Synergistic effect of Fe doping and oxygen vacancy in AgIO3 for effectively degrading organic pollutants under natural sunlight.

In this work, a series of hydrogenated Fe-doped AgIO3 (FAI-x) catalysts are synthesized for photodegrading diverse azo dyes and antibiotics. Under the irradiation of natural sunlight with a light intensity of ∼60 mW/cm2, the optimum FAI-10 exhibits a considerable rate constant for decomposing methyl orange (MO) of 0.067 min-1, about 7.4 times higher than that of AgIO3 (0.009 min-1), and 24.6% and 83.8% of MO can be decomposed over AgIO3 and FAI-10 after irradiation for 40 min. In the amplification photodegradation experiments with using 0.5 g catalyst and 400 mL MO dye solution (10 mg/L), FAI-10 possesses greatly higher photoreactivity to common semiconductors (ZnO, TiO2, In2O3 and Bi2MoO6), and the photodegradation rates over FAI-10 are 92%. Particularly, the FAI-10 shows superior stability, the activity of which remains unaltered after 8 continuous cycles. Foreign ions and water bodies have slight effect on the activity of FAI-10, but the MO degradation rates are decreased by adjusting pH values, especially when pH = 11 because of the strong electrostatic repulsion between MO and FAI-10. FAI-10 can also effectively decompose another azo dye (rhodamine B (RhB)) and diverse antibiotics (sulflsoxazole (SOX), chlortetracycline hydrochloride (CTC), tetracycline hydrochloride (TC) and ofloxacin (OFX)). The activity enhancement mechanism of FAI-10 has been systemically investigated and is ascribed to the promoted photo-absorption, charge separation and transfer efficiency, and affinity of organic pollutants, owing to the synergistic effect of Fe doping and oxygen vacancy (Ov). The photocatalytic mechanisms and process for decomposing MO are verified and proposed based on radical trapping experiments and liquid chromatography-mass spectrometry (LC-MS). This work opens an avenue for the fabrication of effective photocatalysts toward water purification.

The Effects Of Wheat Pill Poisoning (Aluminum Phosphide) Dosage On Arterial Blood Gases And Their Clinical Outcome.

OBJECTIVE: To analyse the effects of aluminum phosphide poisoning dosage on arterial blood gases and the clinical outcome. METHODS: The cross-sectional study was conducted at the intensive care unit of Mardan Medical Complex, Mardan, Pakistan, from January 2021 to May 2022, and comprised patients of either gender who had attempted suicide using aluminum phosphide. Data was collected using a predesigned questionnaire. Data was analysed using SPSS 26. RESULTS: Of the 116 patients, 42(36.2%) were males and 74(63.8%) were females. There were 75(64.65) survivors; 31(41.33) males and 44(58.66) females with overall mean age 26.30±9.45 years. There were 41(35.35%) non-survivors; 11(26.82%) males and 30(73.18) females with overall mean age 28.21±11.16 years.During hospitalisation, the non- survivors showed drastically decreased levels of all arterial blood gas paramters with severe clinical outcomes (p<0.05). As the number of aluminum phosphide pills increased, the chance of survival decreased (p<0.05). The non-survivors spent an average of 32.51±16.02 hours in hospital (range: 6-59 hours). CONCLUSIONS: Patients who ingested more aluminum phosphide pills had more abnormal arterial blood gas parameter with severe clinical outcomes. Also, they had lower chance of survival and unfavourable response to treatment.

Briumvi: a breakthrough in the treatment of relapsing multiple sclerosis: a review.

Multiple sclerosis (MS) is a chronic systemic autoimmune disorder characterized by plaques of demyelination, autoimmune inflammation, and astrocytic gliosis. The primary cells involved in the pathophysiology of MS are T cells. However, B cells have recently been implicated in the pathophysiology of the disease. Therefore, researchers have been exploring B cell therapy as an alternative treatment option for MS. B cell therapy is based on the targeted depletion of CD20-positive B cells. Rituximab, ocrelizumab, and ofatumumab are anti-CD20 antibodies already approved. Briumvi, the fourth type of anti-CD20 antibody was approved by FDA in December 2022, for the treatment of relapsing types of MS, including relapsing-remitting multiple sclerosis, active secondary progressive multiple sclerosis, and clinically isolated syndromes after the drug was tested in two randomized, double-blind, phase III, ULTIMATE I, and II trials which compared Briumvi (ublituximab) with Aubiago (teriflunomide). Ublituximab was found to have a much lower annual relapse rate in the ULTIMATE II trials than teriflunomide. Briumvi is a chimeric recombinant IgG1 monoclonal antibody directed against human CD20 with potential antineoplastic activity. Its mechanism of action involves several distinct processes that collectively lead to the depletion of B cells and suppression of the immune response. The primary mode of action of Briumvi is its high-affinity binding to CD20. Infusion-related reactions are the most common side effects encountered following intravenous administration of ublituximab.

Empathy levels among undergraduate medical students in Karachi, Pakistan: a cross-sectional study.

Empathy is a concept native to the field of medicine. However, over the course of medical school, empathy levels are expected to decline. The aim of this study was to assess the empathy levels among medical students in relation to their year of study and specialties of choice in the future. Materials and methods: A cross-sectional study was conducted to assess empathy levels among students from medical colleges in Karachi, Pakistan, using an online survey. The total duration of the study was 2 months. The authors analyzed the data using SPSS version 20. Results: A total of 463 undergraduate medical students participated in this survey. The overall mean empathy score was 101.9±16.3 with 104.6±14.1 for females, which was significantly higher than the male participants. The highest empathy levels were demonstrated in fourth-year medical students with a mean empathy score of 104.1±16.3, whereas, the lowest empathy levels were found in second-year medical students with a mean empathy score of 99.8±9.4. Study participants considering emergency medicine, neurology, obstetrics/gynecology, and oncology as their specialty of choice demonstrated the highest empathy levels followed by pediatrics and internal medicine. Conclusion: On average, there was a female preponderance in empathy levels among undergraduate medical students. Empathy levels among fourth-year students involved in clinical practice were greater as compared to students in their initial years of study. Further investigations are required to validate the findings of this study.

Priapism in children: an experience of the modified Winter procedure.

BACKGROUND: Priapism in children is a rare disease, which seldom presents during the pediatric surgery practice. It is, however, a surgical and urological emergency. Early diagnosis and prompt management can prevent the devastating sequelae of this potentially fatal condition. MATERIALS AND METHODS: A prospective study was conducted between March 1st, 2007 and February 28th, 2019 at the Department of Pediatric Surgery, Khyber Teaching hospital, Peshawar. All the patients between 3 and 15 years of age, with the diagnosis of priapism, were enrolled in the study with ethical approval. RESULTS: A total of ten patients were enrolled in the study period from March 1st, 2007 to February 28th, 2019. The age ranged between 3 and 15 years and the mean age of presentation was 8 years. The mean duration of symptoms was 4 h. The mean hospital stay was 4 days. The modified Winter procedure by creating a corporoglanular shunt was performed in all cases. Successful detumescence was achieved in eight patients, while two patients needed further detumescence and manual evacuation. Symptomatic relief was achieved in all the children. CONCLUSION: Priparism in children is a rare urological emergency that can lead to permanent erectile dysfunction if prompt medical intervention is not done. The modified Winter procedure technically is a less invasive procedure to achieve satisfactory clinical outcome in terms of achieving good erectile functions.

Oral myiasis: A known case of scar epilepsy in a 45-year-old.

Key Clinical Message: Oral myiasis (OM) is brought on by parasitic larvae that consume both living and dead tissue. Our study aims to present the possible circumstances under which people suffer from this deteriorating condition in juxtaposition to scar epilepsy. Abstract: A uncommon disease known as oral myiasis (OM) is brought on by parasitic larvae that consume both living and dead tissue. OM cases in humans are scarce, although most of those reported come from developing nations or tropical regions. This case report describes a rare larvae infestation in the oral cavity of a 45-year-old woman who had previously undergone a ventriculoperitoneal (VP) shunt procedure, convulsions, and fever. The patient presented with episodic grand-mal seizures accompanied by fever for 2 days. She is a known case of scar epilepsy and underwent VP shunting due to hydrocephalus post-meningoencephalitis 16 years ago. The patient subsequently underwent symptomatic treatment and was later diagnosed with OM during her management. Histopathology of the biopsy following wound debridement revealed invasive fungal growth causing necrosis and erosion of the buccal mucosa and palate with no evidence of malignancy. The presentation of OM is an infrequent and exclusively rare entity. Our study aims to present the possible circumstances under which people suffer from this deteriorating condition in juxtaposition to scar epilepsy. This case report highlights the significance of prompt medicinal intervention and debridement coupled with preventative measures undertaken for a better prognosis and longevity.

Effect of an antimicrobial stewardship program in the prevention of antibiotic misuse in patients with spinal cord injury undergoing minor urologic procedures: a single-group, quasi-experiment study.

BACKGROUND: Antimicrobial stewardship programs (ASPs) are an internationally recognized strategy for reducing antimicrobial resistance while maintaining patient safety. ASP activities include the restriction of broad-spectrum antibiotics, the establishment of hospital guidelines based on antibiograms, and the promotion of appropriate antibiotic use. This study aimed to determine whether the implementation of antimicrobial stewardship practices improved the effects of a peri-procedure antibiotic prophylaxis prescribed by urologists for patients with spinal cord injury/disease (SCI/D) undergoing minor urological procedures at a tertiary care hospital. METHODS: This single-group, quasi-experiment study included adult patients with SCI/D who required minor urological procedures (cystoscopy, cytobotox, cystolitholapaxy, and urodynamic study) and who were hospitalized between 2012 and 2020. RESULTS: In total, 233 patients were included in each of the pre- and post-ASP implantation groups. There was a significant reduction in antibiotic use among patients who received a pre-procedure antimicrobial prophylaxis in the post- compared to the pre-implementation group (45.9% vs. 24.46%, p < 0.0001), and there was a highly significant reduction in the post- compared to the pre-implementation group in the number who received a post-procedure prophylaxis (16.7% vs. 1.2%, p < 0.0001). CONCLUSION: ASP implementation is a highly effective strategy for reducing the use of peri-procedure antimicrobial prophylaxes in patients with SCI/D injuries undergoing minor urological procedures.

A rare case of bilateral renal angiomyolipoma: Radiological findings of tuberous sclerosis complex.

Key Clinical Message: Renal angiomyolipoma is a type of benign hamartoma that may occur sporadically or be associated with tuberous sclerosis complex. Due to their distinct appearance, CT, MRI, or sonography are typically used to diagnose AMLs. Abstract: The uncommon benign hamartoma known as renal angiomyolipoma (AML) linked with tuberous sclerosis has a poor prognosis and potentially fatal side effects. Due of their distinct appearance, computed tomography (CT), magnetic resonance imaging (MRI), or sonography are typically used to diagnose AMLs.

Budd-Chiari syndrome in myeloproliferative neoplasms: A review of literature.

Myeloproliferative neoplasms (MPNs) are defined as clonal disorders of the hematopoietic stem cell in which an exaggerated production of terminally differentiated myeloid cells occurs. Classical, Philadelphia-negative MPNs, i.e., polycythemia vera, essential thrombocythemia and primary myelofibrosis, exhibit a propensity towards the development of thrombotic complications that can occur in unusual sites, e.g., portal, splanchnic or hepatic veins, the placenta or cerebral sinuses. The pathogenesis of thrombotic events in MPNs is complex and requires an intricate mechanism involving endothelial injury, stasis, elevated leukocyte adhesion, integrins, neutrophil extracellular traps, somatic mutations (e.g., the V617F point mutation in the JAK2 gene), microparticles, circulating endothelial cells, and other factors, to name a few. Herein, we review the available data on Budd-Chiari syndrome in Philadelphia-negative MPNs, with a particular focus on its epidemiology, pathogenesis, histopathology, risk factors, classification, clinical presentation, diagnosis, and management.

Influence of access to clean fuels and technology, food production index, consumer price index, and income on greenhouse gas emissions from food system: evidence from developed countries.

Sustainable development objectives heavily promote the advancement of cleaner production technologies to reduce emissions and conserve the average world temperature. For the years 1990-2020, the USA, China, Japan, Russia, Germany, and Australia are studied by using the panel fully modified ordinary least square (FMOLS). The results show that clean fuels and technologies and a consumer price index are helpful to reduce greenhouse gas emissions from food system which reduce environmental degradation. Contrarily, increased income and food production contribute to environmental deterioration. There are bidirectional Dumitrescu-Hurlin causal relationships between access to clean fuels and technology and greenhouse gas emissions from food system; real income and greenhouse gas emissions from food system; income and access to clean fuels and technology; income and consumer price index; and income and food production index. This research also revealed a unidirectional causation between the consumer price index and greenhouse gas emissions from food system; food production index and greenhouse gas emissions from food system; access to clean fuels and technology and the consumer price index; and access to clean fuels and technology and the food production index. These findings provide policymakers with relevant content: to promote the goal of green growth, the government should implement consistent measures to subsidize the food industry. Incorporating carbon pricing into food system emissions models would serve to lower production of polluting foods, which would enhance air quality indicators. Finally, a consumer price index should be controlled by controlling prices of green technologies in environmental modeling to improve sustainable development globally and reduce environmental pollution.

UM171 cooperates with PIM1 inhibitors to restrict HSC expansion markers and suppress leukemia progression.

The pyrimido-indole derivative UM171 promotes human Hematopoietic Stem Cells Expansion (HSCE), but its impact on leukemia is not known. Herein, we show in a mouse model of erythroleukemia that UM171 strongly suppresses leukemia progression. UM171 inhibits cell cycle progression and apoptosis of leukemic cells in culture. The effect of UM171 on leukemia differentiation was accompanied by increased expression of HSCE markers. RNAseq analysis combined with Q-RT-PCR and western blotting revealed that the PIM1 protein kinase is highly elevated in response to UM171 treatment. Moreover, docking analysis combined with immunoprecipitation assays revealed high binding affinity of UM171 to PIM1. Interestingly, pan-PIM kinase inhibitors counteracted the effect of UM171 on HSCE marker expression and PIM1 transcription, but not its suppression of leukemic cell growth. Moreover, combination treatment with UM171 and a pan-PIM inhibitor further suppressed leukemic cell proliferation compared to each drug alone. To uncover the mechanism of growth inhibition, we showed strong upregulation of the cyclin-dependent kinase inhibitor P21CIP1 and the transcription factor KLF2 by UM171. In accordance, KLF2 knockdown attenuated growth inhibition by UM171. KLF2 upregulation by UM171 is also responsible for the activation of P21CIP1 in leukemic cells leading to a G1/S arrest and suppression of leukemogenesis. Thus, suppression of leukemic growth by UM171 through KLF2 and P21CIP1 is thwarted by PIM-mediated expansion of leukemic stemness, uncovering a novel therapeutic modality involving combined UM171 plus PIM inhibitors.

Impact of Cadmium Stress on Growth and Physio-Biochemical Attributes of Eruca sativa Mill.

Plants may experience adverse effects from Cadmium (Cd). As a result of its toxicity and mobility within the soil-plant continuum, it is attracting the attention of soil scientists and plant nutritionists. In this study, we subjected young Eruca sativa Mill. seedlings to different levels of Cd applications (0, 1.5, 6 and 30 µmol/L) via pot experiment to explore its morpho-physio-biochemical adaptations. Our results revealed a significant Cd accumulation in leaves at high Cd stress. It was also demonstrated that Cd stress inhibited photosynthetic rate and pigment levels, ascorbate peroxidase (APX), guaiacol peroxidase (GPX), catalase (CAT), and superoxide dismutase (SOD) enzyme activities, and increased malondialdehyde (MDA) levels. Conversely, the concentration of total ascorbate (TAS) increased at all levels of Cd application, whereas that of ascorbic acid (ASA), and dehydroascorbate (DHA) increased at 1.5 (non-significant), 6, 30 and 6 µmol/L (significant), though their concentrations decreased non-significantly at 30 µmol/L application. In conclusion, Cd-subjected E. sativa seedlings diverted much energy from growth towards the synthesis of anti-oxidant metabolites and osmolytes. However, they did not seem to have protected the E. sativa seedlings from Cd-induced oxidative stress, causing a decrease in osmotic adjustment, and an increase in oxidative damage, which resulted in a reduction in photosynthesis and growth. Accordingly, we recommend that the cultivation of E. sativa should be avoided on soil with Cd contamination.

A case of McKusick-Kaufman syndrome with perinatal diagnosis: Case report and literature review.

Introduction: and importance: McKusick-Kaufman syndrome (MKS) is a rarely reported autosomal recessive syndrome characterized by hydrometrocolpos (HMC), polydactyly and various gastrointestinal and renal manifestations. Case presentation: We present a case of suspected MKS in a prenatal ultrasound with dilated lateral ventricles of the brain and HMC. Clinical discussion: Main differential diagnosis includes Bardet-Beidel syndrome (BBS) which can present with HMC and polydactyly but retinal manifestations are a differentiating feature from MKS. Conclusion: Both of the disease syndromes are diagnosed clinically after birth.Keywords: McKusick Syndrome, Bardet-beidel syndrome, hydrometrocolpos, case report.

Rational design of highly efficient MXene-based catalysts for the water-gas-shift reaction.

Water molecules linked by hydrogen bonds are responsible for the high efficiency of bi-functional catalysts for the water-gas-shift (WGS) reaction because water can act as a proton transfer medium. Herein, we propose an associative pathway for the WGS reaction assisted by water to realize hydrogen production. Based on this pathway, we show by first-principles calculations that a large family of oxygen-terminated two-dimensional transition metal carbides and nitrides (MXenes) deposited on Au clusters are promising catalysts for the WGS reaction. Remarkably, the rate-determining barriers for *CO → *COOH on Au/Mn+1XnO2 are in the range from 0.15 eV to 0.39 eV, indicating that WGS can occur at much lower temperatures. Furthermore, a comprehensive microkinetic model is constructed to describe the turnover frequencies (TOF) for the product under the steady-state conditions. More importantly, there is a perfect linear scaling relationship between the rate-determining barriers of the WGS and the free energy of the adsorbed hydrogen. Besides, the potential energy diagrams for CO reforming reveal that the F terminations introduced in experiments have only a slight influence on the catalytic performance of the oxygen-terminated MXenes. Our work not only opens a new avenue towards the WGS reaction but also provides many ideal catalysts for hydrogen production.

A novel case of lupus nephritis and mixed connective tissue disorder in a COVID-19 patient.

Introduction: Mixed connective tissue disease (MCTD) is a rare autoimmune condition characterized by Scleroderma, Polymyositis, and Systemic Lupus Erythematous (SLE). Though a possible relationship between COVID-19 and autoimmune diseases has been recently reported, its pathophysiological mechanism behind flares in Lupus Nephritis (LN), a complication of SLE, remains unknown. Case presentation: A 22-year-old COVID-19 positive female presented with anemia, bilateral pitting edema, periorbital swelling, and posterior cervical lymphadenitis. Further inspection revealed lower abdominal striae, hepatosplenomegaly, and hyperpigmented skin nodules. Complete blood counts showed elevated inflammatory markers and excessively high protein creatinine ratio. Antinuclear antibody titers were elevated (anti-smith and U1 small nuclear ribonucleoprotein) and Rheumatoid Factor was positive. She was diagnosed with MCTD associated with a flare of LN. To control her lupus flare, a lower dose of steroids was initially administered, in addition to oral hydroxychloroquine and intravenous cyclophosphamide. Her condition steadily improved and was discharged on oral steroid maintenance medication. Discussion: We present a rare phenomenon of newly diagnosed LN, a complication of SLE, with MCTD in a PCR-confirmed COVID-19 patient. The diagnostic conundrum and treatment hurdles should be carefully addressed when patients present with lupus and COVID-19 pneumonia, with further exploration of the immuno-pathophysiology of COVID-19 infection in multi-systemic organ dysfunction in autoimmune disorders. Conclusion: In COVID-19 patients with LN and acute renal injury, it is critical to promptly and cautiously treat symptomatic flares associated with autoimmune disorders such as SLE and MCTD that may have gone unnoticed to prevent morbidity from an additional respiratory infection.

Perforated Meckel's diverticulum in neonates: a report of six cases and systematic review of the literature.

