Nexus among the perceived infrastructural, social, economic, and environmental impact of CPEC: A case of Pakistan.

Despite its ambitious "economic sustainability" objectives, the China-Pakistan Economic Corridor (CPEC) has been the subject of growing environmental anxiety. Considering the CPEC developments, it is clear that Pakistan is ready to fully embrace this new industrial chapter and take advantage of its major benefits to solve social, energy, infrastructure, and economic problems. However, it should also seriously commit to undertaking proper environmental impact assessments and upgrading system resilience. Data was collected from 400 respondents from Pakistan, and structural equation modeling was applied with the help of AMOS. Factor analysis and structural equation modeling techniques were used to estimate the results and test the study's hypothesis. The results indicate a strong socio-economic impact across perceived economic, infrastructure, social, and total impacts, but they identify a negative association between infrastructure innovation and environmental sustainability. Moreover, results revealed that infrastructure supports social and economic growth, but it might have a substantial negative impact on biodiversity. According to findings, Pakistan may be more vulnerable to climate change due to three potential environmental issues: coal-fired power plants, CO2 concentration along the CPEC route, and increased traffic on the Karakorum Highway. Furthermore, future international trade will be significantly impacted by the corridor. It may, however, also accelerate the destruction of the ecosystem over time due to the industrial revolution.

Phytochemical Screening, Anti-Inflammatory, and Antidiabetic Activities of Different Extracts from Caralluma edulis Plant.

The plant Caralluma edulis is traditionally used against diabetes and inflammatory conditions in Pakistan. This study was designed to provide scientific validation of the traditional use of Caralluma edulis. Phytochemicals were extracted from the plant by different solvents (distilled water, methanol, ethanol, and acetone) using the Soxhlet's extraction method. Bioactive compounds were detected by gas chromatography-mass spectrometry (GC-MS). The in vitro anti-inflammatory activities (albumin denaturation, membrane stabilization, and proteinase inhibition) and antioxidant capacity (DPPH scavenging activity, FRAP reducing activity) of different extracts from Caralluma edulis were assessed. The antidiabetic potential of Caralluma edulis plant extracts was determined in acute and subacute diabetic rabbit models. Oxidative stress and enzymatic antioxidant status were also estimated in MDA, CAT, and SOD levels. Results showed that the methanol extract yielded the highest contents of phenolics, flavonoids, alkaloids, and terpenoids. The in vitro anti-inflammatory activity and antioxidant potential of the methanol extract were the highest among the tested solvents. The tested extracts did not show any remarkable antidiabetic activity in the acute diabetic model. However, all tested extracts demonstrated antidiabetic potential in the subacute diabetic model. No adverse effect was observed at the tested dose (200 mg/kg) of Caralluma edulis extracts in experimental animals. It is concluded that methanol is the key solvent for extracting bioactive compounds from Caralluma edulis. The plant can be used against inflammatory disorders and may prove a potential candidate for drug development. Long-term use of Caralluma edulis at the tested dose (200 mg/kg) showed antidiabetic properties in the animal model.

Melatonin regulates mitochondrial dynamics and alleviates neuron damage in prion diseases.

Prion diseases are neurodegenerative diseases associated with neuron damage and behavioral disorders in animals and humans. Melatonin is a potent antioxidant and is used to treat a variety of diseases. We investigated the neuroprotective effect of melatonin on prion-induced damage in N2a cells. N2a cells were pretreated with 10 µM melatonin for 1 hour followed by incubation with 100 µM PrP106-126 for 24 hours. Melatonin markedly alleviated PrP106-126-induced apoptosis of N2a cells, and inhibited PrP106-126-induced mitochondrial abnormality and dysfunction, including mitochondrial fragmentation and overproduction of reactive oxygen species (ROS), suppression of ATP, reduced mitochondrial membrane potential (MMP), and altered mitochondrial dynamic proteins dynamin-related protein 1 (DRP1) and optic atrophy protein 1 (OPA1). Our findings identify that pretreatment with melatonin prevents the deleterious effects of PrPSc on mitochondrial function and dynamics, protects synapses and alleviates neuron damage. Melatonin could be a novel and effective medication in the therapy of prion diseases.

