Seismotectonic analyses of Karachi Arc, Southern Kirthar Fold Belt, Pakistan

In this study geomorphological and seismotectonic analyses were carried out in Karachi arc area, southernPakistan to locate relatively safe areas from earthquakes disasters. Karachi arc is the southern extremity of the Kirtharmountain chain that occupies a major part of southern Pakistan and is comprised of a number of narrow, elongatedmountain ranges, i.e. Laki, Kirthar, Khud, Pab and Mor ranges. Based on geomorphological and seismotectonicanalyses Karachi arc area has been divided into three parts. These parts are northern, frontal and southern part. Thenorthern part of Karachi arc is seismically active where minor to moderate (3-5.9Mb) earthquakes occurred. Somebasement structures in Sehwan area seem to be still active and affected by the present-day transpressional stress field.The frontal part of Karachi arc is also active as manifested by the existence of active faults in Jhimpir, Surjan andMeting areas. These embryonic structures in the eastern part of the Arc are indicators of active deformation of Karachiarc. Presently the active deformation is taking place in frontal and northern parts of the arc, while the southern part thathas experienced deformation prior to Quaternary time is inactive and is relatively stable geoblock. The instrumental andhistoric seismicity record of the adjoining areas of Karachi arc show that the area has experienced light to moderateseismic events (4-5.9) with occasional occurrence of strong and major earthquakes. Any major or strong event in Katchrift zone, Makran subduction zone and Ornach-Nal fault zone may cause intensity of VII to VIII in Karachi arc area aswell as Karachi city of environmental seismic intensity scale 2007

Short-Term Prediction of COVID-19 Using Novel Hybrid Ensemble Empirical Mode Decomposition and Error Trend Seasonal Model

In this article, a new hybrid time series model is proposed to predict COVID-19 daily confirmed cases and deaths. Due to the variations and complexity in the data, it is very difficult to predict its future trajectory using linear time series or mathematical models. In this research article, a novel hybrid ensemble empirical mode decomposition and error trend seasonal (EEMD-ETS) model has been developed to forecast the COVID-19 pandemic. The proposed hybrid model decomposes the complex, nonlinear, and nonstationary data into different intrinsic mode functions (IMFs) from low to high frequencies, and a single monotone residue by applying EEMD. The stationarity of each IMF component is checked with the help of the augmented Dicky–Fuller (ADF) test and is then used to build up the EEMD-ETS model, and finally, future predictions have been obtained from the proposed hybrid model. For illustration purposes and to check the performance of the proposed model, four datasets of daily confirmed cases and deaths from COVID-19 in Italy, Germany, the United Kingdom (UK), and France have been used. Similarly, four different statistical metrics, i.e., root mean square error (RMSE), symmetric mean absolute parentage error (sMAPE), mean absolute error (MAE), and mean absolute percentage error (MAPE) have been used for a comparison of different time series models. It is evident from the results that the proposed hybrid EEMD-ETS model outperforms the other time series and machine learning models. Hence, it is worthy to be used as an effective model for the prediction of COVID-19

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Teacher Discourse and Student Engagement in ESL Learning Settings

This study examines the intricate relationship between teacher discourse and student engagement in English as a Second Language (ESL) classrooms within Karachi schools. Grounded in a qualitative research design, the investigation explores the impact of three key dimensions of teacher discourse—Clarity and Comprehensibility, Encouragement and Support, and Interactive Communication—on student engagement. Classroom observations were conducted across a diverse range of schools to capture a comprehensive view of these interactions. The findings of the study affirm the crucial role that teacher discourse plays in shaping student engagement. The analysis reveals that when teachers communicated with clarity and employed comprehensible language, student engagement levels were notably elevated. Such environments facilitated active participation and comprehension, aligning with previous research highlighting the fundamental importance of clarity in pedagogy. Encouragement and support from teachers emerged as another influential factor in promoting emotional and cognitive engagement. The positive atmosphere created by supportive teacher behavior fostered a greater willingness among students to contribute, ask questions, and partake in discussions. This underscores the significance of emotional connection within the learning environment. The study also underscores the value of interactive communication between teachers and students. Classrooms characterized by dialogic interactions and open-ended questions witnessed heightened levels of student engagement. These findings extend existing literature on the benefits of interactive teaching methods, showcasing their potential to enhance both cognitive and emotional engagement. The implications of these findings underscore the importance of incorporating effective teacher discourse strategies into educational practices to cultivate more engaging ESL learning environments