Facilitators and barriers in acceptance of telemedicine among healthcare providers in Pakistan: A cross-sectional survey.

Objectives: This study aimed to assess healthcare professionals' awareness and acceptance of telemedicine residing in Pakistan. Materials and Methods: A cross-sectional study was conducted across Pakistan from November 2021 to March 2022. Data entry was done through a self-administered questionnaire. In this survey, the non-probability purposive sampling method was adopted. Medical doctors from all specialties that fall into the age category of 20-60 years were included in this study. Statistical Package for Social Sciences (SPSS) version 22.0 was used for univariate data analysis. Results: Among the 860 healthcare professionals who received the survey, 198 responded (23.0% response rate). The mean ± SD age of the participants was 31.16 ± 8.56. The results were found to be statistically significant for knowledge about telemedicine among healthcare professionals workplace, that is, healthcare professionals working in the private sector indicated a high level of awareness regarding telemedicine as compared to those in the public sector (p = 0.03). A significant difference (p-value ⩽ 0.05) in knowledge was seen among doctors working in the public sector and those working in a private setup. Results indicate significant positive associations between telemedicine utilization and perceived benefits over disadvantages (ß = 1.03, p = 0.017), reliance among healthcare professionals (ß = 1.22, p = 0.008), and enhancement in healthcare quality (ß = 1.42, p = 0.001). Moreover, familiarity with telemedicine correlates strongly with its usage (ß = 2.56, p < 0.000). Conclusion: Overall, healthcare professionals exhibited satisfactory knowledge regarding telemedicine and showed an accepting attitude toward telemedicine. Our study recommends enhancing the importance of Telemedicine training at the Healthcare professionals' level to produce quality service delivery in healthcare organizations.

Facilitators and barriers in acceptance of telemedicine among healthcare providers in Pakistan: A Cross-sectional survey: The aim of this study, was to evaluate healthcare professionals' knowledge and acceptance of telemedicine in Karachi, Pakistan. A cross-sectional survey was carried out between November 2021 and March 2022, and 198 out of 860 healthcare professionals responded (representing a 23.0% response rate). The participants' average age was 31.16 years. The results showed that healthcare professionals in the public and private sectors differed significantly in their awareness of telemedicine, with the former group having higher awareness levels. Most of the medical professionals showed adequate understanding and acceptance of telemedicine. However, in order to improve service delivery in healthcare organizations, the study emphasizes the necessity for improved telemedicine awareness and training among healthcare providers, especially in the public sector. The findings highlighted how crucial it is to integrate telemedicine within medical education.

Nonparametric mixed exponentially weighted moving average-moving average control chart.

This research designed a distribution-free mixed exponentially weighted moving average-moving average (EWMA-MA) control chart based on signed-rank statistic to effectively identify changes in the process location. The EWMA-MA charting statistic assigns more weight to information obtained from the recent w samples and exponentially decreasing weights to information accumulated from all other past samples. The run-length profile of the proposed chart is obtained by employing Monte Carlo simulation techniques. The effectiveness of the proposed chart is evaluated under symmetrical distributions using a variety of individual and overall performance measures. The analysis of the run-length profile indicates that the proposed chart performs better than the existing control charts discussed in the literature. Additionally, an application from a gas turbine is provided to demonstrate how the proposed chart can be used in practice.

Deep Learning Based Multiresponse Optimization Methodology for Dual-Axis MEMS Accelerometer.

This paper presents a deep neural network (DNN) based design optimization methodology for dual-axis microelectromechanical systems (MEMS) capacitive accelerometer. The proposed methodology considers the geometric design parameters and operating conditions of the MEMS accelerometer as input parameters and allows to analyze the effect of the individual design parameters on the output responses of the sensor using a single model. Moreover, a DNN-based model allows to simultaneously optimize the multiple output responses of the MEMS accelerometers in an efficient manner. The efficiency of the proposed DNN-based optimization model is compared with the design of the computer experiments (DACE) based multiresponse optimization methodology presented in the Literature, which showed a better performance in terms of two output performance metrics, i.e., mean absolute error (MAE) and root mean squared error (RMSE).

Enhancing Anticorrosion Resistance of Aluminum Alloys Using Femtosecond Laser-Based Surface Structuring and Coating.

We report a robust two-step method for developing adherent and anticorrosive molybdenum (Mo)-based coatings over an aluminum (Al) 6061 alloy substrate using a femtosecond (fs) laser. The fs laser nanostructuring of Al 6061 alloy in air gives rise to regular arrays of microgrooves exhibiting superhydrophilic surface properties. The microstructured surface is further coated with an Mo layer using the fs-pulsed laser deposition (fs-PLD) technique. The combination of the two femtosecond laser surface treatments (microstructuring followed by coating) enabled the development of a highly corrosion-resistant surface, with a corrosion current of magnitude less than that of the pristine, the only structured, and the annealed alloy samples. The underlying mechanism is attributed to the laser-assisted formation of highly rough hierarchical oxide structures on the Al 6061 surface along with post heat treatment, which passivates the surface and provide the necessary platform for firm adhesion for Mo coating. Our results reveal that the corrosive nature of the Al-based alloys can be controlled and improved using a combined approach of femtosecond laser-based surface structuring and coating.

A Two-Step Femtosecond Laser-Based Deposition of Robust Corrosion-Resistant Molybdenum Oxide Coating.

A two-step femtosecond-pulsed laser deposition (fs-PLD) process is reported for the rapid development of uniform, poreless, crack-free, and well-adhering amorphous coatings of source materials with a high melting point. The first step comprises a high-rate raw deposition of the source material via fs-PLD, followed by a second step of scanning the raw sample with fs laser pulses of optimized fluence and scan parameters. The technique is applied to develop substoichiometric molybdenum oxide (MoOx, x < 3) coatings on mild steel. The thickness of the layer was ~4.25 µm with roughness around 0.27 µm. Comprehensive surface characterization reveals highly uniform and relatively moderate roughness coatings, implying the potential of these films as robust corrosion-resistant coats. Corrosion measurements in an aqueous NaCl environment revealed that the coated mild steel samples possess an average corrosion inhibition efficiency of around 95% relative to polished mild steel.

Strange Metallicity and Magnetic Order in the CoNi(Cr/V) Medium-Entropy Alloy System.

CoNiCr is a prototypical example of topical multi-principle element alloys with superior cryogenic and high-temperature mechanical strength, corrosion, oxidation resistance, and yet-to-be-explored magnetic and electronic functionalities. The remarkable properties of this transition metal ternary system are not only due to atomic radii, electronic configurational mismatch, and atomic volume misfit but are also dependent on the debated magnetically driven chemical short-range order. The current study focuses on the electric and magnetic properties of the single-phase face-centered cubic CoNi(Cr/V) system in which V is introduced to the system at the expense of Cr to fine-tune the volume misfit in the system. All the samples exhibited ultra-small magnetic moments due to the complex magnetic interactions of the constituent elements. The electric transport measurements revealed a strange metallicity evidenced through the observation of the linear temperature dependence of the resistivity. Our findings support the recent theoretical studies on the magnetically driven chemical short-range order of the CoNiCr system.

SERS and EC-SERS detection of local anesthetic procaine using Pd loaded highly reduced graphene oxide nanocomposite substrate.

