Existence and data dependence of the fixed points of generalized contraction mappings with applications

The aim of this paper is to introduce a newtype of generalized multivalued contraction mappings and to present some results regarding fixed points of new class of multivalued contractions. As applications we obtain some basic results in fixed point theory like characterization of metric completeness, data dependence of fixed points and homotopy result. We prove the existence and uniqueness of bounded solution of functional equation arising in dynamic programming. Our results generalize, extend and unify various comparable results in the existing literature.http://link.springer.com/journal/133982016-09-30hb201

Exogenously Applied Trinexapac-ethyl Improves Photosynthetic Pigments, Water Relations, Osmoregulation and Antioxidants Defense Mechanism in Wheat under Salt Stress

The impact of trinexapac-ethyl (TE) on salinity subjected wheat plants was evaluated via pot based experiment. The treatments applied to wheat seedlings included (Ck) control (no NaCl nor TE spray), foliar spray of TE (1.95 ml L−1), only NaCl (50 mM) and NaCl+ TE (50 mM + 1.95 ml L−1). Foliar application of TE was done seven days after imposition of salinity. Growth parameters (root length, shoot length, fresh weight, and dry weight) and photosynthetic pigments content (chlorophyll a, b, a + b and a/b), water relation (water potential, osmotic potential, turgor potential and relative water contents) as well as catalase (CAT) activity exhibited marked reduction in comparison to control. In addition, an increment was noted in organic solutes content (proline, soluble protein and soluble sugar) and enzyme activity of superoxide dismutase (SOD), peroxidase (POD), and ascorbate peroxidase (APX) in stressed seedlings over control seedlings. The foliar applied TE mostly enhanced growth of salt stressed seedlings, accompanied by reinforcement in photosynthetic pigments, organic solutes, and enzyme activity (SOD, CAT, POD, and APX) in comparison to stressed seedlings. It is worthy to mention that, TE has potential to enhance salt tolerance of wheat seedlings. Thus, our findings suggest that seedling treated with TE is an effective strategy that can be used to enhance salt tolerance of wheat crop

Clinical practice guidelines on the management of variceal bleeding

Gastroesophageal variceal bleeding occurs in 30 - 50% of patients of liver cirrhosis with portal hypertension, with 20-70% mortality in one year. Therefore, it is essential to screen these patients for varices and prevent first episode of bleeding by treating them with β-blockers or endoscopic variceal band ligation. Ideally, the patients with variceal bleeding should be treated in a unit where the personnel are familiar with the management of such patients and where routine therapeutic interventions can be undertaken. Proper management of such patients include: initial assessment, resuscitation, blood volume replacement, vasoactive agents, prevention of associated complications such as bacterial infections, hepatic encephalopathy, coagulopathy and thrombocytopenia, and specific therapy. Rebleeding occurs in about 60% patients within 2 years of their recovery from first variceal bleeding episode, with 33% mortality. Therefore, it is mandatory that all such patients must be started on combination of β-blockers and band ligation to prevent recurrence of bleeding. Patients who required shunt surgery/TIPSS to control the acute episode do not require further preventive measures. These clinical practice guidelines (CPGs) have been jointly developed by Pakistan Society of Hepatology (PSH) and Pakistan Society of Study of Liver Diseases (PSSLD)

Techno-Economic and Environmental Impact Analysis of Large-Scale Wind Farms Integration in Weak Transmission Grid from Mid-Career Repowering Perspective

Repowering a wind farm enhances its ability to generate electricity, allowing it to better utilize areas with high mean wind speeds. Pakistan’s present energy dilemma is a serious impediment to its economic development. The usage of a diesel generator as a dependable backup power source raises the cost of energy per kWh and increases environmental emissions. To minimize environmental emissions, grid-connected wind farms enhance the percentage of wind energy in the electricity system. These wind generators’ effects, on the other hand, are augmented by the absorption of greater quantities of reactive electricity from the grid. According to respective grid codes, integration of commercial onshore Large-Scale Wind Farms (LSWF) into a national grid is fraught with technical problems and inter-farm wake effects, which primarily ensure power quality while degrading overall system operation and limiting the optimal use of attainable wind resources. The goal of this study is to examine and estimate the techno-economic influence of large-scale wind farms linked to poor transmission systems in Pakistan, contemplating the inter-farm wake effect and reactive power diminution and compensating using a range of voltage-ampere reactive (VAR) devices. This study presents a partial repowering technique to address active power deficits produced by the wake effect by raising hub height by 20 m, which contributed to recovering the active power deficit to 48% and so reduced the effects of upstream wind farms. Simulations were conducted for several scenarios on an actual test system modeled in MATLAB for comparative study using capacitor banks and different flexible alternating current transmission system (FACTS) devices. Using the SAM (System Advisor Model) and RETscreen, a complete technical, economic, and environmental study was done based on energy fed into the grid, payback time, net present value (NPV), and greenhouse gases (GHG) emission reduction. The studies suggest that the unified power flow controller (UPFC) is the optimum compensating device via comparison analysis as it improved the power handling capabilities of the power system. Our best-case scenario includes UPFC with hub height augmentation, demonstrating that it is technically, fiscally, and environmentally viable. Over the course of its lifespan, the planned system has the potential to save 1,011,957 tCO2, resulting in a greener environment. When the energy generated annually by a current wake-affected system is compared to our best-recommended scenario, a recovered shortfall of 4.851% is seen, with improved system stability. This modest investment in repowering boosts energy production due to wake effects, resulting in increased NPV, revenue, and fewer CO2 footprints

Pavement Rehabilitation Strategy Course Development

Pavement rehabilitation and preservation treatments have become standard practice for state and local transportation agencies. The ultimate goals include maintaining a safe and reliable level of service for all users, maximizing pavement service life, and optimizing budget allocations for infrastructure construction projects. The essential key to meet these goals requires transportation agencies to identify the right treatment for the right pavement at the right time. Based on the manuals of Bureau of Design and Environment (BDE) within the Illinois Department of Transportation (IDOT), training course materials were developed in this project. The goals of the training course are to enhance the understanding of fundamental concepts of pavement rehabilitation and preservation strategies, establish consistent practices following the guidance manuals and minimize potential errors by selecting appropriate treatments. The training course is designed to be completed in one-and-a-half days, covering seven blocks: (1) Introduction, (2) Preservation and Rehabilitation Definitions, (3) Distresses, (4) Condition Rating Survey, (5) Testing, (6) Treatments, and (7) Selection Guidelines. The final completed deliverables of this project include PowerPoint slides for in-class instruction, a stand-alone online platform, and review and final examination questions for the initial three blocks.IDOT-R27-170Ope

Hepatocellular carcinoma in Pakistan: where do we stand?

Context: From the 1970s till the mid 1990s, hepatitis B was the most common etiological factor for hepatocellular carcinoma (HCC) in Pakistan. Afterwards, a shift in HCC etiology was observed with a steady rise in hepatitis C virus (HCV) related HCC cases. HCV-3a, which is the most prevalent genotype, is also most frequent in HCV related HCC. There was an increase in the proportion of non-B non-C (NBNC) HCC cases as well, which might be attributed to an increase in non-alcoholic fatty liver disease. Evidence Acquisition: The age-standardized rate for HCC is 7.64/100 000 in males and 2.8/100 000 in females. Male to female ratio is 3.6:1. Usual age of presentation is in the fifth and sixth decade. Most patients present with advanced disease, as they are not in a regular surveillance program. This is more so for patients with NBNC chronic liver disease. As many sonologists in Pakistan are practicing without sufficient training to pick up early lesions, alpha-fetoprotein is still recommended to compliment ultrasound in the surveillance of HCC. Results: Majority of HCC patients present with nonresectable disease. Interventions such as transarterial chemoembolization, radiofrequency ablation, resection and chemotherapy including sorafenib are available in selected centers. Pakistan appears to be in an area of intermediate endemicity for HCC. There is a need for population based epidemiological studies to estimate the exact disease burden. Conclusions: Measures to prevent the spread of hepatitis C and B can slow down the epidemic rise in the incidence of HCC in the coming decades. There is a need to implement a proper surveillance program to identify HCC cases at an early stage

