Homicide-Suicide in Russia and Pakistan: Observations From Press Media Reports.

This study compares the features of homicide-suicide in Russia and Pakistan. To understand this, we conducted a content analysis of news reports about homicide-suicide published in Pakistani and Russian newspapers between March 2020 and May 2023. We identified 35 and 104 homicide-suicide cases in Pakistani and Russian media, respectively. Men were three to five times more likely to commit homicide-suicides than women (3.16: 1 in Russia; 4.83: 1 in Pakistan). Accounting for over 65.73% of all homicide-suicides, spousal homicide-suicides and filicide-suicide were the most common homicide-suicides in both regions. Filicide-suicides were more often done by Russian women and extra-family homicide-suicides by Pakistani women. Reasons for homicide-suicides in Pakistani women were divorce or separation and in Russian women - mental disorders. With the difference of homicide in the victims, Pakistani victims were aged 15-30 years, while Russian were 31-45 years and 46 years and older. There were more similarities in homicide-suicides than differences.

Synthesis, characterization and photocatalytic activity of alginate based hybrid material for efficient degradation of organic pollutants under UV light and sunlight irradiation.

This study reports the development of alginate based hybrid material (Alg/CuO-gC3N4) with copper oxide (CuO) and graphitic carbon nitride (gC3N4). The Alg/CuO-gC3N4 hydrogel bead was prepared by two step process is as follows: formation of CuO-gC3N4 by co-precipitation method and incorporation of CuO-gC3N4 in the calcium alginate (Alg) by ionotropic gelation method. The structural and morphological features of the Alg/CuO-gC3N4 was characterized using different techniques namely Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Thermogravimetric analysis (TGA), UV Diffuse Reflectance spectroscopy (UV-DRS) and Scanning electron microscopy (SEM). The photocatalytic activity of the Alg/CuO-gC3N4 was extensively evaluated by degrading methylene blue (MB) under UV-vis and sunlight irradiation. The influence of various parameters like pollutant type, initial dye concentration, catalyst dosage, effect of pH, light intensity and reusability was investigated. The Alg/CuO-gC3N4 achieved a maximum degradation efficiency of 86.26 % and 85.15 % for MB at a dye concentration of 1 × 10-5 M under UV-vis and sunlight irradiation respectively, within 60 min using 0.3 wt% of catalyst dosage. The Alg/CuO-gC3N4 exhibited excellent stability and reusability over multiple cycles. Additionally, the incorporation of CuO-gC3N4 in alginate facilitates in reducing the bandgap (2.54 to 2.28 eV) for efficient charge separation, further enhancing the overall photocatalytic activity.

Optimization of biodiesel yield from waste cooking oil and sesame oil using RSM and ANN techniques.

In the era of global energy crises and the pressing concern of fossil fuel depletion, the quest for sustainable alternatives has become paramount. The current study aims to optimize biodiesel extraction from a combination of waste cooking oil (WCO) and sesame seed oil (SSO) through response surface methodology (RSM) and artificial neural network (ANN). The cold flow properties of biodiesel produced from WCO are a major obstacle to the commercial use of biodiesel. On the other hand, SSO possesses better oxidation stability and cold flow properties. A mixture of waste cooking oil (i.e. 70 % by volume) and sesame seed oil (i.e. 30 % by volume) has been prepared for biodiesel production via a microwave-assisted transesterification process. For biodiesel yield optimization, the interaction among the operating parameters is developed by RSM, whereas biodiesel yield is predicted by ANN. The operating parameters include reaction speed, RPM (100-600 rpm), reaction time (1-5 min), methanol to oil ratio (8:1-12:1 v/v), and catalyst concentration (0.1-2 % w/w). The highest biodiesel yield of 94 % is found at a reaction speed of 350 rpm, reaction time of 3 min, catalyst concentration of 1.05 w/w, and methanol to oil ratio of 10:1. Furthermore, it is discovered that when estimating biodiesel production rate depending on reaction constraints, ANN shows lower comparative error compared to RSM. The results show that ANN outperforms RSM in terms of percentage improvement when it comes to biodiesel production prediction.

