Mid-upper arm circumference only protocol in Pakistan: missed opportunities for children suffering from severe acute malnutrition? A mixed-methods observational study.

OBJECTIVE: We investigated the missed treatment opportunities affecting programmes using mid-upper arm circumference (MUAC) as the sole anthropometric criterion for identification and monitoring of children suffering from severe acute malnutrition (SAM). DESIGN: Alongside MUAC, we assessed weight-for-height Z-score (WHZ) in children screened and treated according to the national MUAC only protocol in Pakistan. Besides, we collected parents' perceptions regarding the treatment received by their children through qualitative interviews. SETTING: Data were collected from October to December 2021 in Tando Allah Yar District, Sindh. SUBJECTS: All children screened in the health facilities (n 8818) and all those discharged as recovered (n 686), throughout the district, contributed to the study. All children screened in the community in the catchment areas of five selected health facilities also contributed (n 8459). Parents of forty-one children randomly selected from these same facilities participated in the interviews. RESULTS: Overall, 80·3 % of the SAM cases identified during community screening and 64·1 % of those identified in the health facilities presented a 'WHZ-only' diagnosis. These figures reached 93·9 % and 84·5 %, respectively, in children aged over 24 months. Among children treated for SAM and discharged as recovered, 25·3 % were still severely wasted according to WHZ. While parents positively appraised the treatment received by their children, they also recommended to extend eligibility to other malnourished children in their neighbourhood. CONCLUSION: In this context, using MUAC as the sole anthropometric criterion for treatment decisions (referral, admission and discharge) resulted in a large number of missed opportunities for children in need of timely and adequate care.

Exploring the Interplay of the CRISPR-CAS System with Antibiotic Resistance in Staphylococcus aureus: A Poultry Meat Study from Lahore, Pakistan.

Staphylococcus aureus is one of the major pathogens responsible for causing food poisoning worldwide. The emergence of antibiotic resistance in this bacterium is influenced by various factors. Among them, bacterial acquired defense systems described as clustered regularly interspaced short palindromic repeats (CRISPR)-cas system might be involved in antibiotic resistance development in bacteria. The current study was designed to assess the prevalence of S. aureus and its antibiotic resistance profile and identify the relationship of the CRISPR-cas system with antimicrobial resistance, followed by phylogenetic analysis. Total samples (n = 188) of poultry meat were collected from the poultry bird market of Lahore, Punjab, Pakistan. We used both phenotypic (antibiotic disc diffusion) and genotypic methods (PCR) to identify multi-drug resistant (MDR) strains of S. aureus. Additionally, the role of the CRISPR-Cas system in the isolated MDR S. aureus was also assessed. In addition, real-time quantitative PCR (qRT-PCR) was used to evaluate the association of the CRISPR-cas system with antimicrobial resistance. All of the S. aureus isolates showed 100% resistance against erythromycin, 97.5% were resistant to tetracycline, and 75% were resistant to methicillin. Eleven isolates were MDR in the current study. The CRISPR system was found in all MDR isolates, and fifteen spacers were identified within the CRISPR locus. Furthermore, MDR S. aureus isolates and the standard strain showed higher expression levels of CRISPR-associated genes. The correlation of said system with MDR isolates points to foreign gene acquisition by horizontal transfer. Current knowledge could be utilized to tackle antibiotic-resistant bacteria, mainly S. aureus.

Beliefs about causes of psychotic disorders and subsequent help-seeking behaviour in caregivers presenting at the Department of Psychiatry, Civil Hospital, Karachi.

OBJECTIVE: To assess the beliefs about causes of psychotic disorders and subsequent help-seeking behaviour in caregivers. Methods: The descriptive cross-sectional study was conducted at the Department of Psychiatry, Civil Hospital, Karachi, from September 2020 to February 2021, and comprised caregivers of patients with psychotic disorders. Data was collected using a questionnaire that was filled up by caregivers mentioning their beliefs about the cause of the disorder and subsequent help-seeking behaviour. Data was analysed using SPSS 22. RESULTS: Of the 162 participants, 69(42.6%) were male and 93(52.4%) were female. The overall mean age was 39.9+12.9 years. The majority 157(96.9%) subjects were Muslims. In terms of beliefs, anxious personality 62(38.3%), evil eye 62(38.3%) and God's will 56(34.6%) were the major choices picked. With respect to help-seeking behaviour, the choices most picked were taking the patient to a psychiatrist 129(79.6%), praying 108(66.6%) and taking the patient to a family physician 103(63.6%). CONCLUSIONS: There was found to be sufficient awareness among the caregivers, but help-seeking behaviour needed to improve considerably.

Distal radial fractures in adults: 4 versus 6 weeks of cast immobilisation after closed reduction, a randomised controlled trial.

PURPOSE: In this study, we aim to evaluate whether the functional outcome of Distal Radius Fractures (DRFs) could be enhanced by shortening the period of immobilisation from six weeks to four weeks. METHODS: This study is a single blinded randomised controlled trial. Four week plaster cast immobilisation was compared with six week plaster cast immobilisation in adult patients (older than 18 years) with adequately reduced DRFs. The primary outcome parameters were functional outcome measured by Quick DASH score after 1-year follow-up. Secondary outcomes were: Quick DASH after three months, 6 months, range of motion, and complications (such as number of re-interventions, secondary displacement, delayed and non-union). RESULTS: 80 patients (16 male and 64 female, mean age, 61.76 years) were included and randomized. 65 patients completed the 1-year follow-up. After 1-year follow up, no significant differences were found between the two groups in the QUICK DASH score (P = 0.55). Moreover, no significant differences in DASH Score after three and six months (P = 0.24, 0.28, respectively). The complication rate among both cohorts was almost similar, (P = 0.51). CONCLUSION: Reduction in the time of cast immobilisation in patients with DRFs in accepted position reported similar outcomes. Of note, the complication rate in the four and six weeks was also the same. Thus, 4 weeks in cast is a safe immobilisation period. Clinical Trials Number Trial registration number and date of registration for prospectively registered trials at http://ClinicalTrials.gov (NCT05012345), on 19/08/2021.

Design and Implementation of an Atmospheric Anion Monitoring System Based on Beidou Positioning.

Atmospheric oxygen anions play an important role in medical health, clinical medicine, environmental health, and the ecological environment. Therefore, the concentration of atmospheric anions is an important index for measuring air quality. This paper proposes a monitoring system for atmospheric oxygen anions based on Beidou positioning and unmanned vehicles. This approach combines Beidou positioning technology, 4G pass-through, the unmanned capacitance suction method, electromagnetic field theory, and atmospheric detection technology. The proposed instrument can monitor the overall negative oxygen ion concentration, temperature, and humidity in a certain region over time and provide data visualization for the concentration of negative oxygen ions.

Facile Solutions to the Problems Associated with Chemical Information and Mathematical Symbolism While Using Machine Translation Tools.

Advances in computer-aided translation technology have made tremendous progress in accuracy in the past few years. Chemical Abstracts Service of the American Chemical Society summarizes scientific works from more than 50 languages and allows the users to search papers in nine selected languages. Currently, only the abstracts are rendered into English by human experts or by machine translation because full text translation of millions of articles is beyond the human capacity today. An English translation of a research paper, scientific book, or patent is often required for research, data mining, and for historical purposes from various foreign languages. Many fundamental papers in chemistry, quantum chemistry, physics, and mathematics contain a significant number of chemical or mathematical equations. One of the major known problems in machine translation of such symbolically dense texts is incorrect or meaningless output. This article describes how to optimize the existing machine translation tools to read foreign language papers embedded with chemical/mathematical equations. German and French languages have been selected for illustrative purposes for English translation. Direct upload of text with extensive symbolism is possible with certain services, but this also occasionally produces erroneous rendition into English. A facile solution to the associated problems with embedded equations and mathematical formulas is replacing the equations and notations with "dummy" variables. The placeholder or dummy symbols can be removed after translation, and the original equations are substituted again. This approach, which can be automated in future, relies on the idea that chemical formulas and mathematical notations are universal. Following the guidelines in the article, excellent translations can be produced from a text having interspersed equations and chemical symbols.

Multi-Sensor Orientation Tracking for a Façade-Cleaning Robot.

Glass-façade-cleaning robots are an emerging class of service robots. This kind of cleaning robot is designed to operate on vertical surfaces, for which tracking the position and orientation becomes more challenging. In this article, we have presented a glass-façade-cleaning robot, Mantis v2, who can shift from one window panel to another like any other in the market. Due to the complexity of the panel shifting, we proposed and evaluated different methods for estimating its orientation using different kinds of sensors working together on the Robot Operating System (ROS). For this application, we used an onboard Inertial Measurement Unit (IMU), wheel encoders, a beacon-based system, Time-of-Flight (ToF) range sensors, and an external vision sensor (camera) for angular position estimation of the Mantis v2 robot. The external camera is used to monitor the robot's operation and to track the coordinates of two colored markers attached along the longitudinal axis of the robot to estimate its orientation angle. ToF lidar sensors are attached on both sides of the robot to detect the window frame. ToF sensors are used for calculating the distance to the window frame; differences between beam readings are used to calculate the orientation angle of the robot. Differential drive wheel encoder data are used to estimate the robot's heading angle on a 2D façade surface. An integrated heading angle estimation is also provided by using simple fusion techniques, i.e., a complementary filter (CF) and 1D Kalman filter (KF) utilizing the IMU sensor's raw data. The heading angle information provided by different sensory systems is then evaluated in static and dynamic tests against an off-the-shelf attitude and heading reference system (AHRS). It is observed that ToF sensors work effectively from 0 to 30 degrees, beacons have a delay up to five seconds, and the odometry error increases according to the navigation distance due to slippage and/or sliding on the glass. Among all tested orientation sensors and methods, the vision sensor scheme proved to be better, with an orientation angle error of less than 0.8 degrees for this application. The experimental results demonstrate the efficacy of our proposed techniques in this orientation tracking, which has never applied in this specific application of cleaning robots.

Is Machine Translation a Reliable Tool for Reading German Scientific Databases and Research Articles?

A significant number of published databases and research papers exist in foreign languages and remain untranslated to date. Important sources of primary scientific information in German are Beilstein Handbuch der Organischen Chemie, Gmelin Handbuch der Anorganischen Chemie, Landolt-Börnstein Zahlenwerte und Funktionen, Houben-Weyl Methoden der Organischen Chemie, fundamental research papers, and patents. Although Reaxys has acquired Beilstein and Gmelin, many original references are still in German since 1770s, and the information presented in printed and online versions is often not duplicated. To read these resources, either costly professional translation services are needed or a reading knowledge of German has to be acquired. A convenient approach is to utilize machine translation for reading German texts; however, there is a question of translation reliability. In this work, several different platforms that employ neural network for machine translation (NMT) were tested for translation capability of scientific German. From a preliminary survey, Google Translate and DeepL were finalized for further studies (German to English). Excerpts from German documents spanning more than a century have been carefully chosen from standard works. DeepL Translator and Google Translate were found to be reliable for converting German scientific literature into English for a wide variety of technical passages. As a benchmark, human and machine translations are compared for complex sentences from old literature and a recent publication. Care and intuition should be used before relying on machine translation of methods and directions in general. Reagent addition (to or from) may be inverted in some synthetic procedures using machine translations.

Prevalence of Migraine among patients of Depressive Disorder.

OBJECTIVE: To find out the prevalence of Migraine among patients of Depressive Disorder. METHODS: A descriptive cross sectional study, conducted at Department of Psychiatry and Behavioral Sciences, JPMC, Karachi from 1st January 2014 to 30th June 2014. Total 272 patients were enrolled in the study. Depressive disorder was diagnosed as per ICD-10 criteria and Migraine headache as ICHD-2 criteria for diagnosis. RESULTS: A total of 272 patients with mean age of 31.85 ± 8.7 were enrolled. Out of 272 cases 64% were females; Out of total cases 86.4% were married. Migraine with aura was seen among 6.6% and migraine without aura was present among 26.1%. Migraine was linked more with females and married and of those having severe Depressive disorder. CONCLUSION: Migraine headache is common among depressed people, particularly females and having severe depression, so it ought to be remembered that while looking for Depressive disorder or headache the other condition must be remembered.

Synthesis, biological evaluation and docking studies of 2,3-dihydroquinazolin-4(1H)-one derivatives as inhibitors of cholinesterases.

In search of potent inhibitors of cholinesterases, we have synthesized and evaluate a number of 2,3-dihydroquinazolin-4(1H)-one derivatives. The synthetic approach provided an efficient synthesis of the target molecules with excellent yield. All the tested compounds showed activity against both the enzymes in micromolar range. In many case, the inhibition of both enzymes are higher than or comparable to the standard drug galatamine. With the selectivity index of 2.3 for AChE, compound 5f can be considered as a potential lead compound with a feature of dual AChE/BChE inhibition with IC50=1.6±0.10µM (AChE) and 3.7±0.18µM (BChE). Binding modes of the synthesized compounds were explored by using GOLD (Genetic Optimization for Ligand Docking) suit v5.4.1. The computed binding modes of these compounds in the active site of AChE and BChE provide an insight into the mechanism of inhibition of these two enzyme.

Synthesis, crystal structure determination, biological screening and docking studies of N1-substituted derivatives of 2,3-dihydroquinazolin-4(1H)-one as inhibitors of cholinesterases.

Pursuing the strategy of developing potent AChE inhibitors, we attempted to carry out the N1-substitution of 2,3-dihydroquinazolin-4(1H)-one core. A set of 32 N-alkylated/benzylated quinazoline derivatives were synthesized, characterized and evaluated for their inhibition against cholinesterases. N-alkylation of the series of the compounds reported previously (N-unsubstituted) resulted in improved activity. All the compounds showed inhibition of both enzymes in the micromolar to submicromolar range. Structure activity relationship (SAR) of the 32 derivatives showed that N-benzylated compounds possess good activity than N-alkylated compounds. N-benzylated compounds 2ad and 2af were found very active with their IC50 values toward AChE in submicromolar range (0.8µM and 0.6µM respectively). Binding modes of the synthesized compounds were explored by using GOLD (Genetic Optimization for Ligand Docking) suit v5.4.1. Computational predictions of ADMET studies reveal that all the compounds have good pharmacokinetic properties with no AMES toxicity and carcinogenicity. Moreover, all the compounds are predicted to be absorbed in human intestine and also have the ability to cross blood brain barrier. Overall, the synthesized compounds have established a structural foundation for the design of new inhibitors of cholinesterase.

Frequency and pattern of common primary headache among depressed patients at tertiary care centre, Karachi.

OBJECTIVE: To determine the frequency of co-morbid common primary headaches among depressed patients. METHODS: This study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, from July to December 2014, and comprised depressed patients. Diagnosis of depressive disorder was based on diagnostic criteria of International Classification of Diseases (10th version). For the diagnosis of common primary headaches, International Classification of Headache Disorders (2nd edition) criteria were applied. SPSS 17 was used for data analysis. RESULTS: Of the 331 participants, 129(39%) were males and 202(61%) were females. The overall mean age was 31.40±8.6 years (range: 18-50 years). Besides, 208(62.83%) participants had no headache and 123(37.16%) had common primary headaches. Of the latter, 18(5.4%) had migraine with aura, 49(14.8%) had migraine without aura and 56(16.9%) had tension-type headache. Common primary headaches were more common in females and among those having severe depressive disorder. CONCLUSIONS: The primary headache was common among outpatients with depressive disorder, predominantly tension-type headache and migraine without aura.

Probing the potential of polyester for CO2 capture.

Global warming, the major environmental issue confronted by humanity today, is caused by rising level of green house gases. Carbon capture and storage technologies offer potential for tapering CO2 emission in the atmosphere. Adsorption is believed to be a promising technology for CO2 capture. For this purpose, a polyester was synthesized by polycondensation of 1,3,5-benzenetricarbonyl trichloride and cyanuric acid in pyridine and dichloromethane mixture. The polymer was then characterized using FT-IR, TGA, BET surface area and pore size analysis, FESEM and CO2 adsorption measurements. The CO2 adsorption capacities of the polyester were evaluated at a pressure of 1bar and two different temperatures (273 and 298K). The performance of these materials to adsorb CO2 at atmospheric pressure was measured by optimum CO2 uptake of 0.244 mmol/g at 273K. The synthesized polyester, therefore, has the potential to be exploited as CO2 adsorbent in pre-combustion capture process.

Follicular, luteal dynamics and effect of synchronization methods on reproductive responses in Cholistani cows.

The Cholistani cow is considered one of the milch breeds of Zebu cattle. Despite being heat and tick-resistant, it has not yet gained much popularity among Pakistan dairy farmers due to its long calving interval. This study aimed to understand the basic reproductive physiology of Cholistani cows using sonography and reproductive biotechnologies such as estrus synchronization and timed artificial insemination to improve reproductive efficiency. In experiment 1, six Cholistani cows with mixed parity 3.20 ± 1.30 and weighing 400 kg were selected to monitor ovarian dynamics on alternate days by the same sonographer from the onset of heat through ovulation until the next ovulation. Experiment 2 measured the effect of estrus synchronization methods, controlled internal drug release-gonadotropin-releasing hormone (CIDR-GnRH, n = 31) and Ovsynch (OVS, n = 32) on various reproductive parameters. The mean estrous cycle length was 19.81 ± 0.56 days with two follicular waves. The mean inter-ovulatory interval was 20.80 ± 0.52 days, with a preovulatory follicular size of 13.83 ± 2.37 mm. Estrus response was higher (p > 0.05) in controlled internal drug release (CIDR)-GnRH (93.54%) than in OVS (84.37%) cows. Similarly, ovulation and conception rates were higher in CIDR-GnRH (91.66% vs. 68.42%) than in OVS cows (41.37% vs. 33.33%), respectively. In conclusion, CIDR-GnRH results in a better estrus response, higher ovulation rate, and subsequently greater conception rate than OVS in Bos indicus dairy cows.

Low libido despite high normal testosterone levels in a male with an FSH-secreting pituitary macroadenoma.

Summary: Functioning gonadotroph adenomas with clinical manifestations are extremely rare and the majority of these are FSH-secreting macroadenomas. Clinical symptoms are due to excess gonadotrophins and sex hormones, and these may be present for a long time before the diagnosis of pituitary adenoma is made. We present the case of a 37-year-old Caucasian male with clinical manifestations of an FSH-secreting pituitary macroadenoma. He had sexual dysfunction for a year followed by bilateral testicular pain and enlargement which was initially treated as suspected recurrent epididymitis, but his symptoms did not resolve. He presented a year later with headaches and bilateral superior temporal visual field defects. Brain imaging confirmed a pituitary macroadenoma with optic chiasm compression. Pituitary profile demonstrated an unusually high FSH with high normal LH and normal testosterone level. The patient successfully underwent transsphenoidal hypophysectomy and histology confirmed gonadotroph differentiation and immunoreactivity predominantly with FSH. Gonadotrophin levels and testosterone dropped significantly after surgery, and he was started on testosterone replacement. MR imaging, 2 years post surgery, showed no recurrence of pituitary adenoma. In conclusion, testicular enlargement and hypogonadal symptoms associated with low testosterone levels are recognised features in FSH-secreting pituitary adenomas. Our patient had hypogonadal symptoms but consistently high normal testosterone levels prior to surgery. The reason for low libido despite high testosterone is unclear. Our case highlights the need to suspect such rare underlying pituitary pathology when dealing with unusual combinations of hypogonadal symptoms, testicular enlargement with low or normal testosterone levels. Learning points: Functioning pituitary adenomas that secrete excess follicle-stimulating hormone (FSH) are very rare and often present with symptoms related to pituitary mass effect. Testicular enlargement alongside sexual dysfunction are commonly reported symptoms amongst male patients. Pituitary profile results demonstrate a raised FSH level with either a low, normal, or even high testosterone level which may not always correlate to clinical symptoms. Pituitary pathology should be considered in males presenting with unusual combinations of testicular enlargement and hypogonadal symptoms even with normal testosterone levels.

Bee pollen as a food and feed supplement and a therapeutic remedy: recent trends in nanotechnology.

Pollen grains are the male reproductive part of the flowering plants. It is collected by forager honey bees and mixed with their salivary secretions, enzymes, and nectar, which form fermented pollen or "bee bread" which is stored in cells of wax honeycombs. Bee pollen (BP) is a valuable apitherapeutic product and is considered a nutritional healthy food appreciated by natural medicine from ancient times. Recently, BP has been considered a beneficial food supplement and a value-added product that contains approximately 250 different bioactive components. It contains numerous beneficial elements such as Mg, Ca, Mn, K, and phenolic compounds. BP possesses strong antioxidant, anti-inflammatory, antimicrobial, antiviral, analgesic, immunostimulant, neuroprotective, anti-cancer, and hepatoprotective properties. It is used for different purposes for the welfare of mankind. Additionally, there is a growing interest in honey bee products harvesting and utilizing for many purposes as a natural remedy and nutritive function. In this review, the impacts of BP on different organisms in different ways by highlighting its apitherapeutic efficacy are described.

A multi-objective optimisation approach with improved pareto-optimal solutions to enhance economic and environmental dispatch in power systems.

This work implements the recently developed nth state Markovian jumping particle swarm optimisation (PSO) algorithm with local search (NS-MJPSOloc) awareness method to address the economic/environmental dispatch (EED) problem. The proposed approach, known as the Non-dominated Sorting Multi-objective PSO with Local Best (NS-MJPSOloc), aims to enhance the performance of the PSO algorithm in multi-objective optimisation problems. This is achieved by redefining the concept of best local candidates within the search space of multi-objective optimisation. The NS-MJPSOloc algorithm uses an evolutionary factor-based mechanism to identify the optimum compromise solution, a Markov chain state jumping technique to control the Pareto-optimal set size, and a neighbourhood's topology (such as a ring or a star) to determine its size. Economic dispatch refers to the systematic allocation of available power resources in order to fulfill all relevant limitations and effectively meet the demand for electricity at the lowest possible operating cost. As a result of heightened public consciousness regarding environmental pollution and the implementation of clean air amendments, nations worldwide have compelled utilities to adapt their operational practises in order to comply with environmental regulations. The (NS-MJPSOloc) approach has been utilised for resolving the EED problem, including cost and emission objectives that are not commensurable. The findings illustrate the efficacy of the suggested (NS-MJPSOloc) approach in producing a collection of Pareto-optimal solutions that are evenly dispersed within a single iteration. The comparison of several approaches reveals the higher performance of the suggested (NS-MJPSOloc) in terms of the diversity of the Pareto-optimal solutions achieved. In addition, a measure of solution quality based on Pareto optimality has been incorporated. The findings validate the effectiveness of the proposed (NS-MJPSOloc) approach in addressing the multi-objective EED issue and generating a trade-off solution that is both optimal and of high quality. We observed that our approach can reduce ∼ 6.4% of fuel costs and ∼ 9.1% of computational time in comparison to the classical PSO technique. Furthermore, our method can reduce ∼ 9.4% of the emissions measured in tons per hour as compared to the PSO approach.

An integrated experimental and theoretical approach to probe Cr(vi) uptake using decorated halloysite nanotubes for efficient water treatment.

Halloysite nanotubes (HNTs) were surface functionalized using four distinct chemical moieties (amidoxime, hydrazone, ethylenediamine (EDA), and diethylenetriamine (DETA)), producing modified HNTs (H1-H4) capable of binding with Cr(vi) ions. Advanced techniques like FTIR, XRD, SEM, and EDX provided evidence of the successful functionalization of these HNTs. Notably, the functionalization occurred on the surface of HNTs, rather than within the interlayer or lumen. These decorated HNTs were effective in capturing Cr(vi) ions at optimized sorption parameters, with adsorption rates ranging between 58-94%, as confirmed by atomic absorption spectroscopy (AAS). The mechanism of adsorption was further scrutinized through the Freundlich and Langmuir isotherms. Langmuir isotherms revealed the nearest fit to the data suggesting the monolayer adsorption of Cr(vi) ions onto the nanotubes, indicating a favorable adsorption process. It was hypothesized that Cr(vi) ions are primarily attracted to the amine groups on the modified nanotubes. Quantum chemical calculations further revealed that HNTs functionalized with hydrazone structures (H2) demonstrated a higher affinity (interaction energy -26.33 kcal mol-1) for the Cr(vi) ions. This can be explained by the formation of stronger hydrogen bonds with the NH moieties of the hydrazone moiety, than those established by the OH of oxime (H1) and longer amine chains (H3 and H4), respectively. Overall, the findings suggest that these decorated HNTs could serve as an effective and cost-efficient solution for treating water pollution.

Risk Factors of Crimean-Congo Haemorrhagic Fever in Sindh Province, Pakistan.

OBJECTIVES: In Sindh Province, Pakistan, confirmed Crimean-Congo haemorrhagic fever (CCHF) increased from zero in 2008 to 16 in 2015-2016. To counter this increase, in 2016, we initiated structured CCHF surveillance to improve estimates of risk factors for CCHF in Sindh and to identify potential interventions. METHODS: Beginning in 2016, all referral hospitals in Sindh reported all CCHF cases to surveillance agents. We used laboratory-confirmed cases from CCHF surveillance from 2016 to 2020 to compute incidence rates and in a case-control study to quantify risk factors for CCHF. RESULTS: For the 5 years, CCHF incidence was 4.2 per million for the Sindh capital, Karachi, (68 cases) and 0.4 per million elsewhere. Each year, the onset of new cases peaked during the 13 days during and after the 3-day Eid-al-Adha festival, when Muslims sacrificed livestock, accounting for 38% of cases. In Karachi, livestock for Eid were purchased at a seasonal livestock market that concentrated up to 700,000 livestock. CCHF cases were most common (44%) among the general population that had visited livestock markets (odds ratio = 102). CONCLUSIONS: Urban CCHF in Sindh province is associated with the general public's exposure to livestock markets in addition to high-risk occupations.

Synergistic Interaction during Copyrolysis of Soybean Straw and Tire Waste: Improving Emissions and Product Quality.

This study explores copyrolysis of soybean straw (SS) with hydrogen-rich tire waste (TW) to enhance pyrolytic product quality and reduce pollutant emissions. Addition of TW increased SS biomass conversion from 67.19 to 72.46% and decreased coke/residue formation from 32.81 to 27.54%. The activation energy dropped to 121.84 kJ/mol from 160.73 kJ/mol (as calculated by the Kissinger-Akahira-Sunose method) and 122.78 kJ/mol from 159.76 kJ/mol (as calculated by the Ozawa-Flynn-Wall method). Thermogravimetric analysis coupled with Fourier-transform infrared spectroscopy (TG-FTIR) showed lowered CO2, NO2, and SO2 emissions (5.58, 5.72, 3.38) compared to conventional SS pyrolysis (18.38, 11.55, 12.37). Yields of value-added chemicals (phenols, olefins, aromatics) increased (32.38, 22.17, 30.18%) versus conventional SS pyrolysis (23.56, 13.78, 20.36%). Pyrolysis gas chromatography-mass spectrometry (Py/GC-MS) analysis reveals that the addition of TW leads to a decrease in the production of oxygenates and polycyclic aromatic hydrocarbons, reducing their yields to 8.96 and 7.67%, respectively, down from 19.37 and 14.37%. Simultaneously, it enhances the yields of olefins, aromatics, phenols, and aliphatic hydrocarbons to 23.38, 26.78, 26.17, and 25.78%, respectively, compared to 15.37%, 15.29, 18.36, and 17.25%, respectively, in the absence of TW. In summary, copyrolysis of TW with SS improves product quality and reduces pollutant emissions, marking a significant research contribution.