Effect of L-type calcium channel blocker (amlodipine) on myocardial iron deposition in patients with thalassaemia with moderate-to-severe myocardial iron deposition: protocol for a randomised, controlled trial

Introduction: Sideroblastic cardiomyopathy secondary to repeated blood transfusions is a feared complication in thalassaemia. Control of myocardial iron is thus becoming the cornerstone of thalassaemia management. Recent evidence suggests a role for L-type Ca2+ channels in mediating iron uptake by the heart. Blocking the cellular iron uptake through these channels may add to the benefit of therapy to standard chelation in reducing myocardial iron. We aim to determine the efficacy of amlodipine (a calcium channel blocker) as an adjunct to standard aggressive chelation in retarding myocardial iron deposition in thalassaemics with or without cardiomyopathy.Outcomes: The primary outcome is to compare the efficacy of amlodipine+chelation (intervention) versus standard chelation (control) in retarding myocardial iron deposition. Secondary outcomes include the effect of amlodipine therapy on systolic and diastolic function, strain and strain rate and liver iron content.Methods and analysis: This is a single-centre, parallel-group, prospective randomised control trial. Twenty patients will be randomised in a 1:1 allocation ratio into the intervention and control arms. In addition to conventional echocardiography, MRI T2* values for assessment of cardiac and liver iron load will be obtained at baseline and at 6 and 12 months. Cardiac T2* will be reported as the geometric mean and per cent coefficient of variation, and an increase in cardiac T2* values from baseline will be used as an end point to compare the efficacy of therapy. A p Value of Study setting: Department of Pediatric and Child Health, Aga Khan University Hospital, Karachi, Pakistan.Ethics and dissemination: This study has been approved by the Ethics Review Committee and Clinical Trials Unit at The Aga Khan University with respect to scientific content and compliance with applicable research and human subjects regulations. Findings will be reported through scientific publications and research conferences and project summary papers for participants

Adolescent Afghan refugees display a high prevalence of hyperhomocysteinemia and associated micronutrients deficiencies indicating an enhanced risk of cardiovascular disease in later life

A growing body of research evidence suggests that elevated homocysteine level (hyperhomocysteinemia) is an independent risk factor for cardiovascular diseases. The current study aimed to investigate the prevalence and associated risk factors for hyperhomocysteinemia among adolescent Afghan refugees aged 10−19 years. In total, 206 healthy adolescent boys and girls were randomly recruited from a refugee village in Peshawar, Pakistan, in 2020. Socio-demographic data, anthropometric assessment, and blood sample collection were performed following standard methods. Serum homocysteine was assessed using a chemiluminescent microparticle immunoassay, with hyperhomocysteinemia defined as levels ≥ 15 µmol/L. The overall prevalence of hyperhomocysteinemia was 25%, with mean homocysteine levels significantly (p = 0.004) higher among boys (14.1 µmol/L) than girls (11.8 µmol/L). Multivariate logistic regression analysis revealed a significant association between hyperhomocysteineimia and serum levels of vitamin B12 (OR 0.29; 95% CI of 0.14 to 0.62; p 0.01) and folate (OR 0.1; 95% CI of 0.03 to 0.27; p 0.001). Overall, our study findings indicate high prevalence of hyperhomocysteinemia among adolescent Afghan refugees who are potentially at high risk of developing cardiovascular diseases in future. There is a dire need to develop and implement nutritional and public health strategies to control hyperhomocysteinemia, protect against related diseases and complications in future, and ensure healthy lives and well-being among these vulnerable populations

Characterization Of A Novel Hydrolytic Enzyme Producing Thermophilic Bacterium Isolated From The Hot Spring Of Azad Kashmir-Pakistan

ABSTRACT A thermophilic bacterium (TP-2) was isolated from the Tatta Pani hot spring in Azad Kashmir and was characterized using phenotypic and genotypic characters. The strain developed cream colored, round, smooth, flat and slimy colonies while the cells were Gram positive rods that ranged in size from about 2.1-3.6 μm to 0.2-0.3 μm in width. Sequence analysis of its 16S rRNA gene showed that isolate TP-2 had 89% homology with Geobacillus debilis. It grew within pH range of 5.5 to 8.5 with optimum growth at pH 7.0. The isolate showed optimum growth at 65ºC and gave positive results for gelatin hydrolysis (GEL), ortho nitrophenyl-β-D-galactopyranosidase (ONPG), and nitrate production and produced acid from sucrose, glucose and maltose. It utilized glucose, fructose, maltose, lactose, sucrose, xylan, starch, filter paper and carboxymethylcellulose as sole carbon source. Isolate TP-2 produced significant amount of industrially important enzymes i.e. extracellular α-amylase, CMCase, FPase, Xylanase, Protease and Lipase and intracellular CMCase and FPase

