Variations in genomic epidemiology and in-silico screening of potential phytochemicals to cure Monkeypox

Monkeypox virus (MPXV) is passed on when people encounter infectious animals. Before April 2022, the Monkeypox virus was reported only in South Africa and its surrounding region but now it has been spread all over the world. This Monkeypox virus consumes an incubation period of five to twenty-one days and can be communicated through direct contact, breathing, contaminated towels, bedding, and so on. The Orthopoxvirus variety is a subfamily of the Poxviridae family that incorporates the Monkeypox infection. Their unique property is to suppress the host defense system and to exploit host immunity. Treatment of Monkeypox involves two vaccines named JYNNEOSTM and ACAM2000. Antiviral medications can be considered for serious diseases, immunocompromised patients, pediatrics, pregnant and lactating ladies, complex sores, and when injuries happen close to the mouth, eyes, and privates. This review article gives a basic information ofA48R, a thymidine kinase, which is involved in DNA replication pathways in the Monkeypox virus. The potential drugs for A48R inhibition like NMCT and rutaecarpine are considered good synthetic drugs. The maximum affinity -18 was shown by phytochemical dictamnine, amentoflavone -7.5, citral -7.8, and naringin – 6.6 which can be isolated from different plants.  The purpose of this review article is to describe variations in genomic epidemiology and in-silico screening of potential phytochemicals to cure Monkeypox.Keywords: Monkeypox virus; Orthopoxvirus; Poxviridae; A48R; Phytochemicals

EFFECT OF HUDIARA DRAIN ON THE QUALITY OF GROUNDWATER IN THE HOUSING SCHEMES OF LAHORE

A study was carried out to assess the effect of Hudiara Drain on groundwater quality in its vicinity, particularly some well planned residential neighborhoods such as Khayaban-e-Amin and Valencia in the city of Lahore (Qadeer, 2011). A total of eleven sampling points were selected. Three samples were collected from Hudiara Drain and eight samples were drawn from deep and shallow groundwater wells. Eight physical, chemical and biological parameters including pH, turbidity, total dissolved solids, total hardness, chloride, total iron, lead and total coliforms were examined and compared with the desired values mentioned in National Standards for Drinking Water Quality (NSDWQ) and World Health Organization (WHO) guidelines. The test results indicated that physical quality of all groundwater sources was satisfactory. Chemical quality of all groundwater sources was satisfactory for total dissolved solids (TDS), total hardness, and chlorides, however for total iron and lead the water quality was not meeting NSDWQ and WHO guidelines. Bacteriological contamination was also detected in almost all groundwater samples. The presence of higher concentrations of lead in groundwater certainly indicates that there is an external effect on groundwater. It is recommended that release of industrial wastewater in Hudiara Drain should be controlled and strictly monitored. In addition, proper disinfection should be practiced at the tube wells to ensure safe drinking water at the consumers end

100% saturated liquid hydrogen production: Mixed-refrigerant cascaded process with two-stage ortho-to-para hydrogen conversion

To reduce CO2 emissions and address climate change concerns, most futuristic studies investigating 100% renewable energy sources and subsequent power-to-gas/fuel/liquid/X technological developments have been based on hydrogen (H-2). The long-term storage and transportation of H-2 over long distances restrict its feasibility as an energy vector, mainly due to its low energy density. Liquefaction is a promising approach for overcoming these issues. However, it requires a large amount of energy, and if H-2 itself is used to provide this energy, then 25% to 35% of the initial quantity of H-2 is consumed. The existing H-2 liquefaction plants have specific energy consumption values in the range of 10-12 kWh/kg(LH2) and exergy efficiencies in the range of 20%-30% with complicated configurations. Therefore, a thermodynamically efficient and compact design is required to facilitate a roadmap to H-2 economy. This paper proposes a simple, energy-efficient, and cost-effective process for H-2 liquefaction. Three refrigeration cycles with optimal mixed-refrigerant compositions are used, which makes the proposed process energy-efficient. Additionally, two-stage ortho-to-para conversion makes the process compact. The proposed process is unique in terms of its configuration and mixed-refrigerant combination. The modified coordinate descent approach was adopted to identify the optimal design variables for the proposed H-2 liquefaction process. The proposed process consumes an energy of 6.45 kWh/kg(LH2), which is 36.5% and 16.1% lower than that consumed by the base design of the proposed process and a published base case, respectively. Additionally, the exergy efficiency of the proposed process is 47.2%. This study will help process engineers achieve a sustainable green economy by improving the competitiveness of H-2 storage and transportation over long distances

Evaluation of the effectiveness of different herbicides against a new weed Japanese brome (Bromus japonicus Houtt.) in wheat crop

A field experiment was conducted to evaluate the efficacy of different post emergence herbicides for the control of monocot weed the Japanese broom (Bromus japonicus ) in wheat crop. Five herbicides viz., metribuzin, isoproturon, metribuzin plus isoproturon, Atlantis and sulfosulfuron were used at their recommended doses in RCBD with three replications. The weedy check was kept as control where no herbicide was sprayed. All the herbicides were applied as post-emergence after second irrigation at 60 days after sowing the crop. The lowest weed counts per m2 (0.583) and highest percent of weed mortality (99.07%) were observed where metribuzin plus isoproturon was used. This was followed by Atlantis with 3.26 weeds per m2 with 95.14% mortality of weeds. However, significantly higher 1000 grain weight was noted with Atlantis (29.50 g) and metribuzin plus isoproturon (28.58 g). The treatments did not differ significantly with respect to 1000 grain weight. All the herbicide helped to increase the yield from 16 to 22%, but did not differ significantly with respect to yield gain. The highest yield (3759.40 kg ha-1) was produced by Atlantis followed by sulfosulfuron (3757.20 kg ha-1 ). On the basis of cost benefit ratio sulfosulfuron (34.95) proved to be the best followed by metribuzin (16.78). Therefore, sulfosulfuron and metribuzin are recommended for the control of Bromus weed in wheat crop

Biogas to liquefied biomethane: Assessment of 3P's–Production, processing, and prospects

Sustainable scale-up of biomethane to overcome the dependency on fossil energy sources is still not matured, fundamentally owing to its production and availability at a lower pressure (i.e., atmospheric) compared with the conventional natural gas. This is a fundamental assessment that specifically aims to overview the biogas production, cleaning technologies, upgrading technologies, and possible biomethane liquefaction technologies. The digestion technologies for biogas production are analyzed in terms of their important operating and performance parameters corresponding to optimum digester operation. The cleaning and upgrading technologies are assessed corresponding to their competitive factors, merits, and associated challenges. Cryogenic separation relies on different technologies that are based on different mechanisms (anti-sublimation, distillation, etc.). These technologies have been recently studied for CO2 removal from high CO2-content natural gas, showing promising results for application to biogas upgrading, in particular if the final goal is liquefaction. Since liquefaction itself is an energy- and cost-intensive process, cryogenic separation is synergistic in obtaining upgraded and liquefied biomethane in a single process unit, instead of integrating liquefaction with other upgrading technologies. Among all available liquefaction technologies, the nitrogen expander-based liquefaction processes are most promising candidates to produce liquified biomethane (LBM), mainly due to small investment costs, simple operation, and compact design. This study suggests that there is a need to design energy-efficient small-scale biomethane liquefaction processes following biogas upgrading. Thus, incorporating biogas in the energy mix would result in economic, environmental, and climate benefits, globally

Developing a communication-skills training curriculum for resident-physicians to enhance patient outcomes at an academic medical centre: An ongoing mixed-methods study protocol

Introduction: Effective physician-patient communication is directly linked to enhanced patient safety, improved healthcare quality and health outcomes. Numerous studies have been done to implement and reinforce communication skills as core competencies to be acquired during residency training for providing culturally competent care. Pakistan has an ethnically diverse culture with people from varying diasporas. Hence there is a need to develop a curriculum that teaches cultural competency to residents. Thus, the aim of this study is (1) the identification of existing problems of communication skills among residents across various specialties, and (2) to strategise a communication skills curriculum by organising a conference of experts based on the Delphi method/estimate-talk-estimate method.Methods and analysis: This study is divided into two phases. The first phase will employ a mixed-methods approach whereby the perceptions of attendings, residents, fellows, nurses, medical students and patients about resident-patient communication will be assessed via validated surveys, focused group discussions and in-depth interviews. Quantitative and qualitative data will be analysed using Stata and NVivo, respectively. The second phase is the development of a communication skills curriculum for residents based on results from phase one and a Delphi consensus involving medical education experts. Both phases will be conducted at a tertiary care hospital in Karachi, Pakistan.Ethics and dissemination: This study has received ethical approval from the Ethical Review Committee at the Aga Khan University (2021-6041-17126). All participants will be mandated to provide informed consent and their confidentiality will be maintained by using de-identifiers and limiting access of the data to the research team only. The findings from this study will be presented in the form of original research papers

Development, outcome and costs of a simulation-based neurosurgery bootcamp at the national level

Abstract Introduction With a growing interest in simulation-based training to develop clinical proficiency, bootcamps have been utilized for imparting basic skills to medical trainees. While considerable research on the topic exists in high income countries, no such neurosurgical teaching standards have been employed in Low- and Middle-Income Countries. Methods We conducted a cross-sectional study to explore the effectiveness of first low-cost, multi-center regional neurosurgery bootcamp in South Asia. Twenty-two participants attended the bootcamp and practiced 12 hands-on skills over the course of 2 days. Burr-holes and craniotomies were done on 3D printed skulls. Lumbar drain insertion was practiced on a purpose-built lumbar puncture mannequin. For laminectomy, we used an in-house designed simulation. The modified Objective Structured Assessment of Technical Skills tool was utilized for skills Assessment. Feedback from faculty and residents was collected via a standard 5-point Likert scale. Results Only one participant (4.55%) had previously attended a neurosurgical skills workshop. Comparison of outcomes on 1st and 3rd attempts of cranial and spinal skills showed a significant improvement in all 14 domains assessed (p <0.05). Positive feedback was received ranging from 3.9 up to 4.8 on a 5-point Likert scale. Overall cost per participant culminated to $145, significantly lower than previously reported data. Conclusion Our findings report the effectiveness of sustainable, low-cost training models which can be easily reproduced elsewhere. These indigenously designed simulators can be modified for variable difficulty level and serve as an effective educational strategy in improving learners’ skills, knowledge and confidence

Barriers to research productivity amongst postgraduate trainees: Results from a survey of 333 medical and surgical residents

Purpose: We aimed to determine the perceptions of, barriers to, and predictors of research engagement amongst residents at a national level in Pakistan.Methods: This cross-sectional study used REDCap for online survey dissemination to residents from 12 institutes accredited by the national accreditation body (College of Physicians and Surgeons Pakistan) for core medical and surgical specialties. Logistic regression was used to estimate associations between likelihood of publications and participant characteristics.Results: The response rate was 79% (333/423), with 171 (51%) medical and 162 (49%) surgical residents. The mean ± standard deviation age was 28.8 ± 2.7 years; 137 (41%) were males and 195 (59%) females. More than half the residents, 202 (61%), had received research training, but 189 (57%) scored \u3c33% on basic research knowledge. While most residents agreed on the positive impact of research on their careers (P = .012) and realized that they should be involved in it (P = .33), they also strongly believed that it was difficult to engage in research during training (P \u3c .01). Only 60 (18%) trainees had published a paper in local and 37 (11%) in international journals, respectively. The most significant barriers to conducting research included time limitation due to clinical work, lack of financial support, and unavailability of data (P \u3c .01).Conclusion: Residents have a positive attitude towards research. However, research engagement among residents is low. Improving research mentorship and creating systems that enable protected time and institutional access to data are needed to increase research output of postgraduate trainees

Leveraging the vantage point - exploring nurses\u27 perception of residents\u27 communication skills: A mixed-methods study

Introduction: Effective communication is key to a successful patient-doctor interaction and improved healthcare outcomes. However, communication skills training in residency is often subpar, leading to inadequate patient-physician communication. There is a dearth of studies exploring the observations of nurses - key members of healthcare teams with a special vantage point to observe the impact of residents\u27 communication with patients. Thus, we aimed to gauge the perceptions of nurses regarding residents\u27 communication skills expertise.Methods: This study employed a sequential mixed-methods design, and was conducted at an academic medical center in South Asia. Quantitative data was collected via a REDCap survey using a structured validated questionnaire. Ordinal logistic regression was applied. For qualitative data, In-depth interviews were conducted with nurses using a semi-structured interview guide.Results: A total of 193 survey responses were obtained from nurses hailing from various specialties including Family Medicine (n = 16), Surgery (n = 27), Internal Medicine (n = 22), Pediatrics (n = 27), and Obstetrics/Gynecology (n = 93). Nurses rated long working hours, infrastructural deficits, and human failings as the main barriers to effective patient-resident communication. Residents working in in-patient settings were more likely to have inadequate communication skills (P-value = 0.160). Qualitative data analysis of nine in-depth interviews revealed two major themes: existing status-quo of residents\u27 communication skills (including deficient verbal and non-verbal communication, bias in patient counselling and challenging patients) and recommendations for improving patient-resident communication.Conclusion: The findings from this study highlight significant gaps in patient-resident communication from the perception of nurses and identify the need for creating a holistic curriculum for residents to improve patient-physician interaction

Representative quotations from qualitative focus group discussions.

Representative quotations from qualitative focus group discussions.</p