Combined application of zinc and silicon alleviates terminal drought stress in wheat by triggering morpho-physiological and antioxidants defense mechanisms

Wheat is an important global staple food crop; however, its productivity is severely hampered by changing climate. Erratic rain patterns cause terminal drought stress, which affect reproductive development and crop yield. This study investigates the potential and zinc (Zn) and silicon (Si) to ameliorate terminal drought stress in wheat and associated mechanisms. Two different drought stress levels, i.e., control [80% water holding capacity (WHC) was maintained] and terminal drought stress (40% WHC maintained from BBCH growth stage 49 to 83) combined with five foliar-applied Zn-Si combinations (i.e., control, water spray, 4 mM Zn, 40 mM Si, 4 mM Zn + 40 mM Si applied 7 days after the initiation of drought stress). Results revealed that application of Zn and Si improved chlorophyll and relative water contents under well-watered conditions and terminal drought stress. Foliar application of Si and Zn had significant effect on antioxidant defense mechanism, proline and soluble protein, which showed that application of Si and Zn ameliorated the effects of terminal drought stress mainly by regulating antioxidant defense mechanism, and production of proline and soluble proteins. Combined application of Zn and Si resulted in the highest improvement in growth and antioxidant defense. The application of Zn and Si improved yield and related traits, both under well-watered conditions and terminal drought stress. The highest yield and related traits were recorded for combined application of Zn and Si. For grain and biological yield differences among sole and combined Zn-Si application were statistically non-significant (p>0.05). In conclusion, combined application of Zn-Si ameliorated the adverse effects of terminal drought stress by improving yield through regulating antioxidant mechanism and production of proline and soluble proteins. Results provide valuable insights for further cross talk between Zn-Si regulatory pathways to enhance grain biofortification

Service quality of private hospitals: The Iranian Patients' perspective

<p>Abstract</p> <p>Background</p> <p>Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective.</p> <p>Methods</p> <p>A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions.</p> <p>Results</p> <p>The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p < 0.001). There was a significant difference between the expectations scores based on gender, education level, and previous hospitalization in that same hospital. Also, there was a significant difference between the perception scores based on insurance coverage, average length of stay, and patients' health conditions on discharge.</p> <p>Conclusion</p> <p>The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.</p

Molecular epidemiology of Hepatitis B virus genotypes in Pakistan

<p>Abstract</p> <p>Background</p> <p>Eight genotypes of Hepatitis B virus designated A-H, have been known but in Pakistan, no such data is available on the prevalent HBV genotypes. Therefore, the subject study was conducted to determine HBV genotypes in the indigenous Pakistani population.</p> <p>Methods</p> <p>A total of 690 individuals were enrolled for HBV screening with EIA and nested PCR. Positive samples were further analyzed to determine HBV genotypes (A-F) by multiplex-PCR using type specific primers.</p> <p>Results</p> <p>110 (15.94%) individuals were positive for HBV, including 64% males and 36% females. Out of these, 66 samples (65.34%) were classified into genotype D, 27 (26.73%) were of genotype B while 5(4.95%) had genotype A. In 3 (2.98%) samples, multiple genotypes were detected (genotype A+B; 2(1.99%) and genotypes B+D; 1(0.99%). Nine (8.18%) samples remained untyable.</p> <p>Conclusion</p> <p>In Asia, genotypes B and C are the most prevalent but our study reveals that genotype D is predominant and HBV infection constitutes a significant health problem in Pakistan.</p

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation