Arrhythmogenic right ventricular cardiomyopathy: Unveiling clinical presentations, CMR insights and prognosis in a single-center retrospective study.

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is a hereditary condition with a prevalence ranging from 1 in 2000 to 1 in 5000 individuals. ARVC is a significant contributor to sudden cardiac death, particularly in young individuals and athletes, and remains challenging to diagnose definitively. We conducted a single-center retrospective study to evaluate the presentations, electrocardiogram findings, and imaging characteristics of ARVC patients evaluated at our center between 2021 and 2023. Notably, our study is the second investigation of ARVC conducted in Pakistan. We report divergent symptom prevalence as compared to the current literature and have incorporated the Task Force Criteria. Despite limited access to cardiac magnetic resonance (CMR) facilities worldwide, our findings underscore the critical role ofCMR in ARVC diagnosis. Our cohort had a mortality rate of 17 % highlighting the importance of early detection and the need for improved diagnostic facilities for ARVC in the region.

The impact of biochar addition on morpho-physiological characteristics, yield and water use efficiency of tomato plants under drought and salinity stress.

The use of saline water under drought conditions is critical for sustainable agricultural development in arid regions. Biochar is used as a soil amendment to enhance soil properties such as water-holding capacity and the source of nutrition elements of plants. Thus, the research was carried out to assess the impact of biochar treatment on the morphological and physiological characteristics and production of Solanum lycopersicum in greenhouses exposed to drought and saline stresses. The study was structured as a three-factorial in split-split-plot design. There were 16 treatments across three variables: (i) water quality, with freshwater and saline water, with electrical conductivities of 0.9 and 2.4 dS m- 1, respectively; (ii) irrigation level, with 40%, 60%, 80%, and 100% of total evapotranspiration (ETC); (iii) and biochar application, with the addition of biochar at a 3% dosage by (w/w) (BC3%), and a control (BC0%). The findings demonstrated that salt and water deficiency hurt physiological, morphological, and yield characteristics. Conversely, the biochar addition enhanced all characteristics. Growth-related parameters, such as plant height, stem diameter, leaf area, and dry and wet weight, and leaf gas exchange attributes, such rate of transpiration and photosynthesis, conductivity, as well as leaf relative water content were decreased by drought and salt stresses, especially when the irrigation was 60% ETc or 40% ETc. The biochar addition resulted in a substantial enhancement in vegetative growth-related parameters, physiological characteristics, efficiency of water use, yield, as well as reduced proline levels. Tomato yield enhanced by 4%, 16%, 8%, and 3% when irrigation with freshwater at different levels of water deficit (100% ETc, 80% ETc, 60% ETc, and 40% ETc) than control (BC0%). Overall, the use of biochar (3%) combined with freshwater shows the potential to enhance morpho-physiological characteristics, support the development of tomato plants, and improve yield with higher WUE in semi-arid and arid areas.

Fast Interfacial Defluorination Kinetics Enables Stable Cycling of Low-Temperature Lithium Metal Batteries.

The development of low-temperature lithium metal batteries (LMBs) encounters significant challenges because of severe dendritic lithium growth during the charging/discharging processes. To date, the precise origin of lithium dendrite formation still remains elusive due to the intricate interplay between the highly reactive lithium metal anode and organic electrolytes. Herein, we unveil the critical role of interfacial defluorination kinetics of localized high-concentration electrolytes (LHCEs) in regulating lithium dendrite formation, thereby determining the performance of low-temperature LMBs. We investigate the impact of solvation structures of LHCEs on low-temperature LMBs by employing tetrahydrofuran (THF) and 2-methyltetrahydrofuran (2-MeTHF) as comparative solvents. The combination of comprehensive characterizations and theoretical simulations reveals that the THF-based LHCE featured with a strong solvation strength exhibits fast interfacial defluorination reaction kinetics, thus leading to the formation of an amorphous and inorganic-rich solid-electrolyte interphase (SEI) that can effectively suppress the growth of lithium dendrites. As a result, the highly reversible Li metal anode achieves an exceptional Coulombic efficiency (CE) of up to ∼99.63% at a low temperature of -30 °C, thereby enabling stable cycling of low-temperature LMB full cells. These findings underscore the crucial role of electrolyte interfacial reaction kinetics in shaping SEI formation and provide valuable insights into the fundamental understanding of electrolyte chemistry in LMBs.

