A Machine-Learning-Based Approach for Railway Track Monitoring Using Acceleration Measured on an In-Service Train.

In this paper, a novel railway track monitoring approach is proposed that employs acceleration responses measured on an in-service train to detect the loss of stiffness in the track sub-layers. An Artificial Neural Network (ANN) algorithm is developed that works with the energies of the train acceleration responses. A numerical model of a half-car train coupled with a track profile is employed to simulate the train vertical acceleration. The energy of acceleration signals measured from 100 traversing trains is used to train the ANN for healthy track conditions. The energy is calculated every 15 m along the track, each of which is called a slice. In the monitoring phase, the trained ANN is used to predict the energies of a set of train crossings. The predicted energies are compared with the simulated ones and represented as the prediction error. The damage is modeled by reducing the soil stiffness at the sub-ballast layer that represents hanging sleepers. A damage indicator (DI) based on the prediction error is proposed to visualize the differences in the predicted energies for different damage cases. In addition, a sensitivity analysis is performed where the impact of signal noise, slice sizes, and the presence of multiple damaged locations on the performance of the DI is assessed.

Application of Methyl Jasmonate to Papaya Fruit Stored at Lower Temperature Attenuates Chilling Injury and Enhances the Antioxidant System to Maintain Quality.

Papaya fruit has a limited shelf life due to its sensitivity to decay and chilling damage during cold storage. The application of methyl jasmonate (MeJA) is known to reduce the incidence of disease and chilling injury, and to maintain the overall quality of the papaya fruit when stored at low temperature. Consequently, the effects of postharvest MeJA (1 mM) immersion on papaya fruits during low-temperature storage (10 °C ± 2 °C) for 28 days were studied. The experiment revealed that MeJA treatment significantly decreased the papaya fruit's weight loss, disease incidence, and chilling injury index. Furthermore, the accumulation of malondialdehyde and hydrogen peroxide was markedly lower after the application of MeJA. In addition, MeJA treatment exhibited significantly higher total phenols, ascorbic acid, antioxidant activity, and titratable acidity in contrast to the control. Similarly, MeJA-treated papaya fruits showed higher antioxidant enzymatic activity (superoxide dismutase, catalase, and peroxidase enzymes) with respect to the control fruits. In addition, MeJA reduced the soluble solids content, ripening index, pH, and sugar contents compared to the control fruits. Furthermore, MeJA-treated papaya fruit exhibited higher sensory and organoleptic quality attributes with respect to untreated papaya fruits. These findings suggested that postharvest MeJA application might be a useful approach for attenuating disease incidence and preventing chilling injury by enhancing antioxidant activities along with enhanced overall quality of papaya fruits during low-temperature storage.

Hot Water Treatment Improves Date Drying and Maintains Phytochemicals and Fruit Quality Characteristics of Date Palm (Phoenix dactylifera).

Fresh date fruits (cvs. Hillawi and Khadrawi) were harvested at the khalal stage and treated with hot water treatment (HWT) for different time durations (control, HWT-1 min, HWT-3 min, HWT-5 min, and HWT-7 min) to investigate the physicochemical characteristics, phytochemical properties, and sensory attributes. The results revealed that both date cultivars took less time to reach the tamar stage in response to HWT-7 min compared to control. However, Hillawi date fruit showed a higher fruit ripening index (75%) at HWT-3 min, while Khadrawi fruit had a higher ripening index (80%) at HWT-5 min than untreated fruit (10%). Higher weight loss and lower moisture contents were observed in Hillawi (25%) and Khadrawi (20%) date fruit as the immersion period increased in both cultivars. Moreover, soluble solid content was higher in Hillawi (11.77° Brix) in response to HWT-3 min and Khadrawi (10.02° Brix) date fruit immersed in HWT-5 min in contrast with the control group, whereas significantly lower levels of titratable acidity and ascorbic acid content were observed in Hillawi (0.162%, 0.67 mg/100 g) and Khadrawi (0.206%, 0.73 mg/100 g) date fruit in response to HWT (HWT-1 min, HWT-3 min, HWT-5 min, and HWT-7 min) than untreated fruit. Furthermore, noticeably higher levels of reducing sugar (69.83%, 57.01%), total sugar (34.47%, 31.14%), glucose (36.84%, 29.42%), fructose (33.99%, 27.61%), and sucrose (3.16%, 1.33%) were found in hot water-treated Hillawi (immersed for 3-min) and Khadrawi (immersed for 5-min) date fruit, respectively. In addition, total phenolic content, total flavonoids, total antioxidants, and total tannins were substantially superior in date fruits subjected to HWT-3 min (in Hillawi, 128 mg GAE/100 g, 61.78%, 20.18 mg CEQ/100 g) and HWT-5 min (in Khadrawi, 139.43 mg GAE/100 g, 72.84%, and 18.48 mg CEQ/100 g) compared to control. Overall, sensory attributes were recorded to be higher in Hillawi and Khadrawi date fruit after treatment for 3 min and 5 min, respectively. Our findings suggest that HWT is a promising technique that can be adopted commercially to improve fruit ripening and preserved nutritional quality of dates after harvest.

