RAGE signalling contributes to oxidative stress and inflammation in knee osteoarthritis patients with metabolic syndrome.

OBJECTIVES: Metabolic factors play significant role in the natural history of knee osteoarthritis (KO). There is a limited understanding of molecular and cellular events that give rise to the disease in patients. This study explored the possible cellular mechanisms by which metabolic syndrome leads to KO. METHODS: This cross-sectional study enrolled 80 subjects with KO who fulfilled the ACR diagnostic criteria and were undergoing total knee replacement surgery. The patients were divided into two groups: KO patients without metabolic syndrome and KO patients with metabolic syndrome. RESULTS: We hypothesised that metabolic syndrome may accelerate pathogenesis of OA by enhanced RAGE axis in articular cartilage and Infrapatellar fat pad of the knee joint. We have found enhanced protein expression of receptor for advanced glycation end products (RAGE) and its ligands AGEs and HMGB-1 in knee joint tissue of KO patients with metabolic syndrome as compared to KO patients without metabolic syndrome. Further downstream, the gene expression of oxidative stress regulators such as NADPH and inflammation, NFĸB were upregulated in KO patients with MetS as compared to KO patients alone. Higher levels of advanced oxidation products and inflammatory marker IL-17 were exhibited in synovial fluid of KO patients with metabolic syndrome. The enhanced levels of these oxidative stress and inflammatory markers were reflected in the serum of KO patients with metabolic syndrome as well. CONCLUSIONS: We conclude that enhanced function of RAGE axis could be one of the mechanisms by which metabolic syndrome leads to KO.

Investigating associations between climate change anxiety and mental health impact on vulnerable populations: A qualitative analysis.

Climate anxiety has a negative impact on the mental health and psychological wellbeing of the vulnerable population. The goal is to assess many factors that affect mental health and psychological wellbeing, as well as how climate change affects mental health in Pakistan's vulnerable population. This study provides evidence-based insights on the long- and medium-term impacts of extreme weather events on mental health. We conducted semi-structured interviews with a sample of 72 students aged 10-16 years, employing an exploratory qualitative design. The resulting process identified themes and questions for future research on climate change and its psychological effects on children's mental health. As a result, positive emotions embedded in children's climate strategic actions in parent and community contexts helped to mitigate children's perceptions of negative emotions (such as climate anxiety, phobias, fear, sleep disorders, depression, sadness, and substance abuse). Climate change's effects can have a significant impact on mental health. We will be discussing effective strategies to address the expected mental health issues among children caused by climate change. The discussion paper offers a set of recommendations for addressing the mental health impacts of climate change, including improving mental health support systems, integrating climate change education into services, and developing targeted interventions for vulnerable populations.

L'anxiété climatique a un impact négatif sur la santé mentale et le bien-être psychologique de la population vulnérable. L'objectif est d'évaluer de nombreux facteurs qui affectent la santé mentale et le bien-être psychologique, ainsi que la manière dont le changement climatique affecte la santé mentale de la population vulnérable du Pakistan. Cette étude fournit des informations fondées sur des données probantes sur les impacts à long et moyen terme des événements météorologiques extrêmes sur la santé mentale. Nous avons mené des entretiens semi-structurés avec un échantillon de 72 étudiants âgés de 10 à 16 ans, en utilisant une conception qualitative exploratoire. Le processus qui en a résulté a identifié des thèmes et des questions pour de futures recherches sur le changement climatique et ses effets psychologiques sur la santé mentale des enfants. En conséquence, les émotions positives intégrées dans les actions stratégiques climatiques des enfants dans les contextes parental et communautaire ont contribué à atténuer les perceptions des enfants concernant les émotions négatives (telles que l'anxiété climatique, les phobies, la peur, les troubles du sommeil, la dépression, la tristesse et la toxicomanie). Les effets du changement climatique peuvent avoir un impact significatif sur la santé mentale. Nous discuterons de stratégies efficaces pour résoudre les problèmes de santé mentale attendus chez les enfants causés par le changement climatique. Le document de travail propose un ensemble de recommandations pour faire face aux impacts du changement climatique sur la santé mentale, notamment en améliorant les systèmes de soutien en santé mentale, en intégrant l'éducation au changement climatique dans les services et en développant des interventions ciblées pour les populations vulnérables.

Routine Pressure Wire Assessment Versus Conventional Angiography in the Management of Patients With Coronary Artery Disease: The RIPCORD 2 Trial.

BACKGROUND: Measurement of fractional flow reserve (FFR) has an established role in guiding percutaneous coronary intervention. We tested the hypothesis that, at the stage of diagnostic invasive coronary angiography, systematic FFR-guided assessment of coronary artery disease would be superior, in terms of resource use and quality of life, to assessment by angiography alone. METHODS: We performed an open-label, randomized, controlled trial in 17 UK centers, recruiting 1100 patients undergoing invasive coronary angiography for the investigation of stable angina or non-ST-segment-elevation myocardial infarction. Patients were randomized to either angiography alone (angiography) or angiography with systematic pressure wire assessment of all epicardial vessels >2.25 mm in diameter (angiography+FFR). The coprimary outcomes assessed at 1 year were National Health Service hospital costs and quality of life. Prespecified secondary outcomes included clinical events. RESULTS: In the angiography+FFR arm, the median number of vessels examined was 4 (interquartile range, 3-5). The median hospital costs were similar: angiography, £4136 (interquartile range, £2613-£7015); and angiography+FFR, £4510 (£2721-£7415; P=0.137). There was no difference in median quality of life using the visual analog scale of the EuroQol EQ-5D-5L: angiography, 75 (interquartile range, 60-87); and angiography+FFR, 75 (interquartile range, 60-90; P=0.88). The number of clinical events was as follows: deaths, 5 versus 8; strokes, 3 versus 4; myocardial infarctions, 23 versus 22; and unplanned revascularizations, 26 versus 33, with a composite hierarchical event rate of 8.7% (48 of 552) for angiography versus 9.5% (52 of 548) for angiography+FFR (P=0.64). CONCLUSIONS: A strategy of systematic FFR assessment compared with angiography alone did not result in a significant reduction in cost or improvement in quality of life. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01070771.

Identification of potential inhibitors, conformational dynamics, and mechanistic insights into mutant Kirsten rat sarcoma virus (G13D) driven cancers.

The mutations at the hotspot region of K-Ras result in the progression of cancer types. Our study aimed to explore the small molecule inhibitors against the G13D mutant K-Ras model with anti-cancerous activity from food and drug administration (FDA)-approved drug compounds. We implemented several computational strategies such as pharmacophore-based virtual screening, molecular docking, absorption, distribution, metabolism and excretion features, and molecular simulation to ensure the identified hit compounds have potential efficacy against G13D K-Ras. We found that the FDA-approved compounds, namely, azelastine, dihydrocodeine, paroxetine, and tramadol, are potential candidates to inhibit the action of G13D mutant K-Ras. All four compounds exhibited similar binding patterns of sotorasib, and a structural binding mechanism with significant hydrophobic contacts. The descriptor features from the QikProp of all four compounds are within allowable limits compared to sotorasib drug. Consequently, a molecular simulation result emphasized that the dihydrocodeine and tramadol exhibited less fluctuation, minimal basin, significant h-bonds, and potent inhibition against G13D K-Ras. As a result, the current research identifies prospective K-Ras inhibitors that could be further improved with biochemical analysis for precision medicine against K-Ras-driven cancers.

Single Median Raphe Scrotal incision Orchiopexy: A safe & feasible approach for fixation of Palpable Undescended testes.

BACKGROUND: We wish to share our outcome of single median raphe scrotal incision orchiopexy (SMRSO) regarding safety & feasibility of technique by evaluating ease of access, conversion rate, duration of surgery, success rate, complications, and the need for redo-surgery. METHODS: We retrospectively analyzed data of 277 orchiopexies performed in our department on 224 patients operated on between June 2016 to June 2019. SMRSO was considered for palpable testes that can be brought to the upper limit of the scrotum under anesthesia. The conventional inguinoscrotal approach was used for high lying testes. A median raphe incision was made to access & mobilize the testis on either side, ligation of processus vaginalis performed, and the testes secured in the scrotal pouch. The approach was utilized for both unilateral and bilateral orchiopexies. Follow-up done at one week, one month & six months to evaluate the outcome. RESULTS: A total of 277 orchiopexies were performed in 224 patients. 237 (86%) orchiopexies were via the median raphe scrotal approach in 184 patients. Out of these, 53 cases had bilateral orchiopexies. 30 (11%) performed via a conventional inguinoscrotal approach and 10 (4%) by laparoscopic approach. The mean duration of surgery for SMRSO was 24 minutes for unilateral and 42 minutes for bilateral cases. Immediate postoperative complications included scrotal hematoma in three (1.6%) cases, Hematoma of the abdominal wall in one case, and scrotal edema in 4 (2 %) patients. All complications were treated conservatively & resolved. No wound infection or testicular atrophy was reported. Long-term complications included testicular ascend in three cases [1.6%]. CONCLUSION: Single-incision Median Raphe Scrotal orchiopexy is an attractive alternative to the standard inguinoscrotal orchiopexy for palpable low lying undescended testes with a better cosmetic outcome.

SPICED-ACS: Study of the potential impact of a computer-generated ECG diagnostic algorithmic certainty index in STEMI diagnosis: Towards transparent AI.

BACKGROUND: Computerised electrocardiogram (ECG) interpretation diagnostic algorithms have been developed to guide clinical decisions like with ST segment elevation myocardial infarction (STEMI) where time in decision making is critical. These computer-generated diagnoses have been proven to strongly influence the final ECG diagnosis by the clinician; often called automation bias. However, the computerised diagnosis may be inaccurate and could result in a wrong or delayed treatment harm to the patient. We hypothesise that an algorithmic certainty index alongside a computer-generated diagnosis might mitigate automation bias. The impact of reporting a certainty index on the final diagnosis is not known. PURPOSE: To ascertain whether knowledge of the computer-generated ECG algorithmic certainty index influences operator diagnostic accuracy. METHODOLOGY: Clinicians who regularly analyse ECGs such as cardiology or acute care doctors, cardiac nurses and ambulance staff were invited to complete an online anonymous survey between March and April 2019. The survey had 36 ECGs with a clinical vignette of a typical chest pain and which were either a STEMI, normal, or borderline (but do not fit the STEMI criteria) along with an artificially created certainty index that was either high, medium, low or none. Participants were asked whether the ECG showed a STEMI and their confidence in the diagnosis. The primary outcomes were whether a computer-generated certainty index influenced interpreter's diagnostic decisions and improved their diagnostic accuracy. Secondary outcomes were influence of certainty index between different types of clinicians and influence of certainty index on user's own-diagnostic confidence. RESULTS: A total of 91 participants undertook the survey and submitted 3262 ECG interpretations of which 75% of ECG interpretations were correct. Presence of a certainty index significantly increased the odds ratio of a correct ECG interpretation (OR 1.063, 95% CI 1.022-1.106, p = 0.004) but there was no significant difference between correct certainty index and incorrect certainty index (OR 1.028, 95% CI 0.923-1.145, p = 0.615). There was a trend for low certainty index to increase odds ratio compared to no certainty index (OR 1.153, 95% CI 0.898-1.482, p = 0.264) but a high certainty index significantly decreased the odds ratio of a correct ECG interpretation (OR 0.492, 95% CI 0.391-0.619, p < 0.001). There was no impact of presence of a certainty index (p = 0.528) or correct certainty index (p = 0.812) on interpreters' confidence in their ECG interpretation. CONCLUSIONS: Our results show that the presence of an ECG certainty index improves the users ECG interpretation accuracy. This effect is not seen with differing levels of confidence within a certainty index, with reduced ECG interpretation success with a high certainty index compared with a trend for increased success with a low certainty index. This suggests that a certainty index improves interpretation when there is an increased element of doubt, possibly forcing the ECG user to spend more time and effort analysing the ECG. Further research is needed looking at time spent analysing differing certainty indices with alternate ECG diagnoses.

Evaluated Site-Specific Rate Constants for Reaction of Isobutane with H and CH3: Shock Tube Experiments Combined with Bayesian Model Optimization.

Evaluated site-specific rate constants for the reactions of isobutane with CH3 and H were determined in a combined analysis of new shock tube experiments and existing literature data. In our shock tube experiments, CH3 radicals, produced from the pyrolysis of di- tert-butylperoxide, and H atoms, produced from the pyrolysis of C2H5I, were reacted with dilute mixtures of isobutane in argon at 870-1130 K and 140-360 kPa, usually with a radical chain inhibitor. Propene and isobutene, measured with GC/FID and MS, were quantified as characteristic of H-abstraction from the primary and tertiary carbons, respectively. Using the method of uncertainty minimization using polynomial chaos expansions (MUM-PCE), a comprehensive Cantera kinetics model based on JetSurF 2.0 was optimized to our experiments and available literature data spanning ambient temperatures to 1327 K. Based on Bayes' theorem, MUM-PCE constrains the kinetics model to the experimental data. The isobutane literature data used for optimization included both raw experimental data and reported branching and total rate measurements. Data for ethane were also included to better define the absolute rate constant for abstraction of H from primary carbons. For both H and CH3, the optimization increased the relative rate of tertiary to primary H-abstraction compared with existing estimates, especially at higher temperatures. We combine the present data for primary and tertiary sites with previous results from our group on 1-butane to derive site-specific rate constants for the reaction of H and CH3 with generic primary, secondary, and tertiary carbons suitable for a wide range of temperatures.

Computational insights into the molecular interactions of environmental xenoestrogens 4-tert-octylphenol, 4-nonylphenol, bisphenol A (BPA), and BPA metabolite, 4-methyl-2, 4-bis (4-hydroxyphenyl) pent-1-ene (MBP) with human sex hormone-binding globulin.

Environmental contamination has been one of the major drawbacks of the industrial revolution. Several man-made chemicals are constantly released into the environment during the manufacturing process and by leaching from the industrial products. As a result, human and animal populations are exposed to these synthetic chemicals on a regular basis. Many of these chemicals have adverse effects on the physiological functions, particularly on the hormone systems in human and animals and are called endocrine disrupting chemicals (EDCs). Bisphenol A (BPA), 4-tert-octylphenol (OP), and 4-nonylphenol (NP) are three high volume production EDCs that are widely used for industrial purposes and are present ubiquitously in the environment. Bisphenol A is metabolized in the human body to a more potent compound (MBP: 4-Methyl-2, 4-bis (4-hydroxyphenyl) pent-1-ene). Epidemiological and experimental studies have shown the three EDCs to be associated with adverse effects on reproductive system in human and animals. Sex hormone-binding globulin (SHBG) is a circulatory protein that binds sex steroids and is a potential target for endocrine disruptors in the human body. The current study was done in order to understand the binding mechanism of OP, BPA, NP, and MBP with human SHBG using in silico approaches. All four compounds showed high binding affinity with SHBG, however, the binding affinity values were higher (more negative) for MBP and NP than for OP and BPA. The four ligands interacted with 19-23 residues of SHBG and a consistent overlapping of the interacting residues for the four ligands with the residues for the natural ligand, dihydrotestosterone (DHT; 82-91% commonality) was shown. The overlapping SHBG interacting residues among DHT and the four endocrine disruptors suggested that these compounds have potential for interference and disruption in the steroid binding function.

Spontaneous preterm birth and single nucleotide gene polymorphisms: a recent update.

BACKGROUND: Preterm birth (PTB), birth at <37 weeks of gestation, is a significant global public health problem. World-wide, about 15 million babies are born preterm each year resulting in more than a million deaths of children. Preterm neonates are more prone to problems and need intensive care hospitalization. Health issues may persist through early adulthood and even be carried on to the next generation. Majority (70 %) of PTBs are spontaneous with about a half without any apparent cause and the other half associated with a number of risk factors. Genetic factors are one of the significant risks for PTB. The focus of this review is on single nucleotide gene polymorphisms (SNPs) that are reported to be associated with PTB. RESULTS: A comprehensive evaluation of studies on SNPs known to confer potential risk of PTB was done by performing a targeted PubMed search for the years 2007-2015 and systematically reviewing all relevant studies. Evaluation of 92 studies identified 119 candidate genes with SNPs that had potential association with PTB. The genes were associated with functions of a wide spectrum of tissue and cell types such as endocrine, tissue remodeling, vascular, metabolic, and immune and inflammatory systems. CONCLUSIONS: A number of potential functional candidate gene variants have been reported that predispose women for PTB. Understanding the complex genomic landscape of PTB needs high-throughput genome sequencing methods such as whole-exome sequencing and whole-genome sequencing approaches that will significantly enhance the understanding of PTB. Identification of high risk women, avoidance of possible risk factors, and provision of personalized health care are important to manage PTB.

Evaluated kinetics of terminal and non-terminal addition of hydrogen atoms to 1-alkenes: a shock tube study of H + 1-butene.

Single-pulse shock tube methods have been used to thermally generate hydrogen atoms and investigate the kinetics of their addition reactions with 1-butene at temperatures of 880 to 1120 K and pressures of 145 to 245 kPa. Rate parameters for the unimolecular decomposition of 1-butene are also reported. Addition of H atoms to the π bond of 1-butene results in displacement of either methyl or ethyl depending on whether addition occurs at the terminal or nonterminal position. Postshock monitoring of the initial alkene products has been used to determine the relative and absolute reaction rates. Absolute rate constants have been derived relative to the reference reaction of displacement of methyl from 1,3,5-trimethylbenzene (135TMB). With k(H + 135TMB → m-xylene + CH3) = 6.7 × 10(13) exp(-3255/T) cm(3) mol(-1) s(-1), we find the following: k(H + 1-butene → propene + CH3) = k10 = 3.93 × 10(13) exp(-1152 K/T) cm(3) mol(-1) s(-1), [880-1120 K; 145-245 kPa]; k(H + 1-butene → ethene + C2H5) = k11 = 3.44 × 10(13) exp(-1971 K/T) cm(3) mol(-1) s(-1), [971-1120 K; 145-245 kPa]; k10/k11 = 10((0.058±0.059)) exp [(818 ± 141) K/T), 971-1120 K. Uncertainties (2σ) in the absolute rate constants are about a factor of 1.5, while the relative rate constants should be accurate to within ±15%. The displacement rate constants are shown to be very close to the high pressure limiting rate constants for addition of H, and the present measurements are the first direct determination of the branching ratio for 1-olefins at high temperatures. At 1000 K, addition to the terminal site is favored over the nonterminal position by a factor of 2.59 ± 0.39, where the uncertainty is 2σ and includes possible systematic errors. Combining the present results with evaluated data from the literature pertaining to temperatures of <440 K leads us to recommend the following: k∞(H + 1-butene → 2-butyl) = 1.05 × 10(9)T(1.40) exp(-366/T) cm(3) mol(-1) s(-1), [220-2000 K]; k∞(H + 1-butene → 1-butyl) = 9.02 × 10(8)T(1.40) exp(-1162/T) cm(3) mol(-1) s(-1) [220-2000 K]. Analogous rate constants for other unbranched 1-olefins should be very similar. Despite this, a factor of three discrepancy in the branching ratio for terminal and nonterminal addition is noted when comparing the present values with recommendations from a recent model of the important H + propene reaction. This difference is suggested to be well outside of the possible experimental errors of the present study or the expected differences with 1-butene. There thus appear to be inconsistencies in the current model for propene. In particular the addition branching ratio from that model should not be used as a reference value in extrapolations to other systems via rate rules or automated mechanism generation techniques.

Evaluated Kinetics of the Reactions of H and CH3 with n-Alkanes: Experiments with n-Butane and a Combustion Model Reaction Network Analysis.

Presented is a combined experimental and modeling study of the kinetics of the reactions of H and CH3 with n-butane, a representative aliphatic fuel. Abstraction of H from n-alkane fuels creates alkyl radicals that rapidly decompose at high temperatures to alkenes and daughter radicals. In combustion and pyrolysis, the branching ratio for attack on primary and secondary hydrogens is a key determinant of the initial olefin and radical pool, and results propagate through the chemistry of ignition, combustion, and byproduct formation. Experiments to determine relative and absolute rate constants for attack of H and CH3 have been carried out in a shock tube between 859 and 1136 K for methyl radicals and 890 to 1146 K for H atoms. Pressures ranged from 140 to 410 kPa. Appropriate precursors are used to thermally generate H and CH3 in separate experiments under dilute and well-defined conditions. A mathematical design algorithm has been applied to select the optimum experimental conditions. In conjunction with postshock product analyses, a network analysis based on the detailed chemical kinetic combustion model JetSurf 2 has been applied. Polynomial chaos expansion techniques and Monte Carlo methods are used to analyze the data and assess uncertainties. The present results provide the first experimental measurements of the branching ratios for attack of H and CH3 on primary and secondary hydrogens at temperatures near 1000 K. Results from the literature are reviewed and combined with the present data to generate evaluated rate expressions for attack on n-butane covering 300 to 2000 K for H atoms and 400 to 2000 K for methyl radicals. Values for generic n-alkanes and related hydrocarbons are also recommended. The present experiments and network analysis further demonstrate that the C-H bond scission channels in butyl radicals are an order of magnitude less important than currently indicated by JetSurf 2. Updated rate expressions for butyl radical fragmentation reactions are provided.

Paired Exchange Liver Transplantation Using an Altruistic Living Donor: First Case in Saudi Arabia-A Case Report.

Paired exchange (PE) living donor organ transplantation is an innovation designed to expand the pool of organs available for transplantation. In PE liver transplantation, the donor organs are exchanged between the 2 pairs to overcome blood group incompatibility or volume mismatch. There are ethical and logistic issues surrounding PE. This is the first report of PE liver transplantation in Saudi Arabia using an altruistic donor (AD). The AD may facilitate the exchange because there is no reciprocal expectation of transplantation from the AD. Paired exchange may increase only a small number of donated liver allografts. This may be the only solution for some families and in some countries.

Clinical practice guidelines for neonatal hypoxic-ischemic encephalopathy: A systematic review using the appraisal of guidelines for research and evaluation (AGREE) II instrument.

Background and Objective: To systematically review, critically appraise the quality of recent clinical practice guidelines (CPGs) for neonatal hypoxic ischemic encephalopathy (HIE), and map their recommendations. Data Sources: CPG databases (GIN, ECRI, NICE, SIGN, DynaMed), Bibliographic databases (PubMed, Embase, CINAHL), and related specialized professional societies (e.g., AAP, CPS, BAPM, RCPCH, and SNS). Study Selection: Original de-novo developed evidence-based CPGs for HIE, group authorship, Arabic or English languages, and international or national scope. The systematic review was drafted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and Johnston et al methodological guide. Data Extraction: Quality assessment of the included HIE CPGs by the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) Instrument and report their characteristics, AGREE II ratings, and recommendations. Data Synthesis: Our search retrieved 2,489 citations, of which two recent HIE CPGs were eligible and appraised: Canadian Paediatric Society (CPS) and Queensland Maternity and Neonatal Services (QMN). The overall assessment of the QMN CPG was superior (83%). Domain 1 (Scope & Purpose) scored (47%, 63%), Domain 2 (Stakeholder Involvement) (72%, 39%), Domain 3 (Rigour of Development) (48%, 43%), Domain 4 (Clarity & Presentation) (100%, 96%), Domain 5 (Applicability) (59%, 9%), and Domain 6 (Editorial Independence) (67%, 17%) for the QMN and CPS CPGs respectively. All appraisers recommended the QMN CPG for use in practice. Conclusion: The methodological quality of the QMN CPG was superior with the relevant recommendations for its use in neonatal practice. Limitations: limited to Arabic and English languages. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258291, identifier: CRD42021258291.

Pressure dependence and branching ratios in the decomposition of 1-pentyl radicals: shock tube experiments and master equation modeling.

The decomposition and intramolecular H-transfer isomerization reactions of the 1-pentyl radical have been studied at temperatures of 880 to 1055 K and pressures of 80 to 680 kPa using the single pulse shock tube technique and additionally investigated with quantum chemical methods. The 1-pentyl radical was generated by shock heating dilute mixtures of 1-iodopentane and the stable products of its decomposition have been observed by postshock gas chromatographic analysis. Ethene and propene are the main olefin products and account for >97% of the carbon balance from 1-pentyl. Also produced are very small amounts of (E)-2-pentene, (Z)-2-pentene, and 1-butene. The ethene/propene product ratio is pressure dependent and varies from about 3 to 5 over the range of temperatures and pressures studied. Formation of ethene and propene can be related to the concentrations of 1-pentyl and 2-pentyl radicals in the system and the relative rates of five-center intramolecular H-transfer reactions and ß C-C bond scissions. The 3-pentyl radical, formed via a four-center intramolecular H transfer, leads to 1-butene and plays only a very minor role in the system. The observed (E/Z)-2-pentenes can arise from a small amount of beta C-H bond scission in the 2-pentyl radical. The current experimental and computational results are considered in conjunction with relevant literature data from lower temperatures to develop a consistent kinetics model that reproduces the observed branching ratios and pressure effects. The present experimental results provide the first available data on the pressure dependence of the olefin product branching ratio for alkyl radical decomposition at high temperatures and require a value of <ΔE(down)(1000 K)> = (675 ± 100) cm(-1) for the average energy transferred in deactivating collisions in an argon bath gas when an exponential-down model is employed. High pressure rate expressions for the relevant H-transfer reactions and ß bond scissions are derived and a Rice Ramsberger Kassel Marcus/Master Equation (RRKM/ME) analysis has been performed and used to extrapolate the data to temperatures between 700 and 1900 K and pressures of 10 to 1 × 10(5) kPa.

Study of indoor radon concentrations and associated health risks in the five districts of Hazara division, Pakistan.

A total of 200 indoor air samples were collected to measure radon concentration levels and its contribution to the mean effective doses during different seasons of the period 2009-2010 at different sites of the five districts of Hazara division, Pakistan. The major portion of the region is mountainous and is full of thick forests which receives heavy snow fall in winter. The need for conducting the present survey relied on the fact that occupants spend their lives in poorly ventilated indoor environments of the region, especially in the winter season when they use wood fire inside their residences. The measurements of indoor air samples were taken with RAD-7, a solid state α-detector. Radon concentrations in the whole region range from 41 Bq m(-3) to 254 Bq m(-3) with a geometric mean of 128 Bq m(-3). Radon progenies were measured with a surface barrier detector through alpha spectroscopy from which the Equilibrium Factor (EF) for radon and Radon Decay Products (RDPs) for the smoke-bearing as well as smoke-free indoor environments were deduced. The respective mean values of EF were calculated as 0.49 ± 0.08 and 0.40 ± 0.07. The mean effective doses from indoor air of Abbottabad, Mansehra, Haripur, Battgram and Kohistan districts were calculated as 3.5 ± 1.2, 3.7 ± 0.7, 3.9 ± 1.0, 3.6 ± 1.1 and 3.9 ± 0.7 mSv a(-1) respectively, with the maximum value of 5.1 ± 1.8 mSv a(-1) in Kohistan district during winter and the minimum value of 2.9 ± 1.0 mSv a(-1) in Abbottabad district during summer. The annual exposure dose to the inhabitants of the locality lies below the upper bound of 10 mSv a(-1), as recommended by ICRP-65, and may not pose any significant threat to the public health.

Epidemiological profile of tuberculosis in Iraq during 2011-2018.

BACKGROUND: Tuberculosis (TB) is one of the most progressive infectious diseases caused by Mycobacterium tuberculosis. The pathogen is the first cause of mortality linked to a single pathogen worldwide, especially in poor and developing countries. METHODS: A cross-sectional descriptive study was conducted to estimate incidence rate (IR) of TB in Iraq during a period of eight years (2011-2018). TB data were extracted from the computer system of the National Specialized Center for Chest and Respiratory Diseases in Baghdad. RESULTS: During 2011-2018, 65,102 confirmed TB cases were reported in Iraq; 39,640 pulmonary TB (PTB) and 25,462 extra-pulmonary TB (EPTB). The average IR (case/100,000 inhabitants) of TB was 23.4 (14.2 for PTB and 9.1 for EPTB). Annual rate of TB cases showed a gradual decline over years (from 29.2 in 2011 to 18.6 in 2018). The decline in IR was more pronounced in PTB than EPTB. However PTB/EPTB ratio showed a gradual decreasing over years (from 2.04 in 2011 to 1.56 in 2018). GIS-mapping revealed that PTB and EPTB IRs show variations between the 18 governorates of Iraq. Most of the recorded PTB cases were new (average: 90.5%), followed by relapse cases (average: 7.9%). Among the reported PTB cases, percentage of males was greater than females (average: 52.1 vs. 47.9%), whereas an opposite trend was observed in EPTB (42.9 vs. 57.1%). The frequency distribution of PTB and EPTB varied between age groups, and lowest average frequency was recorded in age groups 1-4 and 5-14 year. CONCLUSIONS: TB is still a public health threat, and although a declining trend in incidence was depicted over the years 2011-2018, the disease is still out of control in Iraq, and more investments of resource are necessitated to eliminate the disease. In this context, EPTB and PTB relapse need a recognized attention.

Patterns of differentiated thyroid cancer in Baluchistan Province of Pakistan: some initial observations.

The incidence of thyroid cancer is increasing in several countries. The main objective of this retrospective study was to find and describe province-specific estimates of incidence in males and females by age groups for differentiated thyroid cancer (DTC). This study reports on 87 cases of DTC from Baluchistan province of Pakistan treated with post operative radioiodine at the Center for Nuclear Medicine and Radiotherapy (CENAR) Quetta from January 2003 to December 2009. The patient data has been collected from CENAR Quetta. Patients with DTC were confirmed by clinical examination, thyroid scintigraphy (Thyroid scan), blood tests (T3, T4, TSH) and histopathalogy tests and then treated with radioiodine. The Median age of the patients was 35.5 years (Range 12-70 years). The final histological diagnosis was papillary carcinoma in 71 (81.6 %) cases, follicular carcinoma in 6 (6.9%) cases while 10 (11.5%) cases presented with mixed papillary and follicular carcinoma. About 53 % cases were found in females with age 21-40 years. No strike predominance was observed in any age group for males. Four patients presented with recurrence while six patients showed metastasis in cervical lymph nodes. The small annual incidence did not follow any definite pattern. DTC has a small incidence in Baluchistan due to lack of education and health care facilities. The incidence of DTC is higher in females when compared with males as per this study. This preliminary study will provide an insight to incidence of DTC, its treatment facilities and future planning strategies in Baluchistan, Pakistan.

Dental amalgam: effects of alloy/mercury mixing ratio, uses and waste management.

BACKGROUND: Silver dental amalgam is one of the oldest filling materials used in dentistry. The American Dental Association (ADA) has estimated that billions of amalgam restorations have been placed in patients in the last 150 years. Due to the presence of mercury and mishandling during the filling make it more controversial. The objective of this study was to conduct a survey of the use of different brands and to assess any deviations in practice from the hand mixing manual method of elemental mercury and alloy in a pestle/mortar and encapsulated form. METHODS: A questionnaire was sent to 250 of randomly selected dental practitioner in various localities of Karachi. Data was analysed to record the specified brands used along with their powder/liquid (P/L) ratio and the different methods for disposing off mercury in this study. RESULTS: The most commonly used form of dispensing method was hand mixing (57%) and only 30% of the dentists followed the manufacturer instruction for hand mixing ratio.Eighty-seven percent of dental amalgam restoration was performed and 13% removed by the dentist per month and the method of disposing the amalgam wastage that 55%, 25%, and 20% dentists were used the sink, bin and other methods respectively in their dental clinics. CONCLUSION: Amalgam restoration is still popular filling material in the posterior region of the mouth but we need to create awareness among the dentists who do not follow the ADA specifications.

Decomposition and isomerization of 5-methylhex-1-yl radical.

The decomposition and isomerization reactions of the 5-methylhex-1-yl radical (1-5MeH) have been studied at temperatures of 889-1064 K and pressures of 1.6-2.2 bar using the single pulse shock tube technique. The radical of interest was generated by shock heating dilute mixtures of 5-methylhexyl iodide to break the weak C-I bond, and the kinetics and reaction mechanism deduced on the basis of the olefin cracking pattern observed by gas chromatographic analysis of the products. In order of decreasing molar yields, alkene products from 1-5MeH decomposition are ethene, isobutene, propene, 3-methylbut-1-ene, but-1-ene, E/Z-hex-2-ene, 4-methylpent-1-ene, and hex-1-ene. The first three products account for almost 90% of the carbon balance. The mechanism involves reversible intramolecular H-transfer reactions that lead to the formation of the radicals 5-methylhex-5-yl (5-5MeH), 5-methylhex-2-yl (2-5MeH), 5-methylhex-4-yl (4-5MeH), 5-methylhex-6-yl (6-5MeH), and 5-methylhex-3-yl (3-5MeH). Competitive with isomerization reactions are decompositions by beta C-C bond scission. The main product forming radical is 5-5MeH, which is formed by intramolecular abstraction of the lone tertiary H in the radical. This reaction is deduced to be a factor of 4.0 +/- 0.7 faster on a per hydrogen basis than the analogous abstraction of a secondary hydrogen in 1-hexyl radical. The estimated uncertainty corresponds to 1 standard deviation. The following relative rates have been deduced under our reaction conditions: k(4-5MeH --> C(2)H(5) + 3-methylbut-1-ene)/k(4-5MeH --> CH(3) + Z-hex-2-ene) = 10((0.39+/-0.12)) exp[(675 +/- 270)K/T]; k(4-5MeH --> C(2)H(5) + 3-methylbut-1-ene)/k(4-5MeH --> CH(3) + E-hex-2-ene) = 10((-0.10+/-0.09)) exp[(1125 +/- 210)K/T]; k(3-5MeH --> iso-C(3)H(7) + but-1-ene)/(k)(3-5MeH --> CH(3) + 4-methylpent-1-ene) = 10((0.26+/-0.55)) exp[(1720 +/- 1300)K/T]. Observed olefin distributions depend on the relative rate constants and the interplay of chemical activation and falloff behavior as the energy distributions of the various radicals relax to steady-state values. A kinetic model using an RRKM/master equation analysis has been developed, and absolute rate expressions have been deduced. The model was used to extrapolate the data to temperatures between 500 and 1900 K and pressures of 0.1-1000 bar, and results for 12 isomerization reactions and 10 beta C-C bond scission reactions are reported.

Association between ABO blood groups and susceptibility to COVID-19: profile of age and gender in Iraqi patients.

Background: A case-control study was performed to examine age, gender, and ABO blood groups in 1014 Iraqi hospitalized cases with Coronavirus disease 2019 (COVID-19) and 901 blood donors (control group). The infection was molecularly diagnosed by detecting coronavirus RNA in nasal swabs of patients. Results: Mean age was significantly elevated in cases compared to controls (48.2 ± 13.8 vs. 29.9 ± 9.0 year; probability [p] < 0.001). Receiver operating characteristic analysis demonstrated the predictive significance of age in COVID-19 evolution (Area under curve = 0.858; 95% CI: 0.841 - 0.875; p < 0.001). Males outnumbered females in cases (60.4 vs. 39.6%) and controls (56 vs. 44%). Stratification by age group (< 30, 30 - 39, 40 - 49 and ≥ 50 years) revealed that 48.3% of cases clustered in the age group ≥ 50 years. ABO blood group analysis showed that group A was the most common among cases, while group O was the most common among controls (35.5 and 36.7%, respectively). Blood groups A (35.5 vs. 32.7; corrected p [pc] = 0.021), A+AB (46.3 vs. 41.7%; pc = 0.021) and A+B+AB (68.0 vs. 63.3%; pc = 0.007) showed significantly elevated frequencies in cases compared to controls. Logistic regression analysis estimated odds ratios (ORs) of 1.53 (95% confidence interval [CI]: 1.16 - 2.02), 1.48 (95% CI: 1.14 - 1.93) and 1.50 (95% CI: 1.17 - 1.82) for blood groups A, A+AB and A+B+AB, respectively. Blood group frequencies showed no significant differences between age groups of cases or controls. Regarding gender, male cases were marked with increased frequency of group A (39.9 vs. 28.9%) and decreased frequency of group O (25.9 vs. 41.0%) compared to female cases. Independent re-analysis of ABO blood groups in male and female cases demonstrated that group A was increased in male cases compared to male controls (39.9 vs. 33.1%; OR = 1.65; 95% CI: 1.24 - 2.21; pc = 0.006). On the contrary, no significant differences were found between females of cases and controls. Conclusions: The study results indicated that blood group A may be associated with an increased risk of developing COVID-19, particularly in males.