Non-cardiac surgery in patients with prosthetic heart valves: a 12 years experience

Objective: To study patients with mechanical heart valves undergoing non-cardiac surgery and their anticoagulation management during these procedures. Study Design: It was a cohort study. Place and Duration of Study : The study was conducted at the Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore and Department of Surgery, Services Institute of Medical Sciences, Lahore, from September 1994 to June 2006. Patients and Methods: Patients with mechanical heart valves undergoing non-cardiac surgical operation during this period, were included. Their anticoagulation was monitored and anticoagulation related complications were recorded. Results: In this study, 507 consecutive patients with a mechanical heart valve replacement were followed-up. Forty two (8.28%) patients underwent non-cardiac surgical operations of which 24 (57.1%) were for abdominal and non-abdominal surgeries, 5 (20.8%) were emergency and 19 (79.2%) were planned. There were 18 (42.9%) caesarean sections for pregnancies. Among the 24 procedures, there were 7(29.1%) laparotomies, 7(29.1%) hernia repairs, 2 (8.3%) cholecystectomies, 2 (8.3%) hysterectomies, 1(4.1%) craniotomy, 1(4.1%) spinal surgery for neuroblastoma, 1(4.1%) ankle fracture and 1(4.1%) carbuncle. No untoward valve or anticoagulation related complication was seen during this period.Conclusion: Patients with mechanical valve prosthesis on life-long anticoagulation, if managed properly, can undergo any type of noncardiac surgical operation with minimal risk

Computational analysis and expression profiling of potassium transport-related gene families in mango (Mangifera indica) indicate their role in stress response and fruit development

Mango (Mangifera indica) fruit is known for its taste, health benefits, and drought tolerance. Potassium (K+) is one of the most abundant ions in a plant cell. It is important for various biological functions related to plant growth, development, and flowering/fruiting. It significantly contributes to fruit yield, quality, and drought tolerance in plants. However, molecular mechanisms comprising K+ transport in mango are least known. In the present study, 37 members of K+ transport-related genes (PTGs) were identified in mango, which include 22 K+ transporters (16 HAKs, 1 HKT, and 6 KEAs) and 15 K+ channels (6 TPKs and 8 Shakers). All PTGs were predicted to be expressed at the plasma membrane and possess characteristic motifs and domains. Phylogenetic analysis identified a strong kinship of PTGs among Oryza sativa, Arabidopsis thaliana, Cicer arietinum, Malus domestica, and M. indica. The promoter analysis identified 60 types of cis-elements related to various biological processes. RNA-seq-based expression profiling identified that MiTPK1.2, MiHAK1, MiHAK2.1, HAK6.1, and MiAKT1.1 were most upregulated in roots and that MiKEA2, MiAKT2, and MiAKT1 were upregulated in leaves. Moreover, MiAKT6, MiHAK1.1, MiKAT2, MiKAT2.1, MiHKT1, MiTPK1.1, MiHAK7, and MiHAK12 were highly expressed during the five growth stages of mango fruit. The current study is the first comprehensive report on K+ transport system in tropical fruits. Therefore, it will provide the foundation knowledge for the functional characterization of K+ genes in mango and related plants

Design of Multiplexers for IoT-Based Applications Using Stub-Loaded Coupled-Line Resonators

This paper presents the design of microstrip-based multiplexers using stub-loaded coupled-line resonators. The proposed multiplexers consist of a diplexer and a triplexer, meticulously engineered to operate at specific frequency bands relevant to IoT systems: 2.55 GHz, 3.94 GHz, and 5.75 GHz. To enhance isolation and selectivity between the two passband regions, the diplexer incorporates five transmission poles (TPs) within its design. Similarly, the triplexer filter employs seven transmission poles to attain the desired performance across all three passbands. A comprehensive comparison was conducted against previously reported designs, considering crucial parameters such as size, insertion loss, return loss, and isolation between the two frequency bands. The fabrication of the diplexer and triplexer was carried out on a compact Rogers Duroid 5880 substrate. The experimental results demonstrate an exceptional performance, with the diplexer exhibiting a low insertion loss of 0.3 dB at 2.55 GHz and 0.4 dB at 3.94 GHz. The triplexer exhibits an insertion loss of 0.3 dB at 2.55 GHz, 0.37 dB at 3.94 GHz, and 0.2 dB at 5.75 GHz. The measured performance of the fabricated diplexer and triplexer aligns well with the simulated results, validating their effectiveness in meeting the desired specifications.publishedVersio

Data Augmentation-based Novel Deep Learning Method for Deepfaked Images Detection

Recent advances in artificial intelligence have led to deepfake images, enabling users to replace a real face with a genuine one. deepfake images have recently been used to malign public figures, politicians, and even average citizens. deepfake but realistic images have been used to stir political dissatisfaction, blackmail, propagate false news, and even carry out bogus terrorist attacks. Thus, identifying real images from fakes has got more challenging. To avoid these issues, this study employs transfer learning and data augmentation technique to classify deepfake images. For experimentation, 190,335 RGB-resolution deepfake and real images and image augmentation methods are used to prepare the dataset. The experiments use the deep learning models: convolutional neural network (CNN), Inception V3, visual geometry group (VGG19) and VGG16 with a transfer learning approach. Essential evaluation metrics (accuracy, precision, recall, F1-score, confusion matrix and AUC-ROC curve score) are used to test the efficacy of the proposed approach. Results revealed that the proposed approach achieves an accuracy, recall, F1-score and AUC-ROC score of 90% and 91% precision, with our fine-tuned VGG16 model outperforming other DL models in recognizing real and deepfakes

Factors leading to meconium aspiration syndrome in term- and post-term neonates

Background: Meconium aspiration syndrome (MAS) is considered a major cause of respiratory morbidity. It is a common issue encountered in the delivery room and newborn nursery. There is a need to identify the factors that lead to MAS to develop strategies to screen such patients at an early stage to decrease the mortality and morbidity. The objective of this study was to determine the factors leading to MAS in neonates delivered at ≥37 weeks of gestational age. Methods: A cross-sectional study was conducted through non-probability consecutive sampling technique at Liaquat University Hospital, Hyderabad from August 2016 to February 2017. All neonates at ≥37 weeks of gestation with meconium-stained amniotic fluid (MSAF) detected during delivery were included in this study after obtaining informed consent from their parents. The demographic and factors related to MAS were recorded through predesigned proforma and analyzed using SPSS version 22. Mean and standard deviation were determined for quantitative variables whereas frequency and percentages were calculated for qualitative variables. Results: Overall 136 neonates were included in the study. The mean gestational age was 38 ± 1.43 weeks. The major factors for MAS were detected as fetal distress (67.0%, n = 91), non-reassuring fetal heart rate (54.0%, n = 73), cesarean birth (48.0%, n = 65), intrauterine growth restriction (IUGR; 17.0%, n = 23), and post maturity (12.0%, n = 16). Conclusion: We conclude that the major factors for MAS are fetal distress, non-reassuring FHR tracing, cesarean birth, IUGR, and post maturity. Screening of such patients at an early stage may minimize morbidity and mortality related to MAS

A bibliometric analysis of end-of-life vehicles related research:exploring a path to environmental sustainability

Considering rapid economic development and continuously increasing environmental concerns, end-of-life vehicles (ELVs) have significant socioeconomic value as a crucial waste stream. The research relating to ELVs has rapidly evolved over the last few years. However, existing review studies focus on specific research themes, and thus, fail to present a complete picture. Hence, this research intends to explain the current research scenario relating to ELVs by reviewing the critical published studies of the last 22 years. A total of 1405 research publications were extracted from the Scopus database covering the period from 2000 to 2021. Mainly employing bibliometric analysis techniques, this research analyzes the quantity of literature, researchers, institutions, countries, and research themes to understand the current status and future trends in ELV recycling and management. The results revealed a considerable rise in the number of articles published in the last five years. The key producers of influential ELV research are listed as the United States, China, and the United Kingdom. Globally, Chinese universities have the most ELV-related articles published. Similarly, Serbian researcher Vladimir Simic authored the most ELV-related articles during the research period. This article also identifies various research themes: management and recycling, resource recovery and components, life cycle evaluation, and socioeconomic effects. The results also reveal a strong association between distinct ELV research clusters

ENHANCEMENT IN OVERALL THERMAL EFFICIENCY OF A GAS TURBINE POWER PLANT USING COMBINED CYCLE SYSTEM

The gas turbines are one of the major resources of power generation in the world and its usage is increasing day by day. Although the gas turbines have several advantages over other systems (such as high power to weigh ratio, high rotational speed or fast activation capabilities) but they still waste the energy in the form of high temperature exhaust gases coming out of the gas turbine which pollute the atmosphere and affect the environment. A waste heat recovery system (WHRS) installed at Gas turbine exhaust helps not only to reduce the exhaust temperature of these gases emitting from the uptake into the atmosphere but also enables to produce useful steam for various processes. The air mass flow rate which enters the compressor has a direct relation with the performance of gas turbine power plant. The volumetric efficiency of the gas turbines decreases with rise in the temperature of the inlet air. The increase in temperature will reduce the density which results in the reduction of gas turbine efficiency. In the present work the steam produced from WHRS has been used in the vapor absorption system of refrigeration. The refrigeration system is utilized to cool the air at the entry of the gas turbine compressor power plant. It was observed in gas turbine power plant that there is a 10% increase in thermal efficiency

Effects of Iron Oxide Nanoparticle Supplementation on the Growth Performance, Serum Metabolites, Meat Quality, and Jejunal Basal Morphology in Broilers

Simple Summary: Iron is a necessary micronutrient in animal feed. Iron is an important component of hemoglobin, myoglobin, and the enzymes participating in redox reactions. The aim of the current study was to assess the effects of iron oxide nanoparticle supplementation on production performance, organ development, blood biochemistry, redox status, meat quality, and jejunal histology in broilers. The results indicated that iron oxide nanoparticle supplementation improved the feed conversion ratio, pectoral muscle, and jejunal histology. However, iron oxide nanoparticle supplementation showed no effects on visceral organ development, blood metabolites, redox status, and carcass traits. Abstract: The current research aimed to evaluate the supplemental effects of iron oxide nanoparticles (IONPs) on production performance, viscera development, blood metabolites, redox status, meat quality, and jejunal histology in broilers. A total of 300 day-old broilers were randomly divided into six groups with five replicates per group. Birds were fed on a corn soybean-based diet supplemented with 0, 20, 40, 60, or 80 mg/kg IONPs or 80 mg/kg of FeSO4 for 35 days. The feed conversion ratio (FCR) was improved in birds supplemented with 60 mg/kg IONPs. The pH24h was lower in birds supplemented with 40 mg/kg IONPs compared to that of the bulk group. Pectoral muscle fascicle diameter and fiber density were significantly increased in 20 mg/kg IONP-supplemented birds compared to those of the bulk group, respectively. The muscle fiber diameter was higher in 40 mg/kg IONP-supplemented birds compared with the bulk group. The jejunal villus height, crypt depth, and villus surface area were significantly increased with 60 mg/kg IONP supplementation, whereas villus width was decreased in birds supplemented with 40 mg/kg IONPs. The villus-height-to-crypt-depth ratio was lower in IONP-supplemented birds compared to the bulk group. IONP supplementation improved the FCR, jejunal, and pectoral muscle morphology without affecting the carcass characteristics and redox status of broilers

Effectiveness of typhoid conjugate vaccine against culture-confirmed salmonella enterica serotype typhi in an extensively drug-resistant outbreak setting of Hyderabad, Pakistan: A cohort study

Background: Salmonella enterica serotype Typhi (S Typhi) is a major public health problem in low-income and middle-income countries. We aimed to investigate the effectiveness and impact of the typhoid conjugate vaccine Typbar-TCV against S Typhi among children in an outbreak setting of extensively drug-resistant (XDR) S Typhi in Pakistan.Methods: This cohort study was done from Feb 21, 2018, to Dec 31, 2019. A census survey of all households located in the Qasimabad and Latifabad subdistricts of Hyderabad, Pakistan, was done at baseline, and 174 005 households were registered in the census. The Typbar-TCV immunisation campaign was initiated at temporary vaccination centres and 207 000 children aged 6 months to 10 years were vaccinated from Feb 21, 2018, to Dec 31, 2018. Social mobilisers informed parents about the vaccination process. Vaccination records were maintained electronically and linked with the household census surveys. Active surveillance for suspected and blood-culture-confirmed S Typhi was established in hospitals, clinics, and laboratories to assess the following outcomes: cases of suspected typhoid fever, culture-confirmed S Typhi, and antimicrobial resistance. An age-stratified cohort of 1100 vaccinated children was randomly selected from the vaccination registry, tested for Vi-IgG antibodies (data not reported), and followed up fortnightly (via telephone calls or household visits) until Dec 31, 2019, for ascertainment of outcomes during the study period. 20 847 vaccinated and unvaccinated children were randomly selected from the census registry as a quality control cohort and followed up from Oct 1 to Dec 31, 2019, for ascertainment of outcomes. Vaccine effectiveness against suspected, culture-confirmed, and XDR S Typhi was calculated.Findings: 23 407 children from the census registry and surveillance system were included in the vaccine effectiveness analysis. 13 436 (57·4%) children were vaccinated, 12 214 (52·2%) were male, and 10 168 (43·4%) were aged 6-59 months. 5378 (23·0%) of 23 407 children had suspected S Typhi, among whom 775 (14·4%) had culture-confirmed S Typhi and 361 (68·6%) of 526 had XDR S Typhi. Vaccine effectiveness was 55% (95% CI 52-57) against suspected S Typhi (regardless of culture confirmation), 95% (93-96) against culture-confirmed S Typhi, and 97% (95-98) against XDR S Typhi.Interpretation: Typbar-TCV is effective in protecting children against S Typhi infection in an outbreak setting, and was able, with moderate deployment, to curtail a major XDR S Typhi outbreak in a densely populated setting. The vaccine shows efficacy against S Typhi irrespective of antimicrobial resistance.Funding: Bill & Melinda Gates Foundation

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe