Risk Factors of Wasting-Based Malnutrition in the Flood-Affected Areas of Pakistan: A Cross-Sectional Study.

The current study aimed to find the risk factors of wasting in flood-affected areas of Khyber Pakhtunkhwa, Pakistan. Sociodemographic and anthropometric data was collected. Children living in large family are 2.59 times more likely to be wasted (AOR = 2.59, 95% confidence interval (CI): 1.10, 6.10; p value = .029) and children living in medium size family are 2.23 times more likely to be wasted (AOR = 2.23, 95% CI: 1.03, 4.80; p value = .04) as compared to children in small family size. The study underscores the need for targeted interventions to address the identified risk factors and mitigate the impact of flooding on child nutrition.

Risk factors for eating disorders among Chinese and international university students: a comparative cross-sectional study.

OBJECTIVE: The aim of the study was to investigate the prevalence of eating disorders (EDs) and their association with socio-demographic and behavioural factors among university students. METHODS: A cross-sectional study among university students (Chinese and international) in Nanjing, China. We collected the data from 877 students, of which 811 were eligible for this study. They submitted a self-administered questionnaire (Eating Disorder Examination Questionnaire 6 (EDE-Q6) related to socio-demographic, health variables and lifestyle factors. Data were assessed with the help of SPSS software. RESULTS: A total of 401 Chinese and 410 international university students (49.44% vs. 50.55%) participated in this study. Binary logistic regression showed that young female adults of 18~25 years of age had more risk of developing eating disorders. Higher body mass index (BMI), such as overweight and obesity, were more influential risk factors (p < 0.001) for eating disorders. The significant risks (p < 0.001) EDs were found in students who were athletes, physically active, and involved in various extra-curricular activities. Alcohol and smoking were significant risk factors associated with eating disorders. CONCLUSION: The results indicated higher risks of eating disorders followed by objective binge eating and compensatory behaviour. In this scenario, early assessment and treatment are necessary to reduce the burden of eating disorders and to promote good nutritional practices among university students.

Atrous Convolutions and Residual GRU Based Architecture for Matching Power Demand with Supply.

Nowadays, for efficient energy management, local demand-supply matching in power grid is emerging research domain. However, energy demand is increasing day by day in many countries due to rapid growth of the population and most of their work being reliant on electronic devices. This problem has highlighted the significance of effectively matching power demand with supply for optimal energy management. To resolve this issue, we present an intelligent deep learning framework that integrates Atrous Convolutional Layers (ACL) with Residual Gated Recurrent Units (RGRU) to establish balance between the demand and supply. Moreover, it accurately predicts short-term energy and delivers a systematic method of communication between consumers and energy distributors as well. To cope with the varying nature of electricity data, first data acquisition step is performed where data are collected from various sources such as smart meters and solar plants. In the second step a pre-processing method is applied on raw data to normalize and clean the data. Next, the refined data are passed to ACL for spatial feature extraction. Finally, a sequential learning model RGRU is used that learns from complicated patterns for the final output. The proposed model obtains the smallest values of Mean Square Error (MSE) including 0.1753, 0.0001, 0.0177 over IHEPC, KCB, and Solar datasets, respectively, which manifests better performance as compared to existing approaches.

Risk Factors of Mid-upper Arm Circumference (MUAC) Based Child Malnutrition in the Flood-affected Areas of Pakistan: A Cross-sectional Study.

Low- and middle-income countries are usually at high risk of malnutrition. Not only that but the prevalence of malnutrition is much higher. It is important to evaluate the determinants of malnutrition in flood-affected areas of Pakistan. The present study examined the prevalence and risk factors of MUAC-based child malnutrition in flood-hit regions of Khyber Pakhtunkhwa, Pakistan. Multi-stage sampling was employed to select 656 households. Finally, 298 children of 6-59 months were selected. MUAC, an independent anthropometric parameter, was used to investigate the nutritional status of children. An automated logistic regression model was used to identify the risk factors of MUAC-based malnutrition. The prevalence of MUAC-based malnutrition was found 46%, including 40.5% females and 52.1% males. More than 90% of people had improved water quality and soap hand washing facility. Almost 17% of respondents had no toilet facility. Through automated logistic model, child age, maternal age, family size, income level, mother education, water quality, toilet facility were the significant determinants (P < .05) of MUAC-based undernutrition in flood affecting the area. The findings suggest that MUAC-based malnutrition can be minimized in flood-hit areas by targeting the listed risk factors. Community-based awareness programs regarding guidance on nutrition might be a key to reducing malnutrition in the target areas.

Effect of time-restricted feeding on metabolic risk and circadian rhythm associated with gut microbiome in healthy males.

Time-restricted feeding (TRF) confers protection against nutritional challenges that predispose obesity and metabolic risks through involvement of circadian locomotor output cycles protein kaput genes and gut microbiome, but the underlying mechanism is not clearly understood. Therefore, the present study examined the effects of TRF on metabolic markers and circadian rhythm associated with gut microbiota in healthy males. Two groups (TRF, n 56; non-TRF, n 24) of male adults were enrolled. The TRF group provided blood at pre-TRF and post-TRF, while non-TRF one time after 25 d of trial. Serum lipid and liver profiles were determined. Real time-PCR was applied for circadian and inflammatory gene expression. The 16S rRNA genes were sequenced on the Illumina Miseq v3 platform to comprehensively catalogue the composition and abundance of bacteria in stool. We showed that TRF ameliorated the serum lipid and liver profiles of the individuals. In the TRF group, gut microbial richness was significantly enhanced, with enrichment of Prevotellaceae and Bacteroideaceae. TRF enhanced circadian gene expression probably by activation of sirtuin-1, which is positively associated with gut microbiome richness. TRF could be a safe remedy for the prevention of metabolic diseases related to dyslipidaemia, as it regulates circadian rhythm associated with gut microbiome modulation.

Towards Efficient Building Designing: Heating and Cooling Load Prediction via Multi-Output Model.

In the current technological era, energy-efficient buildings have a significant research body due to increasing concerns about energy consumption and its environmental impact. Designing an appropriate energy-efficient building depends on its layout, such as relative compactness, overall area, height, orientation, and distribution of the glazing area. These factors directly influence the cooling load (CL) and heating load (HL) of residential buildings. An accurate prediction of these load facilitates a better management of energy consumption and enhances the living standards of inhabitants. Most of the traditional machine learning (ML)-based approaches are designed for single-output (SO) prediction, which is a tedious task due to separate training processes for each output with low performance. In addition, these approaches have a high level of nonlinearity between input and output, which need more enhancement in terms of robustness, predictability, and generalization. To tackle these issues, we propose a novel framework based on gated recurrent unit (GRU) that reliably predicts the CL and HL concurrently. To the best of our knowledge, we are the first to propose a multi-output (MO) sequential learning model followed by utility preprocessing under the umbrella of a unified framework. A comprehensive set of ablation studies on ML and deep learning (DL) techniques is done over an energy efficiency dataset, where the proposed model reveals an incredible performance as compared to other existing models.

Comparison of dual task specific training and conventional physical therapy in ambulation of hemiplegic stroke patients: A randomized controlled trial.

OBJECTIVE: To compare the effectiveness of dual task specific training and conventional physical therapy in ambulation of patients with chronic stroke. METHODS: The randomised controlled trial was conducted at the Habib Physiotherapy Complex, Peshawar, Pakistan, from January to August 2017, and comprised patients with chronic stroke. The patients were randomly assigned to two treatment groups. Group A received dual task training, while Group B received conventional physiotherapy. Dual task training included activities such as slowlywalking backward, sideways, and forward on a smooth surface while holding a 100gm sandbag. The conventional physiotherapy included mat activities, stretching and strengthening exercises and gait training. Pre-test and post-test data was taken for both spatial and temporal variables for both groups using Time Up and Go Test and 10-meter walk test. Step length, stride length, cycle time and cadence were also calculated before and after treatment. SPSS 23 was used to analyse the data. RESULTS: Of the 64 patients, there were 32(50%) in each of the two groups that both had 17(53%) males and 15(47%) females. Mean age in Group A was 58.28 ± 7.13 years, while in Group B it was 58.87 ± 6.13 years. Baseline parameters had no significant differences between the groups (p>0.05). Post-treatments scores revealed significant improvement of spatial and temporal variable of gait, 10-meter walk, cadence, step length, stride and cycle time in Group A compared to Group B (p<0.05 each). CONCLUSIONS: Conventional physical therapy and dual task training effectively improved gait ability of chronic stroke patients, and the latter showed significant improvement in all spatial and temporal gait variables compared to former.

Identification of Body Composition, Dietary Patterns and Its Associated Factors in Medical University Students in China.

This study aimed to measure the body composition, dietary patterns and its associated factors in medical students. A cross-sectional study was conducted among 695 students studying at Nanjing medical university, China. Data regarding dietary intake factors was collected by a validated food frequency questionnaire. Principle component analysis and multivariate linear regressions were used. Body composition including BMI and visceral fats index of the males were significantly higher (P < .05) than females. While body fats percentage and fats mass index/free fat mass index (FMI/FFMI) ratio of females was significantly higher (P < .05) than males. Three dietary patterns were identified: western dietary pattern, meat pattern, and vegetables and fruits pattern. The western pattern was having an independent negative association (P < .05) with age and financial status, while positive association (P < .05) with sleeping duration and FMI/FFMI ratio. Vegetables and fruits patterns was having positive association with physical exercise and while negative association with FMI/FFMI ratio. Meat pattern was having positive association with educational levels and sleeping duration, while negative association with physical exercise and FMI/FFMI ratio. In conclusion, medical students adopted less healthy dietary patterns as compared to healthy dietary patterns, which were found to be more associated with some adverse dietary and lifestyle behavior outcomes.

Violence Detection Using Spatiotemporal Features with 3D Convolutional Neural Network.

The worldwide utilization of surveillance cameras in smart cities has enabled researchers to analyze a gigantic volume of data to ensure automatic monitoring. An enhanced security system in smart cities, schools, hospitals, and other surveillance domains is mandatory for the detection of violent or abnormal activities to avoid any casualties which could cause social, economic, and ecological damages. Automatic detection of violence for quick actions is very significant and can efficiently assist the concerned departments. In this paper, we propose a triple-staged end-to-end deep learning violence detection framework. First, persons are detected in the surveillance video stream using a light-weight convolutional neural network (CNN) model to reduce and overcome the voluminous processing of useless frames. Second, a sequence of 16 frames with detected persons is passed to 3D CNN, where the spatiotemporal features of these sequences are extracted and fed to the Softmax classifier. Furthermore, we optimized the 3D CNN model using an open visual inference and neural networks optimization toolkit developed by Intel, which converts the trained model into intermediate representation and adjusts it for optimal execution at the end platform for the final prediction of violent activity. After detection of a violent activity, an alert is transmitted to the nearest police station or security department to take prompt preventive actions. We found that our proposed method outperforms the existing state-of-the-art methods for different benchmark datasets.

Acrolein-induced atherogenesis by stimulation of hepatic flavin containing monooxygenase 3 and a protection from hydroxytyrosol.

Acrolein, a highly toxic α, ß-unsaturated aldehyde, promotes the progression of atherosclerosis in association with inflammatory signaling pathway and reverse cholesterol transport (RCT) process. Additionally, hepatic flavin containing monooxygenase 3 (FMO3) is involved in the pathogenesis of atherosclerosis by regulating cholesterol metabolism. Hydroxytyrosol (HT), as a major phenolic compound in olive oil, exerts anti-inflammatory and anti-atherogenic activities in vitro and animal models. The current study was designed to evaluate whether FMO3 participated in pro-atherogenic process by acrolein and HT showed protective effect during this process. Here, endothelial cells and macrophage Raw264.7 cells were used as the cell models. Following oxidized low-density lipoprotein (OX-LDL) treatment, acrolein exposure promoted foam cells formation in macrophage Raw264.7 cells. The expression of FMO3 and inflammatory makers such as phospho-NF-κB, IL-1ß, TNFα as well as IL-6 were significantly increased. However, ATP-binding cassette transporters subfamily A member 1 (ABCA1), a major transporter in RCT process, was repressed by acrolein. In addition, FMO3 knockdown could suppress inflammatory markers and promote ABCA1 expression. Hydroxytyrosol (HT) was observed to reduce lipid accumulation, FMO3 expression as well as inflammatory response. Moreover, it promoted ABCA1 expression. Therefore, our findings indicated that acrolein-enhanced atherogenesis by increasing FMO3 which increased inflammatory responses and decreased ABCA1 in vitro can be alleviated by HT, which may have a therapeutic potential for the treatment of atherosclerosis.

Epigallocatechin-3-gallate inhibited cancer stem cell-like properties by targeting hsa-mir-485-5p/RXRα in lung cancer.

Non-small-cell lung cancer (NSCLC) appears to be a significant threat to public health worldwide. MicroRNAs have been identified as significant regulators for the development of NSCLC. Previous reports have suggested that hsa-mir-485-5p is dysregulated in various cancers. RXRα, as a kind of nuclear receptor, is an effective target of cancer treatment. Cancer stem cells (CSCs) are recognized as the main cause for tumor metastasis, recurrence, and chemotherapy resistance. However, the mechanism by which hsa-mir-485-5p and RXRα modulate CSCs in NSCLC remains unknown. Here, we found that hsa-mir-485-5p was decreased in serum samples from patients with NSCLC and NSCLC cells. Meanwhile, epigallocatechin-3-gallate (EGCG), an effective anticancer compound extracted from green tea, can enhance hsa-mir-485-5p expression. Hsa-mir-485-5p mimics markedly inhibited NSCLC cell growth and induced cell apoptosis. However, inhibition of hsa-mir-485-5p significantly enriched CSC-like traits. Moreover, bioinformatics analysis predicted the binding correlation between hsa-mir-485-5p and RXRα, which was confirmed by a dual-luciferase reporter assay. We observed that RXRα was increased in NSCLC and EGCG could inhibit RXRα levels dose dependently. In addition, RXRα upregulation or activation expanded the CSC-like properties of NSCLC cells, whereas RXRα inhibition or inactivation could exert a reverse phenomenon. Consistently, in vivo experiments also validated that EGCG could repress the CSC-like characteristics by modulating the hsa-mir-485-5p/RXRα axis. Our findings may reveal a novel molecular mechanism for the treatment of NSCLC.

EGCG inhibits CSC-like properties through targeting miR-485/CD44 axis in A549-cisplatin resistant cells.

Non-small cell lung cancer (NSCLC) remains one of the most aggressive tumors with low life expectancy worldwide. The existence of cancer stem cells (CSCs) contributes to the failure of cancer treatment resulted from drug resistance. Altered microRNA expression has been observed in human tumors due to its role in tumor growth, progression, and metastasis. Hence, the aim of our present study was to investigate the effects of miR-485 on the CSC-like traits in NSCLC A549-cisplatin resistant cells and concentrate on the underlying molecular mechanism. It was found that CSC-like phenotypes were much more enriched in A549/cisplatin (A549/CDDP) cells compared to A549-parental cells. In addition, we observed that miR-485 was greatly decreased in A549/CDDP cells and miR-485 overexpression was able to decrease the stemness of A549/DDP cells. Meanwhile, epigallocatechin-3-gallate (EGCG), a green tea polyphenol which has been identified as an effective anticancer compound was able to increase miR-485 expression dose-dependently in A549/CDDP cells. Inhibitors of miR-485 remarkably increased CSC-like phenotypes, which could be reversed by indicated doses of EGCG. Moreover, CD44 was predicted as downstream target of miR-485 and the correlation between them was validated by performing dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. Subsequently, in vivo experiments were employed to confirm that EGCG restrained CSC-like characteristics by increasing miR-485 and decreasing CD44 expression. Taken together, it was implied that stemness features and CSC population were suppressed by EGCG-modulated miR-485/CD44 axis in A549/CDDP cells.

Determinants of Diarrhea Among Children Aged 1 to 6 Years in Flood-Affected Areas of Pakistan: A Cross-Sectional Study.

Frequent floods can contribute to the spread of various diseases and complications, some of which may result in diarrhea, especially among children. The current study aimed to find the determinants of diarrhea among children aged 1-6 years in flood-affected areas in Khyber Pakhtunkhwa, Pakistan. A cross-sectional study was conducted in flood-affected districts. Data regarding sociodemographic information related to diarrhea and anthropometric data were collected through a validated questionnaire. Logistic regression was used to find the determinants of diarrhea. In the presence of diarrhea, the prevalences found of stunting, wasting, and being underweight were 75.2%, 76.5%, and 74.1%, respectively, which is higher than those in children without diarrhea (stunting, 24.8%; wasting, 23.5%; and being underweight, 25.9%). In bivariate regression, children aged 2-4 years (odds ratio [OR] = 1.65, P < 0.05), large family size (OR = 7.46, P < 0.01), low income (OR = 2.55, < 0.001), bathing in ponds (OR = 3.05, P < 0.05), drinking of untreated water (OR = 3, P < 0.05), flooding (OR = 1.8, P < 0.05), children living in mud houses (OR = 1.5, P < 0.05), and usage of utensils without lids (OR = 1.96, P < 0.001) were significantly associated with occurrence of diarrhea. In multivariate regression, the identified risk factors (P < 0.05) for diarrhea in flood-affected areas included illiterate mothers, flooding, large family size, households without livestock, poor water quality, untreated water, and lack of toilet facilities. In conclusion, addressing the determinants of diarrhea identified in this study is crucial for mitigating the impact of frequent floods on children in flood-affected areas. Moreover, the higher prevalence of malnutrition underscores the urgent need for comprehensive strategies and proper water, sanitation, and hygiene programs to reduce the occurrence and determinants of diarrhea.

Alarming multidrug resistance in Staphylococcus aureus isolated from raw milk of cows with subclinical mastitis: Antibiotic resistance patterns and occurrence of selected resistance genes.

Bovine mastitis is a widespread and costly disease that affects dairy farming globally, characterized by mammary gland inflammation. Bovine intramammary gland infection has been associated with more than 135 different pathogens of which Staphylococcus aureus is the main etiology of sub-clinical mastitis (SCM). The current study was designed to investigate the prevalence, antibiotic resistance pattern, and the presence of antibiotic resistance genes (mecA, tetK, aacA-aphD and blaZ) in S. aureus isolated from the raw milk of cows with subclinical mastitis. A total of 543 milk samples were collected from lactating cows such as Holstein Friesian (n = 79), Sahiwal (n = 175), Cholistani (n = 107), and Red Sindhi (n = 182) from different dairy farms in Pakistan. From the milk samples microscopic slides were prepared and the somatic cell count was assessed to find SCM. To isolate and identify S. aureus, milk was streaked on mannitol salt agar (MSA) plates. Further confirmation was done based on biochemical assays, including gram staining (+ coccus), catalase test (+), and coagulase test (+). All the biochemically confirmed S. aureus isolates were molecularly identified using the thermonuclease (nuc) gene. The antibiotic resistance pattern of all the S. aureus isolates was evaluated through the disc diffusion method. Out of 543 milk samples, 310 (57.09%) were positive for SCM. Among the SCM-positive samples, S. aureus was detected in 30.32% (94/310) samples. Out of 94 isolates, 47 (50%) were determined to be multidrug resistant (MDR). Among these MDR isolates, 11 exhibited resistance to Cefoxitin, and hence were classified as methicillin-resistant Staphylococcus aureus (MRSA). The S. aureus isolates showed the highest resistance to Lincomycin (84.04%) followed by Ampicillin (45.74%), while the least resistance was shown to Sulfamethoxazole/Trimethoprim (3.19%) and Gentamycin (6.38%). Polymerase chain reaction (PCR) analysis revealed that 55.31% of the isolates carried blaZ gene, 46.80% carried tetK gene, 17.02% harbored the mecA gene, whereas, aacA-aphD gene was found in 13.82% samples. Our findings revealed a significant level of contamination of milk with S. aureus and half (50%) of the isolates were MDR. The isolated S. aureus harbored various antibiotic resistance genes responsible for the absorbed phenotypic resistance. The alarmingly high prevalence of MDR S. aureus isolates and MRSA strains in these cases possess a serious risk to public health, emphasizes the urgent need to address this issue to protect both human and animal health in Pakistan.

Nutritional composition, health benefits and bio-active compounds of chickpea (Cicer arietinum L.).

Chickpea (Cicer arietinum L.), an annual plant of the family Fabaceae is mainly grown in semiarid and temperate regions. Among pulses, cultivated worldwide chickpeas are considered an inexpensive and rich source of protein. Chickpea is a good source of protein and carbohydrate, fiber, and important source of essential minerals and vitamins. The quality of protein is better among other pulses. Consumption of chickpeas is related to beneficial health outcomes. Dietary peptides from the protein of chickpeas gaining more attention. Peptides can be obtained through acid, alkali, and enzymatic hydrolysis. Among all these, enzymatic hydrolysis is considered safe. Various enzymes are used for the production of peptides, i.e., flavorzyme, chymotrypsin, pepsin, alcalase, papain, and trypsin either alone or in combinations. Chickpea hydrolysate and peptides have various bioactivity including angiotensin 1-converting enzyme inhibition, digestive diseases, hypocholesterolemic, CVD, antioxidant activity, type 2 diabetes, anti-inflammatory, antimicrobial, and anticarcinogenic activity. This review summarizes the nutritional composition and bioactivity of hydrolysate and peptides obtained from chickpea protein. The literature shows that chickpea peptides and hydrolysate have various functional activities. But due to the limited research and technology, the sequences of peptides are unknown, due to which it is difficult to conduct the mechanism studies that how these peptides interact. Therefore, emphasis must be given to the optimization of the production of chickpea bioactive peptides, in vivo studies of chickpea bioactivity, and conducting human study trials to check the bioactivity of these peptides and hydrolysate.

Assessment of Infection Prevention and Control (IPC) Implementation and Strategies Used for IPC Preparedness at Facility Level in Underdeveloped Areas of Pakistan.

Background: During outbreaks of infectious diseases like COVID-19, the healthcare-associated infections (HCAIs) pose a burden on public health system. There are very limited data about infection prevention and control (IPC) implementation in the healthcare facilities of Pakistan. The aim of the study was to conduct assessment with the IPC Assessment Framework (IPCAF) tool in healthcare facilities of the least developed areas. Methods: A cross-sectional survey was conducted in 12 tertiary level healthcare facilities (HCF) located in the least developed provinces of Pakistan. The facilities were selected through multistage cluster random methods. A well-structured questionnaire, the "IPCAF tool", was used for data collection. The IPCAF comprises eight sections with a 100 score of each section, thus with a maximum score of 800. The scores from 0 to 800 of the HCFs were divided into four gradual ratings through IPCAF, ie from inadequate to advanced. Results: The median score of all facilities was 405, with a range from inadequate to advanced. One facility (8.3%) fell into the "inadequate" category with a score of 172.5; 5 (41.6%) facilities achieved "basic" category, another 5 (41.6%) being "intermediate", and only one (8.3%) hospital achieved "advanced" status. Region-wise median score of facilities of GB was 307.5, facilities in AJK scored 342.5, and a score of 520 was found for health facilities in KPK. The components of Education and Training, HCAIs Surveillance, and Multimodal Strategies achieved the lowest scores. Conclusion: Most of the facilities have developed an IPC program with key focal persons and IPC committees, but did not have relevant education and training. IPC core capacities are being implemented. Equitable attention is required on all eight components of IPC in all facilities.

Modeling the effect of climatic conditions and topography on malaria incidence using Poisson regression: a Retrospective study in Bannu, Khyber Pakhtunkhwa, Pakistan.

Background: Malaria has been identified as a crucial vector-borne disease around the globe. The primary aim of this study was to investigate the incidence of malaria in the district of Bannu and its relationship with climatic conditions such as temperature, rainfall, relative humidity, and topography. Methods: Secondary data were obtained from the metrological office and government hospitals across the district for 5 years (2013-2017). A Poisson regression model was applied for the statistical analysis. Results and discussion: The number of reported cases of malaria was 175,198. The regression analysis showed that temperature, relative humidity, and rainfall had a significant association (p < 0.05) with malaria incidence. In addition, the topographic variables were significantly associated (p < 0.05) with malaria incidence in the region. The percent variation in the odds ratio of incidence was 4% for every unit increase in temperature and 2% in humidity. In conclusion, this study indicated that the temperature, humidity, rainfall, and topographic variables were significantly associated with the incidence of malaria. Effective malaria control and interventions integrated with climatic factors must be considered to overcome the disease burden.

Coordination strategies and concept of operations implemented during activation of public health emergency operations center for COVID-19 response in Pakistan.

Public health emergency management systems encountered difficulties in developing countries, especially in Pakistan. The COVID-19 pandemic was extremely challenging for different agencies/departments in Pakistan. Health emergency management depends on a well-established public health emergency operations center that could generate a coordinated response to emergencies. We conducted an assessment of public health emergency response coordination implemented during the COVID-19 at strategic level. This was mix-method qualitative study. Primary data was collected by using a structured questionnaire, and secondary data was collected by desk review. The agencies engaged in pandemic response at the national level in Pakistan were included in the assessment. The overall score of the emergency response coordination system during COVID-19 was 49% for all agencies. We found that agencies faced challenges in leadership, legislation, and financing issues during the pandemic response (44%). None of the agencies had a fully developed framework for joint planning and response system for health emergencies. Roles and responsibilities attached to designated agencies in response were relatively clear (55%) for most of the agencies. Effective public health emergency response is based on multi-departmental coordination, resource mobilization, and clear roles for each agency. Pakistan must proactively address these challenges for pandemic response in future.

Physiological and Germination Responses of Muskmelon (Cucumis melo L.) Seeds to Varying Osmotic Potentials and Cardinal Temperatures via a Hydrothermal Time Model.

Climatic changes have a direct negative impact on the growth, development, and productivity of crops. The water potential (ψ) and temperature (T) are important limiting factors that influence the rate of seed germination and growth indices. To examine how the germination of seed responds to changes in water potential and temperature, the hydrotime model and hydrothermal model (HTT) have been employed. The HTT calculates the concept of germination time across temperatures, between Tb-To, with alteration, and between Tb-Tc, in supra-optimal ranges. The seeds of Cucumis melo L. were germinated in the laboratory for a hydro-thermal time experiment. Seeds were sown in Petri dishes containing a double-layered filter paper at different osmotic potentials (0, -0.2, -0.4, -0.6, and -0.8 MPa) by providing PEG 6000 (drought stress enhancer) at different temperatures (15, 20, 25, 30, and 35 °C). The controlled replicate was treated with 10 mL of distilled water and the rest with 10 mL of PEG solution. Results indicated that the seed vigor index (SVI-II) was highest at 15 °C with 0 MPa and lowest at 30 °C with -0.2 MPa. However, the highest activity was shown at 15 °C by catalase (CAT) and guaiacol peroxidase (GPX) at (-0.6 MPa), while the lowest values of CAT and GPX were recorded for control at 35 °C with -0.8 MPa at 35 °C, respectively. Germination energy was positively correlated with germination index (GI), germination percentage (G%), germination rate index, seed vigor index-I (SVI-I), mean moisture content (MMC), and root shoot ratio (RSR) and had a negative correlation with mean germination rate, percent moisture content of shoot and root, CAT, superoxide dismutase, peroxidase ascorbate peroxidase, and GPX. In conclusion, thermal and hydrotime models correctly predicted muskmelon germination time in response to varying water potential and temperature. The agronomic attributes were found to be maximum at 30 °C and minimum at 15 °C.

Do Hypertensive Disorders of Pregnancy and Abnormal Placentation Mediate the Association between Advanced Maternal Age and Adverse Perinatal Outcomes?

Background: A tertiary-hospital-based retrospective study (2011-2019) was conducted to determine the mediating role of hypertensive disorders of pregnancy and abnormal placentations between advanced maternal age and adverse neonatal outcomes. Methods: Data from a tertiary-hospital-based retrospective study (n= 23051) was used and conducted regression-based mediation analysis to assess the mediating role of hypertensive disorders of pregnancy and abnormal placentation between the advanced maternal age and adverse neonatal outcomes. Results: After adjusting for confounding factors, the indirect effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight mediated by hypertensive disorders of pregnancy was [aOR 4.95 (95% CI: 4.05, 5.85)], [aOR 2.82 (95% CI: 1.78, 3.86)], and [aOR 5.90 (95% CI: 4.93, 6.87)], respectively. The indirect effect of advanced maternal age on preterm births and low birth weight mediated by abnormal placentation was [aOR 6.83 (95% CI: 5.70, 7.97)] and [aOR 4.18 (95% CI: 3.26, 5.11)]. About, 23%, 37%, and 17% of the effect of advanced maternal age on preterm births, perinatal mortality, and low birth weight was mediated by hypertensive disorders of pregnancy, respectively. Furthermore, abnormal placentation mediates the association between advanced maternal age and preterm births by 18% and low birth weight by 23%. Conclusion: Hypertensive disorders of pregnancy and abnormal placentation partially mediate the association between advanced maternal age and adverse neonatal outcomes.