genome sequencing. Using in silico and machine learning tools, the viral mutational events were analyzed, and variants of concern and of interest were identified during each of the four waves. The overall mutation frequency (mutations per genome) increased during the course of the pandemic from 12.19 to 23.63, 31.03, and 41.22 in the first, second, third, and fourth waves, respectively. We determined that the viral strains rose to higher frequencies in local transmission. The first wave had three most common strains B.1.36, B.1.160, and B.1.255, the second wave comprised B.1.36 and B.1.247 strains, the third wave had B.1.1.7 (Alpha variant) and B.1.36 strains, and the fourth waves comprised B.1.617.2 (Delta). Intriguingly, the B.1.36 variants were found in all the waves of the infection indicating their survival fitness. Through phylogenetic analysis, the probable routes of transmission of various strains in the country were determined. Collectively, our study provided an insight into the evolution of SARS-CoV-2 lineages in the spatiotemporal local transmission during different waves of the pandemic, which aided the state institutions in implementing adequate preventive measures.

Virtual Reality Fitness (VRF) for Behavior Management During the COVID-19 Pandemic: A Mediation Analysis Approach.

BACKGROUND: During the COVID-19 pandemic, cellphone health apps and virtual reality fitness for treating neurological disorders such as Parkinson's were beneficial. Virtual reality has been used to treat PTSD, depression, anxieties, dementia, ADHD, dyslexia, and pain control in various settings. Virtual reality exercise has been studied for its effects on biological, mental, rehabilitation, behavior, and attitude management. PURPOSE: This research aimed to find out the role of virtual reality fitness (VRF) for behavior management during the COVID-19 pandemic concerning the demographic characteristics of the study participants and the use of fitness and health apps. METHODS: The population for the current study was Chinese residents across China who were in home isolation during the early pandemic in China. According to the study objective, a convenience sampling method was used to collect the primary data through an online survey. SPSS-25 statistical software was used to analyze the demographic information and clean and prepare the data to test all proposed hypotheses. The proposed research framework was examined using the structural equation modeling (SEM) approach through SmartPLS 3.0 software. RESULTS: The structural equation model analysis shows that all the proposed hypotheses (H1: ß = 0.137, t = 10.454, p = <0.000; H2: ß = 0.256, t = 16.824, p = <0.000; H3: ß = 0.418, t = 27.827, p = <0.000; H4: ß = 0.133, t = 8.913, p = <0.000; H5: ß = 0.076, t = 4.717, p = <0.000; H6: ß = 0.162, t = 10.532, p = <0.000; H7: ß = 0.384, t = 26.645, p = <0.000) are confirmed. CONCLUSION: Fitness and health apps with virtual reality fitness play a substantial role in improving the overall quality of life and positively influencing behavior and attitude.

An Efficient and Secure Revocation-Enabled Attribute-Based Access Control for eHealth in Smart Society.

The ever-growing ecosystem of the Internet of Things (IoT) integrating with the ever-evolving wireless communication technology paves the way for adopting new applications in a smart society. The core concept of smart society emphasizes utilizing information and communication technology (ICT) infrastructure to improve every aspect of life. Among the variety of smart services, eHealth is at the forefront of these promises. eHealth is rapidly gaining popularity to overcome the insufficient healthcare services and provide patient-centric treatment for the rising aging population with chronic diseases. Keeping in view the sensitivity of medical data, this interfacing between healthcare and technology has raised many security concerns. Among the many contemporary solutions, attribute-based encryption (ABE) is the dominant technology because of its inherent support for one-to-many transfer and fine-grained access control mechanisms to confidential medical data. ABE uses costly bilinear pairing operations, which are too heavy for eHealth's tiny wireless body area network (WBAN) devices despite its proper functionality. We present an efficient and secure ABE architecture with outsourcing intense encryption and decryption operations in this work. For practical realization, our scheme uses elliptic curve scalar point multiplication as the underlying technology of ABE instead of costly pairing operations. In addition, it provides support for attribute/users revocation and verifiability of outsourced medical data. Using the selective-set security model, the proposed scheme is secure under the elliptic curve decisional Diffie-Hellman (ECDDH) assumption. The performance assessment and top-ranked value via the help of fuzzy logic's evaluation based on distance from average solution (EDAS) method show that the proposed scheme is efficient and suitable for access control in eHealth smart societies.

Hand-based multibiometric systems: state-of-the-art and future challenges.

The traditional methods used for the identification of individuals such as personal identification numbers (PINs), identification tags, etc., are vulnerable as they are easily compromised by the hackers. In this paper, we aim to focus on the existing multibiometric systems that use hand based modalities for the identification of individuals. We cover the existing multibiometric systems in the context of various feature extraction schemes, along with an analysis of their performance using one of the performance measures used for biometric systems. Later, we cover the literature on template protection including various cancelable biometrics and biometric cryptosystems and provide a brief comment about the methods used for multibiometric template protection. Finally, we discuss various open issues and challenges faced by researchers and propose some future directions that can enhance the security of multibiometric templates.

Serological Screening of Suspected COVID-19 Patients in Pakistan.

OBJECTIVE: To determine the antibody levels (IgM and IgG), using ELISA in suspected patients of COVID-19. STUDY DESIGN: Descriptive cross-sectional study. Place & Duration of Study: Real Time PCR Diagnostic and Research Laboratory, Peshawar, Khyber Pakhtunkhwa, Pakistan, from May to July 2020. METHODOLOGY: A total of 94 blood specimens were collected from suspected COVID-19 patients. The antibody levels (IgG and IgM) were determined, using a COVID-19 ELISA IgG and IgM kit. RESULTS: Out of a total 94 serum specimens, specimens were predominantly collected from males (70.2%, n=66) as compared to females (29.8%, n=28). Amongst six different age groups, the majority of the samples were found in the 31-45 years, 16-30 years, and 46-60 years groups, 42.6% (n=40), 23.4% (n=22) and 22.3% (n=21), respectively. Of the 94 suspected COVID-19 patients' serum specimens, IgG and IgM were detected in 29.8% (n=28) and 39.4% (n=37), specimens, respectively. The IgG antibodies were detected more in males (60.0%, n=18) than females (40.0%, n=12) samples. Similarly, IgM antibodies were also found more frequently in males (61.1%, n=22) as compared to females (38.9%, n=14). CONCLUSION: Detection of antibodies in COVID-19 infected patients provides vital clinical information for clinicians and could be used for the identification of suspected cases. Moreover, males were more prone to disease compared to females, and the 31-45 years age group was also more affected. Key Words: Serological assays, IgG, IgM, Peshawar, Pakistan.

The Influence of COVID-19 Pandemic on Physical Health-Psychological Health, Physical Activity, and Overall Well-Being: The Mediating Role of Emotional Regulation.

Background: Highly infectious respiratory disease COVID-19 emerged in Wuhan, China, and spread worldwide. Different measures have been adopted worldwide to contain the COVID-19, and these measures have various impacts on health-related quality of life (HRQoL). This study aimed to assess the impact of the COVID-19 pandemic (CP) and lockdown policy on physical health (PH)-psychological health (PsH), physical activity (PA), and overall well-being (OW) in the context of HRQoL, exploring the mediating role of emotional regulation (ER). Method: The current study was conducted in two provincial cities of China. An online survey was conducted in both the cities to collect the data. After quantifying the data, a total of 2,200 respondents data were analyzed through appropriate statistical techniques. Results: The study results indicate that CP was found significantly and negatively related to PH (ß = -0.157, t = 9.444, p < 0.001). A significant relationship was found between CP and PsH (ß = 0.779, t = 45.013, p < 0.001). The third prediction revealed a significant negative relationship between the CP and OW (ß = -0.080, t = 5.261, p < 0.001). The CP and PA had a significant negative relationship (ß = -0.047, t = 3.351, p < 0.001). Conclusion: The PH, PsH, and OW of the Chinese people were affected due to the CP and lockdown measures. It is suggested that ER intervention reduces the negative psychological impacts for improving quality of life. ER can function one's sentiments in their social environment effectively for quality of life.

Physical Inactivity, Non-Communicable Diseases and National Fitness Plan of China for Physical Activity.

BACKGROUND: China has the world's largest population, going under health transition due to industrialization, urbanization, and a sedentary lifestyle. About 82% of China's disease burden is due to the prevalence of non-communicable diseases (NCDs). Physical activity (active travel) is the best preventive measure against NCDs. The Chinese government has introduced several steps to improve national fitness and overcome NCDs among the aging population. Exercise and sports play a vital role in promoting physical activity and helpful in accomplishing the national fitness level for Healthy China under the national fitness plan (NFP). OBJECTIVE: The current study aimed to explore the role of national fitness plan (NFP) in promoting physical activity and health well-being preventing NCDs under built environment intervention. METHODS: The study was exploratory, and the mixed-method approach was used to analyze the primary and secondary data. Quantitative content analysis was used to analyze the collected data. A purposive sampling technique was used to collect the primary data from those individuals rich in knowledge about the National Fitness Plan (NFP) of China and its role in promoting physical activity for physical fitness. RESULTS: The majority of the participants (32.0%) said that the national fitness plan helps promote sports environment and health. About 28.0% reported that NFP helps promote cycling and walk environments for physical activity and health promotion and preventing non-communicable diseases (NCDs). CONCLUSION: Participation in physical exercise and sports is the preferred approach to prevent different diseases. In the context of rising active living among the Chinese people, the facilities such as built environment and green parks under the national fitness plan (NFP) for sports play a crucial role in the mitigation of NCDs.

On GPS spoofing of aerial platforms: a review of threats, challenges, methodologies, and future research directions.

Unmanned Aerial Systems (UAVs, Drones), initially known only for their military applications, are getting increasingly popular in the civil sector as well. Over the military canvas, drones have already proven themselves as a potent force multiplier through unmanned, round-the-clock, long-range and high-endurance missions for surveillance, reconnaissance, search and rescue, and even armed combat applications. With the emergence of the Internet of Things (IoT), commercial deployments of drones are also growing exponentially, ranging from cargo and taxi services to agriculture, disaster relief, risk assessment and monitoring of critical infrastructures. Irrespective of the deployment sector, drones are often entrusted to conduct safety, time and liability critical tasks, thus requiring secure, robust and trustworthy operations. In contrast, the rise in UAVs' demand, coupled with market pressure to reduce size, weight, power and cost (SwaP-C) parameters, has caused vendors to often ignore security aspects, thus inducing serious safety and security threats. As UAVs rely on Global Positioning System (GPS) for positioning and navigation, they can fall prey to GPS jamming and spoofing attacks. The vulnerability of GPS to spoofing has serious implications for UAVs, as victim drones using civil GPS can be misdirected or even completely hijacked for malicious intents, as already demonstrated in several academic research efforts using commercially available GPS spoofing hardware. Beside UAVs, GPS spoofing attacks are equally applicable to other GPS-dependent platforms, including manned aircraft, ground vehicles, and cellular systems. This paper conducts a comprehensive review of GPS spoofing threats, with a special focus on their applicability over UAVs and other GPS-dependent mobile platforms. It presents a novel taxonomy of GPS spoofing attacks and critically analyzes different spoofing techniques based upon placement of spoofing device, attack stealthiness, attack methodologies, and objectives of the attacker. We also discuss some of the recent experiments from open literature which utilized commercially available hardware for successfully conducting spoofing attacks.

The Psychological Impacts of COVID-19 Home Confinement and Physical Activity: A Structural Equation Model Analysis.

BACKGROUND: COVID-19 break out has created panic and fear in society. A strict kind of lockdown was imposed in Wuhan, Hubei province of China. During home confinement due to lockdown, people face multidimensional issues. The present study explored the psychological impacts of COVID-19 home confinement during the lockdown period and Wuhan's residents' attitude toward physical activity. METHODS: A cross-sectional online survey was conducted to collect the primary data according to the study objectives. The population was Wuhan residents (+ 18 years) who were in home confinement. A total of 2280 participant's reply to the online questionnaire survey and collected data after quantifying the data, about 2200 (96.49%); about (49.8%) female, about (49.4%) male, others about (0.2%), and about (0.6%) were not disclosed their gender participants responses were used for analysis. The collected data were analyzed through appropriate statistical techniques. RESULTS: According to results, H1 is supported with ß = -40.793, t = 57.835, p = 0.000, which claimed a negative association between COVID-19 lockdown policy and behavior and attitude. Results for H2 reveals that the COVID-19 lockdown policy have negative influence on emotional control with ß = -0.769, t = 46.766, p = 0.000 and it is supported. H3 documented a significant positive relationship between COVID-19 lockdown policy and lockdown period psychological impact, which means lockdown policy, is the main reason to increase the lockdown psychological impact. Further, COVID-19 lockdown policy have negative influence on physical activity (H4) and self-belief (H5) with ß = -0.657, t = 32.766, p = 0.000 and ß = -0.620, t = -6.766, p = 0.000 respectively. H6 stated that there is a positive impact of behavior and attitude toward physical activity. The results for H6, behavior, and attitude affecting the physical activity with ß = 0.401, t = 10, p = 0.000, which is supported. CONCLUSION: COVID-19 home confinement created various psychological impacts, negatively affecting the emotional state due to depression and anxiety. Physical activity is the best strategy to manage human nature's psychological issues, and people's attitudes were positive toward physical activity during home confinement. However, the lockdown policy also affects physical activity participation negatively, and a sedentary lifestyle prevailed during home confinement.

MARC: A Novel Framework for Detecting MITM Attacks in eHealthcare BLE Systems.

Real-time and ubiquitous patient monitoring demands the use of wireless data acquisition through resource constrained medical sensors, mostly configured with No-input No-output (NiNo) capabilities. Bluetooth is one of the most popular and widely adopted means of communicating this sensed information to a mobile terminal. However, over simplified implementations of Bluetooth low energy (BLE) protocol in eHealth sector is susceptible to several wireless attacks, in particular the Man-in-the-Middle (MITM) attack. The issue arises due to a lack of mutual authentication and integrity protection between the communicating devices, which may lead to compromise of confidentiality, availability and even the integrity of this safety-critical information. This research paper presents a novel framework named MARC to detect, analyze, and mitigate Bluetooth security flaws while focusing upon MITM attack against NiNo devices. For this purpose, a comprehensive solution has been proposed, which can detect MITM signatures based upon four novel anomaly detection metrics: analyzing Malicious scan requests, Advertisement intervals, RSSI levels, and Cloned node addresses. The proposed solution has been evaluated through practical implementation and demonstration of different attack scenarios, which show promising results concerning accurate and efficient detection of MITM attacks.

CATSWoTS: Context Aware Trustworthy Social Web of Things System.

The inevitable revolution of the Internet of Things (IoT) and its benefits can be witnessed everywhere. Two major issues related to IoT are the interoperability and the identification of trustworthy things. The proposed Context-Aware Trustworthy Social Web of Things System (CATSWoTS) addresses the interoperability issue by incorporating web technologies including Service Oriented Architecture where each thing plays the role of a service provider as well as a role of service consumer. The aspect of social web helps in getting recommendations from social relations. It was identified that the context dependency of trust along with Quality of Service (QoS) criteria, for identifying and recommending trustworthy Web of Things (WoT), require more attention. For this purpose, the parameters of context awareness and the constraints of QoS are considered. The research focuses on the idea of a user-centric system where the profiles of each thing (level of trustworthiness) are being maintained at a centralized level and at a distributed level as well. The CATSWoTS evaluates service providers based on the mentioned parameters and the constraints and then identifies a suitable service provider. For this, a rule-based collaborative filtering approach is used. The efficacy of CATSWoTS is evaluated with a specifically designed environment using a real QoS data set. The results showed that the proposed novel technique fills the gap present in the state of the art. It performed well by dynamically identifying and recommending trustworthy services as per the requirements of a service seeker.

Forensic Analysis of Tor Browser: A Case Study for Privacy and Anonymity on the Web.

Web browsers are among the most commonly used applications to access the web from any platform nowadays. With recent digital incidents involving breach of data, users are becoming more cognizant of the threat posed by malicious actors having access to personal data as well as vulnerable applications which may compromise their data. For this very reason, users are being offered privacy preserving solutions for trust maturity. The onion router (Tor) browser is one such application which not only ensures the privacy preservation goals but also provides promising anonymity. Due to this feature, majority of the users use Tor browser for normal use as well as malign activities. In order to validate the claims of Tor browser and help digital forensic investigators and researchers, we created different scenarios to forensically analyze the Tor browser privacy and anonymity. As a result of the findings, it can be concluded that the Tor browser leaves plethora of sensitive digital artifacts on host machine, which can be further used to compromise user data.