Exploring Nanomaterials for Hydrogen Storage: Advances, Challenges, and Perspectives.

Hydrogen energy heralded for its environmentally friendly, renewable, efficient, and cost-effective attributes, stands poised as the primary alternative to fossil fuels in the future. Despite its great potential, the low volumetric density presents a formidable challenge in hydrogen storage. Addressing this challenge necessitates exploring effective storage techniques for a sustainable hydrogen economy. Solid-state hydrogen storage in nanomaterials (physically or chemically) holds promise for achieving large-scale hydrogen storage applications. Such approaches offer benefits, including safety, compactness, lightness, reversibility, and efficient generation of pure hydrogen fuel under mild conditions. This article presents solid-state nanomaterials, specifically nanoporous carbons (activated carbon, carbon fibers), metal-organic frameworks, covalently connected frameworks, nanoporous organic polymers, and nanoscale metal hydrides. Furthermore, new developments in hydrogen fuel cell technology for stationary and mobile applications have been demonstrated. The review outlines significant advancements thus far, identifies key barriers to practical implementation, and presents a perspective for future sustainable energy research. It concludes with recommendations to enhance hydrogen storage performance for cost-effective and long-lasting utilization.

Efficacy and Safety of Radiation Segmentectomy with 90Y Resin Microspheres for Hepatocellular Carcinoma.

Background Limited data are available on radiation segmentectomy (RS) for treatment of hepatocellular carcinoma (HCC) using yttrium 90 (90Y) resin microsphere doses determined by using a single-compartment medical internal radiation dosimetry (MIRD) model. Purpose To evaluate the efficacy and safety of RS treatment of HCC with 90Y resin microspheres using a single-compartment MIRD model and correlate posttreatment dose with outcomes. Materials and Methods This retrospective single-center study included adult patients with HCC who underwent RS with 90Y resin microspheres between July 2014 and December 2022. Posttreatment PET/CT and dosimetry were performed. Adverse events were assessed using the Common Terminology Criteria for Adverse Events, version 5.0. Per-lesion and overall response rates (ie, complete response [CR], objective response, disease control, and duration of response) were assessed at imaging using the Modified Response Evaluation Criteria in Solid Tumors, and overall survival (OS) was assessed using Kaplan-Meier analysis. Results Among 67 patients (median age, 69 years [IQR, 63-78 years]; 54 male patients) with HCC, median tumor absorbed dose was 232 Gy (IQR, 163-405 Gy). At 3 months, per-lesion and overall (per-patient) CR was achieved in 47 (70%) and 41 (61%) of 67 patients, respectively. At 6 months (n = 46), per-lesion rates of objective response and disease control were both 94%, and per-patient rates were both 78%. A total of 88% (95% CI: 79 99) and 72% (95% CI: 58, 90) of patients had a per-lesion and overall duration of response of 1 year or greater. At 1 month, a grade 3 clinical adverse event (abdominal pain) occurred in one of 67 (1.5%) patients. Median posttreatment OS was 26 months (95% CI: 20, not reached). Disease progression at 2 years was lower in the group that received 300 Gy or more than in the group that received less than 300 Gy (17% vs 61%; P = .047), with no local progression in the former group through the end of follow-up. Conclusion Among patients with HCC who underwent RS with 90Y resin microspheres, 88% and 72% achieved a per-lesion and overall duration of response of 1 year or greater, respectively, with one grade 3 adverse event. In patients whose tumors received 300 Gy or more according to posttreatment dosimetry, a disease progression benefit was noted. © RSNA, 2024 Supplemental material is available for this article.

Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4).

BACKGROUND: The practical application of 'virtual' (computed) fractional flow reserve (vFFR) based on invasive coronary angiogram (ICA) images is unknown. The objective of this cohort study was to investigate the potential of vFFR to guide the management of unselected patients undergoing ICA. The hypothesis was that it changes management in >10% of cases. METHODS: vFFR was computed using the Sheffield VIRTUheart system, at five hospitals in the North of England, on 'all-comers' undergoing ICA for non-ST-elevation myocardial infarction acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The cardiologists' management plan (optimal medical therapy, percutaneous coronary intervention (PCI), coronary artery bypass surgery or 'more information required') and confidence level were recorded after ICA, and again after vFFR disclosure. RESULTS: 517 patients were screened; 320 were recruited: 208 with ACS and 112 with CCS. The median vFFR was 0.82 (0.70-0.91). vFFR disclosure did not change the mean number of significantly stenosed vessels per patient (1.16 (±0.96) visually and 1.18 (±0.92) with vFFR (p=0.79)). A change in intended management following vFFR disclosure occurred in 22% of all patients; in the ACS cohort, there was a 62% increase in the number planned for medical management, and in the CCS cohort, there was a 31% increase in the number planned for PCI. In all patients, vFFR disclosure increased physician confidence from 8 of 10 (7.33-9) to 9 of 10 (8-10) (p<0.001). CONCLUSION: The addition of vFFR to ICA changed intended management strategy in 22% of patients, provided a detailed and specific 'all-in-one' anatomical and physiological assessment of coronary artery disease, and was accompanied by augmentation of the operator's confidence in the treatment strategy.

Radiology as a career among medical students of Pakistan: A cross-sectional study.

Radiology has become a fundamental constituent of the modern medicine. However, it has been observed that medical students in Pakistan often lack sufficient guidance and education in this field. This study aims to establish whether Pakistani medical students possess the requisite basic knowledge required in radiology and their attitude and perception toward radiology as a potential career path. This cross-sectional study conducted a survey among 530 medical students of Pakistan via a self-reported online questionnaire from August 01, 2021 to September 01, 2021. The data collected were analyzed using the SPSS software, along with logistic regression analyses to identify factors associated with interest in pursuing radiology as a career and possessing a comprehensive understanding of radiology among medical students. Of the 530 participants, 44.2% rated their understanding of radiology as "poor" with only 17% indicating interest to pursue a career in radiology. Logistic regression model showed significantly higher odds of radiology as a career among males (Crude odds ratio [COR] = 1.78, 95% confidence interval [CI] = 1.17-2.72, P = .007), medical students of Punjab (COR = 1.55, 95% CI = 1.01-2.40, P = .048), and those, who self-reported their knowledge of radiology as excellent (COR = 14.35, 95% CI = 5.13-40.12, P < .001). In contrast, medical students from Punjab (COR = 0.504, 95% CI = 0.344-0.737, P < .001) and second-year medical students (COR = 0.046, 95% CI = 0.019-0.107, P < .001) had lower odds of good knowledge. Our study suggests that the medical student's knowledge of radiology is deficient. Thus, it is advised that radiological societies work with medical school boards to integrate thorough and early radiology exposure into the undergraduate curriculum.

The 100 most influential papers in medical artificial intelligence; a bibliometric analysis.

Objective: To assess the current trends in the field of artificial intelligence in medicine by analysing 100 most cited original articles relevant to the field. METHODS: The bibliometric analysis was conducted in September 2022, and comprised literature search on Scopus database for original articles only. Google and Medical Subject Headings databases were used as resources to extract key words. In order to cover a broad range of articles, original studies comprising human as well as non-human subjects, studies without abstract and studies in languages other than English were part of the inclusion criteria. There was no specific time period applied to the search and no specific selection was done regarding the journals in the database. The screening was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to extract the top 100 most cited articles in the field of artificial intelligence usage in medicine. Data was analysed using SPSS 23. RESULTS: Of the 11,571 studies identified, 100(0.86%) were analysed in detail. The studies were published between 1986 and 2021, with a median of 43 citations (IQR 53) per article. The journal 'Artificial Intelligence in Medicine' accounted for the highest number 9(9%)) of articles, and the United States was the country of origin for most of the articles 36(36%). Conclusion: The trends, development and shortcomings in field of artificial intelligence usage in medicine need to be understood to conduct an effective research in areas that still need attention, and to guide the authorities to direct their funding accordingly.

Digital eye strain and its associated factors among radiology physicians in Pakistan: a cross-sectional survey using logistic regression analysis.

Background and aims: Increased use of digital devices in the modern era has led to the development of digital eye strain (DES) or computer vision syndrome in their users. This can result in the development of various ocular and visual symptoms among them. In this study, the authors aimed to view the prevalence of digital eye strain among radiology physicians in Pakistan and their associated risk factors. Materials and methods: A cross-sectional study was conducted to evaluate occupational DES among radiology physicians in Pakistan. The data collection was done using the convenience sampling technique, and the data were analyzed using IBM SPSS for Windows, Version 25.0. Results: Out of the 247 respondents, 33.6% were males and 66.4% were females. 41.7% of them were between 30 and 40 years of age and 51.8% of them were radiology residents. 52.2% of the participants had a refractive error and were using a corrective lens. The majority of the radiologists in our study (84.2%) preferred picture archiving and communication system (PACS) over films and 82.2% of them reported having breaks of less than 15 min. Major symptoms reported by the participants were tired or heavy eyes (69.6%) and headache (69.3%). The proportion of developing DES was higher in females [P=0.001, adjusted odds ratio (aOR)=2.94], radiology residents (P=0.031, aOR=3.29), and working hours of more than 4 h per day (P<0.001, aOR=0.04). Conclusion: With recent advances in the field of radiology in Pakistan, the frequency of developing DES among radiologists is increasing. Being a female, having long working hours, and having noticeable flickers on the digital screens were among the significant factors in developing DES among radiologists.

Mechanical and Durability Characterization of Hybrid Recycled Aggregate Concrete.

The recycling of construction and demolition waste (CDW) for the extraction of recycled concrete aggregates (RCAs) to be used to produce recycled aggregate concrete (RAC) is widely acknowledged internationally. However, CDW not only contains concrete debris but may also contain burnt clay bricks. The recycling of such CDW without the segregation of different components would result in recycled aggregates having different proportions of concrete and brick aggregates. The utilization of these aggregates in concrete requires a detailed investigation of their mechanical and durability properties. In this regard, the present study focused on investigating the mechanical and durability properties of hybrid recycled aggregate concrete (HRAC) made by the 100% replacing of natural aggregates with recycled brick (RBAs) and RCA in hybrid form. The partial replacement of cement with fly ash was also considered to reduce the corban footprint of concrete. An extensive experimental program was designed and carried out in two phases. In the first phase, a total of 48 concrete mixes containing coarse RBA and RCA in mono and hybrid forms were prepared and tested for their compressive strength. The test results indicated that the compressive strength of HRAC is greatly affected by the proportion of coarse RBA and RCA. In the second phase, based on the results of the first phase, eight concrete mixes with the most critical proportions of RBA and RCA in hybrid form were selected to evaluate their mechanical and durability performance. In addition, four mixes with natural aggregates were also prepared for comparison purposes. To evaluate the mechanical properties of the concrete mixes, compressive strength and modulus of rupture (MOR) tests were performed, while for the evaluation of durability properties, water absorption and behavior after exposure to aggressive conditions of acidic and brine solutions were studied. The results revealed that a 20% replacement of cement with fly ash resulted in acceptable mechanical and durability properties of HRAC intended to be used for making concrete bricks or pavers.

Phase formation and dielectric properties of MgFe2O4 nanoparticles synthesized by hydrothermal technique.