Novel robust digital watermarking in mid-rank co-efficient based on DWT and RT transform

© Springer Nature Switzerland AG 2019. Recent advancement in multimedia is facilitating humanity in data manipulation, transportation, and transmission. All at once, this improvement in multimedia data has exposed sensitive data to various threats, like threats of piracy and copyright materials. The most important application of digital image watermarking scheme are ownership protection of copyrighted materials and authorization of multimedia data. Digital watermark is an imperceptible mark embedded in digital images for various objectives including image captioning, authentication, authorization, copyright protection and proof of ownership of multimedia contents. Watermarking is a procedure of embedding secret information such as logo, number, text and image in multimedia data. The proposed watermarking scheme is based on Discrete Wavelet (DWT) and Ranklets Transform (RT) domain in which the mid-rank coefficients in low frequency sub-band (LL3) of DWT are selected for random number watermark embedding. Experimental results shows that no visible distortion among the cover and watermarked image, representing high level of imperceptibility. The scheme has been tested against various set of malicious attacks, proving that the proposed scheme computationally surpasses other state of the arts schemes

Diverse Impact of Sensitive Sub-Categories of Demographic Variables on Safety Climate of High-Rise Building Projects

The identification of significant areas impacting safety performance has always been a key concern for construction management researchers. This paper aims to examine the diversified influence of sensitive sub-categories of demographic variables on construction safety climate (SC). The data relating to fourteen demographic variables and twenty-four formerly validated SC statements were collected from forty-one under-construction high-rise buildings in Pakistan. The variances in respondents’ distribution among various sub-categories of demographic variables, and influence of each sub-category of demographic variables on SC statements were analyzed using cross-tabulation, Spearman’s rho correlation coefficients, independent sample Kruskal-Wallis and Mann-Whitney U tests. The study comprehends that the employees in the age group of 20 years or below and between 41 and 50 years, engaged for over 48 h per week, having 4 dependent family members, primary education, and/or lesser working experience, attained a comparatively lower SC level. Likewise, frontline workers and foremen are observed to be employed for extended working hours, causing them fatigue. It also discovers that safety alertness level steadily declines once employees get acquainted with their tasks, thus necessitating to arrange periodic refresher safety training sessions. The study recommends concentrating on frontline workers and foremen who are less educated and fall in the age group of 41–50 years by resolving their safety concerns and providing them adequate safety training, promptly replacing their defective equipment, improving worksite conditions, and counselling them about the significance of wearing PPE and adhering to all the safety rules regardless of the difficulty in their enactment. A joint focus on the heightened personal attributes of employees and risky SC statements is expected to enhance safety performance on under-construction building projects. Moreover, the study’s results can be cautiously generalized and applied to other countries having similar work environment

An Efficient Power Scheduling Scheme for Residential Load Management in Smart Homes

In this paper, we propose mathematical optimization models of household energy units to optimally control the major residential energy loads while preserving the user preferences. User comfort is modelled in a simple way, which considers appliance class, user preferences and weather conditions. The wind-driven optimization (WDO) algorithm with the objective function of comfort maximization along with minimum electricity cost is defined and implemented. On the other hand, for maximum electricity bill and peak reduction, min-max regret-based knapsack problem (K-WDO) algorithm is used. To validate the effectiveness of the proposed algorithms, extensive simulations are conducted for several scenarios. The simulations show that the proposed algorithms provide with the best optimal results with a fast convergence rate, as compared to the existing techniques

Elephant Herding Robustness Evolution Algorithm With Multi-Clan Co-Evolution Against Cyber Attacks for Scale-Free Internet of Things in Smart Cities

