Prevalence of neuro-musculoskeletal complications in patients with T2DM

Diabetes mellitus affects normal metabolizing body function and causes long term organs dysfunctions like blindness, kidney failure, neuropathy and autonomic dysfunction. The musculoskeletal is also affected by T2DM and causes pain, dysfunctions, and disabilities. Thus, this study is to find the prevalence of neuro-musculoskeletal complications in patients with T2DM. This cross sectional survey was conducted in various public and private sector hospitals of four major cities of Pakistan (Islamabad, Karachi, Lahore, and Sargodha) from 1st May to 31st December 2015. The patients of type II diabetes mellitus with both gender and age above 40 were included, and patients with active systemic disease of bones and soft tissues were excluded. A self-structured questionnaire was developed, reviewed by experts, and finalized after calculating their recommendations. The questionnaire was distributed among 600 patients, out of whom 500 patients responded. The non-probability convenient sampling technique was used for data collection. The data was analyzed by SPSS and percentages were calculated to estimate the neuro-musculoskeletal complications in patients with T2DM. The prevalence of neuro-musculoskeletal complication in type II Diabetes mellitus was 100 %, while the frozen shoulder, tingling sensations and ants crawling sensations (61%) were equally the most common neuro-musculoskeletal complications followed by knee pain (53%), low back pain (43%).The most involved age group was 61 to 65 years and 58% patients were with positive family history. The most commonly used way of treatment was medications (90%) and physical therapy (10%). It was proved in study that frozen shoulder, altered sensations, knee pain and back pain have high association with long duration of T2DM.There is association between long duration of diabetes mellitus and neuro-musculoskeletal complications. It is concluded that the prevalence of neuro-musculoskeletal complications is high among patients of T2DM and commonly affects shoulder, back, knee and altered sensation in legs. These are most commonly managed with medications followed by physical therapy

How do skills influence the students’ employability in a developing economy?

This paper aims to identify the factors that can affect the overall graduate employability (OGE) of private university graduates in a developing economy. Many economies are facing substantial issues in job markets. Moreover, many young people are unemployed and barely get a good job. Hence, it is necessary to examine how skills set influence the employability in a developing economy like Pakistan. The authors carefully selected six such employable factors after searching the existing literature. Those six factors: academic performance (AP), technical skills (TS), communication skills (CS), personality (PE), leadership & motivational skills (LMS); and teamwork and problem solving skills (TPSS), had been considered as the independent variables while OGE had been considered as the single dependent variable. Design/methodology/approach – The authors collected the primary data from a valid sample of 200 employers through a structured questionnaire working as the hiring managers. Those respondents were selected on a random basis. The authors used exploratory factor analysis to validate the items under those independent variables and structural equation modeling with AMOS (24) to test the hypothesized relationship between each independent variable and the dependent one. Research limitations/implications – Based on the findings, this paper can help scholars in further investigating the employability factors. Practical implications – This explorative study will guide the fresh graduates in developing their required employability skills while assisting the employers in recruiting suitable candidates with the required skills and performance

Age and Prostatic Volume: The Prognosis for Benign Prostatic Hyperplasia

Background: Old age is more susceptible to prostatic sicknesses. Benign prostatic hyperplasia (BPH) is related to repeated urinary tract infections, which influences personal satisfaction. The values of prostatic volume and obesity are viewed as significant factors for the advancement of prostate organ hypertrophy. The study aimed to investigate the effect of age on benign prostatic hyperplasia patients in a tertiary care hospital in Karachi. Methods: A cross-sectional study was conducted in an emergency clinic of Dr. Ruth Pfau and Dow College of health sciences on 60 enrolled patients (50-80 years). All selected patients had BPH and were assessed by a Global prostate side effect score >7. Patients with BPH were divided into two groups obese and non-obese. Transrectal ultrasound was performed to analyze the length, width, diameter and volume of the prostate. The outcomes were then examined to observe the progressions in the morphological construction of the prostate and its relationship with the advancement of age. Results: The mean prostate volume (PV) was higher in the obese group measuring 36.13±3.673ml while in the non-obese group, it was 31.21±6.771 ml, the difference was statistically significant (p=0.001). In the 60-70 years, age group, we obtained the highest count of obese participants with PV ≥ 30ml. In 71-80 years, age groups, again the maximum number of participants had ≥ 30ml PV and were obese. Conclusion:  In the study, patients’ obesity had a significant effect on the prostate volume (p<0.001). Thus, benign prostatic hypertrophy was seen in the higher age group (60-70 years). Keywords: Old Age, BPH, Prostatic Volume, Satisfaction

Comparative Analysis of State-of-the-Art Deep Learning Models for Detecting COVID-19 Lung Infection from Chest X-Ray Images

