Primary leiomyosarcoma of thyroid with pulmonary metastasis: A diagnostic odyssey.

The presented primary thyroid leiomyosarcoma (TL) case report underscores the importance of recognizing and addressing the diagnostic challenges and management complexities associated with this exceedingly rare malignancy. Given the limited effective therapeutic strategies available, timely intervention, thorough diagnostics, and vigilant follow-up are paramount in managing such intricate tumors. Further research focusing on molecular-based treatment modalities is imperative to improve patient outcomes in cases of primary TL.

Smoking behaviour in post-acute myocardial infarction patients: cross-sectional study.

Introduction: Heart disease remains the leading cause of death in developed countries, and cigarette smoking contributes to a significant proportion of cardiovascular-related deaths. Abstaining from tobacco use is associated with a significant reduction in the risk of recurrent myocardial infarctions. Methodology: In this cross-sectional study, 384 participants post-acute myocardial infarction (MI) were recruited through random sampling to explore the associations between smoking status and intention to quit smoking. Data collection took place over a 6-month period at a tertiary care hospital, Islamabad, Pakistan. Results: The majority of participants were male (59.9%) and fell into the age category of 46-50 years (37.5%). Heavy daily smokers comprised the largest smoking group (41.6%), and non-ST-elevated MI was the most common subtype (40.1%). Intention to quit smoking varied among participants, with the pre-contemplation stage having the highest representation (19.3%), followed by contemplation (25.8%). Notably, a significant proportion of participants expressed no intention to quit smoking (35.4%). Conclusion: Multinomial logistic regression analysis identified current smoking as a significant predictor of intention to quit in the preparation and contemplation stages. Overall, this study underscores the importance of considering smoking behaviour when evaluating the intention to quit smoking post-MI and highlights the need for tailored interventions and support strategies to address smoking cessation in this population. These findings offer valuable insights for the development of effective strategies aimed at reducing persistent smoking following MI and improving patient outcomes.

Risk of infection with arboviruses in a healthy population in Pakistan based on seroprevalence.

Infectious diseases caused by arboviruses are a public health concern in Pakistan. However, the studies on data prevalence and threats posed by arboviruses are limited. This study investigated the seroprevalence of arboviruses in a healthy population in Pakistan, including severe fever with thrombocytopenia syndrome virus (SFTSV), Crimean-Congo hemorrhagic fever virus (CCHFV), Tamdy virus (TAMV), and Karshi virus (KSIV) based on a newly established luciferase immunoprecipitation system (LIPS) assays, and Zika virus (ZIKV) by enzyme-linked immunosorbent assays (ELISA). Neutralizing activities against these arboviruses were further examined from the antibody positive samples. The results showed that the seroprevalence of SFTSV, CCHFV, TAMV, KSIV, and ZIKV was 17.37%, 7.58%, 4.41%, 1.10%, and 6.48%, respectively, and neutralizing to SFTSV (1.79%), CCHFV (2.62%), and ZIKV (0.69%) were identified, as well as to the SFTSV-related Guertu virus (GTV, 0.83%). Risk factors associated with the incidence of exposure and levels of antibody response were analyzed. Moreover, co-exposure to different arboviruses was demonstrated, as thirty-seven individuals were having antibodies against multiple viruses and thirteen showed neutralizing activity. Males, individuals aged ≤40 years, and outdoor workers had high risk of exposure to arboviruses. All these results reveal the substantial risks of infection with arboviruses in Pakistan, and indicate the threat from co-exposure to multiple arboviruses. The findings raise the need for further epidemiologic investigation in expanded regions and populations and the necessity to improve health surveillance in Pakistan.

Eco-Transformation of construction: Harnessing machine learning and SHAP for crumb rubber concrete sustainability.

Researchers have focused their efforts on investigating the integration of crumb rubber as a substitute for conventional aggregates and cement in concrete. Nevertheless, the manufacture of crumb rubber concrete (CRC) has been linked to the release of noxious pollutants, hence presenting potential environmental hazards. Rather than developing novel CRC formulations, the primary objective of this work is to construct an extensive database by leveraging prior research efforts. The study places particular emphasis on two crucial concrete properties: compressive strength (fc') and tensile strength (fts). The database includes a total of 456 data points for fc' and 358 data points for fts, focusing on nine essential characteristics that have a substantial impact on both attributes. The research employs several machine learning algorithms, including both individual and ensemble methods, to undertake a comprehensive analysis of the created databases for fc' and fts. In order to ascertain the correctness of the models, a comparative analysis of machine learning techniques, namely decision tree (DT) and random forest (RF), is conducted using statistical evaluation. Cross-validation approaches are used in order to address the possible issues of overfitting. Furthermore, the Shapley additive explanations (SHAP) approach is used to investigate the influence of input parameters and their interrelationships. The findings demonstrate that the RF methodology has superior performance compared to other ensemble techniques, as shown by its lower error rates and higher coefficient of determination (R2) of 0.87 and 0.85 for fc' and fts respectively. When comparing ensemble approaches, it can be seen that AdaBoost outperforms bagging by 6 % for both outcome models and individual decision tree learners by 17% and 21% for fc' and fts respectively in terms of performance. The average accuracy of AdaBoost algorithm for both the models is 84%. Significantly, the age and the inclusion of crumb rubber in CRC are identified as the primary criteria that have a substantial influence on the mechanical properties of this particular kind of concrete.

In-silico analysis of potential anticancer drug for NEK7 and PPP1CA proteins overexpressed in pancreatic ductal adenocarcinoma.

NIMA-related kinase 7 (NEK7) and phosphoprotein phosphatase-1 catalytic subunit alpha (PPP1CA) are the most common proteins overexpressed in pancreatic ductal adenocarcinoma, which is the most common type of pancreatic cancer. The goal of the current study was to identify a possible NEK7 and PPP1CA therapeutic inhibitor. For this investigation, 5000 compounds were retrieved from the IMPPAT library of phytochemicals, which were docked with our respective target proteins. Also, a reference compound, gemcitabine, which is a Food and Drug Administration (FDA) approved drug, was docked with the target proteins. The binding energy of the reference compound for both the targeted proteins was -6.5 kcal/mol. The common ligand with the lowest binding energy for both targets is boeravinone B (PubChem ID: 14018348) with -9.2 kcal/mol of NEK7 and -7.6 kcal/mol for PPP1CA. The compound was further investigated through density function theory (DFT) and molecular dynamic simulation analysis. The root mean square deviation (RMSD), root mean square fluctuation (RMSF), radius of gyration (Rg), and hydrogen bonding analysis indicated the stability of the boeravinone B with the target proteins (NEK7 and PPP1CA).Communicated by Ramaswamy H. Sarma.

Self-Powered Humidity Sensor Driven by Triboelectric Nanogenerator Composed of Bio-Wasted Peanut Skin Powder.

The increasing number of IoT devices has led to more electronic waste production, which harms the environment and human health. Self-powered sensor systems are a solution, but they often use toxic materials. We propose using biocompatible peanut skin as the active material for a self-powered humidity sensor (PSP-SPHS) through integration with a peanut-skin-based triboelectric nanogenerator (PSP-TENG). The PSP-TENG was characterized electrically and showed promising results, including an open circuit voltage (162 V), short circuit current (0.2 µA), and instantaneous power (2.2 mW) at a loading resistance of 20 MΩ. Peanut skin is a great choice for the sensor due to its porous surface, large surface area, eco-friendliness, and affordability. PSP-TENG was further used as a power source for the PSP-humidity sensor. PSP-SPHS worked as a humidity-dependent resistor, whose resistance decreased with increasing relative humidity (%RH), which further resulted in decreasing voltage across the humidity sensor. This proposed PSP-SPHS exhibited a good sensitivity (0.8 V/RH%), fast response/recovery time (4/10 s), along with excellent stability and repeatability, making it a potential candidate for self-powered humidity sensor technology.

Genotypic analysis of hepatitis E virus (HEV) from sporadic symptomatic cases in Pakistan.

Pakistan is the fifth most populous nation in the world and faces several challenges, including devastating floods, sub-optimal sanitary conditions, clustered accommodations, and unregulated cross-border movements. These drastic population shifts make it vulnerable to the efficient spread of the Hepatitis E virus (HEV). The current study analyzed the genotypic characteristics and variants of the Hepatitis E virus circulating in the population of Pakistan. A total of 75 ELISA-IgM positive samples were collected from three metropolitan cities: Lahore, Peshawar, and Karachi, and subjected to viral RNA extraction. The amplification of the HEV RNA-dependent RNA polymerase (RdRp) region was done using Nested PCR and degenerate primers. Out of the total, 40% of the samples were positive for HEV RNA. Sequencing and phylogenetic analysis identified the new HEV isolates as Subtype 1 g, a subtype within an existing HEV genotype 1. This shift warrants investigation into its impact on clinical manifestation and disease severity. Importantly, this study marks the first HEV subtype analysis in Pakistan, contributing valuable insights into subtype diversity and prevalence in the region.

Eco-friendly synthesis of mesoporous bioactive glass ceramics and functionalization for drug delivery and hard tissue engineering applications.

Hard tissue regenerative mesoporous bioactive glass (MBG) has traditionally been synthesized using costly and toxic alkoxysilane agents and harsh conditions. In this study, MBG was synthesized using the cheaper reagent SiO2by using a co-precipitation approach. The surface properties of MBG ceramic were tailored by functionalizing with amino and carboxylic groups, aiming to develop an efficient drug delivery system for treating bone infections occurring during or after reconstruction surgeries. The amino groups were introduced through a salinization reaction, while the carboxylate groups were added via a chain elongation reaction. The MBG, MBG-NH2, and MBG-NH-COOH were analyzed by using various techniques: x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), scanning electron microscopy and energy-dispersive x-ray spectroscopy. The XRD results confirmed the successful preparation of MBG, and the FTIR results indicated successful functionalization. BET analysis revealed that the prepared samples were mesoporous, and functionalization tuned their surface area and surface properties. Cefixime, an antibiotic, was loaded onto MBG, MBG-NH2, and MBG-NH-COOH to test their drug-carrying capacity. Comparatively, MBG-NH-COOH showed good drug loading and sustained release behavior. The release of the drug followed the Fickian diffusion mechanism. All prepared samples displayed favorable biocompatibility at higher concentration in the Alamar blue assay with MC3T3 cells and exhibited the good potential for hard tissue regeneration, as carbonated hydroxyapatite formed on their surfaces in simulated body fluid.

Nanoscale Luminescence Imaging/Detection of Single Particles: State-of-the-Art and Future Prospects.

Single-particle-level measurements, during the reaction, avoid averaging effects that are inherent limitations of conventional ensemble strategies. It allows revealing structure-activity relationships beyond averaged properties by considering crucial particle-selective descriptors including structure/morphology dynamics, intrinsic heterogeneity, and dynamic fluctuations in reactivity (kinetics, mechanisms). In recent years, numerous luminescence (optical) techniques such as chemiluminescence (CL), electrochemiluminescence (ECL), and fluorescence (FL) microscopies have been emerging as dominant tools to achieve such measurements, owing to their diversified spectroscopy principles, noninvasive nature, higher sensitivity, and sufficient spatiotemporal resolution. Correspondingly, state-of-the-art methodologies and tools are being used for probing (real-time, operando, in situ) diverse applications of single particles in sensing, medicine, and catalysis. Herein, we provide a concise and comprehensive perspective on luminescence-based detection and imaging of single particles by putting special emphasis on their basic principles, mechanistic pathways, advances, challenges, and key applications. This Perspective focuses on the development of emission intensities and imaging based individual particle detection. Moreover, several key examples in the areas of sensing, motion, catalysis, energy, materials, and emerging trends in related areas are documented. We finally conclude with the opportunities and remaining challenges to stimulate further developments in this field.

Erratum: Clinical trials landscape in lower middle-income country (Pakistan) - CORRIGENDUM.

[This corrects the article DOI: 10.1017/cts.2023.701.].

Clinical trials landscape in a lower-middle-income country (Pakistan).

In recent times, there have been calls from within the developing nations for increased ownership by governmental research bodies and universities of the priority research setting and research that aligns with national health strategies. This is a review paper of the studies that have been published on clinical trials in developing countries, with a focus mainly on Pakistan. The literature review used online databases such as PubMed, Scopus, and Google Scholar, World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov trial registries to search for clinical trials conducted in Pakistan between January 2000 and December 2022 and analyzed. The results revealed that clinical research in Pakistan is hindered by a number of barriers, including a lack of funding, skilled personnel, and regulatory issues. Lack of funding is a common obstacle, and the majority of funding for clinical trials originates from Western countries or pharmaceutical companies established in the West. In conclusion, clinical studies in developing countries, especially in Pakistan, are hindered by a plethora of barriers, and to improve the current state, increasing funding, streamlining ethical approval procedures, simplifying regulatory systems, addressing cultural and religious concerns, and participating in global efforts to bridge the gap in health-based research are crucial.

Adaptive Skid-Steering Control Approach for Robots on Uncertain Inclined Planes with Redundant Load-Bearing Mobility.

Climbing manufacturing robots can create a revolutionary manufacturing paradigm for large and complex components, while the motion control of climbing manipulation-oriented robots (CMo-Rs) is still challenging considering anti-slippage problems. In this study, a CMo-R with full-scenery climbing capability and redundant load-bearing mobility is designed based on magnetic adsorption. A four-wheel kinematic model considering the slipping phenomenon is established. An adaptive kinematic control algorithm based on slip estimation using Lyapunov theory is designed for uncertain inclined planes. For comparison, the traditional PID-based algorithm without slip consideration is implemented as well. Numeric simulations are conducted to tackle the trajectory tracking problems for both circular and linear trajectories on the horizontal plane (HP), 50° inclined plane (50° IP), 60° inclined plane (60° IP), and vertical plane (VP). The results prove that our approach achieves better tracking accuracy. It demonstrated applicability in various climbing scenarios with uncertain inclined planes. The results of experiments also validate the feasibility, applicability, and stability of the proposed approach.

Global scenario of genetic diversity in cox1 and nad1 genes of Moniezia expansa.

Monieziasis is a parasite-borne production-limiting disease of livestock. Moniezia expansa is the most important species having cosmopolitan distribution. Despite of numerous prevalence reports, very little information is available about the evolutionary biology and population genetics of M. expansa. To close this research gap, this study was undertaken to recognize and inspect the genetic variation of M. expansa populations around the world using the cox1 and nad1 genes and deduce phylogenetic relationships with M. expansa populations. The cox1 and nad1 gene sequences were downloaded from the NCBI GenBank database. Followed by sequence alignment, median-joining networks were constructed using PopArt software. Diversity and neutrality indices were computed through DnaSp software while MEGA software was used to draw the maximum-likelihood phylogenetic tree. Thirty-two cox1 sequences, from five different countries, and 9 nad1 sequences from three different countries, were among the sequences used in this study. The cox1 and nad1 gene sequences had mutations in 97 and 36 different places, respectively. Twenty and 7 unique haplotypes were discovered for the cox1 and nad1 gene sequences, respectively. Comparable haplotype diversities were observed for both the genes under study (cox1 = 0.950; nad1 = 0.944). Negative Tajima's D and Fu Fs were found for the cox1 gene while these indices were positive for the nad1 gene. Phylogenetic analysis also showed the existence of unique haplotypes for both the cox1 and nad1 genes. The results of this study indicate that there is the existence of a huge genetic diversity in M. expansa isolates. For future studies, it is recommended that longer gene sequences should be used to describe genetic variation among M. expansa isolates as the length of the gene under study affects the genetic variation. Moreover, additional mitochondrial markers should also be investigated because the assertive strength of a group of gene targets is superior to defining genetic diversity.

The effectiveness of single antibiotic paste nitrofurantoin V/S double antibiotic paste in alleviation of post-operative pain of patients suffering from symptomatic irreversible pulpitis-A randomized controlled trial.

Objective: The present research evaluated and compared effectiveness between nitrofurantoin and double antibiotic paste in alleviating post-operative pain in patients suffering from symptomatic irreversible pulpitis. Methods: There were 60 subjects enrolled who were allotted among three groups: Group 1 - Nitrofurantoin, Group 2 - double antibiotic paste, and Group 3 - Control. Succeeding access opening and chemo mechanical preparation, intracanal medicament was placed in the root canals. Using a numerical pain scale, pain scores were measured at the following time intervals: preoperative, 12, 24, 48, and 72 h. One-way ANOVA and post hoc statistical analysis were conducted, with a p-value of ⩽ considered as statistically significant. Results: Preoperatively, most patients experienced moderate to severe pain. The patients in groups 1 and 2 reported considerable reduction in their pain scores (p ⩽ 0.001) on each time interval. However, patients in group 3 experienced a higher level of pain even at 72 h. No considerable distinction was found among participant's pain scores of groups 1 and 2 (p = 0.193). Conclusion: For effective pain-relieving, both nitrofurantoin and double antibiotic paste can be successfully used in patients suffering from symptomatic irreversible pulpitis. However, when calcium hydroxide was used, patients experience high levels of pain.

Characterization of Tannic Acid-Coated AZ31 Mg Alloy for Biomedical Application and Comparison with AZ91.

Magnesium alloys are promising materials for bioresorbable implants that will improve patient life and reduce healthcare costs. However, their clinical use is prevented by the rapid degradation and corrosion of magnesium, which leads to a fast loss of mechanical strength and the formation of by-products that can trigger tissue inflammation. Here, a tannic acid coating is proposed to control the degradation of AZ31 and AZ91 alloys, starting from a previous study by the authors on AZ91. The coatings on the two materials were characterized both by the chemical (EDS, FTIR, XPS) and the morphological (SEM, confocal profilometry) point of view. Static degradation tests in PBS and electrochemical measurements in different solutions showed that the protective performances of the tannic acid coatings are strongly affected by the presence of cracks. The presence of fractures in the protective layer generates galvanic couples between the coating scales and the metal, worsening the corrosion resistance. Although degradation control was not achieved, useful insights on the degradation mechanisms of coated Mg surfaces were obtained, as well as key points for future studies: it resulted that the absence of cracks in protective coatings is of uttermost importance for novel biodegradable implants with proper degradation kinetics.

Association of adiponectin gene expression with atrial fibrillation in a Pakistani populace.

Adiponectin, an adipocytokine produced and secreted by adipose tissue, has anti-diabetic, anti-atherogenic, and anti-inflammatory properties. This case-control study was aimed to assess the expression and serum levels of adiponectin in subject suffereing from atrial fibrillation (AF). The study's subjects (n = 690) were enrolled from the Punjab Institute of Cardiology, Lahore and were grouped into control, AF without Metabolic syndrome (MetS), and AF with MetS groups. Along with the collection of demographic data, an analysis of adiponectin and biochemical parameters were performed. A highly significant difference in serum levels of adiponectin was observed among the control, AF without MetS, and AF with MetS groups (61.61 ± 45.30 ng/ml, 37.20 ± 19.46 ng/ml, 63.78 ± 61.69 ng/ml). The expression analysis of adiponectin was decreased (n-fold = Ì´ 0.30) in AF without MetS group as compared to control group (n-fold = ~ 1.16) but increased in AF with MetS group (n-fold = Ì´ 6.26). The correlation analysis revealed a highly significant positive relationship between the expression of the adiponectin gene with waist-to-hip ratio (WHR) in AF without MetS group. Whereas, serum adiponectin was negatively related to serum triglycerides (TG) in AF with MetS group. In multiple regression analysis using adiponectin expression as the dependent variable, WHR was a determinant in AF without MetS. Whereas, when serum adiponectin was used as the dependent variable, serum TG was the determinant in group AF with MetS. The present study implicates that decreased expression and serum levels of adiponectin were associated with the development of AF in which WHR and serum TG also contributed towards the onset of atrial fibrillation.

Cervical Pott's Disease Presenting As Quadriplegia in a Young Patient: A Case Report.

Cervical Pott's disease, a form of spinal tuberculosis (TB), is a significant concern in low- and middle-income countries (LMICs). Early detection and treatment are critical to preventing complications like vertebral collapse. Clinical and radiological features of cervical Pott's disease can resemble other spinal conditions, posing diagnostic challenges. We present a case of a 28-year-old female who initially presented with quadriplegia, cervical instability, and high-grade fever. Through multidisciplinary collaboration and prompt intervention, the patient was diagnosed with cord compression syndrome secondary to a cervical abscess and probable cervical Pott's disease. Anti-tuberculosis treatment (ATT) and steroids were initiated, leading to significant improvement in symptoms and disease resolution. In summary, this case underscores the diagnostic challenge of cervical Pott's disease and the importance of imaging in TB diagnosis in resource-limited settings. The positive treatment response emphasizes early intervention's significance.

Synthesis of Anisotropic Magnetic Polymeric Janus Particles by In Situ Separation of Magnetic Nanoparticles in a Microfluidic Device.

Magnetic Janus particles have been studied extensively for medical and biological applications owing to their controllable mobility in fluid media. In this work, we report a novel microfluidic device designed for the synthesis of magnetically anisotropic Janus particles made of poly(ethylene glycol) diacrylate and embedded with magnetic iron oxide nanoparticles. Our method consists of a droplet generation step followed by magnetic separation using an external magnetic field and ultraviolet polymerization. The synthesized particles exhibit a monodisperse size distribution with a standard deviation of less than 3.5%, which is among the best size distributions obtained in the literature for magnetic Janus particles. The anisotropic magnetic property of the particles enable them to rotate about their own axes in the presence of an external magnetic field, introducing another degree of freedom to their motion. This microfluidic technique is simple, one-step, and versatile, offering control over the size distribution to synthesize magnetically anisotropic Janus particles.

Factors influencing refusal of lumbar puncture in children under age 10: a cross-sectional study.

Background: This study aimed to investigate the factors associated with refusal of lumbar puncture (LP) in children aged 1-10 years who presented to a paediatric department in our hospital. Methods: A sample of parents and guardians of children who presented to the paediatric department were surveyed to gather information about their educational background and decision-making processes. Attending doctors were also interviewed using a questionnaire to gather their perspectives on the reasons for LP refusal in children. Attending doctors then tried to convince the parents or guardians to see if it changed their decision. Results: The study found that the majority of parents and guardians had a lower educational background, with over half being illiterate. Refusal of LP was seen most frequently in parents or guardians who were illiterate. The decision-making process was found to be heavily dependent on the father in a male-dominated society. Peer pressure and lack of knowledge were found to be factors that contributed to LP refusal. Conclusion: Refusal of a LP was linked to having a lower educational background and to societal influences in this cross-sectional study of children aged 1-10 years. More than half of the parents and guardians were illiterate, indicating that they had a lower level of education. Refusing LP was influenced by a number of factors, including social pressure and a lack of information. However, these obstacles were overcome thanks to the efforts of the attending doctors who dispelled myths and reassured the parents and guardians of the necessity and safety of the procedure. Possible roadblocks include a lack of financial resources and common misconceptions about LP. These results highlight the significance of addressing educational and societal factors to enhance children's healthcare.

Patient survival prediction in locally advanced cervical squamous cell carcinoma using MRI-based radiomics: retrospective cohort study.

Cervical cancer is a major health concern for women, ranking as the fourth most common cancer and a significant cause of cancer-related deaths worldwide. To enhance prognostic predictions for locally advanced cervical squamous cell carcinoma, we conducted a study utilizing radiomics features extracted from pretreatment magnetic resonance images. The goal was to predict patient survival and compare the predictive value of these features with clinical traits and the 2018 International Federation of Obstetrics and Gynecology (FIGO) staging system. In our retrospective cohort study, we included 500 patients with confirmed cervical squamous cell carcinoma ranging from FIGO stages IIB to IVA under the 2018 staging system. All patients underwent pelvic MRI with diffusion-weighted imaging before receiving definitive curative concurrent chemoradiotherapy. The results showed that the combination model, incorporating radiomics scores and clinical traits, demonstrated superior predictive accuracy compared to the widely used 2018 FIGO staging system for both progression-free and overall survival. Age was identified as a significant factor influencing survival outcomes. Additionally, primary tumour invasion stage, tumour maximal diameter, and the location of lymph node metastasis were found to be important predictors of progression-free survival, while primary tumour invasion stage and lymph node metastasis position individually affected overall survival. During the follow-up period, a portion of patients experienced disease-related deaths or tumour progression/recurrence in both sets. The radiomics-score significantly enhanced prediction ability, providing valuable insights for guiding personalized therapy approaches and stratifying patients into low-risk and high-risk categories for progression-free and overall survival. In conclusion, our study demonstrated the potential of radiomics features as a valuable addition to existing clinical tools like the FIGO staging system, offering promising advancements in managing locally advanced cervical squamous cell carcinoma.