In the recent development of energy storage devices, the scientific study has demonstrated a significant interest in the applications of the magnesium iron oxide (MgFe2O4) nanoparticles. In this work, we present synthesized novel MgFe2O4 nanoparticles at different molarities (0.1-0.5 M), via hydrothermal technique. An X-ray Diffractometer was used to study the phase analysis of the prepared samples at different molarities. A pure cubic phase of the MgFe2O4 is observed at molar concentrations of 0.3 M and 0.4 M. However, the mixed phases consisting of (MgFe2O4 + Î³-Fe2O3) were also observed at 0.1 M, 0.2 M, and 0.5 M. The pure cubic MgFe2O4 nanoparticles depict the large value of crystallite size, 19.5 nm, and the lowest dislocation density and strain. The vibrating Sample Magnetometer shows the ferromagnetic nature of the pure MgFe2O4 with a high saturation magnetization. The value of saturation magnetization surged from 36.88 emu/g to 55.2 emu/g at 0.4 M concentration. The dielectric response of the materials as a function of applied frequency was studied thoroughly by using an Impedance Analyzer. The highest value of dielectric constant and low tangent loss was also reported at 0.4 M. Cole-Cole plots are the affirmation of the contribution of both grains and grain boundaries in the charge mechanism. These distinctive features make the synthesized material an excellent choice for future spintronics and energy storage devices.

Effects of prilled fat supplementation in diets with varying protein levels on production performance of early lactating Nili Ravi Buffaloes.

Objective: The objective of the current study was to find out the independent and interactive effects of prilled fat supplementation with protein on the production performance of early lactating Nili Ravi buffaloes. Methods: Sixteen early lactating buffaloes (36.75 ± 5.79 d in milk; mean ± SE) received 4 treatments in 4 × 4 Latin-square design according to 2 × 2 factorial arrangements. The dietary treatments were:1) LPLF = low protein low fat, 2) LPHF = low protein high fat, 3) HPLF = high protein low fat, and 4) HPHF = high protein high fat. The dietary treatments contained 2 protein (8.7 and 11.7% CP, crude protein) and fat levels (2.6 and 4.6% EE, ether extract) on a dry matter basis. Results: The yields of milk and fat increased with increasing protein and fat independently (p≤0.05). Energy-, protein-, and fat-corrected milk yields also increased with increasing protein and fat independently (p≤0.05). Increasing dietary protein increased the protein yield by 3.75% and lactose yield by 3.15% and increasing dietary fat supplies increased the fat contents by 3.93% (p≤0.05). Milk yield and fat-corrected milk to dry matter intake ratios were increased at high protein and high fat levels (p≤0.05). Milk nitrogen efficiency was unaffected by dietary fat (p>0.10), whereas it decreased with increasing protein supplies (p≤0.05). Plasma urea nitrogen and cholesterol were increased by increasing protein and fat levels, respectively (p≤0.05). The values of predicted methane production reduced with increasing dietary protein and fat. Conclusion: It is concluded that prilled fat and protein supplies increased milk and fat yield along with increased ratios of milk yield and fat-corrected milk yields to dry matter intake. However, no interaction was observed between prilled fat and protein supplementation for production parameters, body weight, BCS and blood metabolites. Predicted methane production decreased with increasing protein and fat levels.

The 3-component mixture of power distributions under Bayesian paradigm with application of life span of fatigue fracture.

Mixture distributions are naturally extra attractive to model the heterogeneous environment of processes in reliability analysis than simple probability models. This focus of the study is to develop and Bayesian inference on the 3-component mixture of power distributions. Under symmetric and asymmetric loss functions, the Bayes estimators and posterior risk using priors are derived. The presentation of Bayes estimators for various sample sizes and test termination time (a fact of time after that test is terminated) is examined in this article. To assess the performance of Bayes estimators in terms of posterior risks, a Monte Carlo simulation along with real data study is presented.

The palmitoylation of gasdermin D directs its membrane translocation and pore formation during pyroptosis.