A large number of sensors are deployed for performing various tasks in the smart cities. The sensors are connected with each other through the Internet that leads to the emergence of Internet of Things (IoT). As the time passes, the number of deployed sensors is exponentially increasing. Not only this, the enhancement of sensors has also laid the base of automation. However, the increased number of sensors make the IoT networks more complex and scaled. Due to the increasing size and complexity, IoT networks of scale-free nature are found highly prone to attacks. In order to maintain the functionality of crucial applications, it is mandatory to increase the robustness of IoT networks. Additionally, it has been found that scale-free networks are resistant to random attacks. However, they are highly vulnerable to intentional, malicious, deliberate, targeted and cyber attacks where nodes are destroyed based on preference. Moreover, sensors of IoT network have limited communication, processing and energy resources. Hence, they cannot bear the load of computationally extensive robustness algorithms. A communication model is proposed in this paper to save the sensors from computational overhead of robustness algorithms by migrating the computational load to back-end high power processing clusters. Elephant Herding Robustness Evolution (EHRE) algorithm is proposed based on an enhanced communication model. In the proposed work, 6 phases of operations are used: initialization, sorting, clan updating, clan separating,selection and formation, and filtration. These process collectively increase the robustness of the scale-free IoT networks. EHRE is compared with well-known previous algorithms and is proven to be robust with a remarkable lead in performance. Moreover, EHRE is capable to achieve global optimum results in less number of iterations. EHRE achieves 95% efficiency after 60 iterations and 99% efficiency after 70 iterations. Moreover, EHRE performs 58.77% better than Enhanced Differential Evolution (EDE) algorithm, 65.22% better than Genetic Algorithm (GA), 86.35% better than Simulating Annealing (SA) and 94.77% better than Hill climbing Algorithm (HA)

Analysis of Landscape Connectivity among the Habitats of Asian Elephants in Keonjhar Forest Division, India

Land development has impacted natural landforms extensively, causing a decline in resources and negative consequences to elephant populations, habitats, and gene flow. Often, elephants seek to fulfill basic needs by wandering into nearby human communities, which leads to human–elephant conflict (HEC), a serious threat to conserving this endangered species. Understanding elephant space use and connectivity among their habitats can offset barriers to ecological flow among fragmented populations. We focused on the Keonjhar Forest Division in Eastern India, where HEC has resulted in the deaths of ~300 people and several hundred elephants, and damaged ~4100 houses and ~12,700 acres of cropland between 2001 and 2018. Our objectives were to (1) analyze elephant space use based on their occupancy; (2) map connectivity by considering the land structure and HEC occurrences; (3) assess the quality of mapped connectivity and identify potential bottlenecks. We found that (1) the study area has the potential to sustain a significant elephant population by providing safe connectivity; (2) variables like forests, precipitation, rural built-up areas, cropland, and transportation networks were responsible for predicting elephant presence (0.407, SE = 0.098); (3) five habitat cores, interconnected by seven corridors were identified, of which three habitat cores were vital for maintaining connectivity; (4) landscape features, such as cropland, rural built-up, mining, and transportation networks created bottlenecks that could funnel elephant movement. Our findings also indicate that overlooking HEC in connectivity assessments could lead to overestimation of functionality. The study outcomes can be utilized as a preliminary tool for decision making and early planning during development projects

Hop Adjusted Multi-chain Routing for Energy Efficiency in Wireless Sensor Networks

This paper presents two new chain formation based routing protocols: Multi Chain Energy Efficient Greedy (MCEEG) routing and Hop Adjusted MCEEG (HA-MCEEG). The MCEEG protocol divides network area into rectangular subareas of equal size, such that each one contains equal number of randomly deployed nodes. In each rectangular subarea, minimum distance based next hop (Greedy algorithm) for data transmission is used and the sojourn locations are adjusted in a way that, at a time when data reaches to the terminator node, BS moves to sojourn location in that rectangular subregion. Thus, data is transmitted through shorter parallel routes instead of single lengthy route. HA-MCEEG protocol exploits the radio parameters for energy efficiency i.e., closely inspects the energy costs (transmission, reception, aggregation and amplification), avoids unnecessary data hopping and selects route with minimum energy cost. Simulation results show that the newly proposed protocols perform better than the selected existing protocol in terms of stability period, network lifetime, packet sending rate and scalability