Impact Evaluation of a Resident-Driven Research Training Workshop in Idaho: A Feasibility Study.

Objectives: Engagement in research activities is a critical component of clinical residency training. It is vital to build research capacity of residents to help interpret evidence-based medicine and design quality improvement projects. A mixed methods study was conducted to assess the impact of a 1-day research training workshop conducted at Eastern Idaho Regional Medical Centre, Idaho in May 2022. The workshop was targeted to improve the research knowledge of current clinical residents of Internal Medicine and Family Medicine. Methods: Workshop comprised of expert presentations, with assessment of difference in knowledge with a pretest and post-test. The sessions were organized around the core competencies of Institute of Medicine. Suggestions were also gathered from the audience. A pretest and post-test based on 13 questions was administered to the participants to assess change in research-related knowledge. Comments and suggestions of the participants were also recorded. Wilcoxon rank test was applied to determine statistical difference across each question and cumulative knowledge score. Conventional content analysis was applied to explore the comments and feedback. Results: The mean score of participants improved across all 12 questions. Statistically significant results were observed for the questions about types of studies qualifying as qualitative research. The cumulative score of participants increased in the post-test from 8.57 to 9.35. The participants gained new knowledge (94.3%), and felt more comfortable in application of research methods (74.3%). Encouraging feedback was obtained from the audience. They stated that they had benefited from the workshop and felt more prepared and motivated to indulge in scholarly activities. Conclusion: The study shows improvement in research-related knowledge of clinical residents attending a 1-day training workshop. We recommend inclusion of such workshops in the curriculum of residents for skill building and enhanced indulgence in research activities in order to prepare them as future leaders in quality improvement, health policy, and hospital administration.

Patient Perspectives and Side-Effects Experience on Chemotherapy of Non-Small Cell Lung Cancer: A Qualitative Study.

Purpose: This study aimed to explore patients' experiences of palliative chemotherapy for non-small cell lung cancer (NSCLC), how patients adapt to their new and challenging life after chemotherapy, their beliefs, and their quality of life. Patients and Methods: The study used an exploratory descriptive qualitative approach that was designed to explore the experiences and side effects of NSCLC patients on chemotherapy in Pakistan. The study was designed to obtain a deeper understanding of 22 NSCLC patients' experiences, using a face-to-face approach and interviews were conducted. Patients who have completed chemotherapy agreed to participate in semi-structured interviews. Results: The data were arranged into five themes: hospital facilities and environment, patient's beliefs in alternative treatments, presenting a positive/negative face, life is for living, and health insurance coverage. The major complaints related to bad experiences of chemotherapy-induced side effects, but these patients still managed to complete the full course of their respective chemotherapy. Additionally, the current study revealed the real experience of patients with NSCLC which had been less studied. The patient's experience was summarized into four themes and several subthemes. Conclusion: This study aid healthcare providers when deciding on treatment options that will improve shared decision-making between clinicians and treatment outcomes.

Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications.

Antimicrobial resistance (AMR) is an increasing global concern, increasing costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several global and national initiatives to slow down rising AMR rates. NAPs are also helping key stakeholders understand current antimicrobial utilization patterns and resistance rates. The Middle East is no exception, with high AMR rates. Antibiotic point prevalence surveys (PPS) provide a better understanding of existing antimicrobial consumption trends in hospitals and assist with the subsequent implementation of antimicrobial stewardship programs (ASPs). These are important NAP activities. We examined current hospital consumption trends across the Middle East along with documented ASPs. A narrative assessment of 24 PPS studies in the region found that, on average, more than 50% of in-patients received antibiotics, with Jordan having the highest rate of 98.1%. Published studies ranged in size from a single to 18 hospitals. The most prescribed antibiotics were ceftriaxone, metronidazole, and penicillin. In addition, significant postoperative antibiotic prescribing lasting up to five days or longer was common to avoid surgical site infections. These findings have resulted in a variety of suggested short-, medium-, and long-term actions among key stakeholders, including governments and healthcare workers, to improve and sustain future antibiotic prescribing in order to decrease AMR throughout the Middle East.

Exogenous melatonin treatment reduces postharvest senescence and maintains the quality of papaya fruit during cold storage.

Introduction: Exogenous melatonin (EMT) application has been used to reduce postharvest senescence and improve the quality and antioxidant enzyme activities of papaya fruits during cold storage. Methods: The effects of exogenous melatonin application (1. 5 mM) were investigated on papaya fruits during cold storage (10°C ± 2°C) for 28 days in the present study. Results and discussion: The EMT treatment delayed postharvest senescence significantly with lower maturing status compared with untreated papaya fruits (control). In addition, EMT treatment maintained substantially higher titratable acidity values and ascorbic acid content but significantly lower soluble solids content and lower weight loss compared with the untreated fruits. Concerning the antioxidant capacity, the EMT-treated papaya fruit exhibited markedly higher total phenolic content and, consequently, higher DPPH-radical scavenging activity than the control group. The EMT treatment not only kept a higher enzyme activity of superoxide dismutase, peroxidase, and catalase but also significantly inhibited the accumulation of hydrogen peroxide and malondialdehyde, along with satisfying sensory attributes. Conclusion: The findings of this study indicated that EMT application could be commercially used as an eco-friendly strategy to reduce postharvest senescence and maintain the fresh-like quality traits of papaya fruit during cold storage.

Self-medication dilemma in dengue fever.

This paper focuses on the trends of self-medication practices in treating symptoms that may lead to fatal complications in dengue. As dengue is a viral infection with increasing incidence, decision regarding its treatment is mostly affected by public health believes and practices to self-treat the condition by different home remedies, over-the-counter (OTC) drugs or using outdated prescription drugs that proved beneficial in the past experience. Poverty, lack of education, and poor access to health facilities pave the way for making such decisions. Future complications can be averted by raising awareness, counseling the patients and dispensing of pharmaceuticals with strict monitoring.

Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future.

There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These concerns have resulted in a plethora of initiatives globally and nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially with the highest rates of AMR globally. Key activities in NAPs include gaining a greater understanding of current antimicrobial utilization patterns through point prevalence surveys (PPS) and subsequently instigating antimicrobial stewardship programs (ASPs). Consequently, there is a need to comprehensively document current utilization patterns among hospitals across Africa coupled with ASP studies. In total, 33 PPS studies ranging from single up to 18 hospitals were documented from a narrative review with typically over 50% of in-patients prescribed antimicrobials, up to 97.6% in Nigeria. The penicillins, ceftriaxone and metronidazole, were the most prescribed antibiotics. Appreciable extended prescribing of antibiotics up to 6 days or more post-operatively was seen across Africa to prevent surgical site infections. At least 19 ASPs have been instigated across Africa in recent years to improve future prescribing utilizing a range of prescribing indicators. The various findings resulted in a range of suggested activities that key stakeholders, including governments and healthcare professionals, should undertake in the short, medium and long term to improve future antimicrobial prescribing and reduce AMR across Africa.

Knowledge, attitudes, and practices regarding Crimean-Congo hemorrhagic fever among general people: A cross-sectional study in Pakistan.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) continues to pose a serious threat to the fragile healthcare system of Pakistan with a continuous increase of morbidity and mortality. The present study aimed to assess the knowledge, attitudes, and practices regarding CCHF among general people who resided in Pakistan. METHODS: An online cross-sectional survey design was applied, and a convenience sampling technique was used to recruit 1039 adult people from Pakistan. Data were collected from September 08 to October 12, 2021. The questionnaire consisted of a total of 32 questions in four parts assessing socio-demographics, as well as knowledge, attitudes, and practices regarding CCHF. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS), and logistic regression analyses were performed to determine the factors associated with good knowledge, positive attitudes, and good practices. RESULTS: Alarmingly, 51.5% of participants heard about CCHF infection before administering the survey. Among these, 20.2%, 33.3%, and 48.2% of the study participants had demonstrated good knowledge, positive attitudes, and good practices, respectively. Binary logistic regression analysis revealed that education and income status had a significant impact on knowledge and attitudes (p<0.05). Similarly, the mean attitude scores differed significantly by age, education, and income status (p<0.05). CONCLUSIONS: The findings reflected inadequate levels of knowledge, attitudes, and practices regarding CCHF among general people in Pakistan which may regard as lower than expected. As CCHF is a highly contagious disease, it's urgent to initiate a comprehensive approach to handle the situation before it spreads further in Pakistan.

Recent Developments and Anticancer Therapeutics of Paclitaxel: An Update.

Plants are a source of diverse classes of secondary metabolites with anticancer properties. Paclitaxel (Taxol) is an anticancer drug isolated from various Taxus species and is used as a chemotherapeutic agent against various cancers. The biosynthesis of paclitaxel is a complex pathway, making its total chemical synthesis commercially non-viable; hence, alternative novel sources - like plant cell culture and heterologous expression systems, are being investigated to overcome this issue. Advancements in the field of genetic engineering, microbial fermentation engineering, and recombinant techniques have significantly increased the achievable yields of paclitaxel. Indeed, paclitaxel selectively targets microtubules and causes cell cycle arrest in the G2/M phase, inducing a cytotoxic effect in a concentration and time-dependent manner. Innovative drug delivery formulations, like the development of albumin-bound nanoparticles, nano-emulsions, nano-suspensions, liposomes, and polymeric micelles, have been applied to enhance the delivery of paclitaxel to tumor cells. This review focuses on the production, biosynthesis, mechanism of action, and anticancer effects of paclitaxel.

Indirect Monitoring of Frequencies of a Multiple Span Bridge Using Data Collected from an Instrumented Train: A Field Case Study.

In this paper, a field study is carried out to monitor the natural frequencies of Malahide viaduct bridge which is located in the north of Dublin. The bridge includes a series of simply supported spans, two of which collapsed in 2009 and were replaced. The replaced spans are stiffer than most of the others and these differences resulted in higher natural frequencies. An indirect bridge monitoring approach is employed in which acceleration responses from an instrumented train are used to estimate the natural frequencies of each span of the viaduct showing the locations of the two replaced spans with higher stiffness. For the indirect approach, an Ensemble Empirical Mode Decomposition (EEMD)-based Hilbert Huang Transform (HHT) technique is employed to identify the natural frequency of each span. This is carried out by analysing the Instantaneous Frequencies (IFs) from the calculated intrinsic mode functions. The average of the IFs calculated using 41 runs of the instrumented train (with varying carriage mass and speed for each run) are used to estimate the natural frequencies. To assess the feasibility of the indirect approach, a bespoke set of direct measurements was taken using accelerometers attached successively on each span of the viaduct. The free and forced vibrations from each span are used to estimate the first natural frequencies. The frequencies obtained from drive-by measurements are compared to those from direct measurements which confirms the effectiveness of indirect approaches. In addition, the instantaneous amplitudes of the drive-by signals are used to indicate the location of the stiffer spans. Finally, the accuracy and robustness of the indirect approaches for monitoring of multi span bridges are discussed.

Should we offer disaster preparedness and response training workshops across Idaho? A feasibility study.

INTRODUCTION: It is important for individuals and families to prepare for potential disasters to enable communities to generate a consolidated response. It is estimated that 30 percent of residents of the fourth largest city in Idaho, Idaho Falls, are not prepared to deal with disasters. A 1-day training workshop for healthcare professionals and students at Idaho State University in Pocatello was organized to build their capacity for acute disaster response and preparedness. This study assesses the impact of the workshop in improving knowledge and attitudes of the participants toward disaster management. METHODS: A mixed methods study design was employed. Pre- and post-tests were administered to the participants (n = 18) to examine change in self-perceived understanding of disasters, and disaster preparedness and management. Core competencies encompassing knowledge of disaster preparedness were assessed via 18 multiple-choice questions. Participant attitudes toward disaster training exercises in colleges, universities, and healthcare facilities were recorded, and written feedback regarding the workshop obtained. Chi-square and paired t-tests were used to examine changes in disaster preparedness and cumulative knowledge score. Quantitative variables and comments were analyzed using Stata.v.13 and Maxqda, respectively. RESULTS: Our assessment indicates an improvement in mean knowledge score [pretest: 10.7 (2.8), post-test: 12.5 (2.9); p = 0.007] and self-perceived disaster preparedness and management. The attitude of audience toward training workshops was wholly positive in both the pre- and post-tests. Participants commented that the workshop was "excellent," helped them polish their knowledge and skills, trained them to build emergency kits and communication plans, and perform triage amidst crises. CONCLUSION: Training workshops should be offered to communities to build their capacity to prepare for and respond to disasters.

Nanoparticles in clinical trials of COVID-19: An update.

Once the World Health Organization (WHO) declared the COVID-19 (Coronavirus Infectious Disease-19) outbreak to be pandemic, massive efforts have been launched by researchers around the globe to combat this emerging infectious disease. Strategies that must be investigated such as expanding testing capabilities, developing effective medicines, as well as developing safe and effective vaccines for COVID-19 disease that produce long-lasting immunity to human system. Now-a-days, bio-sensing, medication delivery, imaging, and antimicrobial treatment are just a few of the medical applications for nanoparticles (NPs). Since the early 1990s, nanoparticle drug delivery methods have been employed in clinical trials. Since then, the discipline of nanomedicine has evolved in tandem with expanding technological demands to better medicinal delivery. Newer generations of NPs have emerged in recent decades that are capable of performing additional delivery tasks, allowing for therapy via novel therapeutic modalities. Many of these next generation NPs and associated products have entered clinical trials and have been approved for diverse indications in the present clinical environment. For systemic applications, NPs or nanomedicine-based drug delivery systems have substantial benefits over their non-formulated and free drug counterparts. Nanoparticle systems, for example, are capable of delivering medicines and treating parts of the body that are inaccessible to existing delivery systems. As a result, NPs medication delivery is one of the most studied preclinical and clinical systems. NPs-based vaccines delivering SARS-CoV-2 antigens will play an increasingly important role in prolonging or improving COVID-19 vaccination outcomes. This review provides insights about employing NPs-based drug delivery systems for the treatment of COVID-19 to increase the bioavailability of current drugs, reducing their toxicity, and to increase their efficiency. This article also exhibits their capability and efficacy, and highlighting the future aspects and challenges on nanoparticle products in clinical trials of COVID-19.

COVID-19 Omicron variant - Time for airborne precautions.

Genetic mutations in SARS-CoV-2 have resulted in variants with more transmissibility and partial resistance to COVID-19 vaccines, as seen in the recently classified variant of concern (VOC) "Omicron". The rapid spread has raised concerns about Omicron being airborne, which leads to a high risk of contamination in public premises, particularly among the frontline healthcare workers. Mandatory usage of protective face masks and respirators is highly recommended in order to break the chain of transmission. Furthermore, health authorities need to reassess the modes of transmission of VOCs and provide updated guidelines to the general public for its prevention.

In-vitro and In-vivo management of Meloidogyne incognita (Kofoid and White) Chitwood and Rhizoctonia bataticola (Taub.) Butler in cotton using organic's.

Root-knot nematodes Meloidogyne incognita (Kofoid and White) Chitwood and Rhizoctonia bataticola (Taub.) Butler, fungus, are very dangerous root damaging pathogens. Present study was planned to establish a chemical control of these root deteriorating pathogens under lab conditions as well as in field. Maximum death rate of nematode juveniles and minimum numbers of nematode eggs hatched were recorded in plates treated with Cadusafos (Rugby® 100G) @12 g/100 ml and Cartap® (4% G) @9g/100 ml. Chemical treatment of Rhizoctonia bataticola with Trifloxystrobin + Tebuconazole (Nativo®) @0.2 g/100 ml and Mancozeb + Matalaxyl (Axiom) @0.25 g/100 ml significantly controlled the mycelial growth in plates. The best treatments tested in laboratory were applied in field as protective and curative treatments. Results proved that chemical control of root-knot nematode and root rot fungi by tested chemicals at recommended time and dose is a significant management technique under field conditions.

Epidemiology of asthma and associated factors in an urban Pakistani population: adult asthma study-Karachi.

BACKGROUND: This study was conducted in order to determine the prevalence of asthma and associated risk factors in the adult population of Karachi, Pakistan. METHODS: This multi-stage, cross-sectional survey was conducted from May 2014-August 2015; comprising 1629 adults in 75 randomly selected clusters in Karachi, Pakistan. Definitions included: 'self-reported asthma', 'reversibility in FEV1' and 'respiratory symptoms and reversibility in FEV1'. RESULTS: Prevalence of asthma was 1.8% (self-reported) (95% CI: 1.0-2.6), 11.3% (reversibility in FEV1) (95% CI: 9.4-13.3) and 6.6% (symptoms and reversibility in FEV1) (95% CI: 5.1-8.1). Asthmatics were more likely to belong to the age group ≥38 years according to 'reversibility in FEV1' and 'respiratory symptoms and reversibility in FEV1' (AOR: 1.9, 95% CI: 1.2-3.3) and (AOR: 2.1, 95% CI: 1.1-4.2), respectively. Asthmatics were more likely to report history of allergies (AOR: 1.9, 95% CI: 1.2-2.9) and (AOR: 2.8, 95% CI: 1.7-4.8); and were exposed to environmental tobacco smoke (AOR: 1.6, 95% CI: 1.1-2.5) and (AOR: 1.9, 95% CI: 1.1-3.3) according to 'reversibility in FEV1' and 'respiratory symptoms and reversibility in FEV1', respectively. Asthmatics were more likely to report pack years of smoking ≥5 (AOR: 2.3, 95% CI: 1.1-4.7) according to 'respiratory symptoms and reversibility in FEV1'. CONCLUSION: This study reports a high prevalence of asthma among Pakistani adults and calls for developing appropriate public health policies for prevention and control of asthma in the country. Further studies should be conducted to determine the national prevalence as well as follow-up studies to identify preventable causes for adult asthma.

Effectiveness of training on de-escalation of violence and management of aggressive behavior faced by health care providers in a public sector hospital of Karachi.

BACKGROUND & OBJECTIVE: Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings. METHODS: A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology and obstetrics departments of two teaching hospitals in Karachi. Quantitative assessment was done through structured interviews and qualitative through Focus Group Discussions. Healthcare providers` confidence in coping with patient aggression was also measured using a standard validated tool". RESULTS: The overall self-perceived mean score of Confidence in Coping with Patient Aggression Instrument "(CCPAI)" scale was significantly higher in intervention group (Mean= 27.49, SD=3.53) as compared to control group (Mean= 23.92, SD=4.52) (p<0.001). No statistically significant difference was observed between intervention and control groups with regard to frequency of violence faced by HCPs post training and major perpetrators of violence.. CONCLUSION: De-escalation of violence training was effective in improving confidence of healthcare providers in coping with patient aggression.