A COMPARATIVE STUDY TO DETERMINE THE EFFECTS OF VARIABLE CONCENTRATIONS AND DIFFERENT ROUTES OF ADMINISTRATION OF LIDOCAINE IN SUPPRESSING COUGH AND ON HEMODYNAMIC RESPONSE DURING EXTUBATION IN PEDIATRIC AGE GROUP: AN OBSERVATIONAL PROSPECTIVE STUDY

Objectives: The objectives of this study were to compare the effects of different concentrations of lidocaine (2% endotracheal [ET] spray; 10% ET spray; and 2% intravenous [IV]) in suppressing cough and on hemodynamic response during extubation in pediatric age groups; an observational prospective study. Methods: Ninety patients were enrolled for the study and divided into three groups. In Group A, patients were administered (1 mg/kg) of 2% lidocaine ET spray 5 min before extubation; in Group B, patients were administered (1 mg/kg) of 10% lidocaine ET spray 5 min before extubation; and in Group C patients were administered (1 mg/kg) 2% lidocaine IV 3 min before extubation. The three groups were compared for hemodynamic parameters, incidence of cough, breathing pattern, and need for continuous positive airway pressure (CPAP). Results: There was significant attenuation of hemodynamic parameters and less incidence of cough and labored breathing in patient receiving either 10% ET or 2% IV lidocaine. As compared to 2% ET lidocaine, requirement of CPAP support was less in patients who received 10% lidocaine. Patients who were administered 2% IV lidocaine did not receive any CPAP support postextubation. Conclusion: As compared to 2% lidocaine spray postextubation, both 10% lidocaine spray and 2% IV lidocaine postextubation have significantly positive effect on suppression of cough and on hemodynamic parameters

Effects of foliar application of melatonin on gas exchange and certain biochemical characteristics broccoli cv. Palam Samridhi

Considering the rich nutritional status and possibility of broccoli in improving the profitable yield, and wide role of Mel in regulating the plant physiological process, an investigation was carried out at the division of Basic Sciences and Humanities during 2017 to investigate the effect of foliar application of Mel on leaf photosynthetic and biochemical attributes broccoli. Thirty days old and uniform seedlings of broccoli cv. Palam Samridhi were transplanted in the field at a spacing of 45 × 45cm. Different concentrations of Mel, viz. 0, 20, 40, 60 and 80 ppm were sprayed on the plant foliage at 15 days after transplanting (DAT) replicating each treatment four times. Leaf gas exchange and biochemical attributes were tested following the standard procedures. The Results showed the lowest stipulated rate of photosynthesis (10.87 µmole.m-2.sec-1), stomatal conductance (301.44 mole H2O.m-2ses-1) and leaf transpiration (1. 14 mole H2O.m-2ses-1) in untreated plants.  Different doses of Mel significantly increased the values of these attributes and the highest values of photosynthesis (18.63 µmole.m-2.sec-1), stomatal conductance (324.37 mmole.m-2.ses-1) and leaf transpiration (3.23 mmole.m-2.ses-1) with Mel 60 ppm were recorded. The alterations in different biochemical attributes were also evident due to foliar application of Mel and maximum leaf sugar (77.0 and 85.9µg/g), protein (56.9 and 77.3 µg/g), total phenols (260.1 and 339.9 mg/100g), antioxidants (142.8 and 159.9 mg GAE /100g DW) and MSI (94.89 and 97.43 percent) values with Mel 60ppm at 30 and 60DAT, respectively. Therefore, the present study signifies the useful effects of Mel in regulating the physio-biochemical properties of broccoli

Assessment of protein silver nanoparticles toxicity against pathogenic Alternaria solani

Mycogenic synthesis of silver nanoparticles (AgNPs) was carried out in the present investigation using an aqueous extract of endophytic non-pathogenic Alternaria solani F10 (KT721914). The mycosynthesized AgNPs were characterized by means of spectroscopic and microscopic techniques. The surface plasmon resonance found at 430 nm confirmed the formation of stable AgNPs for several weeks at room temperature. Also, the results revealed the formation of spherical and monodispersed AgNPs with an average size of 14.8 +/- 1.2 nm. The FT-IR spectrum suggested that the fungal extracellular proteins and secondary metabolites had the role in Ag reduction and AgNPs capping of which protein Ag nanoconjugates were formed. Furthermore, the mycosynthesized AgNPs exhibited potent antifungal activity against different pathogenic isolates of the same Alternaria solani fungus, the causal pathogen of tomato early blight disease. The antifungal efficiency of the AgNPs at 1, 5 and 10 ppm were evaluated for 8 days after incubation by measuring the inhibition rate of fungal radial growth. The results were further supported by investigating fungal hyphae morphology alteration by scanning and transmission electron microscopy. Treated fungal hyphae showed formation of pits and pores. Also, the mycosynthesized AgNPs were able to pass and distribute throughout the fungal cell area and interact with the cell components.A financial support from European Commission by Erasmus Mundus Scholarship-ACTION 2 WELCOME program is gratefully acknowledged. Work in JAD laboratory was supported by grant BIO2014-54269-R from the Ministerio de Economia y Competividad (Spain).Abdel-Hafez, SII.; Nafady, NA.; Abdel-Rahim, IR.; Shaltout, AM.; Daros Arnau, JA.; Mohamed, MA. (2016). Assessment of protein silver nanoparticles toxicity against pathogenic Alternaria solani. 3 Biotech. 6(199):1-12. https://doi.org/10.1007/s13205-016-0515-6S1126199Abd-Alla MH, Nafady NA, Khalaf DM (2016) Assessment of silver nanoparticles contamination on faba bean-Rhizobium leguminosarum bv. viciae-Glomus aggregatum symbiosis: implications for induction of autophagy process in root nodule. Agric Ecosyst Environ 15(218):163–177Abdel-Hafez SI, Nafady NA, Abdel-Rahim IR, Shaltout AM, Mohamed MA (2016) Biogenesis and optimisation of silver nanoparticles by the endophytic fungus cladosporium sphaerospermum. Int J Nano Chem 2(1):11–19Agrios GN (1997) Plant pathology, 4th edn. Academic Press, LondonAzizi S, Namvar F, Mahdavi M, Ahmad MB, Mohamad R (2013) Biosynthesis of silver nanoparticles using brown marine macroalga, Sargassum muticum aqueous extract. 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Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Purification and Characterization of Glutaminase Free Asparaginase from Enterobacter cloacae: In-Vitro Evaluation of Cytotoxic Potential against Human Myeloid Leukemia HL-60 Cells.

Asparaginase is an important antileukemic agent extensively used worldwide but the intrinsic glutaminase activity of this enzymatic drug is responsible for serious life threatening side effects. Hence, glutaminase free asparaginase is much needed for upgradation of therapeutic index of asparaginase therapy. In the present study, glutaminase free asparaginase produced from Enterobacter cloacae was purified to apparent homogeneity. The purified enzyme was found to be homodimer of approximately 106 kDa with monomeric size of approximately 52 kDa and pI 4.5. Purified enzyme showed optimum activity between pH 7-8 and temperature 35-40°C, which is close to the internal environment of human body. Monovalent cations such as Na+ and K+ enhanced asparaginase activity whereas divalent and trivalent cations, Ca2+, Mg2+, Zn2+, Mn2+, and Fe3+ inhibited the enzyme activity. Kinetic parameters Km, Vmax and Kcat of purified enzyme were found to be 1.58×10-3 M, 2.22 IU μg-1 and 5.3 × 104 S-1, respectively. Purified enzyme showed prolonged in vitro serum (T1/2 = ~ 39 h) and trypsin (T1/2 = ~ 32 min) half life, which is therapeutically remarkable feature. The cytotoxic activity of enzyme was examined against a panel of human cancer cell lines, HL-60, MOLT-4, MDA-MB-231 and T47D, and highest cytotoxicity observed against HL-60 cells (IC50 ~ 3.1 IU ml-1), which was comparable to commercial asparaginase. Cell and nuclear morphological studies of HL-60 cells showed that on treatment with purified asparaginase symptoms of apoptosis were increased in dose dependent manner. Cell cycle progression analysis indicates that enzyme induces apoptosis by cell cycle arrest in G0/G1 phase. Mitochondrial membrane potential loss showed that enzyme also triggers the mitochondrial pathway of apoptosis. Furthermore, the enzyme was found to be nontoxic for human noncancerous cells FR-2 and nonhemolytic for human erythrocytes

Impact of Green Entrepreneurial Orientation and Green Human Resource Management Practices on the Sustainable Performance: Mediating Role of Green Supply Chain Management in Manufacturing Pakistan

Purpose: This study examines how green human resource management and entrepreneurial orientation affect Pakistani manufacturing firms&nbsp; &nbsp;sustainability performance. The study also examines how green supply chain management mediates sustainable company performance and green entrepreneurship Design/Methodology/Approach: This study analyzed employees data from 340 registered manufacturing using random sampling. Exploratory and quantitative research uses structural equation modelling and partial least square methods to examine data. Findings: Our key findings are following, Green HR management at first performance. secondly, green entrepreneurial mentality boosts sustainability performance of the manufacturing sector. The third green supply chain management pillar promotes green entrepreneurship and sustainable business performance. The research takes a fresh approach to sustainable performance theory, green human resource management, and green entrepreneurial strategy. Implications/Originality/Value: &nbsp;The study shows that green supply chain management may improve sustainability by promoting green entrepreneurial attitude and green human resource management. Management implications and future suggestions are found in the research.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp