Dietary Oyster Mushroom (Pleurotus ostreatus) Waste Inhibits Experimentally Induced Eimeria tenella Challenge in Japanese Quails Model.

The aim of this study was to investigate the potential of dietary 3% oyster mushroom (Pleurotus ostreatus) waste in enhancing the anticoccidial effects in broilers challenged with Eimeria tenella infection. The experiment involved a total of 600 Japanese quails, raised from one to thirty-five days of age, which were divided into four treatment groups. These included a negative control group that received a basal diet (BD) without any anticoccidial or antibiotic supplementation in the non-challenged birds (negative control, NC); a positive control (PC) group consisting of NC birds challenged with E. tenella; a group that received the BD with an anticoccidial drug (standard); and a group that received the BD supplemented with 3% waste from oyster mushrooms (3% Pleurotus ostreatus). The results showed that the feed intake, body weight gain, and feed efficiency were significantly lower in the PC (p < 0.05). However, the growth traits were similar in the standard and 3% Pleurotus ostreatus-treated groups. Similarly, there was no difference (p < 0.05) in the mortality rate, oocyst count in the feces, and lesion score between the standard and 3% Pleurotus ostreatus groups. Based on intestinal histology evaluation, the villi height and width were significantly higher in the standard and 3% Pleurotus ostreatus-treated groups compared to those of the PC (p < 0.01). In conclusion, it was found that 3% Pleurotus ostreatus effectively mitigated the low growth rate of Japanese quails induced by coccidial infection.

Determinants of HIV/Aids Knowledge Among Females in Somalia: Findings from 2018 to 2019 SDHS Data.

Background: Immunodeficiency syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV), has become a serious global public health concern, particularly in underdeveloped countries. Even though the fact that just a few case studies have addressed on the HIV/AIDS in the context of Somalia, to the best of our knowledge, no national-scale study on the topic has been attempted. Limited knowledge of HIV/AIDS is highlighted as one of the major factors linked to the high prevalence of HIV among female population. This study aims to fill this knowledge gap in the literature by investigating the effects of several sociodemographic factors on females' knowledge about HIV/AIDS in Somalia. Methods: Secondary data from the Somalia Demographic Health Survey 2018-19 were used in this study. A total of 16,335 women between the ages of 15 and 49 who fit our inclusion criteria have been chosen. The application of multiple logistic regressions was then performed to see if the predictors had a significant association with knowledge of HIV/AIDS. Findings: Women aged 35-39 (AOR = 1.608; 95% CI: 1.372-1.886), women lived in urban (AOR: 2.833, 95% CI: 2.246-3.572), Women's education (AOR: 2.246, 95% CI: 1.988-2.537), frequency of listening to a radio (AOR = 2.312; 95% CI: 1.995-2.679), and frequency of watching television (AOR = 3.936; 95% CI: 3.445-4.497) were significantly related with current knowledge about HIV/AIDS among eligible women in Somalia. Conclusion: This study highlights the importance of mass media (TV and radio) interventions, education, and place of habitation as the main significant predictors of women's knowledge of HIV/AIDS in Somalia. Based on the study, women are more likely to be aware of HIV/AIDS as their education level, frequency of listening a radio and watching a television watching rises. The research additionally indicates that women who reside in urban centers are nearly three times more likely than women who live in nomadic areas to know more about HIV/AIDS.

Factor Associated with HIV/AIDS knowledge among males: Findings from 2017-18 Pakistan Demographic and Health Survey.

Acquired immune deficiency syndrome (UNAIDS) has risen as the serious public health problem across the world. Knowledge about HIV/AIDS is the cornerstone for prevention and treatment. Research is needed to explore the attitude and the effect of different demographic, geographic, and socioeconomic and media exposure factors on males knowledge about HIV in Pakistan. In this study, latest secondary data are used from Pakistan Demographic and Health Survey 2017-18. Sample results show that the majority of the respondents (70%) have knowledge about AIDS. Regression Modeling reveals that man's knowledge about HIV/AIDS is associated with age, place of residence, educational level, wealth index, ethnicity and media exposure factors. Males of age group 35-39, with higher education, belonging to Pukthon ethnicity, having exposure to mass media on a daily basis and belonging to richest wealth quintile has high Knowledge of HIV/AIDS. For example, the regression model predicts that men between the ages of 35 and 39 from Islamabad who live in urban areas, have higher education, are of Pukhtoon ethnicity, are the head of the household, belong to the richest quintile, work in professional occupations, and use media exposure factors on a daily basis would have probability of 97% of having knowledge of HIV/AIDS. But there is still need to focus to increase the men's knowledge of HIV/AIDS.

Clustering-based iterative heuristic framework for a non-emergency patients transportation problem.

Introduction: Non-emergency patient transportation (NEPT) services are particularly important nowadays due to the aging population and contagious disease outbreaks (e.g., Covid-19 and SARS). In this work, we study a NEPT problem with a case study of patient transportation services in Hong Kong. The purpose of this work is to study the discomfort and inconvenience measures (e.g., waiting time and extra ride time) associated with the transportation of non-emergency patients while optimizing the operational costs and utilization of NEPT ambulances. Methods: A mixed-integer linear programming (MILP) formulation is developed to model the NEPT problem. This MILP model contributes to the existing literature by not only including the patient inconvenience measures in the objective function but also illustrating a better trade-off among different performance measures through its specially customized formulation and real-life characteristics. CPLEX is used to find the optimal solutions for the test instances. To overcome the computational complexity of the problem, a clustering-based iterative heuristic framework is designed to solve problems of practical sizes. The proposed framework distinctively exploits the problem-specific structure of the considered NEPT problem in a novel way to enhance and improve the clustering mechanism by repeatedly updating cluster centers. Results: The computational experiments on 19 realistic problem instances show the effective execution of the solution method and demonstrate the applicability of our approach. Our heuristic framework observes an optimality gap of less than 5% for all those instances where CPLEX delivered the result. The weighted objective function of the proposed model supports the analysis of different performance measures by setting different preferences for these measures. An extensive sensitivity analysis performed to observe the behavior of the MILP model shows that when operating costs are given a weightage of 0.05 in the objective function, the penalty value for user inconvenience measures is the lowest; when the weightage value for operating costs varies between 0.8 and 1.0, the penalty value for the same measures is the highest. Conclusions: This research can assist decision-makers in improving service quality by balancing operational costs and patient discomfort during transportation.

Factors associated with female age at first marriage: An analysis using all waves of the Pakistan Demographic and Health Survey.

In conventional Muslim societies, fertility occurs within the marital union. Therefore, fertility outcomes depend on females' age at first marriage (AFM). The present study explores the pattern of AFM in Pakistan, analyses of which are scarce in the literature. We aim to identify the factors associated with the AFM among currently married women in Pakistan. Demographic factors like birth cohort, and socioeconomic and cultural factors such as province and place of residence, education level, whether or not a woman had ever worked before marriage, ethnicity, and husband's education were studied to explore the pattern of female AFM. Data were taken from the Pakistan Demographic and Health Surveys (PDHSs) of 2012-13 and 2017-18, and a comparison was made with the findings from the earlier PDHSs of 1990-91 and 2006-07. The analysis concentrates on women born between 1941 and 1992, aged between 25 and 49 years during the data collection periods. One-way analysis of variance (ANOVA) was used to assess the difference between the mean AFM for different sub-groups of the population. To identify the covariates that are associated with AFM multiple linear regression models were estimated. We observed a gradually increasing trend in female AFM over time among women born after 1950. The ANOVA results revealed that birth cohort, province, and place of residence, female education level, whether or not a woman had ever worked before marriage, ethnicity, and husband's education were significantly associated with AFM (p-values < 0.05). In a multiple regression model, we found that the birth cohort significantly affects the AFM (p-value < 0.05). Having worked before marriage is associated with a statistically significant one-year rise in the AFM. Interestingly, all other ethnic groups have lower AFM compared with women whose mother language was Punjabi. Education has a highly significant effect on the AFM: the regression results revealed that uneducated females have a mean AFM 4 to 5 years lower than highly educated women. The results also revealed that educated men marry older women as compared to uneducated men. We conclude that the education of females and even males in Pakistan could lead to a rise in the female AFM.

