Electrospun PVA/CuONPs/Bitter Gourd Nanofibers with Improved Cytocompatibility and Antibacterial Properties: Application as Antibacterial Wound Dressing

Antibacterial and cyto-compatible tricomponent composite electrospun nanofibers comprised of polyvinyl alcohol (PVA), copper II oxide nanoparticles (CuONPs), and Momordica charantia (bitter gourd, MC) extract were examined for their potential application as an effective wound dressing. Metallic nanoparticles have a wide range of applications in biomedical engineering because of their excellent antibacterial properties; however, metallic NPs have some toxic effects as well. The green synthesis of nanoparticles is undergoing development with the goal of avoiding toxicity. The aim of adding Momordica charantia extract was to reduce the toxic effects of copper oxide nanoparticles as well as to impart antioxidant properties to electrospun nanofibers. Weight ratios of PVA and MC extract were kept constant while the concentration of copper oxide was optimized to obtain good antibacterial properties with reduced toxicity. Samples were characterized for their morphological properties, chemical interactions, crystalline structures, elemental analyses, antibacterial activity, cell adhesion, and toxicity. All samples were found to have uniform morphology without any bead formation, while an increase in diameters was observed as the CuO concentration was increased in nanofibers. All samples exhibited antibacterial properties; however, the sample with CuO concentration of 0.6% exhibited better antibacterial activity. It was also observed that nanofibrous mats exhibited excellent cytocompatibility with fibroblast (NIH3T3) cells. The mechanical properties of nanofibers were slightly improved due to the addition of nanoparticles. By considering the excellent results of nanofibrous mats, they can therefore be recommended for wound dressing applications

Evaluation of Severity of Schizophrenia in Tobacco Addicts

BACKGROUND: Nicotine use is reported more in Schizophrenic patients as compared to general population, which results is decrease efficacy of psychotropic medicines, thus increased severity of illness. OBJECTIVE: The objective of this study is to evaluate the severity of schizophrenia following tobacco use. METHODOLOGY: This cross-sectional study was conducted at department of Psychiatry Civil Hospital Karachi, Pakistan. Patients were recruited using convenience sampling technique. Clinical symptoms in patients were measured by the 18-item Brief Psychiatric Rating Scale (BPRS), scored 1–7 on each item. RESULTS: Out of the 276 patients included in the study, more than half of the participants were tobacco addicts (n=150, 54%). The statistical analysis showed significant relation (p value=0.04) between the Brief Psychiatric Rating Scale (BPRS) and tobacco addiction. CONCLUSION: This study found that schizophrenia patients with tobacco addiction had worse psychiatric symptoms as compared to those who are not addicted to tobacco

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Stress Factors among Dental Postgraduate Residents of Lahore, Pakistan

OBJECTIVES: The aim of this study was to identify the stress factors among dental postgraduate residents of Lahore, Pakistan. METHODOLOGY: A cross-sectional study was conducted using non-probability convenient sampling techniques. Total 150 dental postgraduate residents were enrolled in this study. Questionnaire was composed of questions regarding stress factors and the influence of stressors on individuals. The data was analyzed; Chi-square test was used to find the statistical association of level of stress with the demographic factors (gender, marital status, and accommodation), professional characteristics (working hours and practice) and impact on the individuals (mood change, weight change and headache). The level of significance was set at P≤0.05. RESULTS: Total 150 individuals responded with a mean age of 29 years (SD +/-2.96). Male to female ratio was 1:2.5. The most prevalent factors that contributed to stress were post-graduate examination (81%), clinical case presentations (80%), competition for higher performance (61%), inconsistency of feedback by supervisors (59%), research program (55%) and fear of failure to treat patients (53%). More than half of the respondents (69%) suffered from mood swings and (65%) from tension headaches followed by clenching and bruxism in nearly half of the residents (50%), musculoskeletal problems (49%) and weight changes (48%) with p-value&lt;0.05. CONCLUSION: Post-graduate examination, competition for higher performance and increased workload are the most common stressors. There is a need to come up with effective strategies in the postgraduate curriculum to tackle stress. &nbsp

When and How Servant Leadership Leads to Megaproject Success:The Roles of Project Governance and Interpersonal Trust

Employing social exchange theory, we examined when and how servant leadership leads to megaproject success. Based on the data of 273 responses from project team members and project managers, our findings indicated that servant leadership improves project success in megaprojects by enhancing interpersonal trust. Additionally, when project governance is high, the effect of servant leadership on interpersonal trust is weaker. The study puts forth theoretical and practical implications for professionals working in mega construction projects.</p

Fungal flora and aflatoxin contamination in Pakistani wheat kernels (Triticum aestivum L.) and their attribution in seed germination

This study aimed to isolate fungal pathogens and to subsequently quantify aflatoxin (AF; B1 + B2 + G1 + G2) contamination in wheat crops grown in Pakistan. Accordingly, a total of 185 wheat samples were collected from different areas of Pakistan and numerous potent fungal pathogens were isolated. AF contamination attributed to the presence of intoxicating fungal pathogens and resulting metabolic activities were quantified using a high performance liquid chromatography-fluorescence detector coupled with postcolumn derivatization. Additionally, the effect of fungal pathogens on seed germination was also examined. The results obtained showed that 50% of tested wheat samples were found to be contaminated with a diverse range of fungal species. The rate of recurrence of fungal pathogens were Aspergillus 31%, Penicillium 9%, Fusarium 8%, Rhizopus 3%, and Alternaria 2%. The presence of Tilletia indica and Claviceps purpurea species was found to be inevident in all tested wheat samples. AFB1 contamination was detected in 48 (26.0%) samples and AFB2 in 13 (7.0%) samples. AFG1 and AFG2 were not found in any of the tested samples. The contamination range of AFB1 and AFB2 was 0.05–4.78 μg/kg and 0.02–0.48 μg/kg, respectively. The total amount of AFs (B1 + B2) found in 48 (26.0%) samples had a mean level of 0.53 ± 0.40 μg/kg and a contamination range of 0.02–5.26 μg/kg. The overall results showed that in 137 (74.0%) samples, AFs were not found within detectable limits. Furthermore, in 180 (97.2%) samples, AF levels were found to be below the maximum tolerated levels (MTL) recommended by the European Union (4 μg/kg). In five (2.7%) samples, AF contamination was higher than the MTL of the European Union. However, these samples were fit for human consumption with reference to the MTL (20 μg/kg) assigned by the USA (Food and Drug Administration and Food and Agriculture Organization) and Pakistan (Pakistan Standards and Quality Control Authority). Germination rates in healthy and contaminated wheat kernels were 84.6% and 45.2%, respectively. Based on the obtained results, it was concluded that the levels of fungal pathogen and AF contamination in Pakistani-grown wheat are not a potential threat to consumer health. However, control procedures along with a strict monitoring policy are mandatory to further minimize the prevalence of fungal carriers and the potency of AFs in crops cultivated in Pakistan

Successful pregnancy in a kidney transplant recipient with chronic hepatitis B virus infection

Overall success rate of pregnancies in kidney transplant recipients is higher than 90% if pregnancy goes beyond the 1st trimester. Risks to mother include hypertension, preeclampsia, infections, and worsening proteinuria, and those to the fetus are prematurity, intrauterine growth retardation, and low birth weight. Hepatitis B infection is associated with progressive liver disease and diminished survival in kidney transplant recipients. A 32-year-old woman had undergone living unrelated donor kidney transplant. Two years after transplantation, she presented with live gestation of 6 weeks. She was also found positive for hepatitis B surface antigen and extracellular antigen. Liver enzymes were normal and ultrasonography findings were normal. Cyclosporine dose was reduced and lamivudine was started. She was monitored closely until 33 weeks, when she gave birth to a healthy female baby through spontaneous vaginal delivery. The newborn received vaccination and immunoglobulins for hepatitis B virus. Mother\u27s kidney allograft function remained stable throughout pregnancy

Physical layer security analysis using radio frequency‐fingerprinting in cellular‐V2X for 6G communication

Abstract It is anticipated that sixth‐generation (6G) systems would present new security challenges while offering improved features and new directions for security in vehicular communication, which may result in the emergence of a new breed of adaptive and context‐aware security protocol. Physical layer security solutions can compete for low‐complexity, low‐delay, low‐footprint, adaptable, extensible, and context‐aware security schemes by leveraging the physical layer and introducing security controls. A novel physical layer security scheme that employs the concept of radio frequency fingerprinting (RF‐FP) for location estimation is proposed, wherein the RF‐FP values are collected at different points with in the cell. Then, based on the estimated location, the nearest possible road‐side unit for sending the information signal is located. After this, the effects on secrecy capacity (SC) and secrecy outage probability (SOP) in the presence of multiple eavesdropper per unit time are analysed. It has been shown via simulations that the proposed RF‐FP scheme increases SC by up to 25% for the same signal‐to‐noise ratio (SNR) values as those of the benchmarks, while the SOP tends to decrease by up to 30% as compared to the benchmark scheme for the same SNR value. Thus, the proposed RF‐FP‐based location estimation provides much better results as compared to the existing physical layer security schemes

Electrospun PVA/CuONPs/Bitter Gourd Nanofibers with Improved Cytocompatibility and Antibacterial Properties: Application as Antibacterial Wound Dressing

Antibacterial and cyto-compatible tricomponent composite electrospun nanofibers comprised of polyvinyl alcohol (PVA), copper II oxide nanoparticles (CuONPs), and Momordica charantia (bitter gourd, MC) extract were examined for their potential application as an effective wound dressing. Metallic nanoparticles have a wide range of applications in biomedical engineering because of their excellent antibacterial properties; however, metallic NPs have some toxic effects as well. The green synthesis of nanoparticles is undergoing development with the goal of avoiding toxicity. The aim of adding Momordica charantia extract was to reduce the toxic effects of copper oxide nanoparticles as well as to impart antioxidant properties to electrospun nanofibers. Weight ratios of PVA and MC extract were kept constant while the concentration of copper oxide was optimized to obtain good antibacterial properties with reduced toxicity. Samples were characterized for their morphological properties, chemical interactions, crystalline structures, elemental analyses, antibacterial activity, cell adhesion, and toxicity. All samples were found to have uniform morphology without any bead formation, while an increase in diameters was observed as the CuO concentration was increased in nanofibers. All samples exhibited antibacterial properties; however, the sample with CuO concentration of 0.6% exhibited better antibacterial activity. It was also observed that nanofibrous mats exhibited excellent cytocompatibility with fibroblast (NIH3T3) cells. The mechanical properties of nanofibers were slightly improved due to the addition of nanoparticles. By considering the excellent results of nanofibrous mats, they can therefore be recommended for wound dressing applications