The Role of the Gut Microbiota in the Pathogenesis of Parkinson's Disease.

It is well-recognized that the gut microbiota (GM) is crucial for gut function, metabolism, and energy cycles. The GM also has effects on neurological outcomes via many mechanisms, such as metabolite production and the gut-brain axis. Emerging evidence has gradually indicated that GM dysbiosis plays a role in several neurological diseases, such as Parkinson's disease (PD), Alzheimer's disease, depression, and multiple sclerosis. Several studies have observed that PD patients generally suffer from gastrointestinal disorders and GM dysbiosis prior to displaying motor symptoms, but the specific link between the GM and PD is not clearly understood. In this review, we aim to summarize what is known regarding the correlation between the GM and PD pathologies, including direct, and indirect evidence.

Corrigendum: The Role of the Gut Microbiota in the Pathogenesis of Parkinson's Disease.

[This corrects the article DOI: 10.3389/fneur.2019.01155.].

DLP1-dependent mitochondrial fragmentation and redistribution mediate prion-associated mitochondrial dysfunction and neuronal death.

Mitochondrial malfunction is a universal and critical step in the pathogenesis of many neurodegenerative diseases including prion diseases. Dynamin-like protein 1 (DLP1) is one of the key regulators of mitochondrial fission. In this study, we investigated the role of DLP1 in mitochondrial fragmentation and dysfunction in neurons using in vitro and in vivo prion disease models. Mitochondria became fragmented and redistributed from axons to soma, correlated with increased mitochondrial DLP1 expression in murine primary neurons (N2a cells) treated with the prion peptide PrP106-126 in vitro as well as in prion strain-infected hamster brain in vivo. Suppression of DLP1 expression by DPL1 RNAi inhibited prion-induced mitochondrial fragmentation and dysfunction (measured by ADP/ATP ratio, mitochondrial membrane potential, and mitochondrial integrity). We also demonstrated that DLP1 RNAi is neuroprotective against prion peptide in N2a cells as shown by improved cell viability and decreased apoptosis markers, caspase 3 induced by PrP106-126 . On the contrary, overexpression of DLP1 exacerbated mitochondrial dysfunction and cell death. Moreover, inhibition of DLP1 expression ameliorated PrP106-126 -induced neurite loss and synaptic abnormalities (i.e., loss of dendritic spine and PSD-95, a postsynaptic scaffolding protein as a marker of synaptic plasticity) in primary neurons, suggesting that altered DLP1 expression and mitochondrial fragmentation are upstream events that mediate PrP106-126 -induced neuron loss and degeneration. Our findings suggest that DLP1-dependent mitochondrial fragmentation and redistribution plays a pivotal role in PrPSc -associated mitochondria dysfunction and neuron apoptosis. Inhibition of DLP1 may be a novel and effective strategy in the prevention and treatment of prion diseases.

Rib Fixation Versus Conservative Management Of Rib Fractures In Trauma Patients.

BACKGROUND: 10-15 % of trauma patient has chest injuries. There is a paradigm shift in the last two decades towards rib fixation from conservative management. Rib fixation results in immediate pain reduction in patients. Although rib fixation shows promising results, conservative management is still preferred. METHODS: The study was carried out in CMH Lahore from Jan 2017 to March 2018. It was a Controlled Prospective study. Convenient sampling was used. 43 patients are included in the study. Patients with four or more fracture ribs were included. Patients followed at one, two and three months with spirometry/X-ray /clinical response. Rib fixation was done in 21 patients while 22 were managed conservatively. Patients were given choice of both the management options and treated as per their choice resulting in two groups. RESULTS: Mean age of patients is 51.35 years. Majority of them were males (86.05%), had haemothorax as confirmed with CT scan (69.80%) and unilateral fracture (79.10%). 7.40% have flail segment. Operative group shows statistically significant improvement in the recovery to work and less post-operative pain when compared to control group. There were no statistical differences among variables such as pre-operative severity and pain index, length of hospital stay, number of days for ventilator support and post op FEV1. There is statistically significant reduction in pneumonia (p <0.05), Acquired respiratory distress syndrome (ARDS) (p <0.05), ventilatory support greater than 1 day (p < 0.05) but there is no statistically significant reduction in. CONCLUSIONS: Rib fixation should be performed early after trauma as it decreases pain, lessens complications and facilitate early recovery to work.

