Correlation of Atrial Fibrillation with Left Atrial Volume in Patients with Mitral Stenosis. a Single Centre Study From Pakistan

Background: Rheumatic heart disease has a strong association with mitral valve stenosis. Atrial fibrillation is one of the most common complications of this condition and is a poor prognostic factor. Early detection and prompt management of atrial fibrillation can help to improve the quality of life and increase the life expectancy of the patients. We carried out this study to investigate the significance of left atrial volumetric changes in mitral stenosis and its correlation with atrial fibrillation. Methodology: We audited the data of 60 patients of rheumatic heart disease who had mitral valve stenosis. The patients were randomized into atrial fibrillation (Group A) and normal sinus rhythm (Group B). We conducted this cross-sectional analytical study at Cardiology Department, Mayo Hospital, Lahore, from 1st February 2017 to 31st January 2018. We only included those patients who consented to be a part of this study and fulfilled our predefined inclusion criteria. Left atrial volume was measured by prolate ellipse method and biplane methods on echocardiography. The Data was analyzed on SPSS v20. Results: Sixty patients were included in the study. Among the subjects, thirty-six (60%) were males, and twenty-four (40%) were females. Atrial fibrillation was noted in 43.33% of the patients of mitral valve stenosis. There was a marked difference in the mean volume of the left atrium among the two groups. We observed that the mean area of the mitral valve for Group A patients was larger than that of patients in Group B. Our study showed an inverse correlation between left atrial volume and mitral valve area among Group A patients. Conclusion: Patients of mitral stenosis are at an increased risk of developing atrial fibrillation if the left atrial volume is increasing. All patients with mitral stenosis should have routine echocardiography & measurement of left atrial volumes, so that proper treatment can be started if the left atrial volume is increasing, to prevent atrial fibrillation

Woodcutting Activities in Tabuk Region (Saudi Arabia): Assessment of Conservation Knowledge

The present study aims to investigate the effect of different social factors on the woodcutting frequency in Tabuk Region. A total of 100 people participated in this study by answering the questionnaire questions. The conservation knowledge of the participants was also assessed through 4 questions (Yes or No). The final score of the conservation knowledge assessment is 4. The present study findings showed that most of people like to cut the wood for heating during winter and fall seasons. The frequency of woodcutting in Tabuk Region was once a month. Among the social factors involved in this study, education showed negative and significant relationship with the number of logging times. However, age had positive relationship with the number of logging times. The most favourbale species to be cut and used for heating and cooking in Tabuk are; Acacia tortilis, Acacia ehrenbergiana, Retama reaetam and Calligonum comosum. For the assessment of the public conservation knowledge, it was found that most of participants had moderate to good conservation knowledge as most of them answered 3 questions correctly out of 4. The conservation knowledge showed to be affected positively by education level and negatively by the number of family members. In conclusion, it was found that there is remarkable woodcutting stress on wild plants in Tabuk Region and immediate and effective actions should be performe

Simulation of blended nonlinear hydrodynamics forces using radial basis function in uniform moving frame

This study focuses on the development of a blended technique in moving frame which encompasses nonlinearities and real time simulation of the vital early design parameters using combined exact nonlinear and quasi-nonlinear forcing terms. Generally, a full three-dimensional problem needs to be solved for the precise forward speed correction. However, in this paper the forward speed end corrections are calculated by converting the two dimensional velocity potential into a three dimensional mathematical function using radial basis function then partial differentiation is performed with respect to the longitudinal direction. The difference between the forward speed correction used for time simulation in the blended method and the strip-theory in the frequency domain has been explained. The use of radial basis functions for the estimation of quasi-nonlinear combined radiation and diffraction pressures in moving frame and their conversion between two and three dimensions has been demonstrated and validated experimentally

Cost-effective Authenticated Solution (CAS) for 6G-Enabled Artificial Intelligence of Medical Things (AIoMT)

The Internet of Things (IoT) is a network of interconnected objects, which congregate and exchange gigantic amounts of data. Usually, pre-deployed embedded sensors sense this massive data. Soon, several applications of IoT are anticipated to exploit emerging 6G technology. Healthcare is one of them, where the 6G-inspired paradigm may facilitate the users to exchange information through hundreds of sensors under the assumption of Artificial Intelligence of Things (AIoT). Integration of medical sensors with AIoT is known as Artificial Intelligence of Medical Things (AIoMT). The secure and seamless interactions among 6G-enabled AIoMT users should be the primary challenge. Furthermore, resource-constrained wearable sensing devices, with their inability to execute complex security solutions, provide an ideal attraction for malicious entities to launch diverse attacks. These challenges have motivated us to design a cost-effective authenticated solution (CAS) for 6G-enabled AIoMT healthcare applications. Our CAS protocol not only prevents cyber threats like impersonation session key secrecy, but it can also prevent physical threats like hardware tampering. We observe formal and informal security validations to endorse its robustness and effectiveness. Performance comparison reveals that CAS protocol offers maximum security enrichment. Moreover, CAS is cost-effective as it has achieved 33% and 60% reduction in computation and communication overheads, respectively, compared to contemporary competing related protocols

Skill assessment of Saudi-KAU and C3S models in prediction of spring season rainfall over the Arabian Peninsula

A skillful prediction of precipitation has great value, particularly for regions that suffer from water stress. In this study, we assess the potential predictability and skill of the Copernicus Climate Change Service (C3S) and SaudiKAU models in their simulation of precipitation over the Arabian Peninsula during spring (March–May) for the period 1993–2016. For this purpose, data from individual models as well as the multi-model ensemble (MME) is used. The prediction data for MAM precipitation initialized at Feb (Lead 1), Jan (Lead 2), and Dec (Lead 3), were obtained from the 5 C3S and Saudi-KAU coupled global climate model. The potential predictability was computed by evaluating the signal to noise ratio and the theoretical limit of correlation skill, while the prediction skill was estimated from the temporal anomaly correlation co-efficient. The results show that the Saudi-KAU, CMCC, and UKMO models have slightly higher potential predictability of about 0.25, 0.35, and 0.25 respec­ tively, as compared to other models. It is also observed that individual models as well as their MME show a high (low) potential predictability over southwestern (northern) regions of the Peninsula. Moreover, the Saudi-KAU, CMCC, and MME show a reasonably good correlation skill (0.68, 0.59, and 0.57) while the SEAS model displays lower skill (0.14) for spring precipitation. All model simulations reveal a decrease in prediction skill for longer lead times. On the other hand, the individual models and their MME successfully reproduced the Pacific (i.e. ENSO) teleconnection patterns while displaying lower skill over the tropical Atlantic Ocean. The results indicate that the model biases have negative impacts on potential predictability and prediction skill over the Arabian Peninsula during the spring season

Architecture education: rubrics in Google Classroom as a tool of improving the assessment and learning

Blended learning has emerged as a promising approach in architecture education, combining face-to-face instruction with online tools such as Google Classroom, etc. for teaching and learning as well as assessment. The rubrics is a helpful grading tool that the instructors can use to rate the students’ work in a more standardized, transparent, and easy way. The well-designed rubrics can enable the students in recognising their areas of strength and weakness and it will also help them to improve the quality of their work. Although the rubrics have some limitations, several studies show that they can help teachers communicate their expectations more effectively. In this paper, the researchers discussed the effect of using the rubrics in the Google Classroom in architecture education. The rubrics were developed in Google Classroom to evaluate the main task of the subject i.e., assignments for the students of Bachelor of Architecture. The data was collected from the students through a questionnaire that was developed using the web-based Google Forms platform. The marks obtained in the assignments and the data collected through the questionnaire were presented graphically for ease of understanding. Results indicate that rubrics using Google Classroom facilitate a clearer understanding of expectations, promote consistency in grading and feedback, increased transparency, and support student self-assessment and reflection. The integration of rubrics within Google Classroom enhances students’ engagement, motivation, and overall learning experience

Prevalence and demographics of anxiety disorders: a snapshot from a community health centre in Pakistan

<p>Abstract</p> <p>Background</p> <p>The developing world is faced with a high burden of anxiety disorders. The exact prevalence of anxiety disorders in Pakistan is not known. There is a need to develop an evidence base to aid policy development on tackling anxiety and depressive disorders in the country. This is the first pilot study to address the prevalence of anxiety disorders and their association with sociodemographic factors in Pakistan.</p> <p>Methods</p> <p>A cross-sectional study was conducted among people visiting Aga Khan University Hospital (AKUH), a tertiary care facility in Karachi, Pakistan. The point prevalence of anxiety amongst the sample population, which comprised of patients and their attendants, excluding all health care personnel, was assessed using the validated Urdu version of the Hospital Anxiety and Depression Scale (HADS). The questionnaire was administered to 423 people. Descriptive statistics were performed for mean scores and proportions.</p> <p>Results</p> <p>The mean anxiety score of the population was 5.7 ± 3.86. About 28.3% had borderline or pathological anxiety. The factors found to be independently predicted with anxiety were, female sex (odds ratio (OR) = 2.14, 95% CI 1.36–3.36, p = 0.01); physical illness (OR = 1.67, 95% CI 1.06–2.64, p = 0.026); and psychiatric illness (OR = 1.176, 95% CI 1.0–3.1, p = 0.048). In the final multivariate model, female sex (adjusted odds ratio (AOR) = 2, 95% CI 1.28–3.22) and physical illness (AOR = 1.56, 95% CI 0.97–2.48) were found to be significant.</p> <p>Conclusion</p> <p>Further studies via nationally representative surveys need to be undertaken to fully grasp the scope of this emerging public health issue in Pakistan.</p

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London