Genome-wide analysis of sucrose synthase family in soybean and their expression in response to abiotic stress and seed development.

The sucrose synthase (SS) is an important enzyme family which play a vital role in sugar metabolism to improve the fruit quality of the plants. In many plant species, the members of SS family have been investigated but the detailed information is not available in legumes particularly and Glycine max specifically. In the present study, we found thirteen SS members (GmSS1-GmSS13) in G. max genome. High conserved regions were present in the GmSS sequences that may due to the selection pressure during evolutionary events. The segmental duplication was the major factor to increase the number of GmSS family members. The identified thirteen GmSS genes were divided into Class I, Class II and Class III with variable numbers of genes in each class. The protein interaction of GmSS gave the co-expression of sucrose synthase with glucose-1-phosphate adenylyltransferase while SLAC and REL test found number of positive sites in the coding sequences of SS family members. All the GmSS family members except GmSS7 and few of class III members, were highly expressed in all the soybean tissues. The expression of the class I members decreased during seed development, whireas, the class II members expression increased during the seed developing, may involve in sugar metabolism during seed development. Solexa sequencing libraries of acidic condition (pH 4.2) stress samples showed that the expression of class I GmSS genes increased 1- to 2-folds in treated samples than control. The differential expression pattern was observed between the members of a paralogous. This study provides detailed genome-wide analysis of GmSS family in soybean that will provide new insights for future evolutionary and soybean breeding to improve the plant growth and development.

Prevalence of type-2 diabetes and prediabetes in Malaysia: A systematic review and meta-analysis.

OBJECTIVE: The main purpose of this study was to investigate the pooled prevalence of prediabetes and type-2 diabetes in the general population of Malaysia. METHOD: We systematically searched Medline (PubMed), Embase, Web of Science, Google Scholar and Malaysian Journals Online to identify relevant studies published between January 1, 1995, and November 30, 2021, on the prevalence of type-2 diabetes in Malaysia. Random-effects meta-analyses were used to obtain the pooled prevalence of diabetes and prediabetes. Subgroup analyses also used to analyze to the potential sources of heterogeneity. Meta- regression was carried to assess associations between study characteristics and diabetes prevalence. Three independent authors selected studies and conducted the quality assessment. The quality of the final evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Of 2689 potentially relevant studies, 786 titles and abstract were screened. Fifteen studies with 103063 individuals were eligible to be included in the meta-analyses. The pooled prevalence of diabetes was 14.39% (95% CI, 12.51%-16.38%; I2 = 98.4%, 103063 participants from 15 studies). The pooled prevalence of prediabetes was 11.62% (95% CI, 7.17%-16.97%; I2 = 99.8, 88702 participants from 9 studies). The subgroup analysis showed statistically significant differences in diabetes prevalence by the ethical sub-populations with highest in Indians (25.10%; 95% CI, 20.19%-30.35%), followed by Malays (15.25%; 95% CI, 11.59%-19.29%), Chinese (12.87%; 95% CI, 9.73%-16.37%), Bumiputeras (8.62%; 95% CI, 5.41%-12.47%) and others (6.91%; 95% CI, 5.71%-8.19%). There was no evidence of publication bias, although heterogeneity was high (I2 ranged from 0.00% to 99·8%). The quality of evidence based on GRADE was low. CONCLUSIONS: Results of this study suggest that a high prevalence of prediabetes and diabetes in Malaysia. The diabetes prevalence is associated with time period and increasing age. The Malaysian government should develop a comprehensive approach and strategy to enhance diabetes awareness, control, prevention, and treatment. TRIAL REGISTRATION: Trial registration no. PROSPERO CRD42021255894; https://clinicaltrials.gov/.

Seroprevalence of Transfusion-Transmitted Infections among Voluntary and Replacement Blood Donors at the Peshawar Regional Blood Centre, Khyber Pakhtunkhwa, Pakistan.

Introduction Blood transfusion is linked to several risks, most notably the transmission of transfusion-transmitted infections (TTIs), including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malaria. The risk posed by these blood-borne infectious agents is high in developing countries, including Pakistan. This fact stresses the need for regular surveillance of TTIs. Therefore, the present study was undertaken to assess the seroprevalence of TTIs at a regional blood center. Material and Methods This was a retrospective 4-year descriptive study undertaken at the Regional Blood Centre in Peshawar, Khyber Pakhtunkhwa Province of Pakistan, on the blood donor data from June 2016 to May 2020. A total of 41,817 donors donated blood during the study period and were screened for HBV, HCV, HIV, syphilis, and malaria. To ensure donor privacy, donors were identified via codes and no personal information was available. The data were extracted from the ZAAVIA blood transfusion information system database. Results The study included a total of 41,817 donors-41,493 (99.22%) males and 324 (0.78%) females. Of them, 22,343 (53.43%) were voluntary donors while 19,474 (46.57%) were replacement donors. An overall TTI prevalence rate of 4.61% was found. The TTI prevalence rate in voluntary donors was 3.90% while 5.42% in replacement donors. The overall prevalence of HBV, HCV, HIV, syphilis, and malaria was 1.95, 1.38, 0.23, 0.91, and 0.14%, respectively. Conclusion The current study documented a high prevalence (1,929 out of 41,817, 4.61%) of TTIs, especially in replacement donors (1,057 out of 19,474, 5.42%), and low participation of female donors. The recommendations include the promotion of voluntary blood donors, enrolment of female blood donors, and screening of donated blood through highly sensitive screening assay (i.e., nucleic acid testing).

Chemical composition and pharmacological bio-efficacy of Parrotiopsis jacquemontiana (Decne) Rehder for anticancer activity.

Consistent STAT3 (Single transducer and activator of transcription 3) activation is observed in many tumors and promotes malignant cell transformation. In the present investigation, we evaluated the anticancer effects of Parrotiopsis jacquemontiana methanol fraction (PJM) on STAT3 inhibition in HCCLM3 and MDA-MB 231 cells. PJM suppressed the activation of upstream kinases i.e. JAK-1/2 (Janus kinase-1/2), and c-Src (Proto-oncogene tyrosine-protein kinase c-Src), and upregulated the expression levels of PIAS-1/3 (Protein Inhibitor of Activated STATs-1/3), SHP-1/2 (Src-homology region 2 domain-containing phosphatase-1/2), and PTP-1ß (Protein tyrosine phosphatase 1 ß) which negatively regulate STAT3 signaling pathway. PJM also decreased the levels of protein products conferring to various oncogenes, which in turn repressed the proliferation, migration, invasion, and induced apoptosis in cancer cell lines. The growth inhibitory effects of PJM on cell-cycle and metastasis were correlated with decreased expression levels of CyclinD1, CyclinE, MMP-2 (Matrix metalloproteinases-2), and MMP-9 (Matrix metalloproteinases-9). Induction of apoptosis was indicated by the cleavage and subsequent activation of Caspases (Cysteine-dependent Aspartate-directed Proteases) i.e. caspase-3, 7, 8, 9, and PARP (Poly (ADP-ribose) polymerase) as well as through the down-regulation of anti-apoptotic proteins. These apoptotic effects of PJM were preceded by inhibition of STAT3 cell-signaling pathway. STAT3 was needed for PJM-induced apoptosis, and inhibition of STAT3 via pharmacological inhibitor (Stattic; SC-203282) abolished the apoptotic effects. Conclusively, our results demonstrate the capability of PJM to inhibit cancer cell-proliferation and induce apoptosis by suppressing STAT3 via upregulation of STAT3 inhibitors and pro-apoptotic proteins whereas the down-regulation of upstream kinases and anti-apoptotic protein expression. In future, one-step advance studies of PHM regarding its role in metastatic inhibition, immune response modulation for reducing tumor, and inducing apoptosis in suitable animal models would be an interesting and promising research area.

Surgical outcome of repair of aortic valve prolapse and regurgitation associated with ventricular septal defect.

OBJECTIVE: To analyze the outcome of repair of aortic valve disease associated with various types of ventricular septal defect. METHODS: In a retrospective observational study design, data of seventy-two patients of ventricular septal defect (VSD) associated with aortic valve prolapse (AVP) and aortic regurgitation (AR) who was operated in Punjab Institute of cardiology from May 2016 to April 2020 was collected. Depending on presence of AR, all patients were divided in four groups. Group-I (VSD and AVP but no AR) had fifteen patients. Only VSD was closed in this group. Group-II (VSD and Mild AR) had forty patients, only VSD was closed in this group as well. Group-III (VSD and Moderate AR) had ten patients, VSD closure and aortic valve repair was done. Group-IV (VSD and severe AR) had seven patients. Aortic valve was repaired in five patients and replaced (AVR) in two patients along with VSD closure. Associated anomalies were addressed as well. RESULTS: Group-I: Twelve out of fifteen patients (80%) showed no post-operative AR. While two patients (13.3%) showed Trace AR. Single patient (6.6%) showed mild AR. There results were unchanged after mean follow up of 36 months. Group-II: Eight out of forty patients (20%) had no AR, while eight (20%) had trace AR. Twenty-three (57.5%) patients had mild AR. Single (2.5%) patient had moderate AR. After follow up of 24 months the patient with moderate AR progressed to severe AR. We are planning to do Aortic Valve Replacement (AVR) in this case. Rest of cases showed no progression of disease. Group-III: Two out of ten patients (20%) had no AR, four (40%) had trace AR, while four (40%) had mild AR. Mean follow up was 42 months (2.5 years). Neither trace nor mild AR progressed to severe or moderate AR. Group-IV: Among seven patients, five underwent repair while two had AVR. Out of five patients who underwent aortic valve repair, four patients (57.1%) were declared mild AR, while severe AR was converted to moderate AR in single patient (14.28%). Mean follow up was 18 months. The moderate AR patient has progressed to severe AR for last six months and we are planning to do AVR in this patient. Postoperative echo of patients with AVR showed adequately functioning aortic valve with AVPG mean 10 mmHg and 15 mm Hg respectively, with no residual AR. CONCLUSIONS: Aortic regurgitation associated with VSD is a congenital lesion with continuously active aortic valve disease resulting in significant morbidity and mortality. Early diagnosis, effective treatment and meticulous follow up decelerate and in most cases arrest the disease process.

The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis.

BACKGROUND: The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta-analysis. METHODS: A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta-analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. RESULTS: Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86-16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. CONCLUSIONS: This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. TRIAL REGISTRATION: This review was registered on PROSPERO (registration number CRD42020172624 ).

Single source precursor synthesized CuS nanoparticles for NIR phototherapy of cancer and photodegradation of organic carcinogen.

Herein, we report cost effective and body compatible CuS nanoparticles (NPs) derived from a single source precursor as photothermal agent for healing deep cancer and photocatalytic remediation of organic carcinogens. These NPs efficiently kill MCF7 cells (both in vivo and in vitro) under NIR irradiation by raising the temperature of tumor cells. Such materials can be used for the treatment of deep cancer as they can produce a heating effect using high wavelength and deeply penetrating NIR radiation. Furthermore, CuS NPs under solar light irradiation efficiently convert p-nitrophenol (PNP), an environmental carcinogen, to p-aminophenol (PAP) of pharmaceutical implication. In a nutshell, CuS can be used for the treatment of deep cancer and for the remediation of carcinogenic pollutants. There seems an intrinsic connection between the two functions of CuS NPs that need to be explored in length.

Prevalence of diabetes and pre-diabetes in Bangladesh: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this paper is to perform a systematic review and meta-analysis in order to summarise the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: General population of Bangladesh. DATA SOURCES: PubMed, Medline, Embase, Bangladesh Journals Online, Science Direct, Scopus, Cochrane Library and Web of Science were used to search for studies, published between 1st of January 1995 and 31st of August 2019, on the prevalence of diabetes and pre-diabetes and their associated risk factors in Bangladesh. Only articles published in the English language articles were considered. Two authors independently selected studies. The quality of the articles was also assessed. RESULTS: Out of 996 potentially relevant studies, 26 population-based studies, which together involved a total of 80 775 individuals, were included in the meta-analysis. The pooled prevalence of diabetes in the general population was 7.8% (95% CI: 6.4-9.3). In a sample of 56 452 individuals, the pooled prevalence of pre-diabetes was 10.1% (95% CI: 6.7-14.0; 17 studies). The univariable meta-regression analyses showed that the prevalence of diabetes is associated with the factors: the year of study, age of patients and presence of hypertension. The prevalence of diabetes was significantly higher in urban areas compared with rural areas, while there was no significant gender difference. CONCLUSIONS: This meta-analysis suggests a relatively high prevalence of pre-diabetes and diabetes in Bangladesh, with a significant difference between rural and urban areas. The main factors of diabetes include urbanisation, increasing age, hypertension and time period. Further research is needed to identify strategies for early detecting, prevention and treatment of people with diabetes in the population. PROSPERO REGISTRATION NUMBER: CRD42019148205.

Environmentally friendly green approach for the fabrication of silver oxide nanoparticles: Characterization and diverse biomedical applications.

In the present study, green silver nanoparticles (Ag2 ONPs) were prepared from aqueous and ethanolic leaves extract of Rhamnus virgata in a facile, green, cost-effective, and eco-friendly way. The color changes from light brown to brownish black determined the synthesis of Ag2 ONPs(Aq) and Ag2 ONPs(Et) . The phytofabrication of Ag2 ONPs was confirmed using various spectroscopic and microscopic techniques: energy-dispersive X-ray spectroscopy, dynamic light scattering, ultraviolet-visible spectroscopy, Fourier-transform infrared, X-ray powder diffraction, Raman, scanning electron microscopy, and transmission electron microscopy. Detailed in vitro biological activities determined significant biopotentials for Ag2 ONPs. The Ag2 ONPs(Aq) and Ag2 ONPs(Et) were investigated for anticancer potential against HUH-7 (IC50 : 9.075 µg/ml for Ag2 O(Aq) and 25.66 µg/ml for Ag2 O(Et) ) and HepG2 (IC50 : 25.18 µg/ml for Ag2 O(Aq) and IC50 : 27.74 µg/ml for Ag2 O(Aq) ) cell lines. Concentration-dependent cytotoxicity was performed against brine-shrimps (IC50 : 36.04 µg/ml for Ag2 O(Aq) and 28.82 µg/ml for Ag2 O(Et) ) and Leishmanial parasite (amastigotes and promastigotes). Disc-diffusion method revealed significant antimicrobial activities. In addition, significant enzyme inhibitory activity and antiradical potentials were studied. The hemocompatible nature of Ag2 ONPs(Aq) and Ag2 ONPs(Et) was revealed using biocompatibility tests. In conclusion, the green Ag2 ONPs(Aq) and Ag2 ONPs(Et) are nontoxic and biocompatible and has shown significant biological activities. We further encourage in vivo studies to ensure biosafety and biocompatibility, so that they can be effectively utilized in nano-pharmaceutical industries.

The prevalence of hepatitis C virus in hemodialysis patients in Pakistan: A systematic review and meta-analysis.

BACKGROUND: Hepatitis C virus (HCV) infection is one of the most common bloodborne viral infections reported in Pakistan. Frequent dialysis treatment of hemodialysis patients exposes them to a high risk of HCV infection. The main purpose of this paper is to quantify the prevalence of HCV in hemodialysis patients through a systematic review and meta-analysis. METHODS: We systematically searched PubMed, Medline, EMBASE, Pakistani Journals Online and Web of Science to identify studies published between 1 January 1995 and 30 October 2019, reporting on the prevalence of HCV infection in hemodialysis patients. Meta-analysis was performed using a random-effects model to obtain pooled estimates. A funnel plot was used in conjunction with Egger's regression test for asymmetry and to assess publication bias. Meta-regression and subgroup analyses were used to identify potential sources of heterogeneity among the included studies. This review was registered on PROSPERO (registration number CRD42019159345). RESULTS: Out of 248 potential studies, 19 studies involving 3446 hemodialysis patients were included in the meta-analysis. The pooled prevalence of HCV in hemodialysis patients in Pakistan was 32.33% (95% CI: 25.73-39.30; I2 = 94.3%, p < 0.01). The subgroup analysis showed that the prevalence of HCV among hemodialysis patients in Punjab was significantly higher (37.52%; 95% CI: 26.66-49.03; I2 = 94.5, p < 0.01) than 34.42% (95% CI: 14.95-57.05; I2 = 91.3%, p < 0.01) in Baluchistan, 27.11% (95% CI: 15.81-40.12; I2 = 94.5, p < 0.01) in Sindh and 22.61% (95% CI: 17.45-28.2; I2 = 78.6, p < 0.0117) in Khyber Pukhtoonkhuwa. CONCLUSIONS: In this study, we found a high prevalence (32.33%) of HCV infection in hemodialysis patients in Pakistan. Clinically, hemodialysis patients require more attention and resources than the general population. Preventive interventions are urgently needed to decrease the high risk of HCV infection in hemodialysis patients in Pakistan.

The prevalence of hepatitis C virus infection in ß-thalassemia patients in Pakistan: a systematic review and meta-analysis.

BACKGROUND: Hepatitis C virus infection is the most commonly reported bloodborne infection in Pakistan. Frequent blood transfusions in ß-thalassemia patients expose them to a high risk of HCV infection. The purpose of this paper is to summarise the current data on the prevalence of HCV infection in ß-thalassemia patients in Pakistan by using a systematic review and meta-analysis. METHODS: PubMed, EMBASE, Web of Sciences, the Cochrane Library, Directory of Open Access Journal and local databases were systematically searched for studies published between January 1st, 1995 and May 31st, 2019. Meta-analysis was performed using the DerSimonian and Laird random-effects models with inverse variance weighting. The presence of publication bias was tested by Egger test, and the methodological quality of each included article was evaluated by the STROBE. RESULTS: We identified a total of 229 potential studies, of which 27 studies were finally considered in the meta-analysis. The pooled prevalence of HCV in ß-thalassemia patients in Pakistan was 36.21% (95% CI: 28.98-43.75%) based on 5789 ß-thalassemia patients, but there was considerable heterogeneity. Meta-analysis estimated the HCV prevalence among the ß-thalassemia patients at 45.98% (95% CI: 38.15-53.90%) in Punjab, 31.81% (95% CI: 20.27-44.59%) in Sindh, and 28.04% (95% CI: 13.58-45.26%) in Khyber Pakhtunkhwa. Meta-regression analysis showed that geographical location was a key source of heterogeneity. CONCLUSIONS: The pooled prevalence of HCV in ß-thalassemia patients in Pakistan was more than one in three, and higher than in neighbouring countries. It varies regionally within the country. With the use of standard prevention procedures during blood transfusion, the risk of HCV transmission in ß-thalassemia patients could be controlled and the prevalence of HCV in ß-thalassemia patients reduced.

Facile photocatalytic reduction of carcinogenic Cr(vi) on Fe-doped copper sulfide nanostructures.

In this study, Fe-doped copper sulfide nanoparticles (NPs) were investigated for the solar-assisted reduction of CrVI ions in raw water. The Fe-doped NPs were synthesized by decomposing copper(ii) N,N-diphenylmethylpiperazinecarbamodithioate via a facile single-step, one-pot solvothermal method in the presence of iron salt. The CrVI photoreduction data were fit to a pseudo-first-order kinetic model and a Langmuir model. The CuS/Cu2S NP reduction ability for CrVI increases with an increase in dopant percentage. The best catalyst (9% Fe-doped) was able to reduce CrVI (10-4 M K2Cr2O7) to CrIII in raw water using an initial amount of 10 mg in 6 min with a reduction efficiency of up to 100%. The photocatalytic activity was examined while varying five different parameters: sunlight, diffused light, change in pH, and changes in the concentration of the catalyst and the temperature. This new approach presents an active, simple, and cost-effective means for wastewater treatment.

Quantitative thresholds based decision support approach for the home health care scheduling and routing problem.

In the domain of Home Health Care (HHC), precise decisions regarding patient's selection, staffing level, and scheduling of health care staff have a significant impact on the efficiency and effectiveness of the HHC system. However, decentralized planning, the absence of well defined decision rules, delayed decisions and lack of interactive tools typically lead towards low satisfaction level among all the stakeholders of the HHC system. In order to address these issues, we propose an integrated three phase decision support methodology for the HHC system. More specifically, the proposed methodology exploits the structure of the HHC problem and logistic regression based approaches to identify the decision rules for patient acceptance, staff hiring, and staff utilization. In the first phase, a mathematical model is constructed for the HHC scheduling and routing problem using Mixed-Integer Linear Programming (MILP). The mathematical model is solved with the MILP solver CPLEX and a Variable Neighbourhood Search (VNS) based method is used to find the heuristic solution for the HHC problem. The model considers the planning concerns related to compatibility, time restrictions, distance, and cost. In the second phase, Bender's method and Receiver Operating Characteristic (ROC) curves are implemented to identify the thresholds based on the CPLEX and VNS solution. While the third phase creates a fresh solution for the HHC problem with a new data set and validates the thresholds predicted in the second phase. The effectiveness of these thresholds is evaluated by utilizing performance measures of the widely-used confusion matrix. The evaluation of the thresholds shows that the ROC curves based thresholds of the first two parameters achieved 67% to 71% accuracy against the two considered solution methods. While the Bender's method based thresholds for the same parameters attained more than 70% accuracy in cases where probability value is small (p ≤ 0.5). The promising results indicate that the proposed methodology is applicable to define the decision rules for the HHC problem and beneficial to all the concerned stakeholders in making relevant decisions.

Is recent Afghanistan survey data suitable for fertility analysis? A regional investigation based on fertility inhibiting determinants.

Afghanistan has been a country blighted by war over the past five decades and limited research is available on its demography. This study seeks to assess the suitability of recent survey data for Afghanistan (the 2010 Afghanistan Mortality Survey (AMS)and the 2015 Afghanistan Demographic and Health Survey (ADHS)) for estimating levels and trends in fertility. As several fertility measures rely on the quality of age data, we first apply demographic tools for the identification of age misreporting, finding evidence that it is severe. We then explore the consistency of fertility reporting across the two surveys, finding that the 2015 ADHS reports higher fertility among older women than the 2010 AMS although the seasonal pattern of fertility is consistent across the two surveys. We then estimate total fertility rates in 2008-2010 and 2012-2015 and measures of Bongaarts's key proximate determinants of fertility for Afghanistan and its provinces for urban and rural areas separately. The results show that fertility is similar in urban and rural Afghanistan. Although most of the provincial data on the proximate determinants is reasonably consistent with the fertility rates, there are anomalies in some provinces which indicate the possible under-reporting of births. Overall, we conclude that the fertility data in the two surveys can be used with care to give an indication of broad regional fertility patterns and trends in the country.

Diabetes in Pakistan: A systematic review and meta-analysis.

OBJECTIVE: The purpose of this study was assess the time trend of the prevalence of prediabetes and diabetes and risk factors associated with diabetes in Pakistan by using a systematic review and meta-analysis. METHODS: A systematic literature search of Embase, PubMed, and the Cochrane library was carried out between January 1, 1995 and August 30, 2018. Diabetes and prediabetes prevalence estimates were combined by the random-effects model. The existence of publication bias was tested by Egger regression. This systematic review was reported following the PRISMA guidelines. RESULTS: The search conceded a total of 635 studies, only 14 studies were considered for meta-analysis. The prevalence of diabetes in Pakistan was revealed 14.62% (10.651%-19.094%; 14 studies) based on 49,418 people using the inverse-variance random-effects model. The prevalence of prediabetes was 11.43% (8.26%-15.03%; 10 studies) based on a total sample of 26,999 people. The risk factors associated with diabetes were mean age (ß = 0.48%, 95% CI: 0.21-0.78, p<0.001), the proportion of participants with a family history of diabetes (ß = 0. 45%, 95% CI: 0.08-0.82, p =0.018, p<0.001), hypertension (ß = 0.40%, 95% CI: 0.06-0.75, p = 0.022), weight (BMI) (ß = 0.21%, 95% CI: 0.02-0.4, p=0.030). CONCLUSIONS: There has been a continuous increase in the prevalence of prediabetes and diabetes in Pakistan. All parts of the country have been affected, with the highest in Sindh and lowest in Khyber Pakhtunkhwa. The main factors include growing age, family history, hypertension and obesity. A nationwide diabetes care survey on risk factors and prevention policy is highly recommended.