The localized surface plasmon resonance (LSPR) excitations are critical towards achieving sizable spectral enhancements of the Raman scattered light. Herein, the synthesis of palladium-based highly reduced graphene oxide (Pd-HRG) with LSPR properties as an effective surface-enhanced Raman scattering (SERS) substrate and its utility in the highly sensitive detection of procaine are reported. The concentration detection of procaine samples was optimized by applying a set of pre-concentration parameters. The Pd-HRG nanocomposite showed a remarkable LSPR response with a Raman enhancement factor of 8.7 × 102. The Pd-HRG is employed to modify fluorine doped tin oxide electrode (Pd-HRG/FTO), resulted with an enhancement factor of 7.5 × 104 corresponding to the EC-SERS technique. The electronic and surface properties of synthesized Pd-HRG and functionalized FTO electrode were evaluated using Raman, infrared, EIS, XRD, FESEM and EDX techniques. Quantum chemical calculations were carried out to elaborate on the nature of interaction of procaine molecules with a nanostructured surface model. Pd-HRG, with an efficient and cost-effective fabrication, can be considered as a promising EC-SERS substrate for the detection of organic therapeutic drugs.

Selective Synthesis of Monodisperse CoO Nanooctahedra as Catalysts for Electrochemical Water Oxidation.

Thermal decomposition is a promising route for the synthesis of metal oxide nanoparticles because size and morphology can be tuned by minute control of the reaction variables. We synthesized CoO nanooctahedra with diameters of ∼48 nm and a narrow size distribution. Full control over nanoparticle size and morphology could be obtained by controlling the reaction time, surfactant ratio, and reactant concentrations. We show that the particle size does not increase monotonically with time or surfactant concentration but passes through minima or maxima. We unravel the critical role of the surfactants in nucleation and growth and rationalize the observed experimental trends in accordance with simulation experiments. The as-synthesized CoO nanooctahedra exhibit superior electrocatalytic activity with long-term stability during oxygen evolution. The morphology of the CoO particles controls the electrocatalytic reaction through the distinct surface sites involved in the oxygen evolution reaction.

Crystal and molecular structure of [Ni{2-H2NC(=O)C5H4N}2(H2O)2][Ni{2,6-(O2C)2C5H3N}2]·4.67H2O; DFT studies on hydrogen bonding energies in the crystal.

[Ni{2-H2NC(=O)C5H4N}2(H2O)2][Ni{2,6-(O2C)2C5H3N}2]·4.67H2O, a new complex salt containing a bis(2,6-dicarboxypyridine)nickel(II) anion and a bis(2-amidopyridine)diaquanickel(II) cation, was synthesized and characterized. The crystal is stabilized by an extensive network of hydrogen bonds. Alternate layers of anions and cations/water molecules parallel to (010) can be distinguished. Computational studies of the network packing of the title compound by high-level DFT-D/B3LYP calculations indicate stabilization of the networks with conventional and non-conventional intermolecular O-H...O, N-H...O and C-H...O hydrogen bonds along with π-stacking contacts. Due to the presence of water molecules and the importance of forming hydrogen bonds with the involvement of water clusters to the stability of the crystal packing, the importance and role of these water clusters, and the quantitative stability resulting from the formation of hydrogen bonds and possibly other noncovalent bonds such as π-stacking are examined. The binding energies obtained by DFT-D calculations for these contacts indicate that hydrogen bonds, especially O-H...O and N-H...O, control the construction of the crystalline packing. Additionally, the results of Bader's theory of AIM for these interactions agree reasonably well with the calculated energies.

Enhanced Antimicrobial Activity of Biofunctionalized Zirconia Nanoparticles.

The effective interactions of nanomaterials with biological constituents play a significant role in enhancing their biomedicinal properties. These interactions can be efficiently enhanced by altering the surface properties of nanomaterials. In this study, we demonstrate the method of altering the surface properties of ZrO2 nanoparticles (NPs) to enhance their antimicrobial properties. To do this, the surfaces of the ZrO2 NPs prepared using a solvothermal method is functionalized with glutamic acid, which is an α-amino acid containing both COO- and NH4 + ions. The binding of glutamic acid (GA) on the surface of ZrO2 was confirmed by UV-visible and Fourier transform infrared spectroscopies, whereas the phase and morphology of resulting GA-functionalized ZrO2 (GA-ZrO2) was identified by X-ray diffraction and transmission electron microscopy. GA stabilization has altered the surface charges of the ZrO2, which enhanced the dispersion qualities of NPs in aqueous media. The as-prepared GA-ZrO2 NPs were evaluated for their antibacterial properties toward four strains of oral bacteria, namely, Rothia mucilaginosa, Rothia dentocariosa, Streptococcus mitis, and Streptococcus mutans. GA-ZrO2 exhibited increased antimicrobial activities compared with pristine ZrO2. This improved activity can be attributed to the alteration of surface charges of ZrO2 with GA. Consequently, the dispersion properties of GA-ZrO2 in the aqueous solution have increased considerably, which may have enhanced the interactions between the nanomaterial and bacteria.

Linking traditional anti-ulcer use of rhizomes of Bergenia ciliata (Haw.) to its anti-Helicobacter pylori constituents.

The rhizomes of Bergenia ciliata (B. ciliata, Family: Saxifragaceae) are widely used for treating gastric ulcers in folk medicine in Asia. It was hypothesized that anti-ulcer activity of B. ciliata is due to its anti-Helicobacter pylori (H. pylori) activity. The anti-H. pylori activity was investigated on six clinical bacterial isolates using agar well-diffusion and broth micro-dilution methods. The anti-H. pylori activity of amoxicillin (standard) was the highest (Zone of inhibition; ZI = 25 mm, minimum inhibitory concentration; MIC=0.125 µg/µL) whereas among all the extracts of the rhizomes, methanol extract showed the highest activity (ZI = 16 mm, MIC = 12.50 µg/µL). Bioassay guided isolation of methanol extract using chromatographic and crystallization techniques isolated bergenin (ZI = 21mm, MIC = 0.391µg/µL) as constituent responsible for anti-H. pylori activity. The present study describes for the first time anti-H. pylori activity and possible mechanism of anti-ulcer properties of rhizomes of B. ciliata.

Controlling the Morphology of Au-Pd Heterodimer Nanoparticles by Surface Ligands.

Controlling the morphology of noble-metal nanoparticles is mandatory to tune specific properties such as catalytic and optical behavior. Heterodimers consisting of two noble metals have been synthesized, so far mostly in aqueous media using selective surfactants or chemical etching strategies. We report a facile synthesis for Au@Pd and Pd@Au heterodimer nanoparticles (NPs) with morphologies ranging from segregated domains (heteroparticles) to core-shell structures by applying a seed-mediated growth process with Au and Pd seed nanoparticles in 1-octadecene (ODE), which is a high-boiling organic solvent. The as-synthesized oleylamine (OAm) functionalized Au NPs led to the formation of OAm-Au@Pd heteroparticles with a "windmill" morphology, having an Au core and Pd "blades". The multiply twinned structure of the Au seed particles (⌀ ≈ 9-11 nm) is associated with a reduced barrier for heterogeneous nucleation. This leads to island growth of bimetallic Au@Pd heteroparticles with less-regular morphologies. The reaction process can be controlled by tuning the surface chemistry with organic ligands. Functionalization of Au NPs (Ø ≈ 9-11 nm) with 1-octadecanethiol (ODT) led to the formation of ODT-Au@Pd NPs with a closed Pd shell through a strong ligand-metal binding, which is accompanied by a redistribution of the electron density. Experiments with varied Pd content revealed surface epitaxial growth of Pd on Au. For OAm-Pd and ODT-Pd seed particles, faceted, Au-rich domain NPs and impeded core-shell NPs were obtained, respectively. This is related to the high surface energy of the small Pd seed particles (⌀ ≈ 5-7 nm). The metal distribution of all bimetallic NPs was analyzed by extended (aberration-corrected) transmission electron microscopy (HR-TEM, HAADF-STEM, EDX mapping, ED). The Au and Pd NPs, as well as the ODT-Au@Pd and OAm-Pd@Au heteroparticles, catalyze the reduction of 4-nitrophenol to 4-aminophenol with borohydride. The catalytic activity is dictated by the particle structure. OAm-Au@Pd heteroparticles with faceted Au domains had the highest activity because of a mixed Au-Pd surface structure, while ODT-Au@Pd NPs, where the active Au core is covered by a Pd shell, had the lowest activity.