Plasma membrane perforation elicited by caspase cleavage of the gasdermin D (GSDMD) N-terminal domain (GSDMD-NT) triggers pyroptosis. The mechanisms underlying GSDMD membrane translocation and pore formation are not fully understood. Here, using a proteomic approach, we identified fatty acid synthase (FASN) as a GSDMD-binding partner. S-palmitoylation of GSDMD at Cys191/Cys192 (human/mouse), catalyzed by palmitoyl acyltransferases ZDHHC5 and ZDHHC9 and facilitated by reactive oxygen species (ROS), directly mediated membrane translocation of GSDMD-NT but not full-length GSDMD (GSDMD-FL). Palmitoylation of GSDMD-FL could be induced before inflammasome activation by stimuli such as lipopolysaccharide (LPS), consequently serving as an essential molecular event in macrophage priming. Inhibition of GSDMD palmitoylation suppressed macrophage pyroptosis and IL-1ß release, mitigated organ damage, and enhanced the survival of septic mice. Thus, GSDMD-NT palmitoylation is a key regulatory mechanism controlling GSDMD membrane localization and activation, which may offer an additional target for modulating immune activity in infectious and inflammatory diseases.

Recent Trends and Advances in Additive-Mediated Composting Technology for Agricultural Waste Resources: A Comprehensive Review.

Agriculture waste has increased annually due to the global food demand and intensive animal production. Preventing environmental degradation requires fast and effective agricultural waste treatment. Aerobic digestion or composting uses agricultural wastes to create a stabilized and sterilized organic fertilizer and reduces chemical fertilizer input. Indeed, conventional composting technology requires a large surface area, a long fermentation period, significant malodorous emissions, inferior product quality, and little demand for poor end results. Conventional composting loses a lot of organic nitrogen and carbon. Thus, this comprehensive research examined sustainable and adaptable methods for improving agricultural waste composting efficiency. This review summarizes composting processes and examines how compost additives affect organic solid waste composting and product quality. Our findings indicate that additives have an impact on the composting process by influencing variables including temperature, pH, and moisture. Compost additive amendment could dramatically reduce gas emissions and mineral ion mobility. Composting additives can (1) improve the physicochemical composition of the compost mixture, (2) accelerate organic material disintegration and increase microbial activity, (3) reduce greenhouse gas (GHG) and ammonia (NH3) emissions to reduce nitrogen (N) losses, and (4) retain compost nutrients to increase soil nutrient content, maturity, and phytotoxicity. This essay concluded with a brief summary of compost maturity, which is essential before using it as an organic fertilizer. This work will add to agricultural waste composting technology literature. To increase the sustainability of agricultural waste resource utilization, composting strategies must be locally optimized and involve the created amendments in a circular economy.

Surface modification strategies for improved hemocompatibility of polymeric materials: a comprehensive review.

Polymeric biomaterials are a widely used class of materials due to their versatile properties. However, as with all other types of materials used for biomaterials, polymers also have to interact with blood. When blood comes into contact with any foreign body, it initiates a cascade which leads to platelet activation and blood coagulation. The implant surface also has to encounter a thromboinflammatory response which makes the implant integrity vulnerable, this leads to blood coagulation on the implant and obstructs it from performing its function. Hence, the surface plays a pivotal role in the design and application of biomaterials. In particular, the surface properties of biomaterials are responsible for biocompatibility with biological systems and hemocompatibility. This review provides a report on recent advances in the field of surface modification approaches for improved hemocompatibility. We focus on the surface properties of polysaccharides, proteins, and synthetic polymers. The blood coagulation cascade has been discussed and blood - material surface interactions have also been explained. The interactions of blood proteins and cells with polymeric material surfaces have been discussed. Moreover, the benefits as well as drawbacks of blood coagulation on the implant surface for wound healing purposes have also been studied. Surface modifications implemented by other researchers to enhance as well as prevent blood coagulation have also been analyzed.

Safety and efficacy of extended thrombophilia screening directed venous thromboembolic events (VTE) prophylaxis in live liver donors: do we really need extended thrombophilia screening routinely?

