Supine Percutaneous Nephrolithotomy: Preliminary experience in a single hospital.

Background and Objective: Percutaneous Nephrolithotomy (PCNL) is recommended for large Kidney Stones. It is mostly done in prone position. However, PCNL in Supine position is another safe option. Only few centers in country are doing it and so it is challenging task to adopt supine PCNL approach in an institution initially. In this study our purpose was to assess initial experience of Supine PCNL in our center. Methods: It is a preliminary retrospective study of our first fifty-one supine PCNL procedures, performed by a single Surgeon, over Twelve months period, from April 2021 to April 2022. We managed a retrospective review of patients' records. Analysis was completed by utilizing SPSS version 20. Implementation of Mean along with standard deviation values was utilized for continuous variables. While frequency/percentages represented categorical factors. Results: Patients mean age was 39 years, comprising of 62.74% male and 37.25% female patients. Thirty patients had their stones treated on the left side. Mean Stone burden was 3.2 cm. Most of the stones were GUYs score one and two (complexity wise). The mean procedure time 147minutes. Mean hospital stay of 2.17 days was observed in this study. Forty patients were stone free. Only seven patients (14%) had level I-II complications (Clavien-Dindo classification). Conclusion: Supine PCNL can be adopted safely in an institute if careful selection of patients is done before surgery. In our center it had acceptable success rates and few complications.

Sensitivity to changes in oil prices, tax returns and the cross-section of stock returns: The present situation for net-oil exporting economies.

This study investigates the sensitivity of stock returns to changes in oil prices and tax returns in net-oil exporting economies, focusing on the Gulf Cooperation Council (GCC) countries from March 30, 2003 to March 30, 2022. The problem statement addresses the challenge of understanding the interplay between oil price fluctuations, tax policies, and stock market dynamics in these economies, which are heavily reliant on oil revenues. The aim of the study is to provide insights into how variations in oil prices and tax returns impact the cross-section of stock returns in the GCC region. The objectives include analyzing the econometric relationships between oil prices, tax policies, and stock market performance using an appropriate econometric model. The results reveal a significant sensitivity of stock returns to changes in oil prices and tax returns in the GCC countries during the specified period. The econometric model employed indicates strong correlations between fluctuations in oil prices, tax policies, and stock market movements, highlighting the intricate connections between these variables. Moreover, the study identifies specific sectors within the stock market that are particularly sensitive to oil price changes and tax policy adjustments. Policymakers in the GCC countries can use these insights to design more effective fiscal and economic policies aimed at enhancing market stability and investor confidence amidst dynamic oil market conditions.

Ascorbate, plant hormones and their interactions during plant responses to biotic stress.

Plants can experience a variety of environmental stresses that significantly impact their fitness and survival. Additionally, biotic stress can harm agriculture, leading to reduced crop yields and economic losses worldwide. As a result, plants have developed defense strategies to combat potential invaders. These strategies involve regulating redox homeostasis. Several studies have documented the positive role of plant antioxidants, including Ascorbate (Asc), under biotic stress conditions. Asc is a multifaceted antioxidant that scavenges ROS, acts as a co-factor for different enzymes, regulates gene expression, and facilitates iron transport. However, little attention has been given to Asc and its transport, regulatory effects, interplay with phytohormones, and involvement in defense processes under biotic stress. Asc interacts with other components of the redox system and phytohormones to activate various defense responses that reduce the growth of plant pathogens and promote plant growth and development under biotic stress conditions. Scientific reports indicate that Asc can significantly contribute to plant resistance against biotic stress through mutual interactions with components of the redox and hormonal systems. This review focuses on the role of Asc in enhancing plant resistance against pathogens. Further research is necessary to gain a more comprehensive understanding of the molecular and cellular regulatory processes involved.

A NEW flexible exponent power family of distributions with biomedical data analysis.

Probability distributions are widely utilized in applied sciences, especially in the field of biomedical science. Biomedical data typically exhibit positive skewness, necessitating the use of flexible, skewed distributions to effectively model such phenomena. In this study, we introduce a novel approach to characterize new lifetime distributions, known as the New Flexible Exponent Power (NFEP) Family of distributions. This involves the addition of a new parameter to existing distributions. A specific sub-model within the proposed class, known as the New Flexible Exponent Power Weibull (NFEP-Wei), is derived to illustrate the concept of flexibility. We employ the well-established Maximum Likelihood Estimation (MLE) method to estimate the unknown parameters in this family of distributions. A simulation study is conducted to assess the behavior of the estimators in various scenarios. To gauge the flexibility and effectiveness of the NFEP-Wei distribution, we compare it with the AP-Wei (alpha power Weibull), MO-Wei (Marshal Olkin Weibull), classical Wei (Weibull), NEP-Wei (new exponent power Weibull), FRLog-Wei (flexible reduced logarithmic Weibull), and Kum-Wei (Kumaraswamy Weibull) distributions by analyzing four distinct biomedical datasets. The results demonstrate that the NFEP-Wei distribution outperforms the compared distributions.

Gait asymmetrical evaluation of lower limb amputees using wearable inertial sensors.

This study presents an analysis and evaluation of gait asymmetry (GA) based on the temporal gait parameters identified using a portable gait event detection system, placed on the lateral side of the shank of both lower extremities of the participants. Assessment of GA was carried out with seven control subjects (CS), one transfemoral amputee (TFA) and one transtibial amputee (TTA) while walking at different speeds on overground (OG) and treadmill (TM). Gait cycle duration (GCD), stance phase duration (SPD), swing phase duration (SwPD), and the sub-phases of the gait cycle (GC) such as Loading-Response (LR), Foot-Flat (FF), and Push-Off (PO), Swing-1 (SW-1) and Swing-2 (SW-2) were evaluated. The results revealed that GCD showed less asymmetry as compared to other temporal parameters in both groups. A significant difference (p < 0.05) was observed between the groups for SPD and SwPD with lower limb amputees (LLA) having a longer stance and shorter swing phase for their intact side compared to their amputated side, resulting, large GA for TFA compared to CS and TTA. The findings could potentially contribute towards a better understanding of gait characteristics in LLA and provide a guide in the design and control of lower limb prosthetics/orthotics.

Gait dynamic stability evaluation in patients undergoing hip joint fractures - tools to measure rehabilitation effectiveness.

A hip joint fracture includes a break in the thigh (femur) or coxa bone near the pelvis. During fracture healing, stability and weight bearing by the affected limb are key indicators to measure patients' improvement. Conventionally, the rehabilitation effectiveness is monitored through clinical examinations, patients' feedback, and few studies also reported instrumented gait evaluations. A gap remains there to numerically quantify the recovery in patients' stability and weight bearing in response to rehabilitation therapies. This study introduces Nyquist and Bode (N&B) methods to analyse the instrumented gait signals further and evaluate gait stability in hip fracture patients during weight loading and unloading transitions. The centre of pressure (CoP) data was recorded using force plates for conditions: coxa hip fracture (HC), femur hip fracture (HF), and normal hip joint (NH). The time rate of CoP signals illustrated two major impulses during the loading and unloading phases which were modelled in time and frequency domains. The frequency models were further analysed by applying N&B methods and stability margins were computed for both impaired and healthy conditions. Results illustrated a significant decrease (Kruskal-Wallis's test, p < 0.001) in the intralimb walking stability of both fracture conditions. Further, Spearman's correlation between CoP velocities of fractured and intact limbs illustrated significant interlimb dependencies to maintain walking stability (p < 0.001) during weight loading and unloading transitions. Overall, the HF impairment illustrated the least intralimb walking stability and relatively greater interlimb dependencies. Clinically, these methods and findings are important to measure the recovery in patients undergoing rehabilitation after a hip joint or other lower limb impairments.

FOPBIE: Multi-image cipher based on the random walk of fleet of pawns on the large hypothetical chessboard and chaotic system.

In the last two decades or so, a large number of image ciphers have been written. The majority of these ciphers encrypt only one image at a time. Few image ciphers were written which could encrypt multiple images in one session. The current era needs speedy multiple image ciphers to address its varied needs in different settings. Motivated by this dictation, the current study has ventured to write a multi-image cipher based on the fleet of pawns walking in the large hypothetical chessboard. This walk of pawns on the chessboard has been ingeniously linked with transferring the pixels from the plain image to the scrambled image. The confusion effects have been realized through the XOR operation between the scrambled image and the key image. The plaintext sensitivity has been incorporated by embedding the SHA-384 hash codes of the given large combined plain image. Moreover, the Henon map has been employed to spawn the streams of random numbers. Besides, Blum Blum Shub random number generator has been used to further cement the security of the proposed cipher. We got a computational time of 0.2278 seconds and an encryption throughput of 5.5782 MBit/seconds by using the four images with a size of 256×256. Apart from that, the information entropy gained is 7.9993. Lastly, the cipher has been subjected to an array of validation metrics to demonstrate its aversion to the myriad threats from the cryptanalysis savvy. We contend that the proposed work has great potential for some real-world applications.

Highly efficient aramid fiber supported polypropylene membranes modified with reduced graphene oxide based metallic nanocomposites: antimicrobial and antiviral capabilities.

Polypropylene hybrid polymeric membranes with aramid support have been fabricated using Thermally Induced Phase Separation (TIPS). Different modifying materials, such as metallic nanoparticles and reduced graphene oxide (rGO), improve the properties of these membranes. The nanomaterials and the fabricated membranes have been characterized with FTIR spectrometer, SEM and UV-Vis Spectrophotometer. Following that, the disinfection capabilities of the fabricated hybrid membranes were investigated. The antibacterial capability of the membranes is established through the testing of the membranes against bacterial strains S. aureus and E. coli, whereas the antiviral evaluation of the membranes was made against H9N2 and IBV strains. This research aims to develop advanced hybrid membranes that effectively disinfect water by incorporating novel nanomaterials and optimizing fabrication techniques.

Sequence based model using deep neural network and hybrid features for identification of 5-hydroxymethylcytosine modification.

RNA modifications are pivotal in the development of newly synthesized structures, showcasing a vast array of alterations across various RNA classes. Among these, 5-hydroxymethylcytosine (5HMC) stands out, playing a crucial role in gene regulation and epigenetic changes, yet its detection through conventional methods proves cumbersome and costly. To address this, we propose Deep5HMC, a robust learning model leveraging machine learning algorithms and discriminative feature extraction techniques for accurate 5HMC sample identification. Our approach integrates seven feature extraction methods and various machine learning algorithms, including Random Forest, Naive Bayes, Decision Tree, and Support Vector Machine. Through K-fold cross-validation, our model achieved a notable 84.07% accuracy rate, surpassing previous models by 7.59%, signifying its potential in early cancer and cardiovascular disease diagnosis. This study underscores the promise of Deep5HMC in offering insights for improved medical assessment and treatment protocols, marking a significant advancement in RNA modification analysis.

Salicylic acid- and ethylene-dependent effects of the ER stress-inducer tunicamycin on the photosynthetic light reactions in tomato plants.

Plant hormones such as ethylene (ET) and salicylic acid (SA) have an elementary role in the regulation of ER stress and unfolded protein response (UPR) in plants via modulating defence responses or inducing oxidative stress. Chloroplasts can be sources and targets of reactive oxygen species (ROS) that affect photosynthetic efficiency, which has not been investigated under tunicamycin (Tm)-induced ER stress. In this study, the direct and indirect effects of Tm on chloroplastic ROS production were first investigated in leaves of wild-type tomato (Solanum lycopersicum L.) plants. Secondly changes in activities of photosystem II and I were analysed under Tm exposure and after application of the chemical chaperone 4-phenylbutyrate (PBA) in different genotypes, focusing on the regulatory role of SA and ET Tm treatments significantly but indirectly induced ROS production in tomato leaves and in parallel it decreased the effective quantum yield of PSII [Y(II)] and PSI [Y(I)], as well as the photochemical quenching coefficient (qP) and the quantum yield of non-photochemical energy dissipation in PSI due to acceptor-side limitation [Y(NA)]. At the same time, Tm increased non-photochemical quenching (NPQ) and cyclic electron flow (CEF) in tomato leaves after 24 h. However, the photosynthetic activity of the SA hydroxylase-overexpressing NahG tomato plants was more severely affected by Tm as compared to wild-type and ET-insensitive Never ripe (Nr) plants. These results suggest the protective role of SA in the regulation of photosynthetic activity contributing to UPR and the survival of plants under ER stress. Interestingly, the activation of photoprotective mechanisms by NPQ was independent of SA but dependent on active ET signalling under ER stress, whereas CEF was reduced by ET due to its higher ratio in Nr plants.

Outcomes of initial 100 cases of laparoscopic nephrectomy at tertiary care center (PKLI).

Objective: Laparoscopic nephrectomy has been adopted by many centers in the last few decades. However, there are a few inherent challenges while adopting laparoscopic nephrectomy in a new unit. These include a significant learning curve required to adopt this modality. This study aimed to share the initial experience of adopting laparoscopic nephrectomy at our center. Methods: In total, 101 patients were analyzed in the study. These patients underwent laparoscopic radical or simple nephrectomy (for renal mass and noncancer renal cases respectively) at Department of Urology, Pakistan Kidney and Liver Institute and Research Centre, Lahore from April 2018 till January 2021. Data were entered in the statistical analysis software file. Analysis was attained by utilizing SPSS version 20. Implementation of Mean along with standard deviation values was utilized in the case of the continuous variables. While frequency/percentages represented categorical factors. Results: The mean age of patients was 42.81±15.49 years and their overall BMI was 26.41±5.30 kg/m2. Out of these, 57 (56.43%) were males and 44(43.56%) were female. Eighteen percent of patients had a previous surgical history on the ipsilateral side. Total operative time was 163.98±58.02 minutes while mean hospital stay reached 3.2±0.87 days. The tumor-free margin was attained in all cases of radical nephrectomy. Based on Clavien-Dindo classification, Grade-1 (n=3; 2.97%), Grade-2 (n=6; 5.94%), Grade-3A (n=1; 0.99%), and Grade-3B (n=1; 0.99%) complications were observed. Conclusion: In a newly developed urology center, laparoscopic nephrectomy can be a daunting task. Good teamwork among the surgical team members and careful selection of cases can result in satisfactory procedural outcomes.

Fusaric acid-evoked oxidative stress affects plant defence system by inducing biochemical changes at subcellular level.

Fusaric acid (FA) is one of the most harmful phytotoxins produced in various plant-pathogen interactions. Fusarium species produce FA as a secondary metabolite, which can infect many agronomic crops at all stages of development from seed to fruit, and FA production can further compromise plant survival because of its phytotoxic effects. FA exposure in plant species adversely affects plant growth, development and crop yield. FA exposure in plants leads to the generation of reactive oxygen species (ROS), which cause cellular damage and ultimately cell death. Therefore, FA-induced ROS accumulation in plants has been a topic of interest for many researchers to understand the plant-pathogen interactions and plant defence responses. In this study, we reviewed the FA-mediated oxidative stress and ROS-induced defence responses of antioxidants, as well as hormonal signalling in plants. The effects of FA phytotoxicity on lipid peroxidation, physiological changes and ultrastructural changes at cellular and subcellular levels were reported. Additionally, DNA damage, cell death and adverse effects on photosynthesis have been explained. Some possible approaches to overcome the harmful effects of FA in plants were also discussed. It is concluded that FA-induced ROS affect the enzymatic and non-enzymatic antioxidant system regulated by phytohormones. The effects of FA are also associated with other photosynthetic, ultrastructural and genotoxic modifications in plants.

Enhancing Sumoylation Site Prediction: A Deep Neural Network with Discriminative Features.

Sumoylation is a post-translation modification (PTM) mechanism that involves many critical biological processes, such as gene expression, localizing and stabilizing proteins, and replicating the genome. Moreover, sumoylation sites are associated with different diseases, including Parkinson's and Alzheimer's. Due to its vital role in the biological process, identifying sumoylation sites in proteins is significant for monitoring protein functions and discovering multiple diseases. Therefore, in the literature, several computational models utilizing conventional ML methods have been introduced to classify sumoylation sites. However, these models cannot accurately classify the sumoylation sites due to intrinsic limitations associated with the conventional learning methods. This paper proposes a robust computational model (called Deep-Sumo) for predicting sumoylation sites based on a deep-learning algorithm with efficient feature representation methods. The proposed model employs a half-sphere exposure method to represent protein sequences in a feature vector. Principal Component Analysis is applied to extract discriminative features by eliminating noisy and redundant features. The discriminant features are given to a multilayer Deep Neural Network (DNN) model to predict sumoylation sites accurately. The performance of the proposed model is extensively evaluated using a 10-fold cross-validation test by considering various statistical-based performance measurement metrics. Initially, the proposed DNN is compared with the traditional learning algorithm, and subsequently, the performance of the Deep-Sumo is compared with the existing models. The validation results show that the proposed model reports an average accuracy of 96.47%, with improvement compared with the existing models. It is anticipated that the proposed model can be used as an effective tool for drug discovery and the diagnosis of multiple diseases.

Unveiling the biosynthesis, mechanisms, and impacts of miRNAs in drought stress resilience in plants.

Drought stress is one of the most serious threats to sustainable agriculture and is predicted to be further intensified in the coming decades. Therefore, understanding the mechanism of drought stress tolerance and the development of drought-resilient crops are the major goals at present. In recent years, noncoding microRNAs (miRNAs) have emerged as key regulators of gene expressions under drought stress conditions and are turning out to be the potential candidates that can be targeted to develop drought-resilient crops in the future. miRNAs are known to target and decrease the expression of various genes to govern the drought stress response in plants. In addition, emerging evidence also suggests a regulatory role of long non-coding RNAs (lncRNAs) in the regulation of miRNAs and the expression of their target genes by a process referred as miRNA sponging. In this review, we present the regulatory roles of miRNAs in the modulation of drought-responsive genes along with discussing their biosynthesis and action mechanisms. Additionally, the interactive roles of miRNAs with phytohormone signaling components have also been highlighted to present the global view of miRNA functioning under drought-stress conditions.

Primary retroperitoneal teratoma in a young woman: a case report.

Teratomas are usually seen in gonads but they do occur in other extra gonadal regions such as sacrococcygeal region, mediastinum, head and neck, and retroperitoneum. Rarely in the retroperitoneal area, such tumours mostly develop in the pararenal area and usually on the left side. They have bimodal presentation at the age of six months and then in early adulthood. They originate from the germ cells that have failed to migrate to normal anatomical destinations. Many of such patients are diagnosed incidentally. Here, we report a case of symptomatic primary retroperitoneal mature teratoma in a young lady managed at Pakistan kidney and Liver Institute, Lahore.

Ethylene-dependent regulation of oxidative stress in the leaves of fusaric acid-treated tomato plants.

The mycotoxin fusaric acid (FA) induces rapid oxidative burst leading to cell death in plants. At the same time, plant defence reactions are mediated by several phytohormones for instance ethylene (ET). However, previously conducted studies leave research gaps on how ET plays a regulatory role under mycotoxin exposure. Therefore, this study aims to the time-dependent effects of two FA concentrations (0.1 mM and 1 mM) were explored on the regulation of reactive oxygen species (ROS) in leaves of wild-type (WT) and ET receptor mutant Never ripe (Nr) tomatoes. FA induced superoxide and H2O2 accumulation in both genotypes in a mycotoxin dose- and exposure time-dependent pattern. 1 mM FA activated NADPH oxidase (+34% compared to the control) and RBOH1 transcript levels in WT leaves. However, superoxide production was significantly higher in Nr with 62% which could contribute to higher lipid peroxidation in this genotype. In parallel, the antioxidative defence mechanisms were also activated. Both peroxidase and superoxide dismutase activities were lower in Nr but ascorbate peroxidase showed one-fold higher activity under 1 mM FA stress than in WT leaves. Interestingly, catalase (CAT) activity decreased upon FA in a time- and concentration-dependent manner and the encoding CAT genes were also downregulated, especially in Nr leaves at 20%. Ascorbate level was decreased and glutathione remained lower in Nr than WT plants under FA exposure. Conclusively, Nr genotype showed more sensitivity to FA-induced ROS suggesting that ET serves defence reactions of plants by activating several enzymatic and non-enzymatic antioxidants to detoxify excess ROS accumulation.

Impact of tourism development upon environmental sustainability: a suggested framework for sustainable ecotourism.

The empirical research investigated the relationship between tourism development and environmental suitability to propose a framework for sustainable ecotourism. The framework suggested a balance between business and environmental interests in maintaining an ecological system with the moderating help of government support and policy interventions. The study population encompasses tourism stakeholders, including tourists, representatives from local communities, members of civil administration, hoteliers, and tour operators serving the areas. A total of 650 questionnaires were distributed to respondents, along with a brief description of key study variables to develop a better understanding. After verifying the instrument's reliability and validity, data analysis was conducted via hierarchical regression. The study findings revealed that a substantial number of people perceive socio-economic benefits, including employment and business openings, infrastructure development from tourism development, and growth. However, the state of the natural and environmental capital was found to be gradually degrading. Alongside the social environment, social vulnerability is reported due to the overutilization of land, intrusion from external cultures, and pollution in air and water due to traffic congestion, accumulation of solid waste, sewage, and carbon emissions. The study suggested a model framework for the development of sustained ecotourism, including supportive government policy interventions to ensure effective conservation of environmental and natural resources without compromising the economic viability and social well-beings of the locals. Furthermore, the variables and the constructs researched can be replicated to other destinations to seek valuable inputs for sustainable destination management elsewhere.

Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience.

Background and Objectives: Urolithiasis is prevalent globally. Over time, innovation in endoscopic instruments and miniaturization has untangled the interventional strategy for carrying out remedial surgical procedures for renal stones. However, studies have been scarce as for sequelae of Percutaneous Nephrolithotomy (PCNL) in varying body mass index group patients in the developing world. We aimed to report success rates and complications in different BMI groups. Methods: This was a retrospective study wherein data of 359 patients was reviewed in charts. These patients went through PCNL at our department from July 2011 till September 2019. Three groups of patients were made in agreement with WHO BMI classification. Information concerning study variables was noted in designated and then processed in SPSS version 16 for the statistical computations. Results: On the whole, the mean age of patients was 44.6± 14.4 years. While the mean calculus size was 3.1± 1.4 cm. Moreover, the majority of stones in all the three groups belonged to Guy's stone score 1 and 2 (see Table-I). The overall mean procedure time and inpatient stay were almost comparable in the obese group. The highest stone-free rate was observed in the normal weight group (77.69 %), however, stone-free status in overweight and obese groups was not comparatively too lower (p=0.74). Complication rates were being close among the three groups. Conclusion: PCNL can be ventured with safety and in an effectual manner for attaining stone treatment goals alike in obese and non-obese group patients.

Machine Learning-Based Fragility Assessment of Reinforced Concrete Buildings.

In the past, large earthquakes caused the collapse of infrastructure and killed thousands of people in Pakistan, a seismically active region. Therefore, the seismic assessment of infrastructure is a dire need that can be done using the fragility analysis. This study focuses on the fragility analysis of school buildings in Muzaffarabad district, seismic zone-4 of Pakistan. Fragility curves were developed using incremental dynamic analysis (IDA); however, the numerical analysis is computationally time-consuming and expensive. Therefore, soft computing techniques such as Artificial Neural Network (ANN) and Gene Expression Programming (GEP) were employed as alternative methods to establish the fragility curves for the prediction of seismic performance. The optimized ANN model [5-25-1] was used. The feedforward backpropagation network was considered in this study. To achieve a reliable model, 70% of the data was selected for training and 15% for validation and 15% of data was used for testing the model. Similarly, the GEP model was also employed to predict the fragility curves. The results of both ANN and GEP were compared based on the coefficient of determination, R 2. The ANN model accurately predicts the global drift values with R 2 equal to 0.938 compared to the GEP model having R 2 equal to 0.87.