Monitoring Thiol-Ligand Exchange on Au Nanoparticle Surfaces.

Surface functionalization of nanoparticles (NPs) plays a crucial role in particle solubility and reactivity. It is vital for particle nucleation and growth as well as for catalysis. This raises the quest for functionalization efficiency and new approaches to probe the degree of surface coverage. We present an (in situ) proton nuclear magnetic resonance (1H NMR) study on the ligand exchange of oleylamine by 1-octadecanethiol as a function of the particle size and repeated functionalization on Au NPs. Ligand exchange is an equilibrium reaction associated with Nernst distribution, which often leads to incomplete surface functionalization following "standard" literature protocols. Here, we show that the surface coverage with the ligand depends on the (i) repeated exchange reactions with large ligand excess, (ii) size of NPs, that is, the surface curvature and reactivity, and (iii) molecular size of the ligand. As resonance shifts and extensive line broadening during and after the ligand exchange impede the evaluation of 1H NMR spectra, one- and two-dimensional 19F NMR techniques (correlation spectroscopy and diffusion ordered spectroscopy) with 1H,1H,2H,2H-perfluorodecanthiol as the fluorinated thiol ligand were employed to study the reactions. The enhanced resolution associated with the spectral range of the 19F nucleus allowed carrying out a site-specific study of thiol chemisorption. The widths and shifts of the resonance signals of the different fluorinated carbon moieties were correlated with the distance to the thiol anchor group. In addition, the diffusion analysis revealed that moieties closer to the NP surface are characterized by a broader diffusion coefficient distribution as well as slower diffusion.

Glycine-functionalized copper(ii) hydroxide nanoparticles with high intrinsic superoxide dismutase activity.

Superoxide dismutases (SOD) are a group of enzymes that catalyze the dismutation of superoxide (O2-) radicals into molecular oxygen (O2) and H2O2 as a first line of defense against oxidative stress. Here, we show that glycine-functionalized copper(ii) hydroxide nanoparticles (Gly-Cu(OH)2 NPs) are functional SOD mimics, whereas bulk Cu(OH)2 is insoluble in water and catalytically inactive. In contrast, Gly-Cu(OH)2 NPs form water-dispersible mesocrystals with a SOD-like activity that is larger than that of their natural CuZn enzyme counterpart. Based on this finding, we devised an application where Gly-Cu(OH)2 NPs were incorporated into cigarette filters. Cigarette smoke contains high concentrations of toxic reactive oxygen species (ROS, >1016 molecules per puff) including superoxide and reactive nitrogen species which lead to the development of chronic and degenerative diseases via oxidative damage and subsequent cell death. Embedded in cigarette filters Gly-Cu(OH)2 NPs efficiently removed ROS from smoke, thereby protecting lung cancer cell lines from cytotoxic effects. Their stability, ease of production and versatility make them a powerful tool for a wide range of applications in environmental chemistry, biotechnology and medicine.

Synthesis and Comparative Catalytic Study of Zirconia-MnCO3 or -Mn2O3 for the Oxidation of Benzylic Alcohols.