USB Storage Device Forensics for Windows 10.

Significantly increased use of USB devices due to their user-friendliness and large storage capacities poses various threats for many users/companies in terms of data theft that becomes easier due to their efficient mobility. Investigations for such data theft activities would require gathering critical digital information capable of recovering digital forensics artifacts like date, time, and device information. This research gathers three sets of registry and logs data: first, before insertion; second, during insertion; and the third, after removal of a USB device. These sets are analyzed to gather evidentiary information from Registry and Windows Event log that helps in tracking a USB device. This research furthers the prior research on earlier versions of Microsoft Windows and compares it with latest Windows 10 system. Comparison of Windows 8 and Windows 10 does not show much difference except for new subkey under USB Key in registry. However, comparison of Windows 7 with latest version indicates significant variances.

Hemophagocytic histiocytosis: A Clinicopathological correlation.

OBJECTIVES: Histiocytic hyperplasia with hemophagocytosis (HP) is relatively uncommon condition that has often been mistaken in the past for neoplastic disorders. This study was conducted to investigate the possible etiology of HP, its intensity in the bone marrow (BM), and also its effect on hematological parameters with the extent of disease activity. METHODS: Blood samples were collected and BM examination was performed in 250 patients with varied etiology showing HP. Complete blood counts, reticulocyte count, and red blood cell morphology were determined. HP was examined in the BM smears by Leishman staining. The severity of HP was determined by grading of its intensity in the BM smears. RESULTS: Our data showed variable degree of HP (mild, moderate, and severe) in the BM smears of patients having different underlying disorders. HP syndrome (HPS) with clinical and biochemical derangements was found in 24 (9.6%) patients. HPS was mostly associated with infection. The etiological distribution in different group of disorders was nonmalignant hematological conditions (56.80%), infections (24.80%), storage disorders (4.40%), malignant hematological conditions (4.40%), autoimmune disorders (1.20%), and miscellaneous group (8.40%). Distribution of patients in different grades of intensity of HP was Grade I (35.50%; mild), Grade II (45.50%; moderate), and Grade III (19.60%; severe). CONCLUSION: We conclude that severe degree of HP has profound effect on hematological parameters particularly hemoglobin and platelet counts. This phenomenon may present as HPS with fatal outcome. We also conclude that there was no effect of age on either intensity of HP or on blood counts.

World Health Organisation Global Disability Action Plan 2014-2021: Challenges and perspectives for physical medicine and rehabilitation in Pakistan.

OBJECTIVE: To provide an update on disability and outline potential barriers and facilitators for implementation of the World Health Organization Global Disability Action Plan (GDAP) in Pakistan. METHODS: A 6-day workshop at the Armed Forces Institute of Rehabilitation Medicine, Islamabad facilitated by rehabilitation staff from Royal Melbourne Hospital, Australia. Local healthcare professionals (n = 33) from medical rehabilitation facilities identified challenges in service provision, education and attitudes/approaches to people with disabilities, using consensus agreement for objectives listed in the GDAP. RESULTS: Respondents agreed on the following challenges in implementing the GDAP: shortage of skilled work-force, fragmented healthcare system, poor coordination between acute and subacute healthcare sectors, limited health services infrastructure and funding, lack of disability data, poor legislation, lack of guidelines and accreditation standards, limited awareness/knowledge of disability, socio-cultural perceptions and geo-topographical issues. The main facilitators included: need for governing/leadership bodies, engagement of healthcare professionals and institutions using a multi-sectoral approach, new partnerships and strategic collaboration, provision of financial and technical assistance, future policy direction, research and development. CONCLUSION: The barriers to implementing the GDAP identified here highlight the emerging priorities and challenges in the development of rehabilitation medicine and GDAP implementation in a developing country. The GDAP summary actions were useful planning tools to improve access and strengthen rehabilitation services.