Characterization of Sodium and Potassium Nitrate Contaminated Polyaniline-Poly (Ethylene Oxide) Composites Synthesized via Facile Solution Casting Technique

Fabrication of composites by developing simple techniques can be an effective way to modify some properties of individual materials. The present study relates to facile synthesis of sodium nitrate (NaNO3) and potassium nitrate (KNO3) contaminated polyaniline (PANI) and poly (ethylene oxide) (PEO) composites without using any additives, plasticizers, or fibers. The physic-chemical and rheological properties of synthesized composites were analyzed. The composites showed enhancement in both storage and loss modules in comparison with the polymer matrices. The dynamic viscosity of the synthesized materials has inverse relation with that of temperature and shear stress. Rheological analysis reveals a continuous drop off in viscosity by increasing shear stress. The flow behavior was affected little by temperature. However, the overall results showed a shear thinning effect suggesting that polymer composites show non-Newtonian behavior. The addition of NaNO3 and KNO3 had a profound effect on shear viscosity of the materials, although the overall shear thinning behavior prevails. The PANI-PEO composite follows, as the first approximation models, both Bingham and modified Bingham models, while the salt contaminated system follows only the Bingham model. Both show shear stress values. The greater values of storage (G') and loss (G″) modulus of composites than PANI-PEO blend suggests excellent elasticity, better stiffness, and good mechanical strength of the composites. Furthermore, the composites were more thermally stable than pure polymers

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Computational Modeling of Dynamic Stability Derivatives for Generic Airfoils

This paper presents a method for the computation of the static and dynamic stability derivatives of generic airfoils using high fidelity Computational Fluid Dynamics. Aerodynamic coefficients are calculated for NACA 0012 airfoil and flat plate at different angles of attack. Results of lift coefficient are validated with experimental data. Static and dynamic stability derivatives are calculated by oscillating the airfoil geometry at suitable frequency. Simulations are performed at various flight conditions in terms of angles of attack, frequencies and oscillation amplitudes. The aim of the work is to decipher the behaviour of longitudinal damping derivatives used in flight mechanics through CFD. This approach enables the efficient and accurate computation of dynamic derivatives. Calculations are done for constant air velocity altering only the angle of attack. Inviscid model is tested since its results nearly match with experimental data. The simulations show that the nonlinear characteristics of the stability derivatives are captured by varying angle of attack

Turnover Intentions of Front Line Employees: A Case of the Banking Sector

Spillover of conflict from work to family and vice-versa is a grave concern for today’s organizations and workforce. This research aims to conduct an empirical investigation into the increase in the turnover intentions due to Work-Family and Family-Work Conflict particularly in the banking sector of Pakistan. The study hypothesizes that work-family conflict and family-work conflict leads to higher turnover intentions among frontline banking employees. Moreover, job stress acts as a mediator between the two. For model testing, data was gathered from 260 frontline banking workers operating in Islamabad. Self-administered surveys were employed as the data collection tool. Statistical analysis was conducted using the SPSS software. Results revealed that both work-family and family-work conflicts, invoke the feelings of dissatisfaction among employees, thereby elevating their stress levels. This eventually increases their turnover intentions. The study makes theoretical contribution in the respective fields and also offers directions for future research.

Foreign Inflows and Existence of Dutch Disease: Empirical Evidence from Pakistan

This paper tries to evaluate the economic importance of foreign inflows in determining the real effective exchange rate. Monetary policy plays a substantial role in determining the stability of prices, trade and foreign inflows like foreign direct investment, personal remittances, and foreign aid. In this study, the causal relationship is analyzed among policy variables and control variables. The study used secondary time series data from 1960-to 2020. Augmented Dickey Fuller (ADF) and Philips Perron (PP) unit root tests are used to check the stationary of the variables. Results showed that all variables are stationary at the level I (0) and the first difference I (1). The auto regressive distributive lag (ARDL) approach and Granger Causality approach is discussed to find cointegration and causality respectively. ARDL Bound test reveals the cointegration existence among the variables. ARDL results suggest that foreign inflows (Foreign Direct Investment, Foreign Aid, Personal Remittances), Trade and Inflation showed a significant relationship with Real Effective Exchange Rate in the long run. Granger Causality suggested the existence of Causality among Foreign Aid and Real Effective Exchange Rate, Foreign Direct Investment and Foreign Aid, Trade and Remittances. The results of the study are found in contradiction with the law of one price

Midwives\u27 perception about their practice in a midwifery-led care model in Karachi, Pakistan

Objective: To explore the experiences and perceptions of midwives practising the midwifery-led care model at two private facilities of women and children hospital in Karachi, Pakistan. Methods: The descriptive qualitative data was collected through semi-structured questionnaires with 10 midwives. Results: The findings of the study revealed one theme and four related categories. The theme of the study emerged as ‘struggling to be a professional midwife’ and the related four categories were: (i) asking to perform within the full scope of practice, (ii) obstetricians’ reliance and trust in midwives\u27 expertise, (iii) raising concerns about expensive midwifery services, and (iv) encountering barriers to practise midwifery as independent practitioners. Conclusion: Midwives face some challenges practising the midwifery-led care model such as lack of visibility in society, low salaries and increased workload due to the shortage of staff. Lack of higher education was also highlighted by the midwives as they have no opportunities for career growth. This study will increase midwives\u27 autonomous role and decision-making in the clinical setting

Cardioprotective Effects of Nigella Sativa and Enalapril in Doxorubicin-induced Cardiotoxicity

Objective: To determine the combined cardioprotective effects of Nigella Sativa and enalapril in doxorubicininduced cardiotoxicity in rats. Study Design: Experimental randomized control trials. Place and Duration of Study: This research was carried out from September 2020 to August 2021, in the department of pharmacology, in collaboration with the National Institute of Health (NIH) Islamabad, Pakistan. Materials and Methods: For this experiment, 4 groups of adult male rats were taken, each containing 10 rats. Group 1 rats acquired a normal diet without any medication throughout the experiment. On day 8 (after acclimatization) cardiotoxicity was induced in groups 2, 3, and 4 rats by administering doxorubicin 5mg/kg intraperitoneally for 3 consecutive days. After the confirmation of cardiotoxicity, Group 3 rats were administered only angiotensin-converting enzyme inhibitors (ACEI) enalapril 2mg/kg, while group 4 rats were given a combination of Nigella sativa 100mg/kg and Enalapril 2mg/kg orally for 14 days. Baseline blood samples were taken on day 0 to obtain normal values of Cardiac Troponin T ( cTnT), Cardiac Troponin I (cTnT), and CK-MB enzyme. To confirm cardiotoxicity 2nd sampling was done on day 11, and the final sampling was done through cardiac puncture on day 26. Serum biochemical estimation was done and data were analyzed through SPSS 22 by using one-way ANOVA and paired t-test. A P-value < 0.05 was believed statistically considerable. Results: Enalapril alone produced significant cardioprotective effects as shown by the marked reduction in cTnT, cTnI, and CKMB levels in group 3 (p<0.05), but combined administration of Nigella sativa and enalapril in group 4 mice produced a more significant reduction in Trop T, Trop I, and CK-MB levels (P <0.05). Conclusion: Nigella sativa and enalapril in combination significantly lower cardiac enzyme in Doxorubicininduced cardiotoxicity in rats