Role Of Clamping Tube Thoracostomy Prior To Removal In Non-Cardiac Thoracic Trauma.

BACKGROUND: The frequently encountered thoracic trauma in surgical emergencies is a major cause of mortality and morbidity. Eighty percent of thoracic trauma can be managed by simple insertion of tube thoracostomy. Though guidelines for insertion are comprehensively explained in literature, an ideal algorithm for discontinuation is not available. A standard and safe defined protocol would eliminate hesitancy in confident removal among general surgeons. The objective of this study was to determine role of clamping trial prior to removal in terms of frequency of recurrent pneumothorax. METHODS: This study was conducted in department of Surgery Combined military hospital/Military Hospital Rawalpindi from April 2013 to March 2014. Total 180 patients with blunt or penetrating thoracic trauma were included in the study. Chest tube (28-36 Fr) was inserted in Trauma centre under strict asepsis. Tubes were then connected to under water seal for minimum six hours. Patients were randomly divided in two equal groups (90 in each). In Group A, Clamping trial was given before attempting removal while in Group B, tube was removed immediately without clamping trial. Patients of both groups were observed two hourly for development of recurrent pneumothorax. Data was analysed using SPSS-18. RESULTS: The comparison of frequency of recurrent pneumothorax in Group A (9 patients, 10%) and in Group B (4 patients, 4.5%) was not found to be statistically significant. (p-value 2.073). CONCLUSIONS: Clamping trial is unnecessary prior to removal of tube thoracostomy in blunt and penetrating non-cardiac thoracic trauma in terms of recurrent pneumothorax.

Eventration of diaphragm in adults: eleven years experience.

BACKGROUND: Eventration of diaphragm is a congenital condition in which there is absence of muscle fibers in the diaphragm while maintaining all the anatomical attachments normally. Surgical treatment is warranted in symptomatic patients so as to reduce the abnormal ascent of diaphragm. The present study was conducted to analyse the perioperative outcome of thoracotomy in adult patients with diaphragmatic eventration. METHODS: This descriptive case series was carried out in Cardiothoracic Surgery-Unit, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan. Medical records of patients operated upon for eventration from June 2002 to June 2013 were reviewed. Patients of either gender, above 16 years who were operated for symptomatic eventrtaion were included in study. All the demographic data, presenting complaints, baseline and post-postoperative dyspnea grade, forced expiratory volume at 1 second (FEV1) and forced vital capacity (FVC) were recorded on predesigned pro forma and analysed using SPSS-16. RESULTS: A total of 38 adult patients underwent surgery for diaphragmatic eventration over the past 11 years in our unit out of which 29 (76%) were males and rest of 9 (24%) were females. Mean age of patients was 41.6±13.84 years. In 31 (81.5%) patients left side was involved. Majority of patients had a dyspnea grade-3 on presentation. Preoperative dyspnoea score (MRC), FEV1 and FVC values were 2.6±0.73, 63.5±13.3 and 67.2±14.6 respectively. Pre-operative and 6-months follow-up values of dyspnoea grade, FEV1 and FVC values showed statistically significant improvement. CONCLUSION: Our study showed that adult patients with symptomatic unilateral eventration of diaphragm significantly benefit from diaphragmmatic plication.