Assessment of catalytic, antimicrobial and molecular docking analysis of starch-grafted polyacrylic acid doped BaO nanostructures.

The removal of cationic dyes from water has received a great attention of researchers considering their influence on environment and ecosystem. In current work, starch-grafted-poly acrylic acid (St-g-PAA) doped BaO nanostrucutures have been synthesized by co-precipitation approach. The aim of this research was to reduce the harmful methylene blue dye and evaluate the antibacterial activity of St-g-PAA doped BaO. XRD spectra exhibited the tetragonal structure of BaO and no variations occurred upon doping. The optical properties of St-g-PAA doped BaO have been evaluated by UV-Vis spectrophotometer. The existence of a dopant in the product was verified using EDS spectroscopy. TEM revealed the formation of cubic-shaped NPs of BaO and upon the addition of St-g-PAA, a few nanorod-like structures. The higher concentration of St-g-PAA doped BaO exhibit a remarkable reduction of methylene blue in a basic environment. Furthermore, St-g-PAA doped BaO revealed higher antimicrobial efficacy against Staphylococcus aureus in comparison to Escherichia coli. In silico studies were conducted against enoyl-[acylcarrier-protein] reductase (FabI) and beta-lactamase enzyme to evaluate the potential of both St-g-PAA and St-g-PAA doped BaO nanocomposites as their inhibitors and to rationalize their possible mode of action.

Youth Culturally adapted Manual Assisted Problem Solving Training (YCMAP) in Pakistani adolescent with a history of self-harm: protocol for multicentre clinical and cost-effectiveness randomised controlled trial.

INTRODUCTION: Suicide is a global health concern. Sociocultural factors have an impact on self-harm and suicide rates. In Pakistan, both self-harm and suicide are considered as criminal offence's and are condemned on both religious and social grounds. The proposed intervention 'Youth Culturally Adapted Manual Assisted Problem Solving Training (YCMAP)' is based on principles of problem-solving and cognitive-behavioural therapy. YCMAP is a brief, culturally relevant, scalable intervention that can be implemented in routine clinical practice if found to be effective. METHOD AND ANALYSIS: A multicentre rater blind randomised controlled trial to evaluate the clinical and cost-effectiveness of YCMAP including a sample of 652 participants, aged 12-18 years, presenting to general physicians/clinicians, emergency room after self harm or self referrals. We will test the effectiveness of 8-10 individual sessions of YCMAP delivered over 3 months compared with treatment as usual. Primary outcome measure is repetition of self-harm at 12 months. The seconday outcomes include reduction in suicidal ideation, hopelessness and distress and improvement in health related quality of life. Assessments will be completed at baseline, 3, 6, 9 and 12 months postrandomisation. The nested qualitative component will explore perceptions about management of self-harm and suicide prevention among adolescents and investigate participants' experiences with YCMAP. The study will be guided by the theory of change approach to ensure that the whole trial is centred around needs of the end beneficiaries as key stakeholders in the process. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Ethics Committee of University of Manchester, the National Bioethics Committee in Pakistan. The findings of this study will be disseminated through community workshops, social media, conference presentations and peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04131179.

Green Supply Chain Management With Sustainable Economic Growth by CS-ARDL Technique: Perspective to Blockchain Technology.

Logistics plays a major part in any country's or region's economic success. Logistics performance depends upon the trade between other countries and urbanization. Urbanization has major role in logistics performance. However, being a significant energy user, logistics has negative consequences. As the logistics performance increases, carbon emissions increase as well because of more transportation and urbanization. Logistics performance has positive effects related to trade openness which reduces carbon emissions. As a result, it is necessary to understand function of logistics from both economic and environmental standpoint. Logistics performance is affected by urbanization of any region. The dataset for this research is made up of 10 Asian nations with 550 observations from 2010 to 2018 and is based on the theoretical underpinnings of impact of population affluence and technology (IPAT) and stochastic impacts by regression on population affluence and technology (STIRPAT). After applying various tests like cointegration analysis, unit root test, cross-sectional dependence now long & short-term relation of variables is studied by Cross-sectionally augmented autoregressive distributed lag (CS-ARDL). As indicated by the discoveries, the logistic performance index (LPI) is basically effective on economic growth and carbon emissions, particularly when related to IPAT and STIRPAT. The findings are reviewed, and policy implications are offered, which say that current logistical infrastructure should be transformed to more environmentally friendly operations. Finally, the limits are acknowledged, as well as future research possibilities that should be pursued.

Toward a standard pathological and molecular characterization of recurrent glioma in adults: a Response Assessment in Neuro-Oncology effort.

Regardless of subtype, diffuse gliomas of adulthood are characterized by inexorable progression through treatment. Cancer recurrence in the context of therapy is by no means unique to gliomas. For many tumors residing outside the central nervous system (CNS), tissue-based analyses are routinely employed to document the molecular and cellular features of disease recurrence. Such interventions are inconsistently applied for gliomas, however, and lack rigorous standardization when they are. While many of the reasons underlying these discrepancies reflect pragmatic realities inherent to CNS disease, the suboptimal employment of histological and molecular assessment at recurrence nevertheless represents a missed opportunity to proactively guide patient management and increase knowledge. Herein, we address this quandary by pairing a succinct description of the histological, biological, and molecular characteristics of recurrent glioma with recommendations for how to better standardize and implement quality pathological assessment into patient management. We hope this review will prompt thoughtful revision of standard operating procedures to maximize the utility of glioma re-biopsy.

Personalized Pain Goal as an Outcome Measure in Routine Cancer Pain Assessment.

BACKGROUND: There is currently no universally accepted outcome measure in cancer pain management. The personalized pain goal (PPG) has been shown to be a relevant outcome measure. We examined its use in routine outpatient practice and compared it with the clinically important difference (CID, ≥2 points or 30%), a pain outcome measure frequently used in several clinical studies. MEASURES: Initial and follow-up clinical information of outpatients with advanced cancer pain were retrospectively reviewed. PPG response was defined as pain ≤ PPG and CID response as ≥30% or ≥2-point decrease in pain intensity at follow-up. OUTCOMES: PPG was successfully completed in 375 of 387 eligible patients (97%) with cancer pain. The median baseline PPG was three for all patients and remained unchanged at follow-up. One hundred thirty-two of 375 (35%) had a PPG response and 243 of 375 (65%) were non-responders. The odds ratio for PPG non-response was 1.01 for each milligram increase in morphine equivalent daily dose (P = 0.001), 1.46 for each point increase in the number of adjuvant analgesics (P = 0.006), 2.63 for severe pain (P = 0.002), and 2.55 for moderate depression (P = 0.006). Using PPG response as the gold standard for pain relief, the overall sensitivity and specificity of CID response were 83% and 77%, respectively. CONCLUSION: PPG was successfully completed in the vast majority of patients, suggesting its feasibility as a pain outcome measure in routine clinical practice. Higher baseline pain intensity, depression, opioid dose, and number of adjuvant analgesics were independent predictors of poor pain relief. Further research is needed to further evaluate its clinical importance in cancer pain management.

Timing of Referral and Characteristics of Uninsured, Medicaid, and Insured Patients Referred to the Outpatient Supportive Care Center at a Comprehensive Cancer Center.

CONTEXT: Low-income patients face barriers to palliative care access, which might negatively influence symptom management and advanced care planning. OBJECTIVE: Our aim was to compare time of referral and characteristics (level of symptom distress) among uninsured (indigent), low-insured (Medicaid), and insured patients presenting to our supportive care center (SCC). METHODS: We conducted a retrospective review of randomly selected 100 indigent, 100 Medicaid, and 300 insured outpatients referred during the same five-year period. We reviewed demographic and clinical characteristics including date of diagnosis of advanced cancer and of first visit to SCC, symptom assessment (Edmonton Symptom Assessment System), type and dose of opioid medication, number of total outpatient visits, and date of last contact with palliative care team. RESULTS: Among 482 evaluable patients, indigent, Medicaid, and insured patients, respectively, had mean (SD) ages of 48 (11), 50 (12), and 63 (13) years (P < 0.001); Edmonton Symptom Assessment System pain scores at first visit of 6.7 (2.5), 5.6 (3.2), and 4.9 (3.2) (P < 0.001); nonwhite race in 60%, 49%, and 25% of cases (P < 0.001); unmarried status in 68%, 64%, and 33% of cases (P < 0.001), while 63%, 87%, and 54% of patients (P < 0.001) were on opioids with median number of encounters per month of 0.6, 0.8, and 0.5 (P = 0.001). Median survival (95% CI) from first visit to last contact was 4.6 (2.8-6.2), 5.4 (3.5-7), and 5.6 (4.7-7.3) months (P = 0.036). CONCLUSION: Patients with limited or no insurance had significantly higher pain and were more frequently on opioids, younger, nonwhite, and not married. They required higher number of SCC follow-up visits. Insurance status did not affect timing of SCC referral or follow-ups at our cancer center.