We report on the synthesis of the zirconia-manganese carbonate ZrOx(x %)-MnCO3 catalyst (where x=1-7) that, upon calcination at 500 °C, is converted to zirconia-manganese oxide ZrOx(x %)-Mn2O3 . We also present a comparative study of the catalytic performance of the both catalysts for the oxidation of benzylic alcohol to corresponding aldehydes by using molecular oxygen as the oxidizing agent. ZrOx(x %)-MnCO3 was prepared through co-precipitation by varying the amounts of Zr(NO3)4 (w/w %) in Mn(NO3)2. The morphology, composition, and crystallinity of the as-synthesized product and the catalysts prepared upon calcination were studied by using scanning electron microscopy, transmission electron microscopy, energy-dispersive X-ray spectroscopy, and powder X-ray diffraction. The surface areas of the catalysts [133.58 m2 g-1 for ZrOx(1 %)-MnCO3 and 17.48 m2 g-1 for ZrOx(1 %)-Mn2O3 ] were determined by using the Brunauer-Emmett-Teller method, and the thermal stability was assessed by using thermal gravimetric analysis. The catalyst with composition ZrOx(1 %)-MnCO3 pre-calcined at 300 °C exhibited excellent specific activity (48.00 mmolg-1 h-1) with complete conversion within approximately 5 min and catalyst cyclability up to six times without any significant loss in activity. The specific activity, turnover number and turnover frequency achieved is the highest so far (to the best of our knowledge) compared to the previously reported catalysts used for the oxidation of benzyl alcohol. The catalyst showed selectivity for aromatic alcohols over aliphatic alcohols.

Discrete Wavelet Transform-Based Whole-Spectral and Subspectral Analysis for Improved Brain Tumor Clustering Using Single Voxel MR Spectroscopy.

Many approaches have been considered for automatic grading of brain tumors by means of pattern recognition with magnetic resonance spectroscopy (MRS). Providing an improved technique which can assist clinicians in accurately identifying brain tumor grades is our main objective. The proposed technique, which is based on the discrete wavelet transform (DWT) of whole-spectral or subspectral information of key metabolites, combined with unsupervised learning, inspects the separability of the extracted wavelet features from the MRS signal to aid the clustering. In total, we included 134 short echo time single voxel MRS spectra (SV MRS) in our study that cover normal controls, low grade and high grade tumors. The combination of DWT-based whole-spectral or subspectral analysis and unsupervised clustering achieved an overall clustering accuracy of 94.8% and a balanced error rate of 7.8%. To the best of our knowledge, it is the first study using DWT combined with unsupervised learning to cluster brain SV MRS. Instead of dimensionality reduction on SV MRS or feature selection using model fitting, our study provides an alternative method of extracting features to obtain promising clustering results.

Measures of effective video tracking.

To evaluate multitarget video tracking results, one needs to quantify the accuracy of the estimated target-size and the cardinality error as well as measure the frequency of occurrence of ID changes. In this paper, we survey existing multitarget tracking performance scores and, after discussing their limitations, we propose three parameter-independent measures for evaluating multitarget video tracking. The measures consider target-size variations, combine accuracy and cardinality errors, quantify long-term tracking accuracy at different accuracy levels, and evaluate ID changes relative to the duration of the track in which they occur. We conduct an extensive experimental validation of the proposed measures by comparing them with existing ones and by evaluating four state-of-the-art trackers on challenging real-world publicly-available data sets. The software implementing the proposed measures is made available online to facilitate their use by the research community.

A protocol for evaluating video trackers under real-world conditions.

The absence of a commonly adopted performance evaluation framework is hampering advances in the design of effective video trackers. In this paper, we present a single-score evaluation measure and a protocol to objectively compare trackers. The proposed measure evaluates tracking accuracy and failure, and combines them for both summative and formative performance assessment. The proposed protocol is composed of a set of trials that evaluate the robustness of trackers on a range of test scenarios representing several real-world conditions. The protocol is validated on a set of sequences with a diversity of targets (head, vehicle and person) and challenges (occlusions, background clutter, pose changes and scale changes) using six state-of-the-art trackers, highlighting their strengths and weaknesses on more than 187000 frames. The software implementing the protocol and the evaluation results are made available online and new results can be included, thus facilitating the comparison of trackers.