Dengue Outbreaks in Khyber Pakhtunkhwa (KPK), Pakistan in 2017: An Integrated Disease Surveillance and Response System (IDSRS)-Based Report

Snažni bočni vjetrovi koji pušu na mostovima i vijaduktima mogu dovesti do gubitka dinamičke stabilnosti vozila koja prelaze most. Da bi se omogućio nesmetan i siguran promet čak i u slučajevima nepovoljnih vremenskih uvjeta uzrokovanih snažnim bočnim vjetrom, na mostove se postavljaju zaštitni vjetrobrani. Karakteristike strujanja zraka preko mosta su značajno promijenjene u slučaju postavljanja vjetrobrana različitih visina i poroznosti. U okviru ovog rada ispitan je utjecaj visine vjetrobrana te utjecaj poroznosti vjetrobrana na karakteristike strujanja zraka oko vozila koje se nalazi na mostu. Vjetrobran je postavljen samo na uzvodni rub mosta, a za vozilo je korišten model Ahmedovog tijela koji je u svim simulacijama postavljen na udaljenost 2 m nizvodno od vjetrobrana. Pri računalnim simulacijama korišten je model stacionarnog trodimenzijskog turbulentnog strujanja nestlačivog fluida te k-ω SST model turbulencije sa standardnim zidnim funkcijama. Dobiveni rezultati ukazuju na značajan utjecaj vjetrobrana na koeficijente tlaka na površini vozila. Manja poroznost vjetrobrana i veća visina vjetrobrana uzrokuju smanjenje koeficijenta tlaka na nastrujavanoj površini vozila. Iako su vrijednosti koeficijenta tlaka na površini vozila za male poroznosti vjetrobrana relativno male, raspodjela vrtložnosti struje zraka sugerira da može doći do povećanih vrijednosti standardnih devijacija aerodinamičkih sila koje djeluju na vozilo. Karakteristike vjetrobrana imaju bitan utjecaj na raspodjelu brzine strujanja zraka uzvodno od vozila, odnosno u prostoru između vjetrobrana i vozila. Smanjenjem poroznosti vjetrobrana se brzine strujanja zraka u tom području značajno smanjuju. Utjecaj poroznosti vjetrobrana na raspodjelu brzine strujanja zraka u ovom području je značajniji u odnosu na utjecaj visine vjetrobrana. Aerodinamičke sile i momenti zabilježeni na vozilu su značajno smanjeni kada je vjetrobran postavljen na most. Rezultati dobiveni u okviru ovog rada sugeriraju da je, s obzirom na aerodinamičke sile koje djeluju na vozilo, optimalna visina vjetrobrana 5 m uz njihovu poroznost u iznosu od 30%.Strong cross winds that commonly blow on bridges and viaducts may cause dynamic instabilities of vehicles crossing the bridge. To allow for safe traffic even in the periods of bad weather conditions such as strong cross winds, bridges are equipped with wind barriers. Flow characteristics around the bridge are significantly modified with respect to the wind barrier height and porosity. In the present work, the influence of wind barrier height and porosity on flow characteristics around the vehicle passing the bridge was studied. The wind barrier was placed on the windward bridge-deck edge only, while the Ahmed body was used as a vehicle. It was placed 2 m downwind of the wind barrier. In the computational simulations, the stationary 3D turbulent incompressible flow was modeled together with the k-ω SST turbulence model and standard wall functions. The obtained results generally show a significant influence of the wind barrier on the pressure coefficients observed on the vehicle surface. Smaller porosity and larger height of the wind barrier causes smaller pressure coefficients on the windward side of the vehicle. Even though the pressure coefficients on the vehicle for the low-porous wind barrier are relatively small, the distribution of the flow vorticity suggests larger values of the standard deviation of the aerodynamic forces acting on the vehicle. Wind-barrier characteristics proved to have a large influence on the distribution of flow velocity in the area upstream of the vehicle and downstream of the wind barrier. For smaller porosities of the wind barrier, flow velocities in this area are significantly smaller. The influence of the porosity on the distribution of flow velocities in this area is relatively larger compared to the height of the wind barrier. The aerodynamic forces and moment are generally smaller when the wind barrier is in place. The obtained results suggest that the 5 m high and 30% porous wind barrier is optimal with respect to the aerodynamic forces and moment acting on the vehicle on the bridge

Drivers of Spatiotemporal Eukaryote Plankton Distribution in a Trans-Basin Water Transfer Canal in China

Planktonic eukaryotes are important components of aquatic ecosystems, and analyses of the whole eukaryotic planktonic community composition and function have far-reaching significance for water resource management. We aimed to understand the spatiotemporal variation and drivers of eukaryotic plankton distribution in the Middle Route Project of the South-to-North Water Diversion in Henan Province, China. Specifically, we examined planktonic assemblages and water quality at five stations along the canal and another one located before the dam in March, June, September, and December 2019. High-throughput sequencing revealed that the eukaryotic plankton community was primarily composed of 53 phyla, 200 genera, and 277 species, with Cryptophyta, Ciliophora, and norank_k_Cryptophyta being the dominant phyla. Redundancy analysis of the eukaryotic community and environmental factors showed that five vital factors affecting eukaryotic plankton distribution were oxidation-reduction potential, nitrate nitrogen, pH, total phosphorus, and water flow velocity. Furthermore, the geographical distribution of eukaryotic communities was consistent with the distance decay model. Importantly, environmental selection dominantly shaped the geographical distribution of the eukaryotic community. In summary, our study elucidates the ecological response of planktonic eukaryotes by identifying the diversity and ecological distribution of planktonic eukaryotes in trans-basin diversion channels

Exogenous Melatonin Improves Cold Tolerance of Strawberry (Fragaria × ananassa Duch.) through Modulation of DREB/CBF-COR Pathway and Antioxidant Defense System

The strawberry (Fragaria × ananassa Duch.) is an important fruit crop cultivated worldwide for its unique taste and nutritional properties. One of the major risks associated with strawberry production is cold damage. Recently, melatonin has emerged as a multifunctional signaling molecule that influences plant growth and development and reduces adverse consequences of cold stress. The present study was conducted to investigate the defensive role of melatonin and its potential interrelation with abscisic acid (ABA) in strawberry plants under cold stress. The results demonstrate that melatonin application conferred improved cold tolerance on strawberry seedlings by reducing malondialdehyde and hydrogen peroxide contents under cold stress. Conversely, pretreatment of strawberry plants with 100 μM melatonin increased soluble sugar contents and different antioxidant enzyme activities (ascorbate peroxidase, catalase, and peroxidase) and non-enzymatic antioxidant (ascorbate and glutathione) activities under cold stress. Furthermore, exogenous melatonin treatment stimulated the expression of the DREB/CBF—COR pathways’ downstream genes. Interestingly, ABA treatment did not change the expression of the DREB/CBF—COR pathway. These findings imply that the DREB/CBF-COR pathway confers cold tolerance on strawberry seedlings through exogenous melatonin application. Taken together, our results reveal that melatonin (100 μM) pretreatment protects strawberry plants from the damages induced by cold stress through enhanced antioxidant defense potential and modulating the DREB/CBF—COR pathway. View Full-Tex

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 < 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 (beta 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

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Numerical simulation for aspects of homogeneous and heterogeneous reactions in forced convection flow of nanofluid

Mixed convection stagnation point flow of nanofluid by a vertical permeable circular cylinder has been addressed. Water is treated as ordinary liquid while nanoparticles include aluminium oxide, copper and titanium dioxide. Homogeneous-heterogeneous reactions are considered. The nonlinear higher order expressions are changed into first ordinary differential equations and then solved by built-in-Shooting method in mathematica. The results of velocity, temperature, concentration, skin friction and local Nusselt number are discussed. Our results demonstrate that surface drag force and heat transfer rate are enhanced linearly for higher estimation of curvature parameter. Further surface drag force decays for aluminium oxide and it enhances for copper nanoparticle. Heat transfer rate enhances with increasing all three types of nanoparticles. In addition, the lowest heat transfer rate is obtained in case of titanium dioxide when compared with copper and aluminium oxide. Keywords: Mixed convection, Stagnation point flow, Homogeneous-heterogeneous reactions, Nanofluid

Framing the performance of heat absorption/generation and thermal radiation in chemically reactive Darcy-Forchheimer flow

The present work aims to report the consequences of heterogeneous-homogeneous reactions in Darcy-Forchheimer flow of Casson material bounded by a nonlinear stretching sheet of variable thickness. Nonlinear stretched surface with variable thickness is the main agent for MHD Darcy-Forchheimer flow. Impact of thermal radiation and non-uniform heat absorption/generation are also considered. Flow in porous space is characterized by Darcy-Forchheimer flow. It is assumed that the homogeneous process in ambient fluid is governed by first order kinetics and the heterogeneous process on the wall surface is given by isothermal cubic autocatalator kinetics. The governing nonlinear ordinary differential equations are solved numerically. Effects of physical variables such as thickness, Hartman number, inertia and porous, radiation, Casson, heat absorption/generation and homogeneous-heterogeneous reactions are investigated. The variations of drag force (skin friction) and heat transfer rate (Nusselt number)for different interesting variables are plotted and discussed. Keywords: Casson fluid, Variable sheet thickness, Darcy-Forchheimer flow, Homogeneous-heterogeneous reactions, Heat generation/absorption, Thermal radiatio