The ongoing COVID-19 pandemic has already taken millions of lives and damaged economies across the globe. Most COVID-19 deaths and economic losses are reported from densely crowded cities. It is comprehensible that the effective control and prevention of epidemic/pandemic infectious diseases is vital. According to WHO, testing and diagnosis is the best strategy to control pandemics. Scientists worldwide are attempting to develop various innovative and cost-efficient methods to speed up the testing process. This paper comprehensively evaluates the applicability of the recent top ten state-of-the-art Deep Convolutional Neural Networks (CNNs) for automatically detecting COVID-19 infection using chest X-ray images. Moreover, it provides a comparative analysis of these models in terms of accuracy. This study identifies the effective methodologies to control and prevent infectious respiratory diseases. Our trained models have demonstrated outstanding results in classifying the COVID-19 infected chest x-rays. In particular, our trained models MobileNet, EfficentNet, and InceptionV3 achieved a classification average accuracy of 95\%, 95\%, and 94\% test set for COVID-19 class classification, respectively. Thus, it can be beneficial for clinical practitioners and radiologists to speed up the testing, detection, and follow-up of COVID-19 cases

Improvement in the Mechanical Properties of High Temperature Shape Memory Alloy (Ti 50

High temperature shape memory alloys Ti50Ni25Pd25 and Ti50Ni20Pd25Cu5 were developed, characterized, and tensile tested in both martensite ( Mf − 50°C) and austenite ( Af + 50°C) phases. The transformation temperatures of ternary Ti50Ni25Pd25 alloy were increased by 11 to 12.5°C by substitution of Ni with 5 at% Cu. At the same time, transformation heat absorbed and released during forward and reverse martensitic transformation was also increased. In the martensite phase, the mechanical properties, that is, the stress for reorientation of martensite variants and fracture stress, were increased by 33 and 60 MPa, respectively, whereas the fracture strain was decreased by 1.5%. In the austenite phase, the critical stress for slip and fracture stress were increased by 62 and 40.9 MPa, respectively, whereas the fracture strain was decreased by 1.2%. The increase in both stresses was attributed to the solid solution strengthening by substitution of Ni atoms with relatively greater atomic radius of copper (Cu) atoms. The overall results suggest that the addition of 5 at% Cu in place of Ni in Ti50Ni25Pd25 alloy is very beneficial to improving the mechanical and shape memory properties and increasing the transformation temperatures

Green finance and foreign direct investment–environmental sustainability nexuses in emerging countries: new insights from the environmental Kuznets curve

The primary objective of the present study is to identify the asymmetric relationship between green finance, trade openness, and foreign direct investment with environmental sustainability. The existing research utilizes the asymmetric approach to evaluate annual data from 1980 to 2021. The findings of this study show heterogeneous results. Therefore, the outcomes of the study confirm the nonlinear (NARDL) association between the variables in Pakistan. Moreover, the study describes the positive shock of foreign direct investment (FDI) as a significant and positive relationship with environmental degradation, while the negative shock of FDI shows a negative and significant relationship with the environment. Furthermore, the study scrutinizes the positive shock of green finance as a significant and negative relationship with environmental degradation; the negative shocks also show a negative relationship with environmental degradation in Pakistan. In addition, the consequences of the study suggest that the government should implement taxes on foreign investment and that investors should use renewable energy to produce goods. Furthermore, the results suggest that the government should utilize fiscal policy and fiscal funds to enhance carbon-free projects. Moreover, green securities should be used for green technologies. However, Pakistan can control its carbon emissions and achieve the target of a sustainable environment. Therefore, Pakistan’s government should stabilize its financial markets and introduce carbon-free projects. Furthermore, the main quantitative achievement according to the outcomes suggests that policymakers make policies in which they suggest to the government to control foreign investment that causes carbon emissions because of trade openness and also invest the funds in renewable energy, which helps to control the carbon emissions

Improved Generalization for Secure Data Publishing

In data publishing, privacy and utility are essential for data owners and users respectively, which cannot coexist well. This incompatibility puts the data privacy researchers under an obligation to find newer and reliable privacy preserving tradeoff-techniques. Data providers like many public and private organizations (e.g. hospitals and banks) publish microdata of individuals for various research purposes. Publishing microdata may compromise the privacy of individuals. To prevent the privacy of individuals, data must be published after removing personal identifiers like name and social security numbers. Removal of the personal identifiers appears as not enough to protect the privacy of individuals. K-anonymity model is used to publish microdata by preserving the individual's privacy through generalization. There exist many state-of-the-arts generalization-based techniques, which deal with pre-defined attacks like background knowledge attack, similarity attack, probability attack and so on. However, existing generalization-based techniques compromise the data utility while ensuring privacy. It is an open question to find an efficient technique that is able to set a trade-off between privacy and utility. In this paper, we discussed existing generalization hierarchies and their limitations in detail. We have also proposed three new generalization techniques including conventional generalization hierarchies, divisors based generalization hierarchies and cardinality-based generalization hierarchies. Extensive experiments on the real-world dataset acknowledge that our technique outperforms among the existing techniques in terms of better utility

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: Multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P \u3c 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings