Association Between Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) Scoring and Pathological Severity of Acute Appendicitis: A Cross-Sectional Study.

Background and objectives Appendicitis is a frequent cause of abdominal pain. Because of the limited availability of imaging services in many medical centers and an urge to reduce the substantial number of unnecessary appendectomies, several clinical diagnostic tools have been constructed. A novel diagnostic tool, referred to as the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score, has been created to assist in identifying acute appendicitis (AA) in Asian nations. The study aimed to assess the correlation between RIPASA scores and the severity of appendicitis as determined by pathological examination. Materials and methods The study was a prospective observational investigation undertaken in the Department of General Surgery at Muslim education society (MES) Medical College Perinthalmanna over 12 months. The study included all patients who had been diagnosed with AA and underwent appendectomy, provided they satisfied both the inclusion and exclusion criteria. An analysis was conducted on a convenience sample of 225 individuals using a prestructured proforma. The RIPASA scores were estimated before their surgery, taking into account their age, gender, symptoms, physical examination findings, and laboratory findings. These scores were subsequently contrasted with the histopathological results obtained after the appendectomy. The individuals were categorized into three groups according to their RIPASA scores. The lower-score category, scores between 4 and 7. The intermediate-score category consists of scores ranging from 7.5 to 11.5, while the higher-score category includes scores of 12 and above. These scores are correlated with the histopathology report (HPR) to determine the presence of appendicitis, perforated appendix, appendicular abscess, or the absence of pathology observed. Results The study population comprised of 137 (60.9%) males and 88 (39.1%) females. Among these, 177 individuals (78.7%) were younger than 40 years, while 48 individuals (21.3%) were older than 40 years. Out of 225 cases, 146 cases were AA (64.9%), 27 (12%) appendicular abscess cases, and 41 (18.2%) appendicular perforation cases. The normal appendix was noted in 11 out of 225 cases in the low-score group. The association between the histopathological report and RIPASA score was found to be statistically highly significant (p=0.000). In the low-score group, there were 14 cases of appendicitis (53.8%), one case of appendicular abscess (3.8%), a total of 11 cases without pathology observed (42.3%), and no reported instances of appendicular perforation. In the intermediate-score category, there were 121 cases of appendicitis (89.6%), 12 cases of appendicular abscess (8.9%), 2 cases of appendicular perforation (1.5%), and no reported cases in the non-pathology category. Among the high-score category, there were 11 cases of appendicitis (17.2%), 14 cases of appendicular abscess (21.9%), 39 cases of appendicular perforation (60.9%), and no reported instances of negative appendectomy. Conclusion The study has shown that the RIPASA scoring system had a high diagnostic efficacy in identifying AA. This scoring system is an effective, dependable, cost-effective, noninvasive, reproducible, and safe diagnostic technique that does not require additional expenses or concerns.

Optimization and Detergent Compatibility of Protease Produced from Aspergillus oryzae by Utilizing Agro Wastes.

The biotechnological process called solid-state fermentation (SSF) was applied for hyper production of protease by using a fungal strain called Aspergillus oryzae. From screening of 9 different local substrates (peanut shell, wheat bran, guava leaves, sugar cane bagasse, rice polish, wheat straw, corn straw, reed grass, and rice straw), peanut shells serve as the best substrates for protease production under optimized cultured conditions. The varying physiochemical parameters such as pH (2-9.5), temperature (30-52 °C), incubation time (1-10 days), inoculum size (1-8 mL), moisture level (20-125%), and substrate concentration (1-7 g) were optimized by response surface methodology (RSM). The highest activity of protease was recorded to be 1101.778 U/mL at 660 nm using peanut shell was optimum at pH 8, temperature 52 °C, incubation time 8 days, inoculum size 2 mL, moisture level 20%, and substrate concentration 2 g. The crude form of enzymes produced were further purified through ammonium sulfate precipitation, dialysis, and gel filtration chromatography. Then, purified enzymes were characterized at different pH, temperature, and incubation time. For characterization of purified protease, pH, temperature, and incubation time were 8, 52 °C, and 8 days for peanut shell and was done by one factor at a time method. Hence, isolated enzymes were alkaline in nature, i.e., alkaline proteases. Then, protease produced from peanut shells was applied to locally available detergents to increase their catalytic activity for strain removal. At last, the final results were interpreted in the form of 3D surface and contour plots using Microsoft Excel 2013 and Minitab 17 software. In conclusion, the utilization of A. oryzae and peanut shell as the substrate in the biotechnological process of SSF demonstrated successful hyper production of alkaline protease. The optimized conditions resulted in high enzyme activity and showcased the potential application of the isolated enzymes in improving the catalytic activity of locally available detergents.

Urban residential building stock synthetic datasets for building energy performance analysis.

The urban building stock dataset consists of synthetic input and output data for the energy simulation of one million buildings. The dataset consists of four different residential types, namely: terraced, detached, semi-detached, and bungalow. Constructing this buildings dataset requires conversion, categorization, extraction, and analytical processes. The dataset (in .csv) format comprises 19 input parameters, including advanced features such as HVAC system parameters, building fabric (walls, roofs, floors, door, and windows) U-values, and renewable system parameters. The primary output parameter in the dataset is Energy Use Intensity (EUI in kWh/(m2*year)), along with Energy Performance Certificate (EPC) labels categorized on an A to G rating scale. Additionally, the dataset contains end-use demand output parameters for heating and lighting, which are crucial output parameters. jEPlus, a parametric tool, is coupled with EnergyPlus and DesignBuilder templates to facilitate physics-based parametric simulations for generating the dataset. The dataset can be a valuable resource for researchers, practitioners, and policymakers seeking to enhance sustainability and efficiency in urban building environments. Furthermore, dataset holds immense potential for future research in the field of building energy analysis and modeling.

Constructing copper Phthalocyanine/Molybdenum disulfide (CuPc/MoS2) S-scheme heterojunction with S-rich vacancies for enhanced Visible-Light photocatalytic CO2 reduction.

Constructing a heterojunction by combining two semiconductors with similar band structures is a successful approach to obtaining photocatalysts with high efficiency. Herein, a CuPc/DR-MoS2 heterojunction involving copper phthalocyanine (CuPc) and molybdenum disulfide with S-rich vacancies (13.66%) is successfully prepared by the facile hydrothermal method. Experimental results and theoretical calculations firmly demonstrated that photoelectrons exhibit an S-scheme charge transfer mechanism in the CuPc/DR-MoS2 heterojunction. The S-scheme heterojunction system has proven significant advantages in promoting the charge separation and transfer of photogenerated carriers, enhancing visible-light responsiveness, and achieving robust photoredox capability. As a result, the optimized 3CuPc/DR-MoS2 S-scheme heterojunction exhibits photocatalytic yields of CO and CH4 at 200 and 111.6 µmol g-1h-1, respectively. These values are four times and 4.5 times greater than the photocatalytic yields of pure DR-MoS2. This study offers novel perspectives on the advancement of innovative and highly effective heterojunction photocatalysts.

Thermal performance of Joule heating in radiative Eyring-Powell nanofluid with Arrhenius activation energy and gyrotactic motile microorganisms.

Background: Bioconvection is the term for macroscopic convection of particles accompanied by a variable density gradient and a cluster of swimming microorganisms. The accumulation of gyrotactic microbes in the nanoparticles is important to exaggerate the thermal efficacy of various structures for instance, germs powered micro-churns, microbial fuel cubicles, micro-fluidics policies, and chip-designed micro plans like bio-microstructures. Purpose: Here approach in the current effort is to present an innovative study of bio-convection owing to gyrotactic microbes in a nanofluid comprising non-uniform heat source/sink, space and temperature-dependent viscosity and Joule dissipation. The physical constraints such as convective-surface and new mass flux conditions are examined for 3D Eyring-Powell magneto-radiative nanofluid via porous stretched sheet. Method: ology: Over suitable similarity alterations, the related non-linear flow, temperature, and concentration phenomena, equations are altered into non-linear equations. By combining the shooting methodology with the Runge-Kutta fourth-order technique is applied to get numerical solutions. A thorough investigation for the impact of important non-dimensional thermophysical parameters regulating flow characteristics is carried out. Motivation: Lots of the studies on nanofluids realize their performance therefore that they can be exploited where conventional heat transport development is paramount as in numerous engineering uses, micro-electronics, transportation in addition to foodstuff and bio-medicine. The gyrotactic microbes flow in nanofluids has attained great devotion amongst researchers and the scientist community because of its works in numerous areas of bio-technology. The benefits of counting nanoparticles in mobile microbe's deferral can be established in micro-scale involvement and stability of nanofluid. Significant results: For a few chosen parameters, the computed results for friction factor and transport for motile microorganism values are shown. The computed numerical results for parameters of engineering interest are given using tables. Furthermore, the recent solutions are stable with the former stated results and excellent association is found. The temperature of the fluid exaggerates for higher values of thermo-Biot and radiation parameter; however, Peclet and bio-convective Lewis's factor decay the motile microorganisms' field of Eyring-Powell fluid. The concentration field also enhances the activation energy parameter.

Effects of Supplemented Coriander, Ajwain, and Dill Seed Essential Oils on Growth Performance, Carcass Characteristics, Gut Health, Meat Quality, and Immune Status in Broilers.

Numerous studies have assessed the benefits and optimal dosage of supplementation with essential oils (EOs), including extracts from plants of the Apiaceae family, as an alternative to antibiotic growth promoters (AGPs) in broilers. However, little consideration has been given to the actual chemical composition of the evaluated EOs when drawing critical conclusions, even though EO composition can vary with different extraction conditions and plant characteristics. Therefore, the present study was conducted to evaluate the effects of EOs from seeds of plants of the Apiaceae family: coriander (CEO), ajwain (AjEO), and dill (DEO), containing 56.8% linalool, 68.2% thymol, and 41.1% carvone, respectively, on the growth performance, gut health, and immune status of broilers. In total, 660 one-day-old broiler chicks were divided into 11 experimental diet groups and fed for 35 days with either the control diet, basal diet with added AGP (lincomycin, 500 mg/kg), or one of nine EO diets supplemented with CEO, AjEO, or DEO at 200, 400, and 600 mg/kg. Final body weights were improved by supplementation with not only AGP but also any EO except AjEO at 600 mg/kg; within each EO, supplementation of CEO at 400 mg/kg, AjEO at 200 mg/kg, and DEO at 200 mg/kg afforded the best growth performance. EO supplementation had beneficial effects on gut morphology, such as increased villus height in the duodenum, jejunum, and ileum, and against harmful microbiota, such as reduction of Escherichia coli and Salmonella spp. populations. Furthermore, EOs enhanced humoral immunity and improved meat quality by reducing drip loss, likely consequent to their antioxidant properties. Overall, this study presents evidence that CEO, AjEO, and DEO can each play a pivotal role in replacing AGPs, as well as providing information regarding optimal doses for broilers.

Reproducibility and stability of the immature platelet fraction using Sysmex XN-10.

BACKGROUND: The Immature Platelet Fraction (IPF) is an indicator of thrombopoiesis which is a useful parameter in thrombocytopenia. It demonstrates compensatory mechanisms in production of platelets, but currently not implemented in routine clinical practice. The aim of this study was to establish the reproducibility and stability of IPF, for both percentage (%-IPF) and absolute (A-IPF) measurements.Material/methods: A total of 71 samples, of which 45 for reproducibility and 26 for stability analysis, were assayed for full blood count using the Sysmex XN-10 analyser at room temperature (RT:19-25 °C). For reproducibility analysis, IPF measurements were analysed 11 times by different appraisers using the same sample, while for stability analysis, IPF was measured over fourteen hourly-intervals up to 24 h (n = 21) and then separately extended beyond the point of stability to 72 h (n = 5). RESULTS: Reproducibility analysis of %-IPF and A-IPF (n = 45) showed very reliable results, with the range of mean CV% values between 1.25-8.90% and 1.70-9.96%, respectively. On the other hand, overall, stability analysis of %-IPF and A-IPF (n = 21) at RT over 24 h showed reliable results, with pooled mean CV% values of 1.32% and 1.43%, respectively, with no significant difference between %-IPF and A-IPF (p = 0.767 and p = 0.821). All %-IPF and A-IPF values had exceeded the set acceptance criterion of stability (CV% ≥ 10.0%) before 72 h. CONCLUSIONS: Overall, %-IPF and A-IPF reproducibility and storage at RT for 24 h predominantly demonstrates the suitability of their usage for testing on the Sysmex XN-series analysers.

Readthrough events in plants reveal plasticity of stop codons.

Stop codon readthrough (SCR) has important biological implications but remains largely uncharacterized. Here, we identify 1,009 SCR events in plants using a proteogenomic strategy. Plant SCR candidates tend to have shorter transcript lengths and fewer exons and splice variants than non-SCR transcripts. Mass spectrometry evidence shows that stop codons involved in SCR events can be recoded as 20 standard amino acids, some of which are also supported by suppressor tRNA analysis. We also observe multiple functional signals in 34 maize extended proteins and characterize the structural and subcellular localization changes in the extended protein of basic transcription factor 3. Furthermore, the SCR events exhibit non-conserved signature, and the extensions likely undergo protein-coding selection. Overall, our study not only characterizes that SCR events are commonly present in plants but also identifies the recoding plasticity of stop codons, which provides important insights into the flexibility of genetic decoding.

Reporting Practices of Serum Protein Electrophoresis in Pakistan - a Multicenter Survey.

BACKGROUND: Serum Protein Electrophoresis (SPE) is crucial for the diagnosis and follow-up of monoclonal gammopathy (MG), as it helps to separate and identify these paraproteins. Currently, Pakistan lacks standardized guidelines for SPE reporting and analytical performance. This survey aims to analyze reporting variations from Consultant Chemical Pathologists in Pakistani laboratories. METHODS: This cross-sectional survey was conducted by the section of Chemical Pathology, Department of Pathology and Laboratory Medicine, at Aga Khan University Hospital, Karachi. A previously validated and published tool was used with some modifications to assess analytical techniques, reporting patterns, and interpretations provided with SPE by different laboratories. Frequency and percentages were calculated for each response and descriptive results were also evaluated. Differences between laboratories were also assessed qualitatively. RESULTS: Out of the eight laboratories contacted, seven participated in the survey, yielding a response rate of 87.5%. Immunofixation Electrophoresis (IFE) was used by all labs for serum immunotyping. All labs reported a new small abnormal band in patients with no known monoclonal gammopathy or with a known M-protein. Variations were found in terminologies used to label paraprotein, terminologies used to report normal and pathological SPE patterns, electrophoretic technique, methods for quantifying paraprotein in the gamma region on SPE and for albumin quantification. Similarly, the number of decimal places reported, reporting of multiple monoclonal proteins and small paraprotein in the beta region or monoclonal proteins less than 1 g/L, approach for screening, number of fractions reported in gamma region and reporting of interferences were also not standardized and var-iations were noticed. CONCLUSIONS: Our survey highlighted variations in practices of SPE reporting. These differences in laboratory practices could result in inconsistent test results, which could adversely affect patient care.

Fabrication of curcumin-loaded oleogels using camellia oil bodies and gum arabic/chitosan coatings for controlled release applications.

This study has explored the potential of plant-derived oil bodies (OBs)-based oleogels as novel drug delivery systems for in vitro release under simulated physiological conditions. To obtain stable OBs-based oleogels, gum arabic (GA) and chitosan (CH) were coated onto the curcumin-loaded OBs using an electrostatic deposition technique, followed by 2,3,4-trihydroxybenzaldehyde (TB) induced Schiff-base cross-linking. Microstructural analyses indicated successful encapsulation of curcumin into the hydrophobic domain of the OBs through a pH-driven method combined with ultrasound treatment. The curcumin encapsulation efficiency of OBs increased up to 83.65 % and 92.18 % when GA and GA-CH coatings were applied, respectively, compared to uncoated OBs (63.47 %). In addition, GA-CH coatings retained the structural integrity of oleogel droplets with superior oil-holding capacity (99.07 %), while TB addition induced interconnected 3D-network structures with excellent gel strength (≥4.8 × 105 Pa) and thermal stability (≥80 °C). GA-CH coated oleogels appeared to provide the best protection for loaded bioactive against UV irradiation and high temperature-induced degradation during long-term storage. The combination of biopolymer coatings and TB-induced Schiff-base cross-linking synergistically hindered the simulated gastric degradability of oleogels, releasing only 23.35 %, 12.46 % and 7.19 % of curcumin by GA, GA-CH and GA-CH-TB stabilized oleogels, respectively, while also resulting in sustained release effects during intestinal conditions.

Metformin Alleviates Pain States by Regulating the Balance of Spinal Synaptic Transmission.

BACKGROUND: Metformin has been shown to have potent analgesic effects; however, the underlying mechanism of synaptic plasticity mediating analgesia remained ambiguous. METHODS: In this study, animal behavioral tests, whole-cell patch­clamp recording, immunofluorescence staining, and network pharmacology techniques were applied to elucidate the mechanisms and potential targets of metformin-induced analgesia. RESULTS: Single or consecutive injections of metformin significantly inhibited spinal nerve ligation (SNL)-induced neuropathic pain, and formalin-induced acute inflammatory pain. Network pharmacology analysis of metformin action targets in pain database-related targets revealed 25 targets, including five hub targets (nitric oxide synthase 1 (NOS1), NOS2, NOS3, epidermal growth factor receptor (EGFR), and plasminogen (PLG)). Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis demonstrated that metformin-induced analgesia was markedly correlated with calcium signaling and synaptic transmission. Intrathecal injection of metformin significantly reversed nerve injury-induced c-Fos (neural activity biomarker) mRNA and protein expression in neuropathic rats by regulating NOS2 expression. In addition, whole-cell recordings of isolated spinal neurons demonstrated that metformin dose-dependently inhibited the enhanced frequency and amplitude of miniature excitatory synaptic currents (mEPSCs) but did not affect those of miniature inhibitory synaptic currents (mIPSCs) in neuropathic pain. CONCLUSIONS: This study further demonstrated that metformin might inhibit spinal glutamatergic transmission and abnormal nociceptive circuit transduction by monitoring synaptic transmission in pain. Results of this work provide an in-depth understanding of metformin analgesia via synaptic plasticity.

Outcomes of patients with elevated pulmonary artery systolic pressure on echocardiography due to chronic lung diseases.

BACKGROUND: Pulmonary hypertension is associated with increased mortality, and lung diseases are the second most common cause of pulmonary hypertension. We aimed to evaluate the prognostic value of echocardiography in low-middle income countries where right heart catheterization is difficult to perform. METHODS: This retrospective chart review study included adult patients hospitalized from June 2012 to May 2021, with a pulmonary artery systolic pressure (PASP) of ≥35 mmHg on echocardiography. The control arm consisted of patients with similar lung diseases who did not have an elevated PASP. RESULTS: The study and control arm consisted of 128 patients each, with both groups having similar lung diseases. Obesity hypoventilation syndrome was the most common etiology of elevated PASP (28.1 %), followed by pulmonary embolism (20.3 %). The overall 1-year mortality of the study cohort, after diagnosis of elevated PASP, was 20.3 %. The control cohort with normal PASP had a 1-year mortality of 4.7 %. In the study cohort, patients with bronchiectasis had the highest cause-specific 1-year mortality (45.5 %). In the normal PASP cohort, the highest cause-specific 1-year mortality was observed in patients with interstitial lung disease (13.0 %). One-year hospital readmission was observed in 46.9 % and 33.6 % of patients in the study and control arms, respectively. On multivariate analysis, increased odds of 1-year mortality were observed in patients with elevated PASP, patients with 1-year hospital readmission, and in patients with interstitial lung disease or bronchiectasis. CONCLUSION: Elevated PASP on echocardiography may be a prognostic factor for mortality in patients with chronic lung diseases.

In Situ Fe-Substituted Hexacyanoferrate for High-Performance Aqueous Potassium Ion Batteries.

The eco-friendliness, safety, and affordability of aqueous potassium batteries (AKIBs) have made them popular for large-scale energy storage devices. However, the cycling and rate performance of research materials, particularly cobalt hexacyanoferrate, have yet to meet satisfactory standards. Herein, a room-temperature drafted K1.66 Fe0.25 Co0.75 [Fe(CN)6 ]·0.83H2 O (KFCHCF) sample is reported using an in situ substitution strategy. A higher concentration of ferrocyanide ions decreases the water content and increases the potassium content, while citric acid works as a chelating agent and is responsible for Fe-substitution in the KFCHCF sample. The resultant KFCHCF sample exhibits good rate performance, and about 97% and 90.6% of discharge capacity are conserved after 400 and 1000 cycles at 100 and 200 mA g-1 , respectively. The full cell using the KFCHCF cathode and 1,4,5,8-naphthalenetetracarboxylic dianhydride-derived polyimide (PNTCDA) anode maintains ≈74.93% and 74.35% of discharge capacity at 200 mA g-1 and 1000 mA g-1 for 1000 and >10,000 cycles, respectively. Furthermore, ex situ characterizations demonstrate the high reversibility of K-ions and structural stability during the charge-discharge process. Such high performance is attributed to the fast K-ion migration and crystal structure stabilization caused by in situ Fe-substitution in the KFCHCF sample. Other hexacyanoferrates can be synthesized using this method and used in grid-scale storage systems.

Laparoscopic Versus Open Inguinal Hernia Repair: A Comparative Study.

BACKGROUND: Inguinal hernia is a common surgical problem around the world. The two types of groin hernias are femoral hernias and direct and indirect inguinal hernias. The incidence rate is higher among males. This investigation intends to differentiate between open and laparoscopic methods of inguinal hernia surgery with respect to operative time, seroma formation, duration of hospitalization, and return to normal activity. MATERIALS AND METHODS: This prospective observational study included 84 patients with unilateral, bilateral, direct, and indirect inguinal hernias, but excluded those who were unwilling to have surgery, were under 12, had comorbidities, or had complete and recurrent hernias. In the end, 42 underwent open, and 42 underwent laparoscopic repair. Visual analog scales were used for pain assessments. Chi-square and unpaired student T-tests were employed (p<0.05). RESULTS: Among the 84 individuals analyzed, 79 (94.04%) were male patients, with the majority of them falling between the ages of 41 and 55. In contrast to the open group of patients, the laparoscopic group experienced a significant increase in operative time with a highly significant statistical difference (p<0.0001), and the laparoscopic group experienced a significant decrease in post-operative pain score with an insignificant p-value. A significant statistical difference (p<0.005) was estimated among the laparoscopic and open groups of patients in terms of post-operative hospitalization. Returning to normal activities was significantly different for laparoscopic patients relative to the open group (p-value<0.001). With a high level of significance of p<0.001, laparoscopic hernia repair required less time to recover before returning to normal activities than open hernia repair (p<0.005). CONCLUSION: In terms of decreased post-operative discomfort, shorter hospitalization, and an earlier return to activities, laparoscopic hernia repair has been found to be superior to open hernia repair, which is also known as Lichtenstein surgery. However, there was no discernible difference among the two groups with regard to post-operative problems, including seroma development and wound infections. To assess chronic discomfort and recurrence rates after laparoscopic hernia surgery, additional studies and extended follow-up are required.

Orthopaedic Surgery Complications at a Tertiary Care Hospital in a Low- and Middle-Income Country: A National Surgical Quality Improvement Project Analysis.

BACKGROUND: Through a comparison of orthopaedic surgical procedures performed at a tertiary care hospital in Pakistan with other participating hospitals of National Surgical Quality Improvement Project (NSQIP), we aim to identify the areas of orthopaedic surgical care at our center that need improvement and also those which are at par with international standards. METHODS: The study analyses orthopaedic surgeries at a tertiary care hospital in Pakistan using NSQIP registry to compare complication rates with other American College of Surgeons-NSQIP participant hospitals. Two reviewers collect data in different days every 8 days to reduce bias, and the results are reported in odds ratios using quarterly reports. This study included 584 eligible orthopaedic cases performed in 2021. Yearly institutional reports with odds ratios were also used to identify areas needing improvement and to implement changes to improve orthopaedic surgical outcomes at said institute. RESULTS: The quarterly reports suggest a relatively higher OR for certain indicators such as cardiac events, surgical site infection, mortality, and morbidity throughout. The renal failure rate was very high in the third and fourth quarters with odds ratios of 4.57 and 10.31, respectively. However, the official NSQIP annual institutional report for 2021 identified sepsis, surgical site infections, and cardiac complications as areas 'needing improvement'. It also indicated that the hospital performed exemplarily when it came to venous thromboembolism (VTE). As for the rest of the indicators, the hospital fell in the 'as expected' category of the NSQIP standards. CONCLUSION: This initial report helps the hospital's orthopaedic department in recognizing areas for improvement and making system-level changes to improve patient outcomes. The implementation of these interventions has yielded favorable outcomes, as evidenced by the findings in the NSQIP yearly report for 2022. Reinforcements and measures are needed to be taken to reduce the adverse events even further and to improve the patient outcomes and quality.

Assessment of Acceptability of Pre-exposure Prophylaxis for HIV Prevention Among Men Who Sex with Men and Transgender Community in Pakistan.

OBJECTIVE: To assess the level of acceptability of oral pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) and transwomen (TW) in Pakistan. STUDY DESIGN: Cross-sectional study. Place and Duration of the Study: Online study portal from September to November 2021. METHODOLOGY: The study participants were recruited through snowball sampling. Consenting individuals who were >13 years and were identified as MSM or TW were included in the study. Data were analysed using SPSS version 25. Frequencies, percentages and correlation coefficients were computed. RESULTS: A total of 347 participants were recruited. The mean age of all participants was 29.8 ± 6.7 years. Fifty-eight (19.7%) of the participants had chemsex with amphetamine-type stimulants (ATS) at least once in preceding six months of the study, and 58 (19.7%) had a sexually transmitted infection (STI) in preceding six months whereas 10 (3.4%) participants had used drugs via injection. Two hundred and thirty-eight (72%) of the participants were aware of PrEP, 30 (11.7%) had used PrEP in the past, and 3.88% were currently using PrEP. The willingness to use PrEP, free of cost, was shown by 300 participants (86.45%) and by 180 (54.5%), if available at a low cost. CONCLUSION: There was a high prevalence of risk factors posing them at considerable risk of human immunodeficiency virus (HIV). The majority was aware of PrEP for HIV prevention. The willingness to use PrEP was high when PrEP was offered free of cost but dropped down when participants were asked to pay for PrEP. Based on this finding, PrEP should be available free of cost at the community preferred outlets. KEY WORDS: Gay, Men who have sex with men, HIV, Pre-exposure prophylaxis Pakistan, Transwomen, Chemsex, People living with HIV.

Immobilization of α-transglucosidase on silica-coated magnetic nanoparticles and its application for production of isomaltooligosaccharide from the potato peel.

In this study, the production of isomaltooligosaccharide from potato peel starch was carried out in three steps: liquefaction, saccharification, and transglucosylation. Further, cloning α-transglucosidase gene from Aspergillus niger (GH31 family), transforming into E. coli BL21 (DE3), overexpressing and purifying the resulting protein for the production of α-transglucosidase. The generated α-transglucosidase was then bound with magnetic nanoparticles, which improved reusability up to 5 cycles with more than 60% activity. All the modifications were characterized using the following methods: Fourier transform infra-red analysis, Transmission Electron Microscopy, Field Emission Scanning Electron Microscopy, Energy Dispersive X-ray spectroscopy, X-Ray Diffraction Spectroscopy, Thermogravimetric Analysis, and Dynamic Light Scattering (DLS) analysis. Further, the optimum conditions for transglucosylation were determined by RSM as follows: enzyme-to-substrate ratio 6.9 U g-1, reaction time 9 h, temperature 45 °C, and pH 5.5 with a yield of 70 g l-1 (± 2.1). MALDI-TOF-MS analysis showed DP of the IMOs in ranges of 2-10. The detailed structural characterization of isomaltooligosaccharide by GC-MS and NMR suggested the α-(1 → 4) and α-(1 → 6)-D-Glcp residues as major constituents along with minor α-(1 → 2) and α-(1 → 3) -D-Glcp residues.

Zone-wise occupancy schedules developed using Time Use Survey data for building energy performance simulations.

The occupancy profile dataset presented in this study leverages publicly available UK Time Use Survey (TUS) 2014-15 data to evaluate the impact of occupancy on energy consumption at various spatial and temporal scales using multi-scale archetypes. Constructing this occupancy dataset includes conversion, categorisation, extraction and analysis processes. The resulting dataset (in .csv) format represents realistic day-wise zone-level occupancy availability schedules that account for the effect of the type of dwelling, the number of occupants, the month of the year and the day of the week. A total of 5,376 occupancy profiles were extracted, representing a large number of dwellings. These profiles demonstrate the realistic behaviour of occupants' availability in dwellings. These profiles allow us to gain valuable insights into the energy usage patterns in dwellings based on the realistic behaviour of occupants, leading to more accurate and context-specific energy assessments.

Prevalence of Depression and Subjective Job Stress Among Men who have Sex with Men and Transgender Community Health Workers in Pakistan.

OBJECTIVE: To determine the prevalence of depression, subjective work-related stress and associated factors among men who have sex with men and transgender people working in community-based organisations in Pakistan. STUDY DESIGN: Cross-sectional descriptive study. Place and Duration of the Study: Community-based organisations in Lahore, October 2022. METHODOLOGY: Community-based organisations were contacted and link of the study tool in the Urdu language was shared. The study tool consisted of sociodemographic questions, substance abuse history, Patient Health Questionnaire (PHQ) 9, the General Self-Efficacy Scale (GSE), and the Subjective job stress scale (SJSS). The composite score for each scale was calculated and compared. RESULTS: A total of 91 men participated in the study. Of them, 52.1% were below 30 years of age. The mean PHQ-9 score was 7.62 (range 0-27), mean GSE score was 32.38 (range 12-40), and mean SJSS score was 10.48 (4-14). While 41.7% of the participants were not depressed, 31.77% had depression of at least moderate severity. About 56.52% of the study participants had an SJSS score of more than ten showing a high level of work-related stress. CONCLUSION: There is a high frequency of depression among MSM and TG community health workers. High degree of self-efficacy may protect against depression. There is a need of developing comprehensive referral systems with psychiatric units for these community workers. KEY WORDS: Community health workers, Homosexual men, Transgender, Depression.

Ion Pre-Embedding Engineering of δ-MnO2 for Chemically Self-Charging Aqueous Zinc Ions Batteries.

Aqueous zinc ion batteries (ZIBs), especially those with self-charging properties, have been promisingly developed in recent years. Yet, most inorganic materials feature high redox potential, which limit their development in the self-charging field. To achieve this target, by pre-embedding potassium ions into δ-MnO2 to reduce the energy barrier in oxygen adsorption, the first application of MnO2 in self-charging ZIBs is realized. The design features a facile two-electrode configuration with no excessively complex component to allow for energy storage and conversion. Due to the voltage difference between the oxygen in the air and the discharge products, a redox reaction can be carried out spontaneously to realize the self-charging process. After the chemical self-charging process, the Zn-K0.37 MnO2 ·0.54H2 O/C cell achieves an open circuit voltage of around 1.42 V and a discharge capacity of 201 mAh g-1 , reflecting the promising self-charging capability. Besides, the chemically self-charging ZIBs operate well in multiple modes of constant current charge/discharge/chemical charging. And decent cycling capability can also be achieved at extreme temperatures and high mass loading. This work promotes the development of ZIBs and further broadens the application of inorganic metal oxides in the self-charging systems.