Visceral leishmaniasis among children presenting with pancytopenia

Background: Pancytopenia can result from either a failure of production of hematopoietic progenitors or peripheral destruction of a cellular element either due to infection, immune-mediated damage or hypersplenism. Visceral leishmaniasis (VL), one of the chronic parasitic diseases in the world that affects millions of people recently, leishmaniasis has been seen with increasing frequency in patients with Pancytopenia.Objective: To determine the frequency of visceral leishmaniasis among children presenting with pancytopenia at Pediatric Department, Azzd Jammu and Kashmir Medical College MuzaffarabadMethodology This cross sectional study was conducted at the Department of paeds SKBZ/ CMH, Muzaffarabad. The study duration was 6 months from June 2018 to December 2018. All children with pancytopenia either of gender were enrolled. After taking informed demographic information, all the cases underwent bone marrow sampling to assess the Visceral Leishmaniasis. All the data was collected by self-made proforma.Results: Total 75 patients were studied; their mean age of patients was 6.74±3.14 years. Males were in majority 67.69% and 32.31% were females. Leishmaniasis was found 15.38% of the cases. Leishmaniasis was statistically insignificant according to age and gender; p-values were quite insignificant.Conclusion: It is concluded that the visceral leishmaniasis in children with pancytopenia was 15.38%

Suitability of various plant derived gelling agents as agar substitute in microbiological growth media

Eleven putative gelling agents were investigated as agar substitutes. These included arrowroot (Maranta arundinaceae), coconut powder (Cocos nucifera), corn flour (Zea mays var. amylacea), gel rite (a water-soluble polysaccharide produced by Sphingomonas elodea), glue (Cyanoacrylates), katira gum (Cochlospermum religiosum), guar gum (Cyamopsis tetragonolobus L.), isubgol husk (Plantago ovata), pectin and rice (Oryza sativa L.) powder. Among these, guar gum was found a promising alternate candidate for agar. Media solidified with 2.8% guar gum was transparent and supportive for the growth of three test fungi (Trichoderma harzianum, Alternaria alternata and Alternaria solani) as good as agar. Guar gum also excelled in terms of cost benefit ratio when compared with agar. Guar gum fortified media was found to cost $0.005/L as compared to agar supplemented media costing$ 1.17/L. Further, guar gum is easily available and can be added with ease thereby serving as a suitable and inexpensive substitute of agar and thus, can be adopted for routine microbiological testing in resource poor countries.Key words: Guar gum, media, agar, gelling agents

BIM-driven energy simulation and optimization for net-zero tall buildings: sustainable construction management

The growing demand for sustainable and energy-efficient buildings, particularly in the context of tall structures, has prompted increased attention to innovative solutions. Despite advancements in Building Information Modelling (BIM) technology, there exists a critical gap in understanding its comprehensive application for achieving net-zero energy consumption in tall buildings, particularly in the Malaysian construction industry. This research addresses this gap by presenting a novel strategy that integrates BIM technology with energy analysis tools for net-zero tall buildings in Malaysia. The aim of the study is to contribute valuable insights to the construction industry, policymakers, and researchers by conducting empirical research, utilizing case studies, validating the proposed framework, advancing sustainable design practices, and supporting the transition towards net-zero energy tall buildings in Malaysia. The methodology involves a three-phase approach, including qualitative analysis, a pilot survey, and a main questionnaire. Exploratory factor analysis (EFA) validates the categorization derived from qualitative interviews, while Partial Least Squares Structural Equation Modelling (PLS-SEM) assesses the convergent and discriminant validity of the measurement model. Hypotheses testing using bootstrapping establishes the significance of correlations between BIM deployment and key factors such as early design integration, enhanced energy efficiency, optimized system integration, predictive performance analysis, and validation of sustainable design. The research findings support the positive associations between BIM deployment and the mentioned factors, providing statistical significance through T-statistics and p-values. The implications of this research extend beyond the Malaysian context, offering valuable insights for architects, engineers, and stakeholders involved in designing and managing sustainable tall buildings. By addressing the identified gaps and leveraging BIM technology effectively, stakeholders can contribute to the construction of net-zero energy structures, aligning with global efforts towards sustainable and energy-efficient building practices

COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records

BACKGROUND: Updatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, we aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework. METHODS: In this cohort study, we used eight linked National Health Service (NHS) datasets for people in England alive on Jan 23, 2020. Data on COVID-19 testing, vaccination, primary and secondary care records, and death registrations were collected until Nov 30, 2021. We defined ten COVID-19 phenotypes reflecting clinically relevant stages of disease severity and encompassing five categories: positive SARS-CoV-2 test, primary care diagnosis, hospital admission, ventilation modality (four phenotypes), and death (three phenotypes). We constructed patient trajectories illustrating transition frequency and duration between phenotypes. Analyses were stratified by pandemic waves and vaccination status. FINDINGS: Among 57 032 174 individuals included in the cohort, 13 990 423 COVID-19 events were identified in 7 244 925 individuals, equating to an infection rate of 12·7% during the study period. Of 7 244 925 individuals, 460 737 (6·4%) were admitted to hospital and 158 020 (2·2%) died. Of 460 737 individuals who were admitted to hospital, 48 847 (10·6%) were admitted to the intensive care unit (ICU), 69 090 (15·0%) received non-invasive ventilation, and 25 928 (5·6%) received invasive ventilation. Among 384 135 patients who were admitted to hospital but did not require ventilation, mortality was higher in wave 1 (23 485 [30·4%] of 77 202 patients) than wave 2 (44 220 [23·1%] of 191 528 patients), but remained unchanged for patients admitted to the ICU. Mortality was highest among patients who received ventilatory support outside of the ICU in wave 1 (2569 [50·7%] of 5063 patients). 15 486 (9·8%) of 158 020 COVID-19-related deaths occurred within 28 days of the first COVID-19 event without a COVID-19 diagnoses on the death certificate. 10 884 (6·9%) of 158 020 deaths were identified exclusively from mortality data with no previous COVID-19 phenotype recorded. We observed longer patient trajectories in wave 2 than wave 1. INTERPRETATION: Our analyses illustrate the wide spectrum of disease trajectories as shown by differences in incidence, survival, and clinical pathways. We have provided a modular analytical framework that can be used to monitor the impact of the pandemic and generate evidence of clinical and policy relevance using multiple EHR sources. FUNDING: British Heart Foundation Data Science Centre, led by Health Data Research UK

Super-MAC: Data Duplication and Combining for Reliability Enhancements in Next-Generation Networks

A piece of user equipment (UE), typically, has access to multiple radio access technologies (RATS). Moreover, apart from the standard primary cellular network, the secondary cellular networks can assist the primary network in downlink UE communications. In this way, the data can reach the UEthrough multiple entities. This paper exploits the multiple entities' idea by proposing a cross-layer scheme that combines data to improve the block error rate (BLER) and the throughput. For this, we define a new entity, called the super-MAC, just above the Medium Access Control (MAC) layer. Morespecifically, we propose data duplication (at the transmitter) and combining (at UE) at the super-MAC, where the super-MAC gets the Radio Link Layer protocol data unit (RLC-PDU) and sends multiple-copies across various interfaces to different MAC-entities. In doing so, the super-MAC attaches a unique sequence number to a group of RLC-PDUs together. At the UE, the data from different MAC entities are combined at super-MAC to clear any block error. The super-MAC operates in between the CyclicRedundancy Check and Forward Error Correction stages of the HARQ process. The additional complexityintroduced by the scheme is negligible in front of the existing operations. Moreover, the average latency improves due to the significant improvement in the Block Error rate (BLER) that the combining scheme offers over the BLER of the conventional standalone system. Also, since the errors significantly reduce, the throughput shows significant improvement. Finally, the proposed scheme is an advancement in HARQ to reduce retransmissions, and hence it is suitable for the next-generation networks like B5G or 6G to adopt the super-MAC

Reliability Enhancement by PDCP Duplication and Combining for Next Generation Networks

User equipment (UE), in general, has access to multiple radio access technologies (RATS). Besides, secondary base-stations can also aid the UE's communication. Thus data can reach the UE from the primary base-station via multiple secondary base-stations. Taking advantage of the benefits of using such multiple paths, we propose in this paper a cross-layer scheme that improves block error rate (BLER) and throughput. We propose data duplication and integration at the Packet Data Convergence Protocol (PDCP) sublayer of layer 2 for downlink operations of 4G LTE / 5G NR. At the PDCP of ENodeB (gnodeB), the PDCP protocol data unit (PDU) is duplicated and sent to the UE via various paths. All these PDUs have the same sequence number (SN). Data from various networks are aptly linked using the PDCP assigned SN at EnodeB to obtain a composite and improved version of the PDU at UE. Although the cross-layer technique involves new procedures when combining data at PDPCP, the average delay for a PDCP-based aggregation scheme is very small compared with the standalone scheme because of the significant improvement in the block error rate (BLER) provided by the scheme over the BLER of the traditional standalone system. Finally, the BLER improvement results in throughput enhancement. © 2021 IEEE

Petrographic and Geochemical Analysis of Indus Sediments: Implications for Placer Gold Deposits, Peshawar Basin, NW Himalaya, Pakistan

Alluvial placer gold deposits that accumulate in streams across the globe are essentially allochthonous sedimentary deposits that are transported from their source to their location of deposition. The purpose of this study was to find placer gold deposits in alluvial sediments along the Indus River in the NW Himalaya of Pakistan. The investigated region was divided into five clusters based on river morphology. The research focused on mineralogical distribution, sediment source, gold transport distance, elemental composition, and gold concentration in river sediments. Throughout, during the deposition at point and channel bars, the mixed source of alluvial sediments was revealed by its mineralogical composition. However, the SEM analysis demonstrated that the gold grains had a high flatness index, indicating that they had been transported a significant distance. The elemental composition of several samples revealed a significant concentration of silicon dioxide, iron oxide, and alumina oxide transported from the Himalaya. The study of the trace elements indicated gold and related base metals with granitic provenance were transported from an acidic/granitic source. Based on gold concentration, it is demonstrated that the left riverbank (clusters C1, C2, and C3) has a higher concentration of gold deposits and higher potential for economic gold exploration than the right bank (clusters C4 and C5) due to the lower velocity of running water in the study area. The findings revealed that the studied area has good potential for commercial exploration of gold resources, and the workflow can be adopted in any region with a similar geological setting and morphology

Petrographic and Geochemical Analysis of Indus Sediments: Implications for Placer Gold Deposits, Peshawar Basin, NW Himalaya, Pakistan

Alluvial placer gold deposits that accumulate in streams across the globe are essentially allochthonous sedimentary deposits that are transported from their source to their location of deposition. The purpose of this study was to find placer gold deposits in alluvial sediments along the Indus River in the NW Himalaya of Pakistan. The investigated region was divided into five clusters based on river morphology. The research focused on mineralogical distribution, sediment source, gold transport distance, elemental composition, and gold concentration in river sediments. Throughout, during the deposition at point and channel bars, the mixed source of alluvial sediments was revealed by its mineralogical composition. However, the SEM analysis demonstrated that the gold grains had a high flatness index, indicating that they had been transported a significant distance. The elemental composition of several samples revealed a significant concentration of silicon dioxide, iron oxide, and alumina oxide transported from the Himalaya. The study of the trace elements indicated gold and related base metals with granitic provenance were transported from an acidic/granitic source. Based on gold concentration, it is demonstrated that the left riverbank (clusters C1, C2, and C3) has a higher concentration of gold deposits and higher potential for economic gold exploration than the right bank (clusters C4 and C5) due to the lower velocity of running water in the study area. The findings revealed that the studied area has good potential for commercial exploration of gold resources, and the workflow can be adopted in any region with a similar geological setting and morphology

Non-inferiority of mammalian cell-derived quadrivalent subunit influenza virus vaccines compared to trivalent subunit influenza virus vaccines in healthy children: a phase III randomized, multicenter, double-blind clinical trial

Objectives: The safety and immunogenicity of mammalian cell-derived quadrivalent influenza vaccine (QIVc) as compared with trivalent influenza vaccines (TIV1c/TIV2c) was evaluated in children aged ≥4 to <18 years. Methods: Two thousand three hundred and thirty-three subjects were randomized 2:1:1 to receive either one or two doses of study vaccine depending on previous vaccination status. Hemagglutination inhibition antibody responses for all four influenza strains were performed 3 weeks after the last dose. Reactogenicity and safety were also assessed (ClinicalTrials.gov: NCT01992107). Results: QIVc met the non-inferiority criteria against all four vaccine strains and demonstrated superiority for both influenza B strains over the unmatched B lineage included in the comparator vaccines, when geometric mean titers and seroconversion rates were compared at 3 weeks after the last vaccination. Similar percentages of subjects experienced solicited and unsolicited adverse events (AEs) across all subgroups. Unsolicited AEs, serious AEs, medically attended AEs, and new onset chronic disease were reported in comparable percentages of subjects in all study groups. No vaccine-related serious AEs or deaths occurred. Conclusions: QIVc demonstrated a similar safety profile and immunogenicity responses against all four vaccine strains without signs of immune interference on addition of an alternate lineage B strain compared with TIV1c/TIV2c and may provide broader protection against both influenza B lineages in children