Changes in particulate matter concentrations at different altitudinal levels with environmental dynamics

Ambient air quality is defined not only by the source strength but a variety of meteorological parameters as well. In the current study, ambient concentrations of PM along with temperature and relative humidity levels were monitored at seven different locations of Pakistan. A DustTrak DRX (Model 8533, TSI Inc.) was employed for twenty four hours real time monitoring of particulate matter at the selected sites. A considerable variation was observed in the 24 hour trend of particulate matter (PM) at different locations owing to variation in meteorological conditions due to different altitudes and seasons, and natural and anthropogenic sources in the vicinity. The highest average concentrations of PM2.5 (407μg/m3 were observed at highest elevation (Makra Peak, Shogran, 3089 m) while lowest averages (102 μg/m3) were obtained at the seaside (Hawks Bay, Karachi, 0 m).On the other hand PMTotal fraction exhibited highest levels at site B (506 μg/m3) and lowest at Site A (121 μg/m3).Correlation factors were determined for PM and meteorological parameters at each location. More research needs to be conducted to have a comprehensive knowledge about the physical parameters controlling particulate dispersal at different altitudes within the country

Functional results of minimally invasive cheap fixation technique for all types of intertrochanteric femoral fractures using enders nail and cannulated cancellous screws

Background: The objective was to study functional results of fixation of intertrochanteric fractures of femur using enders nail and cannulated cancellous screws.Methods: This was a prospective observational study. The study was conducted on 30 patients of intertrochanteric femoral fractures who underwent fixation by enders nailing and cannulated cancellous screws in Department of Orthopaedics, GMCH, Aurangabad from January 2018 to January 2021. Patients were assessed functionally using Harris hip score, visual analogue score, and radiological assessment at 3, 6, and 12 months.Results: All patients showed radiological union within 3 months. Functional assessment was done with Visual analogue scale (VAS) in which mean VAS score was 0.9 (range 0-3), mean Harris hip score which was 86 (range 81-90). One patient developed superficial infection at incision site which was treated by giving appropriate antibiotics and one patient complained of prominent nail on medial side of knee which was treated by implant removal after union of fracture.Conclusions: Fixation of intertrochanteric femur fractures using enders nailing and cannulated cancellous screws achieves good stability with minimal complications and improved patients’ outcome in terms of less intraoperative blood loss, less chances of infection, less operative time with minimal patient morbidity and good functional outcome

Clinical evaluation of diaphyseal femoral fractures operated in lateral decubitus position with interlocking nail

Background: The diaphyseal fractures of femur in adults are conventionally treated in supine position on traction table, which carries risk of compartment syndrome, pudendal nerve palsy, whereas in lateral decubitus position these complications can be avoided with additional advantage of easy access to greater trochanter particularly in obese patients. The aim of this study is to evaluate outcomes of femur diaphyseal fractures treated with intramedullary interlocking nail in lateral decubitus position.Methods: In this study 40 patients with femur diaphysea fractures were treated with intramedullary interlocking nail in lateral decubitus position, were studied for a period of 9 months from September 2019 to May 2020.Results: At the end of our study of 40 patients, outcome is graded according Thoresen’s criteria where 22 (55%) patients had excellent results with full, pain-free, function of the extremity and 11 (27.5%) patients had good result; 10 patients had range of motion 1200 and shortening of femur by 1.5 was observed in 1 patient. There were 6 (15%) patients with fair result; with range of motion 900 and 1 poor result (2.5%) had non-union with range of motion <900.Conclusions: Fixation of femur diaphyseal fracture in lateral decubitus position leads to easy access to the proximal femur making it easy to establish an entry point for an intramedullary device and it significantly eliminates the complications caused by other conventionally used methods

Combined search for the quarks of a sequential fourth generation

Results are presented from a search for a fourth generation of quarks produced singly or in pairs in a data set corresponding to an integrated luminosity of 5 inverse femtobarns recorded by the CMS experiment at the LHC in 2011. A novel strategy has been developed for a combined search for quarks of the up and down type in decay channels with at least one isolated muon or electron. Limits on the mass of the fourth-generation quarks and the relevant Cabibbo-Kobayashi-Maskawa matrix elements are derived in the context of a simple extension of the standard model with a sequential fourth generation of fermions. The existence of mass-degenerate fourth-generation quarks with masses below 685 GeV is excluded at 95% confidence level for minimal off-diagonal mixing between the third- and the fourth-generation quarks. With a mass difference of 25 GeV between the quark masses, the obtained limit on the masses of the fourth-generation quarks shifts by about +/- 20 GeV. These results significantly reduce the allowed parameter space for a fourth generation of fermions.Comment: Replaced with published version. Added journal reference and DO

Updates in Hospital Palliative Care

Background: This review critiques recent palliative care (PC) literature with likelihood of impacting general hospital practice in order to help address the PC needs of patients. Methods: Articles published between January and December 2018 were identified through hand-search of leading PC journals and MEDLINE search. The final ten selected articles were determined by consensus based on scientific rigor, relevance to general hospital medicine, and impact to practice. Results: Key findings include: Early PC interventions reduced healthcare costs; Prognostic awareness of surrogates of patients with advanced dementia was associated with reduced burdensome interventions; Care transitions, especially in the last 3 days of life, can be detrimental to caregivers' well-being and perceptions of care; Haloperidol was effective for treatment of nausea and vomiting without untoward effects; Antipsychotics did not improve delirium symptoms in hospitalized patients; A fan directed to the face improved dyspnea; Disparities in advance directive completion disappeared when equal opportunities were given; Improving communication with families of critically ill patients improved perceptions of patient-centered care; Communication-priming tools improved the quality and documentation of goals of care conversations; Discussing prognosis did not harm the patient-provider relationship. Conclusion: Recent PC research affirmed the importance of PC delivery to patients with life-limiting illness and provided important guidance to hospitalists on symptom management, advance care planning, and communication.Rachel D. Havyer (1*), Nauzley Abedini (2), Robert L. Jayes (3), Brenda Matti-Orozco (4), Daniel H. Pomerantz (5), Aziz A. Ansari (6); 1. Division of Community Internal Medicine, Mayo Clinic. 2. Division of Palliative Medicine, University of California San Francisco. 3. Division of Geriatrics and Palliative Medicine, George Washington University Medical Faculty Associates. 4. Division of General Internal Medicine and Palliative Medicine, Morristown Medical Center, Atlantic Health System. 5. Department of Medicine, Montefiore New Rochelle Hospital. 6. Division of Hospital Medicine, Loyola University Medical CenterIncludes bibliographical reference

Changes in particulate matter concentrations at different altitudinal levels with environmental dynamics

Ambient air quality is defined not only by the source strength but a variety of meteorological parameters as well. In the current study, ambient concentrations of PM along with temperature and relative humidity levels were monitored at seven different locations of Pakistan. A DustTrak DRX (Model 8533, TSI Inc.) was employed for twenty four hours real time monitoring of particulate matter at the selected sites. A considerable variation was observed in the 24 hour trend of particulate matter (PM) at different locations owing to variation in meteorological conditions due to different altitudes and seasons, and natural and anthropogenic sources in the vicinity. The highest average concentrations of PM2.5 (407 mu g/m(3)) were observed at highest elevation (Makra Peak, Shogran, 3089 m) while lowest averages (102 mu g/m(3)) were obtained at the seaside (Hawks Bay, Karachi, 0 m). On the other hand PMTotal fraction exhibited highest levels at site B (506 mu g/m(3)) and lowest at Site A (121 mu g/m(3)). Correlation factors were determined for PM and meteorological parameters at each location. More research needs to be conducted to have a comprehensive knowledge about the physical parameters controlling particulate dispersal at different altitudes within the country

Search for Pair Production of Third-Generation Leptoquarks and Top Squarks in pp Collisions at √s=7 TeV

Results are presented from a search for the pair production of third-generation scalar and vector leptoquarks, as well as for top squarks in R-parity-violating supersymmetric models. In either scenario, the new, heavy particle decays into a τ lepton and a b quark. The search is based on a data sample of pp collisions at √s=7  TeV, which is collected by the CMS detector at the LHC and corresponds to an integrated luminosity of 4.8  fb[superscript -1]. The number of observed events is found to be in agreement with the standard model prediction, and exclusion limits on mass parameters are obtained at the 95% confidence level. Vector leptoquarks with masses below 760 GeV are excluded and, if the branching fraction of the scalar leptoquark decay to a τ lepton and a b quark is assumed to be unity, third-generation scalar leptoquarks with masses below 525 GeV are ruled out. Top squarks with masses below 453 GeV are excluded for a typical benchmark scenario, and limits on the coupling between the top squark, τ lepton, and b quark, λ333′ are obtained. These results are the most stringent for these scenarios to date

General public awareness, knowledge and attitude toward COVID-19 infection and prevention: a cross-sectional study from Pakistan [version 2; peer review: 2 approved]

Background: The aim of this study is to evaluate the knowledge, perceptions, and attitude of the public in Pakistan (using social media) towards COVID-19. Methods: A cross-sectional study was conducted amongst 1120 individuals nationwide. A self-developed, pre-tested questionnaire was used that comprised of sections covering demographic characteristics, medical history, hygiene awareness, COVID-19-related knowledge, and learning attitude. Descriptive statistics were used for frequencies, percentages, averages and standard deviations. Inferential statistics were done using the Student’s t-test and ANOVA. Results: The average age of participants was 31 years (range 18-60 years). In total 56 individuals (5%) had completed primary or secondary school education; 448 (40%) were employed (working from home) and 60% were jobless due to the COVID-19 crisis. Almost all the study subjects (1030 (92%)) were washing their hands multiple times a day. A total of 83% had awareness regarding quarantine time, 82% used face masks whenever they left their homes, 98% were aware of the origin of the disease, and 70% had knowledge regarding the most common symptoms of COVID-19. Conclusion: It can be concluded from the current study that female participants had higher level of education, and more awareness regarding the coronavirus. The majority of the participants followed proper hand washing regimes and washed their faces. Further knowledge and awareness should be promoted

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations