Predictors of mortality after craniotomy for geriatric traumatic brain injury.

BACKGROUND: With a sustained increase in the proportion of elderly trauma patients, geriatric traumatic brain injury (TBI) is a significant source of morbidity, mortality and resource utilization. The aim of our study was to assess the predictors of mortality in geriatric TBI patients who underwent craniotomy. METHODS: We performed a 4-year analysis of ACS-TQIP database (2016-2019) and included all geriatric trauma patients (≥65y) with isolated severe TBI who underwent craniotomy. We calculated 11- point modified frailty index (mFI) for patients. Our primary and secondary outcomes were mortality and unfavorable outcome, respectively. Multivariate regression analysis was performed to identify the predictors of outcomes. Patients with mFI ≥ 0.25 were defined as Frail, whereas patient with mFI of 0.08 or higher (<0.25) were identified as pre-frail; Non-frail patients were identified as mFI of <0.08. RESULTS: We analyzed data from 20,303 patients. The mortality rate was 17.7 % (3,587 patients). Having ≥ 2 concomitant types of intra-cranial hemorrhage (OR = 2.251, p < 0.001), and pre-hospital anticoagulant use (OR = 1.306, p < 0.001) increased the risks of mortality. Frailty, as a continuous variable, was not considered as a risk factor for mortality (p = 0.058) but after categorization, it was shown that compared to non-frails, patients with pre-frailty (OR = 1.946, p = 0.011) and frailty (OR = 1.786, p = 0.026) had increased risks of mortality. Higher mFI (OR = 4.841), age (OR = 1.034), ISS (OR = 1.052), having ≥ 2 concomitant types of intra-cranial hemorrhage (OR = 1.758), and use of anticoagulants (OR = 1.117) were significant risk factors for unfavorable outcomes (p < 0.001, for all). CONCLUSIONS: Having more than two types of intra-cranial hemorrhage and pre-hospital anticoagulant use were significant risk factors for mortality. The study's findings also suggest that frailty may not be a sufficient predictor of mortality after craniotomy in geriatric patients with TBI. However, frailty still affects the discharge disposition and favorable outcome. LEVEL OF EVIDENCE: Level III retrospective study.

Integrative Genomics and Bioactivity-Guided Isolation of Novel Antimicrobial Compounds from Streptomyces sp. KN37 in Agricultural Applications.

Actinomycetes have long been recognized as an important source of antibacterial natural products. In recent years, actinomycetes in extreme environments have become one of the main research directions. Streptomyces sp. KN37 was isolated from the cold region of Kanas in Xinjiang. It demonstrated potent antimicrobial activity, but the primary active compounds remained unclear. Therefore, we aimed to combine genomics with traditional isolation methods to obtain bioactive compounds from the strain KN37. Whole-genome sequencing and KEGG enrichment analysis indicated that KN37 possesses the potential for synthesizing secondary metabolites, and 41 biosynthetic gene clusters were predicted, some of which showed high similarity to known gene clusters responsible for the biosynthesis of antimicrobial antibiotics. The traditional isolation methods and activity-guided fractionation were employed to isolate and purify seven compounds with strong bioactivity from the fermentation broth of the strain KN37. These compounds were identified as 4-(Diethylamino)salicylaldehyde (1), 4-Nitrosodiphenylamine (2), N-(2,4-Dimethylphenyl)formamide (3), 4-Nitrocatechol (4), Methylsuccinic acid (5), Phenyllactic acid (6) and 5,6-Dimethylbenzimidazole (7). Moreover, 4-(Diethylamino)salicylaldehyde exhibited the most potent inhibitory effect against Rhizoctonia solani, with an EC50 value of 14.487 mg/L, while 4-Nitrosodiphenylamine showed great antibacterial activity against Erwinia amylovora, with an EC50 value of 5.715 mg/L. This study successfully isolated several highly active antimicrobial compounds from the metabolites of the strain KN37, which could contribute as scaffolds for subsequent chemical synthesis. On the other hand, the newly predicted antibiotic-like substances have not yet been isolated, but they still hold significant research value. They are instructive in the study of active natural product biosynthetic pathways, activation of silent gene clusters, and engineering bacteria construction.

Role of SGLT2 Inhibitors, DPP-4 Inhibitors, and Metformin in Pancreatic Cancer Prevention.

Pancreatic carcinoma is a highly aggressive tumor that usually presents when it has already metastasized. Therapeutic options for cure remain scarce and rely on combination chemotherapy with limited sustainability. Diabetes is considered an important risk factor for the development of pancreatic cancer due to the production of proinflammatory cytokines, which result in increased cell proliferation. More than half of patients diagnosed with pancreatic cancer eventually develop diabetes due to the destruction of insulin-producing cells. The interlinkage of both diseases might identify a possible preventative strategy for reducing the incidence of pancreatic carcinoma. This study reviewed the recent literature on the association between pancreatic cancer risk and SGLT2 inhibitors, GLP-1 RA, DPP-4 inhibitors, and biguanides. There are mixed data regarding the relationship between GLP-1 RA and DPP-4 inhibitors and pancreatic cancer, with some trials suggesting that they might increase the risk. In contrast, studies have mostly revealed that SGLT2 inhibitors have an antiproliferative effect on various tumors, such as liver, pancreatic, prostate, bowel, lung, and breast carcinoma, which might be due to their mechanism of blockage of reabsorption of glucose by cells, lowering the amount of available glucose for the growth of tumor cells. Metformin, the first-line agent for diabetes, has also been shown to be associated with decreasing pancreatic cancer risk and improving prognosis in those who already have the disease. Dedicated trials are needed to further delineate the association of antidiabetic drugs with the risk of pancreatic cancer in the general population, as previous studies have mostly focused on diabetic patients.

Novel design and performance evaluation of an indirectly forced convection desiccant integrated solar dryer for drying tomatoes in Pakistan.

The process of drying agricultural products for food preservation is a difficult task that requires a significant amount of energy. The increasing cost and depletion of fossil fuels have led to the development of a food dryer that utilizes renewable energy sources. This research paper proposes the design and performance evaluation of an indirectly forced convection desiccant integrated solar dryer (IFCDISD) at the Solar Energy Research Lab at USPCAS-E, NUST Pakistan. Tomatoes were chosen as the test product due to their importance and widespread consumption. The drying process involves slicing the tomatoes and placing them on the IFCDISD rack, where a desiccant called calcium chloride (CaCl2) is integrated into the dryer. The experiments were conducted during both sunshine (SS) hours and Off-sunshine (OSS) hours. The IFCDISD operates using sunlight during SS hours and utilizes the absorbed heat of CaCl2 in OSS hours via a forced DC brushless fan powered by battery charged thro solar panel. The tomatoes were weighed before and after each drying mode, and the moisture removal was calculated. The results show that the dryer efficiency was 50.14 % on day 1, 66 % on day 2, and an overall efficiency of 58.07 %. The moisture content removal was 42.858 % on day 1, 22.9979 % on day 2, and an overall moisture content removal of 58.07 %. Moreover, the payback period is 5.1396 and the carbon mitigation was recorded as 2.0335, and the earned carbon credit was recorded as 11559.6.

Serological and epidemiological investigation of Mycobacterium avium subspecies paratuberculosis in bovines in Pakistan.

Objective: To investigate the prevalence of paratuberculosis in cattle and buffaloes at twelve public dairy farms in Punjab, Pakistan. Methods: A total of 2181 more than two-year-old animals (1242 cattle and 939 buffaloes) were tested by avian tuberculin, i.e., killed purified protein derivative (PPD) of Mycobacterium avium paratuberculosis and indirect ELISA. Blood and fecal samples were collected from tuberculin positive animals. These samples were further processed by indirect ELISA. The data were analyzed using frequency analysis and logistic analysis procedures. Results: The prevalence of paratuberculosis at public dairy farms was 3.8%, as determined by tuberculin + ELISA test. It varied from 0.71-13.5% with a 100% herd prevalence. Multivariate logistic regression analysis revealed that species, milk production, total animals, total small ruminants, and total buffaloes were significantly associated with the occurrence of paratuberculosis. Odd ratio analysis revealed that with a one-kilogram increase in body weight, there will be a 0.006% increase in disease occurrence. With the increase in one animal in small ruminants and buffaloes, there will be 0.008% and 0.42% greater chances of developing paratuberculosis, respectively. Bivariate logistic regression analysis of cattle and buffaloes revealed that farm number, age, and total number of cattle were significantly associated with the occurrence of paratuberculosis. A one-month increase in lactation length increases the chance of tuberculosis by 0.004%; similarly, a one-liter increase in milk production increases the chance of disease by 10%. With each additional buffalo in the herd, there will be a 0.007% greater chance for the occurrence of paratuberculosis. Conclusion: This study concluded that tuberculin testing can be used in conjunction with ELISA to screen animals for paratuberculosis in countries with scarce resources, such as Pakistan. The efficacy of disease diagnosis can be improved by combining multiple tests.

A new modified biased estimator for Zero inflated Poisson regression model.

Zero-inflated Poisson (ZIP) model is widely used for counting data with excessive zeroes. The multicollinearity is the common factor in the explanatory variables of the count data. In this context, typically, maximum likelihood estimation (MLE) generates unsatisfactory results due to inflation of mean square error (MSE). In the solution of this problem usually, ridge parameters are used. In this study, we proposed a new modified zero-inflated Poisson ridge regression model to reduce the problem of multicollinearity. We experimented within the context of a specified simulation strategy and recorded the behavior of proposed estimators. We also apply our proposed estimator to the real-life data set and explore how our proposed estimators perform well in the presence of multicollinearity with the help of ZIP model for count data.

Nanofiltration PVP Membrane with Gradient Cross-Linking for Efficient Polycyclic Aromatic Hydrocarbons Removal.

Polycyclic aromatic hydrocarbons (PAHs) are persistent organic pollutants that may contaminate various water sources and pose serious dangers to human health and the environment. Due to their capacity for size-based separation, nanofiltration membranes have become efficient instruments for PAH removal. However, issues such as membrane fouling and ineffective rejection still exist. To improve PAH rejection while reducing fouling problems, this work created a new gradient cross-linking poly(vinylpyrrolidone) (PVP) nanofiltration membrane. The gradient cross-linking technique enhanced the rejection performance and antifouling characteristics of the membrane. The results demonstrated that the highest membrane flow was achieved at a 0.15% SDS-PVP membrane. There is a trade-off between membrane flux and salt rejection since salt rejection increases with SDS owing to the growth of big pores. The membrane flux was reduced for the 0.25% SDS-PVP membrane owing to poor SDS dispersion. The prepared membrane showed enhanced removal efficiencies for the removal of the PAH compounds. The PVP membrane has the potential to be used in several water treatment applications, improving water quality, and preserving the environment.

Tailoring parenting styles and family-based interventions cross-culturally as an effective prevention strategy for youth substance use: a scoping review.

Background: The challenge of substance use among youth continues to be a highly concerning public health issue across the globe. The notion that parenting lifestyles and family-based intervention can help in the prevention of adolescent substance use have received robust attention from policy makers, researchers' clinicians and general public, nonetheless, there is scarcity of high quality evidence to support these concepts. Objective: To review available literature which assessed the effects of parenting styles and family-based interventions on the prevention of adolescent substance use. Methods: A scoping review of literature to identify studies published in English between 2012 and 2022 was conducted searching Scopus, MEDLINE, PsychInfo, and CINAHL databases focused on effects of parenting styles and family-based interventions in the prevention of adolescent substance use.Keywords of family-based intervention strategies and possible outcomes of parenting styles on youth substance use were coded from the results, discussion, or conclusion. Strategies were inductively categorized into themes according to the focus of the strategy. Results: A total of 47 studies, published between 2012 and 2022 in English language included. Narrative synthesis illustrated that parental involvement, restriction of mature-rated content, parental monitoring, authoritative parenting styles, and parental support and knowledge can help in the prevention of adolescent substance use. On the contrary, poor parent-child bonding, overprotection, permissive parenting, parental frustrations, authoritarian and harsh parenting styles promoted adolescent substance use disorders. Proximal risk factors like peer influence, previous use of other substances, and risky behaviours had more effect than just parenting styles. Culturally tailored family-based intervention strategies such as "Preventive Parenting", "Parent Training", and "Parent Involvement", with focus on "Technology Assisted Intervention", particularly "SMART "(Substance Misuse among Adolescents in Residential Treatment) are found as effective family-based intervention strategies to mitigate substance use in youth. Conclusion: Culturally tailored family-based behavioural strategies psychosocial intervention strategies can be considered of the most effective strategies to prevent substance use disorders in youth.

The smoldering pandemic: Prevalence of prolonged grief disorder. A cross-sectional study of bereaving adults during the COVID pandemic in Pakistan.

The world continues to face unprecedented psycho-social challenges after the COVID-19 pandemic. Prolonged Grief Disorder (PGD) is a young psychiatric condition describing grief exceeding standard cultural, social, and religious norms. We assessed the prevalence of PGD in Pakistan along with its correlation to anxiety, depression, and psychological distress. The prevalence of PGD was estimated to be 15 % with grief intensity correlating with depression, anxiety, and serious mental illness. People who were closely related to the deceased were more likely to experience severe PGD symptoms. Discussions about grief and measures to curb its psychological effects are crucial in the post-pandemic world.

Nanoparticles Based Sensors for Cyanide Ion Sensing, Basic Principle, Mechanism and Applications.

Rapidly detecting potentially toxic ions such as cyanide is paramount to maintaining a sustainable and environmentally friendly ecosystem for living organisms. In recent years, molecular sensors have been developed to detect cyanide ions, which provide a naked-eye or fluorometric response, making them an ideal choice for cyanide sensing. Nanosensors, on the other hand, have become increasingly popular over the last two decades due water solubility, quick reaction times, environmental friendliness, and straightforward synthesis. Researchers have designed many nanosensors and successfully utilized them for the detection of cyanide ions in various environmental samples. The majority of these sensors use gold and silver-based nanosensors because cyanide ions have a high affinity for these metals ions and coordinate through covalent bonds. These metal nanoparticles are typically combined or coated with fluorescent materials, which quench their fluorescence. However, adding cyanide ions etches out the metal nanoparticles, restoring their fluorescence/color. This principle has been followed by most nanosensors used for cyanide ion sensing. In this review, different nanosensors and their sensing mechanisms are discussed in relation to cyanide ions. The primary purpose is to compare the sensing abilities of these sensors, mainly their sensitivity, advantages, application and to find out research gaps for future work. In this review paper, the development made in nanosensors in the last thirteen years (2010-2023) was discussed and the nanosensors for cyanide ions were compared with molecular sensors while the nanosensors with the excellent limit of detection were highlighted.

The impact of digital transformation on green total factor productivity of heavily polluting enterprises.

Introduction: Digital transformation has become an important engine for economic high-quality development and environment high-level protection. However, green total factor productivity (GTFP), as an indicator that comprehensively reflects economic and environmental benefits, there is a lack of studies that analyze the effect of digital transformation on heavily polluting enterprises' GTFP from a micro perspective, and its impact mechanism is still unclear. Therefore, we aim to study the impact of digital transformation on heavily polluting enterprises' GTFP and its mechanism, and explore the heterogeneity of its impact. Methods: We use Chinese A-share listed enterprises in the heavily polluting industry data from 2007 to 2019, measure enterprise digital transformation indicator using text analysis, and measure enterprise GTFP indicator using the GML index based on SBM directional distance function, to investigate the impact of digital transformation on heavily polluting enterprises' GTFP. Results: Digital transformation can significantly enhance heavily polluting enterprises' GTFP, and this finding still holds after considering the endogenous problem and conducting robustness tests. Digital transformation can enhance heavily polluting enterprises' GTFP by promoting green innovation, improving management efficiency, and reducing external transaction costs. The improvement role of digital transformation on heavily polluting enterprises' GTFP is more obvious in the samples of non-state-owned enterprises, non-high-tech industries, and the eastern region. Compared with blockchain technology, artificial intelligence technology, cloud computing technology, big data technology, and digital technology application can significantly improve heavily polluting enterprises' GTFP. Discussion: Our paper breaks through the limitations of existing research, which not only theoretically enriches the literature related to digital transformation and GTFP, but also practically provides policy implications for continuously promoting heavily polluting enterprises' digital transformation and facilitating their high-quality development.

Current challenges and potential solutions to the use of digital health technologies in evidence generation: a narrative review.

Digital health is a field that aims to improve patient care through the use of technology, such as telemedicine, mobile health, electronic health records, and artificial intelligence. The aim of this review is to examine the challenges and potential solutions for the implementation and evaluation of digital health technologies. Digital tools are used across the world in different settings. In Australia, the Digital Health Translation and Implementation Program (DHTI) emphasizes the importance of involving stakeholders and addressing infrastructure and training issues for healthcare workers. The WHO's Global Task Force on Digital Health for TB aims to address tuberculosis through digital health innovations. Digital tools are also used in mental health care, but their effectiveness must be evaluated during development. Oncology supportive care uses digital tools for cancer patient intervention and surveillance, but evaluating their effectiveness can be challenging. In the COVID and post-COVID era, digital health solutions must be evaluated based on their technological maturity and size of deployment, as well as the quality of data they provide. To safely and effectively use digital healthcare technology, it is essential to prioritize evaluation using complex systems and evidence-based medical frameworks. To address the challenges of digital health implementation, it is important to prioritize ethical research addressing issues of user consent and addressing socioeconomic disparities in access and effectiveness. It is also important to consider the impact of digital health on health outcomes and the cost-effectiveness of service delivery.

Corrigendum: Sero-epidemiological study of zoonotic bacterial abortifacient agents in small ruminants.

[This corrects the article DOI: 10.3389/fvets.2023.1195274.].

Fates of potentially persistent and mobile organic substances in embedded outdoor columns for artificial groundwater recharge simulation.

Persistent and mobile organic micropollutants (OMP) are ubiquitously found in the aquatic environment and have a high propensity to distribute in water resources and are difficult to remediate. Managed aquifer recharge systems such as artificial groundwater recharge, produce high-quality drinking water by removing numerous OMP from the source water. In this study, the fates of selected emerging and potentially persistent and mobile OMP were investigated in outdoor columns for artificial groundwater recharge simulation. Breakthrough curves of OMP were modeled to differentiate between sorption and bio-transformation. The study showed that selected OMP were persistent in the surface water and no photo-degradation was observed, except for diclofenac. The trends of dissolved organic carbon concentrations and UV light absorption at 254 nm wavelength suggest elevated biological activity in the first 0.3 m of the columns. The study revealed that the bio-transformation of cyanoguanidine, valsartan acid and diclofenac correlated with the biological activity in the sand columns. Benzyltrimethylammonium, n-(3-(dimethylamino)-propyl)methacrylamide, 1,3-di-o-tolylguanidine, 1,3-diphenylguanidine and melamine were completely eliminated within the first 0.3 m, likely due to sorption. Less mobile compounds such as carbamazepine and adamantan-1-amine also showed sorption. Sorption was also observed for diclofenac, likely due to decreased pH along the column depth. Retardation factors of several OMP were higher in the first 0.3 m of the columns, likely due to higher organic carbon contents compared to the remaining depth. Six organic substances (for example 2-acrylamido-2-methylpropane sulfonate and dimethylbenzene sulfonate) were persistent and mobile throughout the experiment. Overall, this study reveals the vital role of pH and sand organic carbon for sorption and residence time and biological activity for OMP elimination.

Phytochemical analysis and bioactivity assessment of five medicinal plants from Pakistan: Exploring polyphenol contents, antioxidant potential, and antibacterial activities.

Plants have always been the prime focus in medicine industries due to their enormous ethnobotanical uses and multitude of biological and therapeutic properties. In the current study, preliminary phytochemical composition, Total phenolic content (TPC), and total flavonoid content (TFC) with the antioxidant and antibacterial activity of hydroalcoholic extract and n-hexane, chloroform and n-butanol fractions of five selected medicinal plants [Tephrosia purpurea (L.) Pers., Lavandula stoechas L., Aesculus indica (Wall. ex Cambess.) Hook, Iris ensata Thunb., and Kalanchoe pinnata (Lam.) Pers.] from Pakistan, have been evaluated. TPC and TFC were determined by Folin-Ciocalteu's and AlCl3 methods respectively. The antioxidant activity was performed by DPPH, ABTS, FRAP, and CUPRAC while the antibacterial potential of these plants was determined by agar well diffusion assay. K. pinnata (Lam.) Pers. exhibited the highest TPC (695 ± 13.2 mg.GA.Eq.g-1DE ± SD) in n-butanol fraction and the highest TFC in its chloroform faction (615 ± 6.31 mg Q.Eq.g-1 DE ± SD). The n-butanol fraction and hydroalcoholic extract of I. ensata Thunb. exhibited strong antioxidant potential by DPPH and CUPRAC assays respectively, whereas K. pinnata (Lam.) Pers. n-butanol fraction exhibited the strongest reducing potential. The hydroalcoholic extract of all tested plants exhibited significant antibacterial activity against tested bacterial strains with ZI (12-18 mm). Conclusively, K. pinnata (Lam.) Pers. (Family: Crassulaceae) and I. ensataThunb. (Family: Iridaceae) exhibited the highest antioxidant and antibacterial potential. They can be explored for the isolation of phytoconstituents responsible for this potential and serve as a lead for the production of new natural antioxidants and antibacterial agents that can be used to cure various diseases.

Sero-epidemiological study of zoonotic bacterial abortifacient agents in small ruminants.

Abortion is one of the leading causes of economic losses in the livestock industry worldwide. Chlamydia abortus, Coxiella burnetii, and Brucella spp. are the leading cause of late fetal loss in small ruminants. This study determined the seroprevalence of these agents in small ruminants in district Jhang. A total of 385 serum samples were taken from the sheep and goats from different flocks with a history of abortion and subjected to i-ELISA. Further, samples were analysed for liver enzymes and total serum protein using a semi-automated chemistry analyzer. The result of indirect commercial ELISA showed 13.0, 4.2 and 11.2% prevalence for Coxiella burnetii, Chlamydia abortus, and Brucella spp., respectively. Values of different serum parameters (ALT, AST, and total protein) of seropositive animals were also determined. There was a significant rise in AST and ALT values of infected animals (p ≤ 0.05). Total protein decreased for all three infections, but a significant drop was noted in Brucella positive sheep serum samples. Various risk factors were studied. Binary logistic regression proved a significant role of ticks for coxiellosis and brucellosis. Age, parity, and species did not impact the prevalence of diseases studied.

Effect of Operating Parameters on the Performance of Integrated Fixed-Film Activated Sludge for Wastewater Treatment.

Integrated fixed-film activated sludge (IFAS) is a hybrid wastewater treatment process that combines suspended and attached growth. The current review provides an overview of the effect of operating parameters on the performance of IFAS and their implications for wastewater treatment. The operating parameters examined include hydraulic retention time (HRT), solids retention time (SRT), dissolved oxygen (DO) levels, temperature, nutrient loading rates, and aeration. Proper control and optimization of these parameters significantly enhance the treatment efficiency and pollutant removal. Longer HRT and appropriate SRT contribute to improved organic matter and nutrient removal. DO levels promote the growth of aerobic microorganisms, leading to enhanced organic matter degradation. Temperature influences microbial activity and enzymatic reactions, impacting treatment efficiency. Nutrient loading rates must be carefully managed to avoid system overload or inhibition. Effective aeration ensures uniform distribution of wastewater and biofilm carriers, optimizing contact between microorganisms and pollutants. IFAS has been used in water reuse applications, providing a sustainable and reliable water source for non-potable uses. Overall, IFAS has proven to be an effective and efficient treatment process that can provide high-quality effluent suitable for discharge or reuse. Understanding the effects of these operating parameters helps to optimize the design and operation for efficient wastewater treatment. Further research is needed to explore the interactions between different parameters, evaluate their impact under varying wastewater characteristics, and develop advanced control strategies for improved performance and sustainability.

Comparative study of five topological invariants of supramolecular chain of different complexes of N-salicylidene-L-valine.

L-valine is a crucial amino acid that has rising market demand and numerous uses. It can be used to make specific nutrients, animal feed additives, cosmetic ingredients, and other things in the medical and agricultural fields. N-salicylidene-L-valine (NsLv) is attracting a lot of attention due to its unusual structure and enhanced catalytic and cytotoxic activities. Topological index is a numerical value which is associated with the molecular structure. It is very helpful to predict physio-chemical properties and Quantitative structure-activity relationship and Quantitative structure-property relationship modeling. We study the supramolecular chain (Sc) in the dialkyl tin of complexes 2, 3 and 4 of NsLv to better understand this structure and its topological index-related characteristics. Additionally, we compare topological indices and analyze how these structures relate to one another using concrete examples.

Fates of selected pharmaceuticals in a large recirculated mesocosm with a pond and bank filtration.

Pharmaceuticals such as carbamazepine (CBZ), sulfamethoxazole (SMX) and diclofenac (DCF) are detected at a high frequency in the aquatic environment. The fates of these compounds in bank filtration (BF), a nature-based water treatment system, have been extensively studied, mainly in batch and laboratory column studies. This study, for the first time, investigated the fates of CBZ, SMX and DCF in a large recirculated mesocosm with a pond and subsequent BF. Changes in dissolved organic carbon (DOC) in the pond and bank filtrate were also observed. The averaged spiking concentration of CBZ, SMX and DCF was 1 µg/L at the pond influent and the hydraulic retention time of surface water in the pond was 15 days to reach at the bank. The infiltrated surface water travelled through two parallel subsurface layers and a combined effluent (from both layers) was collected (35 m from the bank) and recirculated as an influent of the pond. The redox conditions in both layers were significantly different (p < 0.05) and correlated with temperature (R2 = 0.91, p < 0.05). The results revealed that CBZ was persistent in the surface water and groundwater passage, SMX was persistent in surface water and removed entirely through BF within 50 days of operation. DCF was completely removed after infiltration and groundwater passage (within 2 m). The DOC in the surface water showed insignificant variations between the influent and the bank. A significant reduction of DOC was observed within the first 5 m after infiltration, and the reduction was associated with the removal of biopolymers. This work shows that the selected organic micropollutants in surface water were not affected by sunlight intensity, water chemistry and water depth. In addition, recirculation mesocosm BF confirms the potential environmental risk and predictive concentrations of organic micropollutants in the aquatic environment.

Usefulness of electrocardiography QT interval for prediction of left ventricular diastolic dysfunction: a cross-sectional study.

Heart failure (HF) is a leading cause of morbidity and mortality worldwide, with projections showing a further rise in incidence, impacting a decline in quality of life and the costs incurred in its diagnosis and treatment. The authors aim to establish the correlation between the prediction of left ventricular diastolic dysfunction based on a change in QT wave intervals. Methods: A cross-sectional at Holy-family Hospital, Rawalpindi Medical University, Pakistan. One thousand five hundred patients were referred for electrocardiography (ECG) for clinical suspicion of HF between May and July 2022. Ejection fraction (EF), lateral mitral annulus velocity (e'), mitral inflow early (E) and late (A) velocities, left ventricular filling pressure (E/e' ratio), and QT interval (QTc) was calculated. Odds ratios with a 95% CI (odds) were obtained by comparing QTc with all variables. Results: The patients were mostly middle-aged adults with a mean age of 30.27 (±7.64). Male to female ratio was nearly balanced, with 771 (51.4%) males included in the clinical survey. The ECG parameters were; QT interval-494.07 (±63.61), EF-57.11 (±11.96), early to atrial filling velocity ratio-0.71 (±0.20), and lateral mitral annulus velocity-8.29 (±1.64). Conclusion: The promising results for correlation between QT interval and ECG parameters, particularly EF and lateral mitral annulus velocity, should not be considered as the alternative in diagnosing left ventricular diastolic dysfunction thus far. Prolonged electrocardiographic QTc interval in patients with HF is useful in predicting diastolic dysfunction.