Clinical profile and management of non-tubal ectopic pregnancy: Experience from a tertiary care hospital in the United Arab Emirates (UAE).

Objective: To study the clinical profile and management outcomes of non-tubal ectopic pregnancy at a tertiary care hospital in the United Arab Emirates (UAE). Methods: Case files of non-tubal ectopic pregnancy (NTEP) patients from October 2017 to October 2020 presented to Alqasmi Women and Children's Hospital, Sharjah, were included in the study. The data was extracted from available medical records. Results: A total of 30 confirmed cases of NTEP were identified with the following break-up: caesarean scar ectopic pregnancy (n=14; 46.7%), cornual pregnancy (n=11; 36.7%), cervical pregnancy (n=3; 10%) and ovarian pregnancy n=2; 6.7%). Abdominal pain was the most common presenting symptom, present in 23 (76.7% patients) followed by vaginal bleeding in 17 (56.7%) patients. Ten women were managed medically, ten required surgical treatment, and eight were managed with combined medical and surgical treatments; Two patients were managed expectantly. Patients in each treatment strategy did well and there were no deaths. One patient in the medical treatment group developed complications after one month and underwent subtotal hysterectomy. Conclusion: Patients with NTEP were presented with varying symptoms and signs depending upon the location of NTEP. The different currently available management options for NTEP seem to be effective and safe when carefully selected based on the clinical merits of each case.

Comparison of efficacy of neoadjuvant chemotherapy with gemcitabine plus cisplatin versus docetaxil, cisplatin, plus fluorouracil in locally advanced nasopharyngeal carcinoma.

Induction followed by concurrent chemoradiation (CCRT) is the standard of care for locally advanced nasopharyngeal carcinoma (LANPC). This study evaluated and compared the efficacy of two regimens of neoadjuvant chemotherapy along with CCRT in LANPC. Patients with LANPC were randomly divided in Group I (receiving neoadjuvant gemcitabine and cisplatin) and Group II (receiving neoadjuvant docetaxil, cisplatin and fluorouracil). Both groups also received concurrent single agent (i.e., cisplatin) chemotherapy and radiotherapy (70Gy). Treatment response was assessed at 8 weeks after the completion of CCRT using RECIST criteria. A total of 68 LANPC patients were enrolled. Group I comprised of 32 patients, with male to female ratio of 2.2, a mean (range, median) age of 38.6±11.3 (19-58, 36) years. Group II comprised of 36 patients, with male to female ratio of 3.5, mean (range, median) age of 40.9 ±11.6 (17-63, 40) years. The complete response was higher whereas the partial response was lower in Group I as compared to Group II (23/32 versus 16/36 and 06/32 versus 18/36, respectively). LANPC patients receiving gemcitabine plus cisplatin based neoadjuvant chemotherapy showed higher response, as compared with docetaxil, cisplatin and fluorouracil based neoadjuvant chemotherapy.

Insight into the biochemical characterization of phytocystatin from Glycine max and its interaction with Cd+2 and Ni+2.

Phytocystatins are cysteine proteinase inhibitors ubiquitously present in plants and animals. They are known to carry out various significant physiological functions and also maintain the balance of protease-antiprotease activity. In the present disquisition, a phytocystatin after preliminary treatment has been isolated and purified to homogeneity from soybean (Glycine max) by a simple two-step stratagem using ammonium sulfate fractionation and gel filtration chromatography performed on Sephacryl S-100-HR. Soybean phytocystatin (SBPC) was purified with a fold purification of 635 and percent yield of 77.6%. A single band was observed on native gel electrophoresis confirming the homogeneity of the purified SBPC. The molecular weight of SBPC was found to be 19.05 kDa as determined by SDS-PAGE. The SBPC was found to be devoid of carbohydrate moieties and sulfhydryl group content. The binding stoichiometry of SBPC-papain interaction was determined by isothermal calorimetry suggesting 1:1 complex, and the value of binding constant (K) was found to be 2.78 × 105  M-1 The affinity of binding (Kd ) value obtained through ITC was 3.59 × 10-6  M. The purified SBPC was found to be stable in the pH range of 3 to 7 and is thermostable up to 50°C. The UV-visible and fluorescence studies showed significant changes in the conformation upon the formation of the SBPC-papain complex. Furthermore, fluorescence spectroscopy, ANS binding, and caseinolytic activity assay were conducted out to explore the effect of metal ions on SBPC which showed that there was a loss in the inhibitory activity along with conformational changes of SBPC upon complex formation with Cd+2 and Ni+2 .

Physico-chemical and in-silico analysis of a phytocystatin purified from Brassica juncea cultivar RoAgro 5444.

This study describes the isolation and purification of a phytocystatin from seeds of Brassica juncea (Indian mustard; cultivar RoAgro 5444), which is an important oilseed crop both agriculturally and economically. The protein was purified by gel filtration chromatography with 24.3% yield and 204-fold purification, and visualised by 2D gel electrophoresis. The 18.1 kDa mustard cystatin was highly specific for cysteine proteinases. The plant cystatin inhibited cathepsin B, confirming its role in conferring pest resistance. The inhibitor was highly stable over a pH range of 3-10 and retained significant inhibitory potential up to 70 °C. The stoichiometry of its interaction with papain, determined by isothermal calorimetry, suggests a 1:1 complex. Secondary structural elements calculated by far-UV circular dichroism (CD) spectroscopy show an 18.8% α-helical and 21% ß-sheet structure. The protein was a non-competitive inhibitor of thiol proteinases. The Stokes radius and frictional co-efficient were used to describe the shape and size of the protein. Homology modelling and docking studies proposed a prototype illustrating the Brassica phytocystatin mediated papain inhibition. Molecular dynamics (MD) study revealed the excellent stability of the papain-phytocystatin complex during a simulation for 100 ns. Detailed results identify the mustard cystatin as an important member of the phytocystatin family.

Toward robust and privacy-enhanced facial recognition: A decentralized blockchain-based approach with GANs and deep learning.

In recent years, the extensive use of facial recognition technology has raised concerns about data privacy and security for various applications, such as improving security and streamlining attendance systems and smartphone access. In this study, a blockchain-based decentralized facial recognition system (DFRS) that has been designed to overcome the complexities of technology. The DFRS takes a trailblazing approach, focusing on finding a critical balance between the benefits of facial recognition and the protection of individuals' private rights in an era of increasing monitoring. First, the facial traits are segmented into separate clusters which are maintained by the specialized node that maintains the data privacy and security. After that, the data obfuscation is done by using generative adversarial networks. To ensure the security and authenticity of the data, the facial data is encoded and stored in the blockchain. The proposed system achieves significant results on the CelebA dataset, which shows the effectiveness of the proposed approach. The proposed model has demonstrated enhanced efficacy over existing methods, attaining 99.80% accuracy on the dataset. The study's results emphasize the system's efficacy, especially in biometrics and privacy-focused applications, demonstrating outstanding precision and efficiency during its implementation. This research provides a complete and novel solution for secure facial recognition and data security for privacy protection.

Comparison of Efficacy of Autologous Platelet Rich Plasma Therapy With 5% Topical Minoxidil Spray in Treating Alopecia Areata: A Head-to-Head Assessment of Novel Approaches.

BACKGROUND: Alopecia areata (AA) remains one of the most challenging afflictions encountered in dermatology clinics. It is characterized by an autoimmune-mediated inflammatory process of and around hair follicles, causing reversible, non-scarring hair loss. With the ongoing search for optimal treatment strategies, the potentially positive role of autologous platelet-rich plasma (PRP) therapy as well as minoxidil has been reported in various studies; however, the comparison of the two treatment modalities is largely underexplored. This research aims to compare and assess the effectiveness of intralesional PRP with topical minoxidil therapy in AA to identify efficacious management options amongst the newly described treatment modalities. METHODOLOGY: The research work was conducted over four months and included 40 (31 males and 9 females) patients suffering from alopecia areata. They were divided into Group A, which was administered monthly autologous PRP injections, while Group B was given daily topical 5% minoxidil therapy. In group A, four treatments of PRP were given, each one month apart. While in group B, daily topical minoxidil spray was administered for the same duration. The alopecia areata severity grade was recorded by employing the "Severity of Alopecia Tool" (SALT) scoring system. The pre- and post-treatment SALT scores were noted and compared at each monthly visit. RESULTS: The study comprised nine (22.5%) female and 31 (77.5%) male patients. At the beginning of the study and after one month of treatment, the difference in the SALT score was not statistically significant between the two groups, suggesting that both interventions had similar effects during the early stages of the treatment. At two months, a statistically significant difference emerged (p-value 0.037), indicating that a more significant fall in the SALT score was observed with autologous PRP treatment compared to topical minoxidil. After four months, a highly significant difference was noted between the two groups (p-value <0.0001), implying that intralesional PRP therapy led to a far more significant decrease in the SALT score compared to topical minoxidil therapy. CONCLUSION: Monthly intralesional autologous PRP therapy for four months manifests better outcomes in alopecia areata than daily 5% topical minoxidil therapy.

Idiopathic gastroparesis: case report and literature review of diagnostic and treatment modalities.

Gastroparesis is a disorder characterized by a delay in gastric emptying of a meal in the absence of a mechanical gastric outlet obstruction. The most common etiologies include diabetes, postsurgical and idiopathic. Idiopathic Gastroparesis is at least as common as diabetic Gastroparesis in most case series. Diagnosis of Gastroparesis is based on the presence of symptoms such as nausea, vomiting, postprandial abdominal fullness, and on an objectively determined delay in gastric emptying. The true prevalence of Gastroparesis is unknown. Gastric emptying can be assessed by scintigraphy and stable isotope breath tests. Management of Gastroparesis consists of dietary and lifestyle measures, possible pharmacological interventions (prokinetics, antiemetics, intrapyloric botulinum toxin injection) and/or interventions that focus on adequate nutrient intake either through a nasoduodenal tube, percutaneous gastrostomy, or jejunostomy. New advances in drug therapy and gastric electrical stimulation techniques have been introduced and might provide new hope to patients. Presented here is an interesting case of idiopathic Gastroparesis along with its management and review of the literature.

Climate risk, natural resources, and climate change mitigation options in BRICS: implications for green recovery.

The study tests the dynamic nexus between climate risk, natural resource exploration strategy in BRICS economies, and climate change mitigation. The study further extended the research aim and presented the recommendations for greening the globe by suggesting green recovery. Climate change protection and climate risk reduction may be efficiently funded using climate risks and natural resources. Still, it is vital to look at the carbon risk in BRICS countries as an example. The researchers used the GMM analysis technique to infer the study findings. According to the study's findings, environmental mitigation was significant at 17%, and financial strength and carbon risks were significant at 22.0%. In addition, the 20.5% association between climate risks and environmental drift in the BRICS nations highlights climate change concerns. A state's financial strength is essential to execute green economic recovery strategies, one of the most highly regarded measures to reducing climate change and guaranteeing long-term economic status at the national level. As a result of the study on green economic growth, decision-makers are provided with specific policy recommendations.

The Global Dilemma of Soil Legacy Phosphorus and Its Improvement Strategies under Recent Changes in Agro-Ecosystem Sustainability.

Phosphorus (P) is one of the six key elements in plant nutrition and effectively plays a vital role in all major metabolic activities. It is an essential nutrient for plants linked to human food production. Although abundantly present in both organic and inorganic forms in soil, more than 40% of cultivated soils are commonly deficient in P concentration. Then, the P inadequacy is a challenge to a sustainable farming system to improve the food production for an increasing population. It is expected that the whole world population will rise to 9 billion by 2050 and, therefore, it is necessary at the same time for agricultural strategies broadly to expand food production up to 80% to 90% by handling the global dilemma which has affected the environment by climatic changes. Furthermore, the phosphate rock annually produced about 5 million metric tons of phosphate fertilizers per year. About 9.5 Mt of phosphorus enters human food through crops and animals such as milk, egg, meat, and fish and is then utilized, and 3.5 Mt P is physically consumed by the human population. Various new techniques and current agricultural practices are said to be improving P-deficient environments, which might help meet the food requirements of an increasing population. However, 4.4% and 3.4% of the dry biomass of wheat and chickpea, respectively, were increased under intercropping practices, which was higher than that in the monocropping system. A wide range of studies showed that green manure crops, especially legumes, improve the soil-available P content of the soil. It is noted that inoculation of arbuscular mycorrhizal fungi could decrease the recommended phosphate fertilizer rate nearly 80%. Agricultural management techniques to improve soil legacy P use by crops include maintaining soil pH by liming, crop rotation, intercropping, planting cover crops, and the consumption of modern fertilizers, in addition to the use of more efficient crop varieties and inoculation with P-solubilizing microorganisms. Therefore, exploring the residual phosphorus in the soil is imperative to reduce the demand for industrial fertilizers while promoting long-term sustainability on a global scale.

Thinking beyond the obvious: hepatotoxicity secondary to idiosyncratic depakote toxicity.

Depakote-induced hepatotoxicity has been well established as an adverse effect, and periodic monitoring of drug level is often required. Depakote-induced hepatotoxicity mostly occurs at supratherapeutic drug level. Rarely, an idiosyncratic response is triggered, and hepatotoxicity can occur at the therapeutic drug level mostly in chronic users. Here, we describe a rare case of idiosyncratic depakote-induced hepatotoxicity. A 25-year-old female with non-insulin-dependent diabetes mellitus, hypothyroidism, seizure disorder, and Dandy Walker Syndrome presented with an unwitnessed seizure and altered mental status. The patient's medication list included zonisamide, depakote, and synthroid. She was noted to be lethargic, disoriented, nonverbal, but awake. An arterial blood gas examination showed severe anion gap metabolic acidosis. Blood work was consistent with hepatitis, hyperammonemia, thrombocytopenia, and coagulopathy. The Depakote level was therapeutic. Head computed tomography and liver ultrasound results were not significant. After ruling out all other causes and seeing improvement of parameters after the drug was discontinued, idiosyncratic depakote toxicity was diagnosed. Based on the patient's rapid improvement; idiosyncratic valproate toxicity was confirmed. This case signifies the importance of recognizing, diagnosing, and treating depakote toxicity in chronic users who have no other explanation for their symptomatology.

Employees' Green Enterprise Motivation and Green Creative Process Engagement and Their Impact on Green Creative Performance.

Based on the recent surge in environmental degradation issues mainly caused by the manufacturing industry and the inadequacy of the measures taken to respond to them, this research focuses on investigating whether employees' motivation to protect the natural environment leads to their green creative performance (GCP) at work. It also examines the role of green creative process engagement (GCPE) as a mediator between green motivation (GM) and GCP. Structural equation modeling (SEM) is used to examine the hypotheses which indicated that employees' GCP appears to be significantly influenced by their GM. Moreover, GCPE is also found to act as a mediating factor between the two. Moreover, industry type and gender are found to play significant roles in the studied variables. The current research is among the pioneer studies that focus on involving employees in the pro-environmental creative process through green motivation, leading towards GCP, an essential element for achieving the United Nations Sustainable Development Goals. The study's findings can help companies promote GCP to solve today's most pressing environmental issues and achieve sustainable development goals.

Comparison of Efficacy of Platelet-Rich Plasma (PRP) With PRP Microneedling in Androgenetic Alopecia.

Background Limited data are available on the efficacy of platelet-rich plasma (PRP) and microneedling versus PRP alone. In this study, we aimed to compare the efficacy of PRP and microneedling with PRP alone in androgenetic alopecia (AGA). Methodology This prospective, randomized, interventional study was conducted in Pak-Emirates Military Hospital, Rawalpindi, from September 2020 to December 2020. In total, 60 individuals suffering from AGA of up to Hamilton-Norwood grade 4 were randomly assigned to two groups, namely, PRP+microneedling versus PRP alone. A total of three sessions, each one month apart, were offered. Pre and post-intervention photographs, hair count (/cm2), hair-pull test, and physician's and patient's perception of hair loss were recorded. The data were statistically analyzed. Results A greater proportion of patients in the microneedling group achieved a negative hair-pull test and improved perception of hair loss compared to the PRP-alone group (82.1% vs. 51.9% and 88.0% vs. 73.9%, respectively). The percentage increase in mean hair count in the microneedling group (24.53 ± 9.49%) was significantly higher than the increase in the PRP-alone group (17.88 ± 10.15%) (p = 0.011). For grades 2 and 3 hair loss, microneedling+PRP caused a much greater increase in hair count than PRP alone. This difference was less pronounced for Norwood grade 4. No notable side effects were noted in any patient. Conclusions Combined PRP and microneedling is more efficacious than PRP alone in patients with AGA up to Hamilton-Norwood grade 4.

Diet impacts on the biological aspects of pink bollworm, Pectinophora gossypiella (Lepidoptera: Gelechiidae) under controlled laboratory conditions.

BACKGROUND: Pink bollworm, Pectinophora gossypiella (Lepidoptera: Gelechiidae) is a native pest of Asia and preferably invasion on cotton (Gossypium hirsutum L.) crop as a commendatory host plant. Commercially, G. hirsutum is known as white gold and is an important cash crop all over the globe. Limited studies were published to focus on certain dietary compositions against different cotton pests. Therefore, the present study was undertaken in the laboratory under controlled conditions (temperature: 27 ± 2°C and relative humidity: 60 ± 10%) to determine the impact of three different treatment diets (wheat germ meal, okra, and chickpea) on the biological aspects (lifetime, developmental period) of P. gossypiella. RESULTS: Results revealed that the shortest larval time of P. gossypiella was observed on the okra feed diet while the longest period was recorded on the wheat germ diet. Meanwhile, the pupation delay was noted on the wheat germ diet. The dietary influence was also observed on adult stages of female and male P. gossypiella (43.00 and 37.50 days respectively) and compared with a standard diet (56.50 and 52.50 days respectively). Furthermore, larval weighed more on the okra and chickpea diet followed by the wheat germ diet, whereas highest pupal weight was observed on the standard diet followed by the chickpea diet and okra diet. CONCLUSION: Developmental parameters were significantly variant across all treatment diets, whereas the higher significant difference was reported on the okra diet. Therefore, the existing data of this study offers fruitful interventions for the future as a modified diet for large-scale and rapid mass production of P. gossypiella larvae.

Thermochemistry of radicals and molecules relevant to atmospheric chemistry: determination of group additivity values using G3//B3LYP theory.

Thermochemistry of radicals is not as extensively tabulated as that of stable molecular species, even when group additivity schemes are applied. When these radicals contain oxygen or nitrogen atoms, the availability of radical groups is even more limited. Many oxygen- and nitrogen-containing radicals and molecules are present in the atmosphere, and thermochemistry is a valuable component of the development of atmospheric models with predictive capabilities. This paper presents quantum chemical calculations using G3//B3LYP that have been performed to obtain heats of formation, entropies, and heat capacities as a function of the temperature of radicals and molecules from which group additivity values were obtained. Isodesmic and homodesmotic reactions were used to obtain improved estimates of the heats of formation. Thermodynamic property estimates were corrected to account for internal rotations. A total of 323 molecules were studied from which a total of 122 different groups, 21 gauche and cis corrections, and 5 secondary corrections were regressed.

In-sights into the effect of heavy metal stress on the endogenous mustard cystatin.

Phytocystatins have been ascribed several protective roles against abiotic and biotic stress conditions. It was, therefore, thought worthwhile to document the effect of heavy metal stress on the endogenous plant cystatin. The mustard cystatin, purified from Brassica juncea (B. juncea) seeds retained its functional property of cysteine proteinase inhibition, despite exposure to high concentrations of metal ions, Cd2+ and Ni2+. An increase in inhibitory activity, ∼26% for Ni2+ and ∼16% for Cd2+ was observed, suggesting changes in protein conformation upon metal ion interaction. Isothermal calorimetric (ITC) studies show formation of a 1:1 binary complex on interaction with both metal ions but suggest a higher affinity for Ni2+. Fluorescence quenching data suggest a static quenching mechanism of interaction. Various spectroscopic analyses, namely, synchronous fluorescence, ANS fluorescence, far UV CD and ATR-FTIR spectroscopy show that the native mustard cystatin acquires a more ordered conformation upon interaction with metal ions. Differential Scanning Calorimetry indicates that the thermo-stability of the Ni2+ bound protein (Tm=109.4°C) is greater than both, the Cd2+ bound (Tm=104.5°C) and the native (Tm=99.5°C) forms. The B. juncea seed cystatin, is thus, identified as a potent and resilient member of the phytocystatin family with considerable inhibitory capacity despite exposure to heavy metal stress.