Obesity and high risk pathological features of papillary thyroid carcinoma: A retrospective analysis of a university hospital in Pakistan

BACKGROUND: Incidence of papillary thyroid carcinoma (PTC) and the frequency of obesity is increasing globally. In literature, relationship between excessive body weight and bad prognostic features of PTC is still debatable. In this study, we aimed to explore the association of obesity with high risk pathological features of PTC in a population treated by total thyroidectomy +/- neck dissection. MATERIALS AND METHODS: Retrospective analysis of patients at Aga Khan University Hospital from January 2013 to December 2014, who underwent total thyroidectomy +/- neck dissection due to PTC. Patients were grouped according to World Health Organization (WHO) classification of BMI. They were categorized into two groups, i.e. normal (BMI= 18.5 - 24.9 kg/m2) and obese (BMI = 30 kg/m2) as none of our patients lie in underweight and overweight category. Pathological features i.e. T-stage, multifocality, bilaterality, extrathyroidal extension, vascular invasion and N-stage were assessed. All tumors were staged according to TNM staging system proposed by 2010 American Joint Committee on Cancer (AJCC). Odds ratio (OR) with 95% confidence interval was used to examine the association between BMI ∧ pathological characteristics of PTC. RESULTS: A total of 53 patients were treated for PTC in two-years period. There were 38 female and 15 male patients. Twenty-eight patients had BMI in normal while twenty-five in obese category. Patients who were in obese category had a significantly greater risk of having a multifocal tumor (OR=5.55, p-value=0.02) and bilaterality (OR=6.54, p-value=0.01) compared to normal weight patients. No positive associations were identified between BMI and extrathyroidal extension, high T-stage, vascular invasion and N-stage. CONCLUSION: Obesity is not associated with high risk pathological features such as extrathyroidal extention, high T-stage, vascular invasion and N-stage in PTC. Although it has been correlated with multifocal and bilateral tumors in this retrospective study, the presence of these factors alone is not adequate to support the association conclusively

Shadow of your former self: Exploring project leaders’ post-failure behaviors (resilience, self-esteem and self-efficacy) in high-tech startup projects

Globally, demands for sustainable strategies in the ICT industry have attracted greater momentum as high-tech projects continue to fail in large numbers. Recent studies have underpinned project resilience as a major factor for overcoming these increasing project failures, delays, or ter-mination. However, the complex behaviors of resilient project leaders, especially in post-failure conditions, have been largely overlooked. To address this critical research gap, the present study identifies the direct relationships between three potential behavioral traits of project leaders (i.e., resilience, self-esteem, and self-efficacy) and examines how they move forward beyond project failures. The present study also explored whether self-esteem mediates project leaders’ resilience and self-efficacy. Drawing on data from 232 project leaders in Pakistan’s high-tech start-ups, the new findings suggest that there are significant positive effects of project leaders’ resilience and self-esteem on their self-efficacy, and that project leaders’ resilience and self-efficacy is significantly mediated by their self-esteem. As the project resilience theory gains traction, the present study findings have pinpointed major steps for meeting project challenges ahead of time, allowing leaders and teams to learn from failures, and also for improving organisations’ ability to implement successful and sustainable high-tech projects especially in emerging economies

Automatic eduction and statistical analysis of coherent structures in the wall region of a confine plane

This paper describes a vortex detection algorithm used to expose and statistically characterize the coherent flow patterns observable in the velocity vector fields measured by Particle Image Velocimetry (PIV) in the impingement region of air curtains. The philosophy and the architecture of this algorithm are presented. Its strengths and weaknesses are discussed. The results of a parametrical analysis performed to assess the variability of the response of our algorithm to the 3 user-specified parameters in our eduction scheme are reviewed. The technique is illustrated in the case of a plane turbulent impinging twin-jet with an opening ratio of 10. The corresponding jet Reynolds number, based on the initial mean flow velocity U0 and the jet width e, is 14000. The results of a statistical analysis of the size, shape, spatial distribution and energetic content of the coherent eddy structures detected in the impingement region of this test flow are provided. Although many questions remain open, new insights into the way these structures might form, organize and evolve are given. Relevant results provide an original picture of the plane turbulent impinging jet

The crosstalk between FGF21 and GH leads to weakened GH receptor signaling and IGF1 expression and is associated with growth failure in very preterm infants.

BACKGROUND: Fibroblast growth factor 21 (FGF21) is an essential metabolic regulator that adapts to changes in nutritional status. Severe childhood undernutrition induces elevated FGF21 levels, contributing to growth hormone (GH) resistance and subsequent linear growth attenuation potentially through a direct action on chondrocytes. METHODS: In this study, we assessed expression of the components of both GH and FGF21 pathways in rare and unique human growth plates obtained from children. Moreover, we investigated the mechanistic interplay of FGF21 on GH receptor (GHR) signaling in a heterologous system. RESULTS: Chronic FGF21 exposure increased GH-induced GHR turnover and SOCS2 expression, leading to the inhibition of STAT5 phosphorylation and IGF-1 expression. The clinical significance of FGF21 signaling through GH receptors was tested in nutritionally driven growth failure seen in very preterm (VPT) infants right after birth. VPT infants display an immediate linear growth failure after birth followed by growth catch-up. Consistent with the in vitro model data, we show that circulating FGF21 levels were elevated during deflection in linear growth compared to catch-up growth and were inversely correlated with the length velocity and circulating IGF1 levels. CONCLUSIONS: This study further supports a central role of FGF21 in GH resistance and linear growth failure and suggests a direct action on the growth plate

Ethno-botanical and geo-referenced profiling of medicinal plants of Nawagai Valley, District Buner (Pakistan)

The prime objective of the research was to list the important ethnomedicinal plants of Nawagai village, District Buner. During the survey, 44 plant species from 27 families were observed and collected from the targeted area of Khyber Pakhtunkhwa, Pakistan. Lamiaceae members were the most dominant (54%) followed by members of Asteraceae (30%), Poaceae (18%) and Solanaceae (12%). Relevant information such as field data, GPS coordinates family names, local names, therapeutic uses and plant habits were recorded for each species. For preservation purposes, specimens were mounted on herbarium sheets, and identified with the help of flora of Pakistan, flora of Australia and other relevant floristic records. During this research work all the collected specimens were preserved in the (BG&H, UOM) Botanical Garden and Herbarium, the data were also provided to the Department of Botany, University of Malakand Dir (Lower), Khyber Pakhtunkhwa, Pakistan.The prime objective of the research was to list the important ethnomedicinal plants of Nawagai village, District Buner. During the survey, 44 plant species from 27 families were observed and collected from the targeted area of Khyber Pakhtunkhwa, Pakistan. Lamiaceae members were the most dominant (54%) followed by members of Asteraceae (30%), Poaceae (18%) and Solanaceae (12%). Relevant information such as field data, GPS coordinates family names, local names, therapeutic uses and plant habits were recorded for each species. For preservation purposes, specimens were mounted on herbarium sheets, and identified with the help of flora of Pakistan, flora of Australia and other relevant floristic records. During this research work all the collected specimens were preserved in the (BG&H, UOM) Botanical Garden and Herbarium, the data were also provided to the Department of Botany, University of Malakand Dir (Lower), Khyber Pakhtunkhwa, Pakistan.The prime objective of the research was to list the important ethnomedicinal plants of Nawagai village, District Buner. During the survey, 44 plant species from 27 families were observed and collected from the targeted area of Khyber Pakhtunkhwa, Pakistan. Lamiaceae members were the most dominant (54%) followed by members of Asteraceae (30%), Poaceae (18%) and Solanaceae (12%). Relevant information such as field data, GPS coordinates family names, local names, therapeutic uses and plant habits were recorded for each species. For preservation purposes, specimens were mounted on herbarium sheets, and identified with the help of flora of Pakistan, flora of Australia and other relevant floristic records. During this research work all the collected specimens were preserved in the (BG&H, UOM) Botanical Garden and Herbarium, the data were also provided to the Department of Botany, University of Malakand Dir (Lower), Khyber Pakhtunkhwa, Pakistan

Investigation of sequential outbreaks of Burkholderia cepacia and multidrug-resistant extended spectrum β-lactamase producing Klebsiella species in a West African tertiary hospital neonatal unit: a retrospective genomic analysis

Background Sick newborns admitted to neonatal units in low-resource settings are at an increased risk of developing hospital-acquired infections due to poor clinical care practices. Clusters of infection, due to the same species, with a consistent antibiotic resistance profile, and in the same ward over a short period of time might be indicative of an outbreak. We used whole-genome sequencing (WGS) to define the transmission pathways and characterise two distinct outbreaks of neonatal bacteraemia in a west African neonatal unit. Methods We studied two outbreaks of Burkholderia cepacia and multidrug-resistant extended spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae in a neonatal unit that provides non-intensive care on the neonatal ward in the Edward Francis Small Teaching Hospital, Banjul, The Gambia. We used WGS to validate and expand findings from the outbreak investigation. We retrospectively sequenced all clinical isolates associated with each outbreak, including isolates obtained from swabs of ward surfaces, environmental fluid cultures, intravenous fluids, and antibiotics administered to newborns. We also sequenced historical B cepacia isolates associated with neonatal sepsis in the same ward. Results Between March 1 and Dec 31, 2016, 321 blood cultures were done, of which 178 (55%) were positive with a clinically significant isolate. 49 episodes of neonatal B cepacia bacteraemia and 45 episodes of bacteraemia due to ESBL-producing K pneumoniae were reported. WGS revealed the suspected K pneumoniae outbreak to be contemporaneous outbreaks of K pneumoniae (ST39) and previously unreported Klebsiella quasipneumoniae subspecies similipneumoniae (ST1535). Genomic analysis showed near-identical strain clusters for each of the three outbreak pathogens, consistent with transmission within the neonatal ward from extrinsically contaminated in-use intravenous fluids and antibiotics. Time-dated phylogeny, including retrospective analysis of archived bacterial strains, suggest B cepacia has been endemic in the neonatal ward over several years, with the Klebsiella species a more recent introduction. Interpretation Our study highlights the emerging threat of previously unreported strains of multidrug-resistant Klebsiella species in this neonatal unit. Genome-based surveillance studies can improve identification of circulating pathogen strains, characterisation of antimicrobial resistance, and help understand probable infection acquisition routes during outbreaks in newborn units in low-resource settings. Our data provide evidence for the need to regularly monitor endemic transmission of bacteria within the hospital setting, identify the introduction of resistant strains from the community, and improve clinical practices to reduce or prevent the spread of infection and resistance

Tourism, Environment and Energy: An Analysis for China

International tourism as a cause of global warming is a controversial and topical issue. Here, we use the novel Morlet Wavelet time-frequency approach to gain a deeper insight into the dynamic nexus between tourism, renewable energy utilization, energy utilization and carbon dioxide emissions for China using annual data over the era 1974-2016. The techniques we use include Continuous Wavelet power spectrum, the Wavelet Coherency, and the Partial and the Multiple Wavelet Coherence for time-frequency decomposition that can capture local oscillatory components in time series. Our findings support the hypothesis that tourism can cause increased energy utilization and carbon dioxide emissions in China, which challenges the sustainable tourism development goal. However, on the positive side, the relationship between tourism and renewable energy utilization is shown to facilitate reduced environmental degradation in the medium-long run

Security Challenges and Air Quality Management in india: Emissions Inventory and Forecasting Estimates

The defense and peace literature have focused mainly on the military-growth nexus, with little attention paid to the environmental sustainability agenda, which is impacted by increased global arms transfers. The supply of lead-containing ammunition generates complex gas mixtures (including CO2 emissions) and particulates that harm the healthcare sustainability agenda. Based on the significance of the subject matter, the study uses the Indian economy as a case study, with a significant rate of arms transfers associated with higher carbon emissions. The study analyzed data from more than four decades, from 1975 to 2020. Data on arms imports, military personnel, and military expenditures are used to evaluate the ‘ammunition emissions function’. It corresponds to the three research hypotheses, namely, the ‘emissions-defense burden hypothesis’ (arms transfers increase carbon emissions), the ‘emissions-cleaner hypothesis’ (arms transfers reduce carbon emissions), and the ‘emissions-asymmetric hypothesis’ (positive and negative shocks of arms transfers either support the ‘defense burden hypothesis’ or ‘cleaner hypothesis’). The non-linear autoregressive distributed lag (NARDL) results confirmed the ’emissions-defense burden hypothesis‘ in the long run, as positive and negative shocks from arms imports increase carbon emissions. However, in the short run, positive arms imports increase carbon emissions while negative arms imports decrease carbon emissions. Furthermore, the findings supported the ’emissions-cleaner hypothesis‘ in the relationship between armed forces personnel and carbon emissions. The findings imply that the positive and negative shocks experienced by armed forces personnel reduce carbon emissions in the short and long run. Positive shocks to military spending support the ’emissions-defense burden hypothesis‘ in the short run; however, the results vanished when negative shocks to military spending supported the ’emissions-spillover hypothesis‘ (lowering military spending reduces carbon emissions and increases economic productivity) in the short and long run. The country’s unsustainable economic activities are viewed as a negative factor contributing to long-term carbon emissions increases. The negative shocks of armed forces personnel and positive arms imports would almost certainly have a significant long-term impact on carbon emissions. As a result, the ‘treadmill theory of destruction’ has been confirmed in a country. The study concludes that lead-free ammunition and managing ammunition safety are beneficial to a country’s environmental sustainability agenda. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Researchers Supporting Project number (RSP-2021/87), King Saud University, Riyadh, Saudi Arabia

‘Our newsroom in the cloud’: Slack, virtual newsrooms and journalistic practice

Virtual newsrooms have enormous potential: enabling journalists around the world to pool their knowledge, skills and perspectives within joint projects, such as the Panama Papers. These virtual newsrooms are supported by Online Collaborative Software (OCS), the most popular of which is Slack. But although many of the world’s top news organisations now use Slack, there is no empirical research examining its impact on workplace processes or culture. This article presents the results of a year-long ethnographic study of a global digital news outlet, whose remote journalists collaborate, almost exclusively, via Slack. We found that the platform deepened relationships and enabled new creative practices across geographic regions. However, it also contributed to the erasure of the line between private and professional spheres for workers, and introduced new opportunities for management to shape newsroom culture. We argue that the concept of ‘space’ as developed by Harvey can helpfully frame the analysis of these new, important digital platforms