Association Between Hip Flexor Tightness And Lumbar Instability In Adults.

The study aimed to explore the association between hip flexors tightness and lumbar instability in adults. The study design was correlational and 64 subjects of both genders (male and female) with age range from 20 to 50 years were selected with a history of low back pain (LBP) with or without referred pain. Two examiners were assigned for application of the Modified Thomas Test (MTT) for hip flexors tightness and lumbar prone Instability Test (LPIT) and Prone Lumbar Extension Tests (PLET) for lumbar instabilities. The numeric pain rating scale (NPRS) was used for pain assessment. The two examiners were not aware of each other's findings. The lambda value 0.238 which shows there is a weak association between MTT and PLET. The Cramer's V value 0.179 also shows a weak relationship between MTT and LPIT. This study observed that there is a weak association between tight hip flexors and lumbar instability.

Correlation of Antithrombin Functional Status and Levels with Liver Fibrosis in Patients with Hepatitis C.

BACKGROUND: Abnormal levels of coagulation factors and their inhibitors have shown association with liver diseases. The objective of this study was to determine the qualitative and quantitive status of antithrombin (AT) in patients with chronic liver disease associated hepatitis C infection and their correlation with severity of liver fibrosis. METHODS: In this study, 75 (43 male and 32 female) known patients with chronic liver disease associated hepatitis C infection were enrolled. AT activity and quantitative immunoassays were carried out using Stachrom AT reagent kit (Diagnostica Stago, France) and Liatest AT reagent (Diagnostica Stago, France), respectively. Hepatic biopsies were obtained and graded for liver fibrosis from all study participants. RESULTS: Of the 75 patients, 45 had normal AT while 30 showed lower activity of AT. Similarly, the quantitative assay showed reduced levels of AT in 30 patients and normal levels in 45 patients. CONCLUSIONS: In the early stages of liver fibrosis, AT activity and antigenic levels were found to be normal or minimally affected. While advanced stages of the disease showed markedly reduced levels of AT and activity. Hence, it can be concluded that the degree of fibrosis affects the status of AT.

A highly efficient technique to simultaneously remove acidic and basic dyes using magnetic ion-exchange microbeads.

The purpose of this study was to examine the combination of magnetic anion-exchange microbeads (MAM) and magnetic cation-exchange microbeads (MCM) to remove crystal violet (CV; a basic dye) and acid green 9 (AG9; an acidic dye) from their individual and combined solutions. Adsorption kinetics and isotherms experiments were performed in batch mode. CV and AG9 displayed superior affinity towards MCM and MAM, respectively, and their combined solution was efficiently adsorbed by combining MCM and MAM. The pseudo-first-order, pseudo-second-order, Elovich and intra-particle diffusion models well described the adsorption kinetic data, and the pseudo-second-order model appeared a better fit for the two-component CV/AG9 system. The better fit of the Langmuir isotherm for CV adsorption indicated that CV adsorption occurred on active sites with equal affinity in the monolayer. In contrast, AG9 adsorption onto the heterogeneous MAM surface appeared to be multilayered adsorption. The adsorption capacities of the two dyes decreased with the increase in the co-existing salt concentration and increased only slightly at the high salt level due to the salting-out effect. Moreover, these microbeads maintained most of their initial capacity during five reuse cycles, indicating the great potential of MCM and MAM to remove basic and acidic dyes in practical applications.

Hepatic arterial system anomalies encountered during pancreaticoduodenectomy - our experience.

We present our experience of incidence and management of aberrant hepatic arterial anatomy encountered during pancreaticoduodenectomy (PD). Patients undergoing PD between December 2014 and November 2016 at the Shaukat Khanum Memorial Cancer Hospital, Lahore were included in this short report. Preoperative imaging and operative findings of these patients were reviewed to evaluate the hepatic arterial anatomy and classified according to Hiatt classification. Sixty-four PD were performed with aberrant arterial anatomy identified in 24 (37.5%) of the cases. Most common anomaly was replaced right hepatic artery (rRHA) arising from the superior mesenteric artery seen in seven (11%) of the patients. Aberrant vessels were recognised and preserved in 23 cases. In one patient, the rRHA was coursing through the pancreatic parenchyma needing resection and reconstruction with uneventful postoperative recovery. Hepatic arterial anomalies are common and it is possible to preserve these vessels with careful surgical dissection using artery first technique.

Assessment of potentially toxic and mineral elements in paddy soils and their uptake by rice (Oryza sativa L.) with associated health hazards in district Malakand, Pakistan.

Rice, a primary food source in many countries of the world accumulate potentially harmful elements which pose a significant health hazard to consumers. The current study aimed to evaluate potentially toxic and mineral elements in both paddy soils and rice grains associated with allied health risks in Malakand, Pakistan. Rice plants with intact root soil were randomly collected from paddy fields and analyzed for mineral and potentially toxic elements (PTEs) through inductively coupled plasma optical emission spectrometry (ICP‒OES). Through deterministic and probabilistic risk assessment models, the daily intake of PTEs with allied health risks from consumption of rice were estimated for children and adults. The results of soil pH (< 8.5) and electrical conductivity (EC > 400 µs/cm), indicated slightly saline nature. The mean phosphorus concentration of 291.50 (mg/kg) in soil samples exceeded FAO/WHO permissible limits. The normalized variation matrix of soil pH with respect to Ni (0.05), Ca (0.05), EC (0.08), and Mg (0.09), indicated significant influence of pH on PTEs mobility. In rice grains, the mean concentrations (mg/kg) of Mg (463.81), Al (70.40), As (1.23), Cr (12.53), Cu (36.07), Fe (144.32), Mn (13.89), and Ni (1.60) exceeded FAO/WHO safety limits. The transfer factor >1 for K, Cu, P and Zn indicated bioavailability and transfer of these elements from soil to rice grains. Monte Carlo simulations of hazard index >1 for Cr, Zn, As, and Cu with certainties of 89.93% and 90.17%, indicated significant noncarcinogenic risks for children and adults from rice consumption. The total carcinogenic risk (TCR) for adults and children exceeded the USEPA acceptable limits of 1×10-6 to 1×10-4, respectively. The sensitivity analysis showed that the ingestion rate was a key risk factor. Arsenic (As) primarily influenced total cancer risk (TCR) in children, while chromium (Cr) significantly impacted adults. Deterministic cancer risk values slightly exceeded probabilistic values due to inherent uncertainties in deterministic analysis. Rice consumption poses health risks, mainly from exposure to Cr, Ni and As in the investigated area.

Virulence and resistance profiling of Staphylococcus aureus isolated from subclinical bovine mastitis in the Pakistani Pothohar region.

Mastitis is considered one of the most widespread infectious disease of cattle and buffaloes, affecting dairy herds. The current study aimed to characterize the Staphylococcus aureus isolates recovered from subclinical mastitis animals in Pothohar region of the country. A total of 278 milk samples from 17 different dairy farms around two districts of the Pothohar region, Islamabad and Rawalpindi, were collected and screened for sub clinical mastitis using California Mastitis Test. Positive milk samples were processed for isolation of Staphylococcus aureus using mannitol salt agar. The recovered isolates were analyzed for their antimicrobial susceptibility and virulence genes using disc diffusion and PCR respectively. 62.2% samples were positive for subclinical mastitis and in total 70 Staphylococcus aureus isolates were recovered. 21% of these isolates were determined to be methicillin resistant, carrying the mecA gene. S. aureus isolates recovered during the study were resistant to all first line therapeutic antibiotics and in total 52% isolates were multidrug resistant. SCCmec typing revealed MRSA SCCmec types IV and V, indicating potential community-acquired MRSA (CA-MRSA) transmission. Virulence profiling revealed high prevalence of key genes associated with adhesion, toxin production, and immune evasion, such as hla, hlb, clfA, clfB and cap5. Furthermore, the Panton-Valentine leukocidin (PVL) toxin, that is often associated with recurrent skin and soft tissue infections, was present in 5.7% of isolates. In conclusion, the increased prevalence of MRSA in bovine mastitis is highlighted by this study, which also reveals a variety of virulence factors in S. aureus and emphasizes the significance of appropriate antibiotic therapy in combating this economically burdensome disease.

Comparing the Efficacy of Topical 4% Benzoyl Peroxide Versus Topical 0.1% Adapalene for Treatment of Acne Vulgaris in Skin of Color Population: A South Asian Perspective.

Introduction Acne vulgaris is one of the most common skin problems encountered in the dermatology department. It is a chronic, inflammatory disease of the pilosebaceous unit, clinically presenting with comedones, papules, pustules, nodules, and cysts. With its particularly high prevalence in the younger population, it has significant adverse sequelae on patient's quality of life. At present, due to an enhanced understanding of the pathogenesis of acne, various therapeutic modalities are available. The current management strategies generally follow a systematic treatment escalation based on disease severity and treatment response. However meticulous choice of appropriate anti-acne medicine for the acne type is the key to the management plan. Starting with mild to moderate types of acne as per the Leeds photometric grading scale, the most useful topical agents include topical retinoids, benzoyl peroxide, and topical antibiotics while systemic therapies such as oral antibiotics or isotretinoin are generally reserved for moderate to severe acne treatment. The skin of color (SOC) population is a relatively neglected group concerning the optimum and safe management strategies in different dermatological conditions and acne is no different, where there remains a need for comparing the available topical modalities for appropriate drug selection in the treatment of mild to moderate acne in SOC population. Objective The objective of this study was to compare the efficacy of topical 4% benzoyl peroxide versus topical 0.1% adapalene in the treatment of acne vulgaris in the SOC population. Methods The participants were divided into two groups, groups A and B. A total of 64 patients of both genders, with acne vulgaris (duration > three months) were included in the study. In group A, 32 patients were administered topical 0.1% adapalene whereas, in group B, 32 patients were given topical 4% benzoyl peroxide. Both medicines were applied at night daily. Patients were called for follow-up after 12 weeks. In both groups, the final efficacy evaluation was done using the Global Acne Grading System (GAGS) score after 12 weeks of treatment period. Results In group A, the age ranged from 15 to 40 years with a mean age of 25.781±3.93 years while the duration of complaint was 5.843±1.27 months. GAGS score was 25.281±2.65 and mean BMI was 23.092±3.51 kg/m2. In group B, the mean age was 25.187± 4.06 years, the duration of complaint was 7.375±2.25 months, the GAGS score was 23.906± 2.60 while the mean BMI was 21.485±3.88 kg/m2. Efficacy in group A was noted in 25 (78.1%) patients as compared to 24 (75%) patients in group B (p =0.768). Conclusion The present study showed that the safety and efficacy of 0.1% adapalene the traditional drug 4% benzoyl peroxide in the SOC population was comparable.

Efficacy of Paraffin Wax Bath with and without Joint Mobilization Techniques in Rehabilitation of post-Traumatic stiff hand.

OBJECTIVE: Post-traumatic stiff hand is common a condition which causes pain and disability, the paraffin wax bath and joint mobilizations have the key role in its rehabilitation. We conducted the present study to determine the efficacy of paraffin wax bath with mobilization techniques compared with joint mobilization alone. METHODOLOGY: This single blind randomized control trial was conducted on 71 patients in department of physical therapy and rehabilitation, Riphah International University Islamabad, and patients with post-traumatic stiff hand after distal upper extremity fractures, were included. The patients were randomized into two groups: the joint mobilization techniques with paraffin wax bath were included in group A, and joint mobilization techniques without paraffin wax bath in group B. The study variables were pain score on visual analogue scale (VAS) 0/10, thumb function score (TFS) and passive range of motion (PROM) of wrist flexion, extension, radial and ulnar deviation, and were compared at baseline and at completion on plan-of-care after six weeks. RESULTS: Seventy one patients with post-traumatic stiff hand were enrolled and placed randomly into two groups. The baseline characteristics were similar in both groups. Six week after intervention, patients in group A had more improvement in pain score (p=0.001), TFS (p=0.003), and PROM of wrist flexion (p=0.002), extension (p=0.003), radial deviation (p=0.013), and ulnar deviation (p=.004), as compared to group B. However, in group B the improvement was less in pain score (p=0.104), TFS (p=0.520), and PROM of wrist flexion (p=0.193), extension (p=0.1081), radial deviation (p=0.051), and ulnar deviation (p=.168), as compared to group A. CONCLUSION: Paraffin wax bath with joint mobilization techniques are more effective than mobilization techniques without paraffin wax bath in the rehabilitation of post traumatic stiff hand.

Fermatean hesitant fuzzy rough aggregation operators and their applications in multiple criteria group decision-making.

The precise selection of suppliers to fulfill production requirements is a fundamental component of all manufacturing and process industries. Due to the increasing consumption levels, green supplier selection (GSS) has been one of the most important issues for environmental preservation and sustainable growth. The present work aims to develop a technique based on Fermatean hesitant fuzzy rough set (FHFRS), a robust fusion of Fermatean fuzzy set, hesitant fuzzy set, and rough set for GSS in the process industry. On the basis of the operational rules of FHFRS, a list of innovative Fermatean hesitant fuzzy rough weighted averaging operators has been established. Further, several intriguing features of the proposed operators are highlighted. To cope with the ambiguity and incompleteness of real-world decision-making (DM) challenges, a DM algorithm has been developed. To illustrate the applicability of the methodology, a numerical example for the chemical processing industry is presented to determine the optimum supplier. The empirical findings suggest that the model has a significant application of scalability for GSS in the process industry. Finally, the improved FHFR-VIKOR and TOPSIS approaches are employed to validate the proposed technique. The results demonstrate that the suggested DM approach is practicable, accessible, and beneficial for addressing uncertainty in DM problems.

Functional Outcome Of Fracture Shaft Of Femur In Children Treated With Early Hip Spica.

BACKGROUND: Femoral shaft fractures in children are a significant concern. Early hip spica casting is a treatment modality, but its functional outcomes need thorough evaluation. The objective of the study is to assess the functional outcomes of early hip spica management for femoral shaft fractures in children up to 5 years. METHODS: A prospective observational study was conducted at Ayub Teaching Hospital from 15 January 2022 to 26 December 2022. Sixty-two children diagnosed with femoral shaft fractures and treated with early hip spica were enrolled. Exclusion criteria were defined. Functional outcomes, including limb shortening, malunion, skin breakdown, foot drop, and compartment syndrome, were evaluated. Follow-ups were scheduled at 6 weeks, 12 weeks, and 6 months. Data analysis was performed using SPSS software package 25. RESULTS: Of the 45 patients analyzed, 75.56% were males. The average age was 3.56 years. Most fractures were proximal (75.55%) and resulted from motor vehicle accidents (66.67%). Limb shortening was observed in 17.77% of patients, with no significant correlation with age or fracture type. Malunion was rare (1%), and no skin breakdown, foot drop, or compartment syndrome cases were reported. CONCLUSIONS: Early hip spica casting for femoral shaft fractures in children up to 5 years is associated with minimal complications. The findings can guide clinical decisions and patient counselling.

Novel Information Measures for Fermatean Fuzzy Sets and Their Applications to Pattern Recognition and Medical Diagnosis.

Fermatean fuzzy sets (FFSs) have piqued the interest of researchers in a wide range of domains. The striking framework of the FFS is keen to provide the larger preference domain for the modeling of ambiguous information deploying the degrees of membership and nonmembership. Furthermore, FFSs prevail over the theories of intuitionistic fuzzy sets and Pythagorean fuzzy sets owing to their broader space, adjustable parameter, flexible structure, and influential design. The information measures, being a significant part of the literature, are crucial and beneficial tools that are widely applied in decision-making, data mining, medical diagnosis, and pattern recognition. This paper aims to expand the literature on FFSs by proposing many innovative Fermatean fuzzy sets-based information measures, namely, distance measure, similarity measure, entropy measure, and inclusion measure. We investigate the relationship between distance, similarity, entropy, and inclusion measures for FFSs. Another achievement of this research is to establish a systematic transformation of information measures (distance measure, similarity measure, entropy measure, and inclusion measure) for the FFSs. To accomplish this aim, new formulae for information measures of FFSs have been presented. To demonstrate the validity of the measures, we employ them in pattern recognition, building materials, and medical diagnosis. Additionally, a comparison between traditional and novel similarity measures is described in terms of counter-intuitive cases. The findings demonstrate that the innovative information measures do not include any absurd cases.

Complex Fermatean fuzzy extended TOPSIS method and its applications in decision making.

The fuzzy set has its own limitations due to the membership function only. The fuzzy set does not describe the negative aspects of an object. The Fermatean fuzzy set covers the negative aspects of an object. The complex Fermatean fuzzy set is the most effective tool for handling ambiguous and uncertain information. The aim of this research work is to develop new techniques for complex decision-making based on complex Fermatean fuzzy numbers. First, we construct different aggregation operators for complex Fermatean fuzzy numbers, using Einstein t-norms. We define a series of aggregation operators named complex Fermatean fuzzy Einstein weighted average aggregation (CFFEWAA), complex Fermatean fuzzy Einstein ordered weighted average aggregation (CFFEOWAA), and complex Fermatean fuzzy Einstein hybrid average aggregation (CFFEHAA). The fundamental properties of the proposed aggregation operators are discussed here. The proposed aggregation operators are applied to the decision-making technique with the help of the score functions. We also construct different algorithms based on different aggregation operators. The extended TOPSIS method is described for the decision-making problem. We apply the proposed extended TOPSIS method to MAGDM problem "selection of an English language instructor". We also compare the proposed models with the existing models.

Development of Novel Multifunctional Electroactive, Self-Healing, and Tissue Adhesive Scaffold To Accelerate Cutaneous Wound Healing and Hemostatic Materials.

Designing a multifunctional conducting hydrogel wound dressing of suitable mechanical properties, adhesiveness, self-healing, autolytic debridement, antibacterial properties, and radical scavenging ability, as well as retaining an appropriate level of moisture around the wound is highly desirable in clinical application for treating cutaneous wounds healing. Here, we designed a novel class of electroactive hydrogel based on thiol-functionalized silver-graphene oxide nanoparticles (GO/Ag/TGA) core polyaniline (PANI) shell GO/Ag/TGA/PANI nanocomposites. Thus, a series of physically cross-linked hydrogel based on GO/Ag/TGA/PANI and poly(vinyl alcohol) (PVA) was prepared by freeze-thawing method. The hydrogel was characterized by XRD, UV, FTIR, TGA, TEM, SEM, Raman spectroscopy, cyclic voltammetry (CV), and four probes test. The hydrogel showed favorable properties such as excellent tensile strength, suitable gelation time (30-56 s), tunable rheological properties (G' ∼ 1 kPa), adhesiveness, and interconnected porous structure (freeze-dried). Besides this, the hydrogel also exhibits excellent exudate uptake capacity (10.4-0.2 g/g), high swelling ratio (72.4 to 93.5%), long-term antibacterial activity against multidrug-resistant (MDR) bacterial isolates, promising antioxidant (radical scavenging) efficiency, keeping the wound moisturized, prominent hemostatic efficiency, and fast self-healing ability to bear deformation. Interestingly, in vivo experiments indicated that electroactive hydrogels can significantly promote the healing rate of artificial wounds in rats, and histological analysis by H&E reveals higher granulation tissue thickness, collagen deposition, hair follicles, dermal papillary, keratinocytes, and marked increase (P < 0.05) in hydroxyproline at the wound site during 15 days of healing of impaired wounds. On the basis of vivo and vitro assay results, it is concluded that electroactive-hydrogel-attributed multifunctional properties may serve as suitable scaffold for treating chronic wound healing and skin regeneration.

Zinc and Potassium Fertilizer Synergizes Plant Nutrient Availability and Affects Growth, Yield, and Quality of Wheat Genotypes.

The growth and productivity of wheat crops depend on the availability of essential nutrients such as zinc (Zn) and potassium (K2O), which play critical roles in the plant's physiological and biochemical processes. This study aimed to investigate the synergizing effect of zinc and potassium fertilizers on uptake of both the nutrients, growth, yield, and quality of the Hashim-08 cultivar and local landrace, during the 2019-2020 growing season in Dera Ismail Khan, Pakistan. The experiment was designed using a split plot pattern in a randomized complete pattern, with main plots for the wheat cultivars and subplots for the fertilizer treatments. Results indicated that both cultivars responded positively to the fertilizer treatments, with the local landrace exhibiting maximum plant height and biological yield, and improved Hashim-08, showing increased agronomic parameters, including the number of tillers and grains and spike length. Application of Zn and K2O fertilizers significantly enhanced agronomic parameters, such as the number of grains per plant, spike length, thousand-grain weight, grain yield, harvest index, Zn uptake of grain, dry gluten content, and grain moisture content, while crude protein and grain potassium remained relatively unchanged. The soil's Zn and K content dynamics were found to vary among treatments. In conclusion, the combined application of Zn and K2O fertilizers proved beneficial in improving the growth, yield, and quality of wheat crops, with the local landrace exhibiting lower grain yield but greater Zn uptake through fertilizer application. The study's findings highlight that the local landrace showed good response to the growth and qualitative parameter when compared with the Hashim-08 cultivar. Additionally, the combined application of Zn and K showed a positive relation in terms of nutrient uptake and soil Zn and K content.

Fermatean fuzzy soft aggregation operators and their application in symptomatic treatment of COVID-19 (case study of patients identification).

ABSTRACT: The main focus of this paper is the application of aggregation operators (AOs) in the environment of Fermatean fuzzy soft sets (FFSS). The unique feature of the work is its application in the symptomatic treatment of the COVID-19 disease. For this purpose, the idea of FFSS is introduced which is based on the Senapati and Yagar's Fermatean fuzzy set. Next we have defined Fermatean fuzzy soft aggregation operators (FFSAOs) like, Fermatean fuzzy soft weighted averaging (FFSWA) operator, Fermatean fuzzy soft ordered weighted averaging (FFSOWA) operator, Fermatean fuzzy soft weighted geometric (FFSWG) operator and Fermatean fuzzy soft ordered weighted geometric (FFSOWG). The prominent properties of these operators are given in details. We have also developed some approaches to solve multi-criteria decision making (MCDM) problems in Fermatean fuzzy soft (FFS) information. An introduction to the novel pandemic, safety measures, and then its possible symptomatic treatment is also provided. The developed operators are utilized in the symptomatic treatment of COVID-19 disease in order to show the practical applications and importance of these AOs as well as Fermatean fuzzy soft information. The stability of the proposed work is also proved by the comparative analysis.

Green synthesized silver nanoparticles (AgNPs) from Parrotiopsis jacquemontiana (Decne) Rehder leaf extract and its biological activities.

Parrotiopsis jacquemontiana (Decne) Rehder aqueous extract of leaf was used for biosynthesis of AgNPs and characterized through UV-Visible spectroscopy, X-ray diffraction, Fourier-transform-infrared, diffraction light scattering, and scanning electron microscope analysis. Moderate to strong antioxidant activity during in vitro antioxidant assays for scavenging of 2,2-diphenyl-1-picryl hydrazyl (DPPH), hydroxyl (OH), nitric oxide (NO) radicals, iron chelation, and inhibition of ß-carotene bleaching was recorded with minimum IC50 value (27.70 ± 2.67 µg/ml) calculated for OH radicals. The AgNPs were evaluated against six multidrug resistant human bacterial strains and minimum inhibitory concentration (MIC) along with minimum bactericidal concentration (MBC) values was determined and all were found remarkably susceptible. The bacterial strain Staphylococcus aureus was the most susceptible with MIC = 5 µg/ml and MBC = 10 µg/ml. Among six fungal strains, Fumigatus esculentum was the most susceptible with MIC and MBC of 10 µg/ml. 3-(4,5-Dimethylthiazol-2 yl)-2,5-diphenyltetrazolium bromide (MTT) screening assay against cancer cell lines (HCCLM3, HEPG2, MDA-MB 231, and MCF-7) revealed the least IC50 values against HCCLM3 (74.20 ± 5.04) and MCF-7 (91.90 ± 1.17). While no cytotoxicity against normal cell lines; LO2 and MCF-10a was recorded. Parrotiopsis jacquemontiana silver nanoparticles (PJAgNPs) significantly (p > .001) prevented the migration of HCCLM3 cells in a dose-dependent style, relative to control. The wound healing potential of AgNPs in rat was found higher (p < .05) for wound contraction rates, hydroxyproline content, hemostatic and re-epithelization and regeneration efficiency in comparison to the reference group.

A wind power plant site selection algorithm based on q-rung orthopair hesitant fuzzy rough Einstein aggregation information.

Wind power is often recognized as one of the best clean energy solutions due to its widespread availability, low environmental impact, and great cost-effectiveness. The successful design of optimal wind power sites to create power is one of the most vital concerns in the exploitation of wind farms. Wind energy site selection is determined by the rules and standards of environmentally sustainable development, leading to a low, renewable energy source that is cost effective and contributes to global advancement. The major contribution of this research is a comprehensive analysis of information for the multi-attribute decision-making (MADM) approach and evaluation of ideal site selection for wind power plants employing q-rung orthopair hesitant fuzzy rough Einstein aggregation operators. A MADM technique is then developed using q-rung orthopair hesitant fuzzy rough aggregation operators. For further validation of the potential of the suggested method, a real case study on wind power plant site has been given. A comparison analysis based on the unique extended TOPSIS approach is presented to illustrate the offered method's capability. The results show that this method has a larger space for presenting information, is more flexible in its use, and produces more consistent evaluation results. This research is a comprehensive collection of information that should be considered when choosing the optimum site for wind projects.

Novel Decision-Making Techniques in Tripolar Fuzzy Environment with Application: A Case Study of ERP Systems.

The intuitionistic fuzzy set (IFS) and bipolar fuzzy set (BFS) are all effective models to describe ambiguous and incomplete cognitive knowledge with membership, non-membership, negative membership, and hesitancy sections. But in daily life problems, there are some situations where we cannot apply the ordinary models of IFS and BFS, separately. Hence, there is a need to combine both the models of IFS and BFS into a single one. A tripolar fuzzy set (TFS) is a generalization of IFS and BFS. In circumstances where BFS and IFS models cannot be used individually, a tripolar fuzzy model is more dependable and efficient. Further, the IFS and BFS models are reduced to corollaries due to the proposed model of TFS. For this purpose in this article, we first consider some novel operations on tripolar fuzzy information. These operations are formulated on the basis of well-known Dombi T-norm and T-conorm, and the desirable properties are discussed. By applying the Dombi operations, arithmetic and geometric aggregation operators of TFS are proposed, and we introduce the concepts of a TF-Dombi weighted average (TFDWA) operator, a TF-Dombi ordered weighted average (TFDOWA) operator, and a TF-Dombi hybrid weighted (TFDHW) operator and explore their fundamental features including idempotency, boundedness, monotonicity, and others. In the second part, we propose TF-Dombi weighted geometric (TFDWG) operator, TF-Dombi ordered weighted geometric (TFDOWG) operator, and TF-Dombi hybrid geometric (TFDHG) operator. The features and specific cases of the mentioned operators are examined. Enterprise resource planning (ERP) is a management and integration approach that organizations employ to manage and develop many aspects of their operations. The study's primary contribution is to employ TFS to create certain decision-making strategies for the selection of optimal ERP systems. The proposed operators are then used to build several techniques for solving multiattribute decision-making (MADM) issues with TF information. Finally, an example of ERP system selection is investigated to demonstrate that the techniques suggested are trustworthy and realistic.

Irrigation suitability, health risk assessment and source apportionment of heavy metals in surface water used for irrigation near marble industry in Malakand, Pakistan.

Water is a vital, finite resource whose quantity and quality are deteriorating as the world population increases. The current study aims to investigate the concentration of heavy metals (HM) in surface water for irrigation purposes with associated human health risks and pollution sources near the marble industry in Malakand, Pakistan. Twenty-seven water samples were randomly collected and analyzed for HM concentration by inductively coupled plasma‒optical emission spectrometry (ICP‒OES). pH, electrical conductivity (EC), total dissolved solids (TDS), biological oxygen demand (BOD), and chemical oxygen demand (COD) were measured using standard methods of American Public Health Association (APHA). Irrigation suitability was assessed using specific water quality parameters. The associated health risks from ingestion and dermal exposure to heavy metals were calculated by USEPA health risk indices. Pollution sources and spatial distribution mapping were studied using compositional data analysis (CoDa) and the application of a geographic information system (GIS) to understand the changing behavior of heavy metals in surface waters. The concentrations of BOD (89%), COD (89%), Al (89%), Ca (89%), Cr (56%), Cu (78%), Fe (56%), K (34%) Mg (23%), Mn (56%), Na (89%), Ni (56%), P (89%), and Zn (11%) exceeded the safety limits of National Environmental Quality standards (NEQs) of Pakistan. The results of Kelly's ratio (KR) classified surface water as unsuitable for irrigation. The average daily doses (ADD, mg/kg/day) for Al, Cu, Cr, Fe, Mn, Ni, and Zn were higher in children than in adults. The hazard index (HI) for children and adults was above the threshold (HI > 1), indicating a significant risk of non-carcinogenic toxicity. The carcinogenic risk values for Cr and Ni were above the USEPA limit (1 × 10-6 to 1 × 10-4), suggesting a potential carcinogenic risk for the target population. Principal component analysis (PCA), biplot (CLR), and the CoDa-dendrogram allowed for the identification of elemental associations, and their potential source was anthropogenic rather than natural in origin. Regular monitoring and phytoremediation strategies are proposed to safeguard crops and human health.

Determinants of Response at 2 Months of Treatment in a Cohort of Pakistani Patients with Pulmonary Tuberculosis.

Mycobacterium tuberculosis infection continues to be a major global challenge. All patients with pulmonary tuberculosis are treated with a standard 6-month treatment regimen. Historical data suggest that even with shortened treatment, most patients achieve long-term remission. Risk stratification is a goal for reducing potentially toxic prolonged treatment. This study aimed to determine the factors associated with the early clearance of sputum acid-fast bacilli (AFB). A total of 297 freshly diagnosed patients with pulmonary tuberculosis were included and enrolled in this study. Information related to their ethno-demographic and anthropometric characteristics was collected. We also assessed their complete blood counts, and blood iron, folate, and vitamin B12 levels. We found that the presence of higher levels of acid-fast bacilli (AFB) in diagnostic sputum microscopy was the single most significant prognostic factor associated with early clearance of sputum AFB after 2 months of treatment. All of our patients achieved treatment success after 6 months of treatment and were disease free. Our results support the data obtained from previous studies indicating that AFB clearance at 2 months is unlikely to be a clinically useful biomarker or indicator for therapeutic stratification. Furthermore, demographic, anthropometric, and nutritional factors are not clinically useful biomarkers.