Comparison of outcome of botulinum toxin injection with and without glyceryl trinitrate in chronic anal fissure in terms of post operative pain and healing.

Objectives: To compare the outcome of botulinum toxin injection with and without glyceryl trinitrate with respect to postoperative pain and healing in the treatment of anal fissures. METHODS: The prospective, comparative study was conducted at the Department of General Surgery, Mayo Hospital, Lahore, Pakistan, from September 1, 2021, to August 31, 2022, and comprised adult chronic anal fissure patients of either gender. They were randomised using the lottery method into group A which received botulinum toxin injection, and group B which received botulinum toxin injection plus 1g of 0.2% topical glyceryl trinitrate cream. Post-operative pain was measured 24 hours after the procedure using the visual analogue scale. Healing was assessed by examining the wound for the appearance of granulation tissue 4 weeks post-procedure. Data was analysed using SPSS 26. RESULTS: Of the 88 patients, 44(50%) were in group A; 32(72.7%) males and 12(27.3%) females with mean age 33.91±14.8 years. There were 44(50%) patients in group B; 35(79.5%) males and 9(20.5%) females with mean age range 36.33±14.9 years. The mean postoperative pain at 24 hours in group A was 4.67±1.16 and it was 3.06±0.65 in group B (p=0.009). In group A, 23(69.7%) patients showed complete healing at 4 weeks compared to 30(90.9%) in group B (p=0.030). CONCLUSIONS: Botulinum toxin injection with glyceryl trinitrate could be considered as first line of treatment for chronic anal fissure in patients who refuse surgery and with previous sphincter surgery.

Twisted van der Waals Quantum Materials: Fundamentals, Tunability, and Applications.

Twisted van der Waals (vdW) quantum materials have emerged as a rapidly developing field of two-dimensional (2D) semiconductors. These materials establish a new central research area and provide a promising platform for studying quantum phenomena and investigating the engineering of novel optoelectronic properties such as single photon emission, nonlinear optical response, magnon physics, and topological superconductivity. These captivating electronic and optical properties result from, and can be tailored by, the interlayer coupling using moiré patterns formed by vertically stacking atomic layers with controlled angle misorientation or lattice mismatch. Their outstanding properties and the high degree of tunability position them as compelling building blocks for both compact quantum-enabled devices and classical optoelectronics. This paper offers a comprehensive review of recent advancements in the understanding and manipulation of twisted van der Waals structures and presents a survey of the state-of-the-art research on moiré superlattices, encompassing interdisciplinary interests. It delves into fundamental theories, synthesis and fabrication, and visualization techniques, and the wide range of novel physical phenomena exhibited by these structures, with a focus on their potential for practical device integration in applications ranging from quantum information to biosensors, and including classical optoelectronics such as modulators, light emitting diodes, lasers, and photodetectors. It highlights the unique ability of moiré superlattices to connect multiple disciplines, covering chemistry, electronics, optics, photonics, magnetism, topological and quantum physics. This comprehensive review provides a valuable resource for researchers interested in moiré superlattices, shedding light on their fundamental characteristics and their potential for transformative applications in various fields.

Artificial Intelligence-Based Mitosis Scoring in Breast Cancer: Clinical Application.

In recent years, artificial intelligence (AI) has demonstrated exceptional performance in mitosis identification and quantification. However, the implementation of AI in clinical practice needs to be evaluated against the existing methods. This study is aimed at assessing the optimal method of using AI-based mitotic figure scoring in breast cancer (BC). We utilized whole slide images from a large cohort of BC with extended follow-up comprising a discovery (n = 1715) and a validation (n = 859) set (Nottingham cohort). The Cancer Genome Atlas of breast invasive carcinoma (TCGA-BRCA) cohort (n = 757) was used as an external test set. Employing automated mitosis detection, the mitotic count was assessed using 3 different methods, the mitotic count per tumor area (MCT; calculated by dividing the number of mitotic figures by the total tumor area), the mitotic index (MI; defined as the average number of mitotic figures per 1000 malignant cells), and the mitotic activity index (MAI; defined as the number of mitotic figures in 3 mm2 area within the mitotic hotspot). These automated metrics were evaluated and compared based on their correlation with the well-established visual scoring method of the Nottingham grading system and Ki67 score, clinicopathologic parameters, and patient outcomes. AI-based mitotic scores derived from the 3 methods (MCT, MI, and MAI) were significantly correlated with the clinicopathologic characteristics and patient survival (P < .001). However, the mitotic counts and the derived cutoffs varied significantly between the 3 methods. Only MAI and MCT were positively correlated with the gold standard visual scoring method used in Nottingham grading system (r = 0.8 and r = 0.7, respectively) and Ki67 scores (r = 0.69 and r = 0.55, respectively), and MAI was the only independent predictor of survival (P < .05) in multivariate Cox regression analysis. For clinical applications, the optimum method of scoring mitosis using AI needs to be considered. MAI can provide reliable and reproducible results and can accurately quantify mitotic figures in BC.

Characterization of alkaline metalloprotease isolated from halophilic bacterium Bacillus cereus and its applications in various industrial processes.

Microbial proteases are one of the most demanding enzymes for various industries with diverse applications in food, pharmaceutics, and textile industries to name the few. An extracellular alkaline metalloprotease was produced and purified from moderate halophilic bacterial strain, Bacillus cereus TS2, with some unique characteristics required for various industrial applications. The protease was produced in basal medium supplemented with casein and was partially purified by ion exchange chromatography followed by ammonium sulphate precipitation. The alkaline metalloprotease has molecular weight of 35 kDa with specific activity of 535.4 µM/min/mg. It can work at wide range of pH from 3 to 12, while showing optimum activity at pH 10. Similarly, the alkaline metalloprotease is stable till the temperature of 80 °C and works at wide range of temperature from 20 to 90 °C with optimum activity at 60 °C. The turnover rate increases in the presence of NaCl and Co+2 with k cat/KM of 1.42 × 103 and 1.27 × 103 s-1.M-1 respectively, while without NaCl and Co+2 it has a value of 7.58× 102. The alkaline metalloprotease was relatively resistant to thermal and solvent mediated denaturation. Applications revealed that the metalloprotease was efficient to remove hair from goat skin, remove blood stains and degrade milk, thus can be a potential candidate for leather, detergent, and food industry.

Is there an EKC between economic growth and air pollutant emissions in SAARC countries? Evidence from disaggregated analysis.

The manufacturing and construction (M&C) sector not only plays a vital role in promoting economic growth, but is also a significant contributor to global air pollution. Growing concerns regarding air pollutant emissions necessitate a more disaggregated (i.e., sectoral) investigation in order to identify the major contributors. This study employs aggregated and disaggregated data to determine the fundamental effects of economic growth (i.e., overall growth and sectoral growth) on air pollutant emissions (APE) (specifically, PM2.5 and PM10 released by the M&C sector) in SAARC economies between 1995 and 2018. It assesses the environmental Kuznets curve (i.e., inverted U-shaped and N-shaped) using the feasible generalized least squares (FGLS), panel-corrected standard errors (PCSE), and generalized method of moments (GMM) techniques. The sectoral analysis reveals the presence of an N-shaped EKC while the overall analysis indicates an inverted U-shaped EKC. Population, financial development (FD), and merchandise exports (MX) have no influence on the estimates. Population and FD increase APE in all models, whereas the effects of MX vary between models. As SAARC economies are capital-deficient, these economies can adopt unbalanced environmental protection policies. First, focus on major contributing sectors (e.g., M&C sector) to curb APE, then focus on less emitting sectors in turn. By implementing pollution reduction strategies on M&C sector activities, governments may reach their threshold (peak) points earlier than expected. A reduction in APE is impossible without rigorous monitoring and application. Being capital-deficient nations and given the collective nature of the problem, a Transboundary Haze/Pollution agreement is required to solve this issue.

Identification and genome-wide analysis provide insights into the genetic diversity and biotechnological potentials of novel cold-adapted Acinetobacter strain.

Extreme cold environments, such as polar regions or high-altitude mountains, are known for their challenging conditions including low temperatures, high salinity, and limited nutrient availability. Microbes that thrive in these environments have evolved specialized strategies to survive and function under such harsh conditions. The study aims to identify, sequence the genome, perform genome assembly, and conduct a comparative genome-wide analysis of Acinetobacter sp. strain P1, which was isolated from the Batura glacier regions of Pakistan. A basic local alignment search tool of NCBI using 16 s RNA gene sequence confirmed the strain Acinetobacter following phylogenetic analysis revealed that strain P1 clustered with Acinetobacter sp. strain AcBz01. The high-throughput Genome sequencing was done by the NovaSeq 6000 sequencing system following de novo genome assembly reported 23 contigs, a genome size of 3,732,502 bp containing approximately 3489 genes and 63 RNAs (60 tRNA, 3 rRNA). The comparative genome analysis revealed that Acinetobacter sp. strain P1 exhibited the highest homology with the Acinetobacter baumannii ATCC 17978 genome and encompassed 1668 indispensable genes, 1280 conserved genes 1821 specific genes suggesting high genomic plasticity and evolutionary diversity. The genes with functional assignments include exopolysaccharide phosphotransferase enzyme, cold-shock proteins, T6SS, membrane modifications, antibiotic resistance, and set of genes related to a wide range of metabolic characteristics such as exopolysaccharides were also present. Moreover, the structural prediction analysis of EPS proteins reveals that structural flexibility allows for conformational modifications during catalysis, which boosts or increases the catalytic effectiveness at lower temperatures. Overall, the identification of Acinetobacter, a cold-adapted bacterium, offers promising applications in bioremediation, enzyme production, food preservation, pharmaceutical development, and astrobiology. Further research and exploration of these microorganisms can unlock their full biotechnological potential and contribute to various industries and scientific endeavors.

Deciphering the Morphology of Tumor-Stromal Features in Invasive Breast Cancer Using Artificial Intelligence.

Tumor-associated stroma in breast cancer (BC) is complex and exhibits a high degree of heterogeneity. To date, no standardized assessment method has been established. Artificial intelligence (AI) could provide an objective morphologic assessment of tumors and stroma, with the potential to identify new features not discernible by visual microscopy. In this study, we used AI to assess the clinical significance of (1) stroma-to-tumor ratio (S:TR) and (2) the spatial arrangement of stromal cells, tumor cell density, and tumor burden in BC. Whole-slide images of a large cohort (n = 1968) of well-characterized luminal BC cases were examined. Region and cell-level annotation was performed, and supervised deep learning models were applied for automated quantification of tumor and stromal features. S:TR was calculated in terms of surface area and cell count ratio, and the S:TR heterogeneity and spatial distribution were also assessed. Tumor cell density and tumor size were used to estimate tumor burden. Cases were divided into discovery (n = 1027) and test (n = 941) sets for validation of the findings. In the whole cohort, the stroma-to-tumor mean surface area ratio was 0.74, and stromal cell density heterogeneity score was high (0.7/1). BC with high S:TR showed features characteristic of good prognosis and longer patient survival in both the discovery and test sets. Heterogeneous spatial distribution of S:TR areas was predictive of worse outcome. Higher tumor burden was associated with aggressive tumor behavior and shorter survival and was an independent predictor of worse outcome (BC-specific survival; hazard ratio: 1.7, P = .03, 95% CI, 1.04-2.83 and distant metastasis-free survival; hazard ratio: 1.64, P = .04, 95% CI, 1.01-2.62) superior to absolute tumor size. The study concludes that AI provides a tool to assess major and subtle morphologic stromal features in BC with prognostic implications. Tumor burden is more prognostically informative than tumor size.

Validation of arrhythmogenic right ventricular cardiomyopathy risk calculator for sudden cardiac death: a systematic review

In the context of ARVC, a systematic review of the validation of the ARVC risk score can provide insights into the accuracy and reliability of this score in identifying patients at high risk of ARVC. Digital databases were searched to identify the relevant studies using Medical Subject Headings (MeSH). A total of 8 studies were included in this systematic review. A total of 8 studies were included in this review. The review found that the sensitivity of the ARVC risk scores ranged from 80 to 95%, and the specificity ranged from 31 to 79%. The PPV was 55%, and the NPV was 88%. The ARVC score provided a C-index for a 5-year VA risk prediction of 0.84 [95% CI (0.74–0.93)] and a Harrell C-index of 0.70 (95% CI 0.65–0.75). The calibration slope was 1.01 (95% CI 0.99–1.03). ARVC score demonstrated a significant event 5-year threshold between 15 and 20% and the classical ARVC 5-years/freedom-from-VA rate was 0.76(0.66–0.89) and the non-classical form 5-years/freedom-from-VA rate was 0.58 (0.43–0.78). In conclusion, the validation of ARVC risk scores is an essential step toward improving the accuracy of ARVC diagnosis and risk stratification. Further studies are needed to establish the accuracy and reliability of ARVC risk scores and to address the limitations of the current evidence.

Extraordinary Nonlinear Optical Interaction from Strained Nanostructures in van der Waals CuInP2S6.

Local strain engineering and structural modification of 2D materials furnish benevolent control over their optoelectronic properties and provide an exciting approach to tune light-matter interaction in layered materials. Application of strain at the nanoscale is typically obtained through permanently deformed nanostructures such as nanowrinkles, which yield large band gap modulation, photoluminescence enhancement, and surface potential. Ultrathin transition metal dichalcogenides (TMDs) have been greatly analyzed for such purposes. Herein, we extend strain-induced nanoengineering to an emerging 2D material, CuInP2S6 (CIPS), and visualize extraordinary control over nonlinear light-matter interaction. Wrinkle nanostructures exhibit ∼160-fold enhancement in second harmonic generation (SHG) compared to unstrained regions, which is additionally influenced by a change in the dielectric environment. The SHG enhancement was significantly modulated by the percentage of applied strain which was numerically estimated. Furthermore, polarization-dependent SHG revealed quenching and enhancement in the parallel and perpendicular directions, respectively, due to the direction of the compressive vector. Our work provides an important advancement in controlling optoelectronic properties beyond TMDs for imminent applications in flexible electronics.

Direct observation of contact resistivity for monolayer TMD based junctions via PL spectroscopy.

Monolayer transition metal dichalcogenides (mTMDs) possess a direct band gap and strong PL emission that is highly sensitive to doping level and interfaces, laying the foundation for investigating the contact between mTMD and metal via PL spectroscopy. Currently, electrical methods have been utilized to measure the contact resistance (RC), but they are complicated, time-consuming, high-cost and suffer from inevitable chemical disorders and Fermi level pinning. In addition, previously reported contact resistances comprise both Schottky barrier and tunnel barrier components. Here, we report a simple, rapid and low-cost method to study the tunnel barrier dominated contact resistance of mTMD based junctions through PL spectroscopy. These junctions are free from chemical disorders and Fermi level pinning. Excluding the Schottky barrier component, solely tunnel barrier dominated contact resistances of 1 L MoSe2/Au and 1 L MoSe2/graphene junctions were estimated to be 147.8 Ω µm and 54.9 Ω µm, respectively. Density functional theory (DFT) simulations revealed that the larger RC of the former was possibly due to the existence of intrinsic effective potential difference (Φbarrier) between mTMD and metal. Both junctions exhibit an increasing tendency of RC as temperature decreases, which is probably attributed to the thermal expansion coefficient (TEC) mismatch-triggered interlayer spacing (d) increase and temperature-induced doping. Remarkably, a significant change of RC was observed in 1 L MoSe2/Au junctions, which is possibly ascribed to the changes of their orbital overlaps. Our results open new avenues for exploring fundamental metal-semiconductor contact principles and constructing high-performance devices.

Chromatographic evaluation of tocols and sterols of processed canola oil and deodorizer distillate.

Tocopherols and tocotrienols in the combined form are known as tocols. Changes of total and individual tocols and sterols concentration of canola oil and deodorizer distillate (DD) during different processing stages were evaluated with the application of gas chromatography (GC) and high-performance liquid chromatography (HPLC). For sterols analysis, GC coupled with flame ionization detector (FID) was used while tocols in canola oil samples and DD, normal phase (NP) HPLC was applied. The results of the present study indicated that levels of total and individual tocols and sterols content were decreased during processing (neutralization to deodorization). Deodorization was found to be the most effective process for the reduction of total sterols and tocols as 55.9% and 34.2%, respectively. A high amount of tocols and sterols was observed in DD. Among tocols and sterols; beta tocopherol (ß-T) and ß-sitosterol were found to be in greater concentration 53.97% and 31.82%, respectively. Therefore, DD could be used as a valuable by-product in the cosmetics and food industries.

Recent Developments in van der Waals Antiferromagnetic 2D Materials: Synthesis, Characterization, and Device Implementation.

Magnetism in two dimensions is one of the most intriguing and alluring phenomena in condensed matter physics. Atomically thin 2D materials have emerged as a promising platform for exploring magnetic properties, leading to the development of essential technologies such as supercomputing and data storage. Arising from spin and charge dynamics in elementary particles, magnetism has also unraveled promising advances in spintronic devices and spin-dependent optoelectronics and photonics. Recently, antiferromagnetism in 2D materials has received extensive attention, leading to significant advances in their understanding and emerging applications; such materials have zero net magnetic moment yet are internally magnetic. Several theoretical and experimental approaches have been proposed to probe, characterize, and modulate the magnetic states efficiently in such systems. This Review presents the latest developments and current status for tuning the magnetic properties in distinct 2D van der Waals antiferromagnets. Various state-of-the-art optical techniques deployed to investigate magnetic textures and dynamics are discussed. Furthermore, device concepts based on antiferromagnetic spintronics are scrutinized. We conclude with remarks on related challenges and technological outlook in this rapidly expanding field.

Do health infrastructure and services, aging, and environmental quality influence public health expenditures? Empirical evidence from Pakistan.

Rapidly growing health expenditure is a matter of grave concern for households and governments. Every government is compelled to allocate a sufficient budget to improve people's health. This study, therefore, identifies some major factors that influence the trajectory of public health care expenditure (HCE) in Pakistan for the period 1974-2017. The ARDL-bounds test and Bayer-Hanck cointegration test consistently reveal that HCE and its specified determinants are cointegrated. Long-term estimates show that healthcare infrastructure and services, income, and environmental degradation exert a positive influence on HCE. Elderly population size has a negative association with HCE. Income elasticity is inelastic, showing that healthcare is a necessity. The findings suggest that the government must pay due attention to the fair distribution of health-related infrastructure and personnel in all regions of Pakistan.

Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure.

OBJECTIVE: To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure. METHODS: It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1st January 2018 to 31st December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared. RESULTS: Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063). CONCLUSION: Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn't help in healing of wound and reclosure of the dehisced abdominal wound is needed.

Zero-Effort Ambient Heart Rate Monitoring Using Ballistocardiography Detected Through a Seat Cushion: Prototype Development and Preliminary Study.

BACKGROUND: Cardiovascular diseases are a leading cause of death worldwide and result in significant economic costs to health care systems. The prevalence of cardiovascular conditions that require monitoring is expected to increase as the average age of the global population continues to rise. Although an accurate cardiac assessment can be performed at medical centers, frequent visits for assessment are not feasible for most people, especially those with limited mobility. Monitoring of vital signs at home is becoming an increasingly desirable, accessible, and practical alternative. As wearable devices are not the ideal solution for everyone, it is necessary to develop parallel and complementary approaches. OBJECTIVE: This research aims to develop a zero-effort, unobtrusive, cost-effective, and portable option for home-based ambient heart rate monitoring. METHODS: The prototype seat cushion uses load cells to acquire a user's ballistocardiogram (BCG). The analog signal from the load cells is amplified and filtered by a signal-conditioning circuit before being digitally recorded. A pilot study with 20 participants was conducted to analyze the prototype's ability to capture the BCG during five real-world tasks: sitting still, watching a video on a computer screen, reading, using a computer, and having a conversation. A novel algorithm based on the continuous wavelet transform was developed to extract the heart rate by detecting the largest amplitude values (J-peaks) in the BCG signal. RESULTS: The pilot study data showed that the BCG signals from all five tasks had sufficiently large portions to extract heart rate. The continuous wavelet transform-based algorithm for J-peak detection demonstrated an overall accuracy of 91.4% compared with electrocardiography. Excluding three outliers that had significantly noisy BCG data, the algorithm achieved 94.6% accuracy, which was aligned with that of wearable devices. CONCLUSIONS: This study suggests that BCG acquired through a seat cushion is a viable alternative to wearable technologies. The prototype seat cushion presented in this study is an example of a relatively accessible, affordable, portable, and unobtrusive zero-effort approach to achieve frequent home-based ambient heart rate monitoring.

Environmental and Occupational Considerations of Anesthesia: A Narrative Review and Update.

With an estimated worldwide volume of 266 million surgeries in 2015, the call for general inhalation anesthesia is considerable. However, widely used volatile anesthetics such as N2O and the highly fluorinated gases sevoflurane, desflurane, and isoflurane are greenhouse gases, ozone-depleting agents, or both. Because these agents undergo minimal metabolism in the body during clinical use and are primarily (≥95%) eliminated unchanged via exhalation, waste anesthetic gases (WAGs) in operating rooms and postanesthesia care units can pose a challenge for overall elimination and occupational exposure. The chemical properties and global warming impacts of these gases vary, with atmospheric lifetimes of 1-5 years for sevoflurane, 3-6 years for isoflurane, 9-21 years for desflurane, and 114 years for N2O. Additionally, the use of N2O as a carrier gas for the inhalation anesthetics and as a supplement to intravenous (IV) anesthetics further contributes to these impacts. At the same time, unscavenged WAGs can result in chronic occupational exposure of health care workers to potential associated adverse health effects. Few adverse effects associated with WAGs have been documented, however, when workplace exposure limits are implemented. Specific measures that can help reduce occupational exposure and the environmental impact of inhaled anesthetics include efficient ventilation and scavenging systems, regular monitoring of airborne concentrations of waste gases to remain below recommended limits, ensuring that anesthesia equipment is well maintained, avoiding desflurane and N2O if possible, and minimizing fresh gas flow rates (eg, use of low-flow anesthesia). One alternative to volatile anesthetics may be total intravenous anesthesia (TIVA). While TIVA is not associated with the risks of occupational exposure or atmospheric pollution that are inherent to volatile anesthetic gases, clinical considerations should be weighed in the choice of agent. Appropriate procedures for the disposal of IV anesthetics must be followed to minimize any potential for negative environmental effects. Overall, although their contributions are relatively low compared with those of other human-produced substances, inhaled anesthetics are intrinsically potent greenhouse gases and pose a risk to operating-room personnel if not properly managed and scavenged. Factors to reduce waste and minimize the future impact of these substances should be considered.