Background: Perforation of Meckel Diverticulum (MD) is a rare cause of pneumoperitoneum in neonates. We hereby report six cases of perforation of MD in neonates, with addition of 53 cases from systematic review of the literature. A systematic review was performed using Mesh terms "Neonate, Meckel Diverticulum, Perforation, Pneumoperitoneum." All reports of perforated MD in the English literature were identified. Details of our 6 cases were analyzed in similar fashion. Results: A total of 3027 manuscripts were screened and 59 cases including 6 of our own were identified. The vast majority (78%) were female. Fifty patients (84.7%) presented in the newborn period. Half of the cases (52.5%) had associated anomalies and 13 neonates (22%) required oxygen supplementation including CPAP or ventilatory support before surgery. In 73% of the cases, a resection of gut was undertaken. Histopathological assessment in 44 cases (74.6%) revealed no ectopic gastric mucosa. Three cases demised prior to treatment. The outcome in the vast majority was excellent with 84.7% surviving and discharged well. Conclusion: Perforated MD is an unusual cause of a pneumoperitoneum in the newborns. Diagnosis is established at laparotomy and it rare to find ectopic mucosa histopathologically. The overall outcome is excellent.

Residual Impact Performance of ECC Subjected to Sub-High Temperatures.

Despite the fact that the mechanical properties of Engineered Cementitious Composites (ECC) after high-temperature exposure are well investigated in the literature, the repeated impact response of ECC is not yet explored. Aiming to evaluate the residual impact response of ECC subjected to sub-high temperatures under repeated drop weight blows, the ACI 544-2R repeated impact test was utilized in this study. Disk impact specimens (150 mm diameter and 64 mm thickness) were prepared from the M45 ECC mixture but using polypropylene fibers, while similar 100 mm cube specimens and 100 × 100 × 400 mm prism specimens were used to evaluate the compressive and flexural strengths. The specimens were all cast, cured, heated, cooled, and tested under the same conditions and at the same age. The specimens were subjected to three temperatures of 100, 200 and 300 °C, while a group of specimens was tested without heating as a reference group. The test results showed that heating to 100 and 200 °C did not affect the impact resistance noticeably, where the retained cracking and failure impact numbers and ductility were higher or slightly lower than those of unheated specimens. On the other hand, exposure to 300 °C led to a serious deterioration in the impact resistance and ductility. The retained failure impact numbers after exposure to 100, 200, and 300 °C were 313, 257, and 45, respectively, while that of the reference specimens was 259. The results also revealed that the impact resistance at this range of temperature showed a degree of dependency on the compressive strength behavior with temperature.

Novel Reconstruction of Neosternum With Steel Wires for Recurrent Chondrosarcoma.

Chondrosarcoma is a primary chest wall tumor causing huge masses arising from rib, sternum, or costochondral junction. Successful treatment warrants complete surgical resection with wide, free margins followed by reconstruction of the bony chest wall and soft tissue coverage of the defect. We report the case of excision of giant recurrent sternal chondrosarcoma followed by reconstruction of neosternum using steel wires. This novel technique portrays steel wire-based reconstructions as a safe, reproducible, and readily available prosthetic material for complex chest wall surgeries.

Extracts of Euphorbia nivulia Buch.-Ham. showed both phytotoxic and insecticidal capacities against Lemna minor L. and Oxycarenus hyalinipennis Costa.

Many phytochemicals can affect the growth and development of plants and insects which can be used as biological control agents. In this study, different concentrations of crude, hexane, chloroform, butanol, and aqueous extracts of Euphorbia nivulia Buch.-Ham., an endemic plant of the Cholistan desert in South Punjab of Pakistan, were analysed for their chemical constituents. Their various concentrations were also tested for their phytotoxic and insecticidal potential against duckweed, Lemna minor L., and the dusky cotton bug, Oxycarenus hyalinipennis Costa. various polyphenols, i.e., quercetin, gallic acid, caffeic acid, syringic acid, coumaric acid, ferulic acid, and cinnamic acid were detected in different concentrations with different solvents during the phytochemical screening of E. nivulia. In the phytotoxicity test, except for 100 µg/mL of the butanol extract gave 4.5% growth regulation, no phytotoxic lethality could be found at 10 and 100 µg/mL of all the extracts. The highest concentration, 1000 µg/mL, of the chloroform, crude, and butanol extracts showed 100, 63.1, and 27.1% of growth inhibition in duckweed, respectively. In the insecticidal bioassay, the highest O. hyalinipennis mortalities (87 and 75%) were recorded at 15% concentration of the chloroform and butanol extracts of E. nivulia. In contrast, the lower concentrations of the E. nivulia extracts caused the lower mortalities. Altogether, these findings revealed that E. nivulia chloroform extracts showed significant phytotoxicity while all the extracts showed insecticidal potential. This potential can be, further, refined to be developed for bio-control agents.