Background and aims: The study aimed to determine the prevalence of hereditary thrombophilia, and stratify its severity among live liver donors in Pakistan. Also, the authors evaluated the safety and efficacy of thrombophilia profile testing directed venous thromboembolic events (VTE) prophylaxis while balancing bleeding risk and the need for routine thrombophilia testing before live liver donation among living donor candidates. Materials and methods: Protein S (PS), protein C (PC), anti-thrombin (AT) III, and anti-phospholipid antibody panel (APLA) levels were measured in 567 potential donor candidates. Donors were divided into normal, borderline and high-risk groups based on Caprini score. The safety endpoints were VTE occurrence, bleeding complications or mortality. Results: Among 567 donors, 21 (3.7%) were deficient in protein C, and 14 (2.5%) were deficient in anti-thrombin-III. IgM and IgG. Anti-phospholipids antibodies were positive in 2/567 (0.4%) and 2/567 (0.4%), respectively. IgM and IgG lupus anticoagulant antibodies were positive in 3/567 (0.5%) and 3/567 (0.5%), respectively. VTE events, bleeding complications and postoperative living donors liver transplantation-related complications were comparable among the three donor groups (P>0.05). One donor in the normal donor group developed pulmonary embolism, but none of the donors in either borderline or high-risk group developed VTE. The mean length of ICU and total hospital stay were comparable. No donor mortality was observed in all donor groups. Conclusions: Due to thrombophilia testing directed VTE prophylaxis, VTE events were comparable in normal, borderline and high-risk thrombophilia donor groups, but more evaluations are required to determine the lower safe levels for various thrombophilia parameters including PC, PS and AT-III before surgery among living donor candidates.

Situation analysis of the quality of primary health care services in Pakistan.

Background: Primary health care services to promote the mental and physical health of communities include preventive, promotive, curative, general hygiene, and nutritional elements. Aim: To assess the quality of service delivery at primary healthcare settings in Punjab, Pakistan. Methods: Quantitative surveys were conducted at 106 health facilities: 92 basic health units (BHUs) and 14 rural health centres (RHCs) across Punjab in 2020. Data from the survey were supplemented with information from observations by the researchers and all data were analysed using SPSS version 25. Findings: All the 7 district health authorities surveyed had monthly targets for number of normal deliveries and the outpatient department. Systems for safe transportation and storage of medicines were deficient except in 2 districts. Anti-venom and anti-rabies vaccines were either limited or not available at most of the health units visited. Some 14% of clinical equipment examined at the BHUs and RHCs were non-functional, and no BHU had ultrasonic machines to improve the quality of antenatal care. Sterilization of surgical instruments was unsatisfactory at most health units. Several key positions at BHU and RHC were vacant. Most health units did not have fence and their main buildings were in poor condition. Conclusions: Several gaps were identified at the primary healthcare level in Punjab that need to be addressed to improve the quality of service delivery.

A DFT investigation on structural, electronic, magnetic, optical, elastic and hydrogen storage properties of Ru-based hydride-perovskites XRuH3 (X = Cr, V, Ni).

The present investigation delves into various physical properties exhibited by CrRuH3, VRuH3 and NiRuH3. Notably adopting a stable cubic configuration, both compounds manifest a distinct metallic demeanor characterized by an absolute absence of band gap. In-depth analysis through Total Density of States (TDOS) and Partial Density of States (PDOS) justify this metallic conduct by distinctly showcasing peak conductivity at the Fermi level. The materials' magnetic behavior reveals an antiferromagnetic disposition for CrRuH3 and NiRuH3, while their intrinsic attributes emerge as anisotropic and rigid. Applying Poisson's ratio (ν) and the B/G ratio, all investigated compounds show ductility, but the CrRuH3 is superior among them. The heightened values of Young's modulus, Bulk modulus, and mean shear modulus observed in CrRuH3 underscore its enhanced rigidity as compared to VRuH3 and NiRuH3. Within the optical realm, CrRuH3 displays notable optical conductivity and absorption, particularly within the lower energy spectrum. Remarkably, at 0 eV, CrRuH3 showcases elevated reflectivity and refractive index as compared to the other investigated materials. On the hydrogen storage front, XRuH3 (X = Cr, V, Ni) exhibit promising potential, yet CrRuH3 emerges as the more favorable candidate for hydrogen storage applications.