A Randomized Control Trails for the Assessment of Impact of Moderate Intensity Exercise on Blood Serum Creatinine Concentration among the Male Athletes

Purpose: The main purpose of the study was to examine the impact of moderate intensity exercise on blood serum creatinine concentration among the male. Method & Materials: A randomized control trails were conducted for purpose to evaluate the effects of moderate intensity exercise on creatinine level among the subjects (Experimental Group (EG) = 10, Control group (CG). A written informed consent from all the subjects and ethical approval was taken from Gomal University Ethical Review Committee before initiating the study protocols. 5ml blood were taken from all the subjects and each blood sample was marked with separate identification code. Twelve weeks exercise (moderate intensity exercise) protocols was employed on the selected subjects. The collected blood samples were tested and thus the collected results were processed through Statistical Package for Social Sciences (SPSS, Version, 24) by applying Mean and Standard deviation etc. Results & Conclusion: On the basis of analysis, the researcher concluded that inferentially there is no significant effect of moderate intensity exercise on BMI and Creatinine of the subjects but descriptively the experimental group shows better results in BMI and Creatinine (after the treatment)

Current progress in Striga management

The Striga, particularly S. he rmonthica, problem has become a major threat to food security, exacerbating hunger and poverty in many African countries. A number of Striga control strategies have been proposed and tested during the past decade, however, further research efforts are still needed to provide sustainable and effective solutions to the Striga problem. In this paper, we provide an update on the recent progress and the approaches used in Striga management, and highlight emerging opportunities for developing new technologies to control this enigmatic parasite.

Hemodynamic performance limits of the neonatal Double-Lumen cannula

Venovenous extracorporeal membrane oxygenation (VV-ECMO) is the preferred surgical intervention for patients suffering from severe cardiorespiratory failure, also encountered in SARS-Cov-2 management. The key component of VV-ECMO is the double-lumen cannula (DLC) that enables single-site access. The biofluid dynamics of this compact device is particularly challenging for neonatal patients due to high Reynolds numbers, tricuspid valve location and right-atrium hemodynamics. In this paper we present detailed findings of our comparative analysis of the right-atrial hemodynamics and salient design features of the 13Fr Avalon Elite DLC (as the clinically preferred neonatal cannula) with the alternate Origen DLC design, using experimentally validated computational fluid dynamics. Highly accurate 3D-reconstructions of both devices were obtained through an integrated optical coherence tomography and micro-CT imaging approach. Both cannula configurations displayed complex flow structures inside the atrium, superimposed over predominant recirculation regimes. We found that the Avalon DLC performed significantly better than the Origen alternative, by capturing 80% and 94% of venous blood from the inferior and superior vena cavae, respectively and infusing the oxygenated blood with an efficiency of more than 85%. The micro-scale geometric design features of the Avalon DLC that are associated with superior hemodynamics were investigated through 14 parametric cannula configurations. These simulations showed that the strategic placement of drainage holes, the smooth infusion blood stream diverter and efficient distribution of the venous blood capturing area between the vena cavae are associated with robust blood flow performance. Nevertheless, our parametric results indicate that there is still room for further device optimization beyond the performance measurements for both Avalon and Origen DLC in this study. In particular, the performance envelope of malpositioned cannula and off-design conditions require additional blood flow simulations for analysis.

Alteration in Metabolic Cost of Blood Urea, Serum Albumin and Oxidative Stress Induced by Oral Contraceptive Pills (OCP) among Elite Females

Background: For controlling unwilling pregnancy, sustaining gorgeousness and good health, among the elite level female athletes the use of contraceptive pills is quite common.                                                                                                                         Objective: Oxidative stress in female athletes is understudied. This research study was carried out in order to assess the alteration in metabolic rate of blood urea, bilirubin and oxidative stress induced by Levonorgestrel and Ethinylestradiol (oral contraceptive pills). The outcome of the study will reveal the impact of oral contraceptive pills on the overall health of the females.   Methods: User and non-user of oral contraceptive pills were included as participants of the study. Sixty elite level female athletes using Levonorgestrel and Ethinylestradiol were recruited as experimental group and twenty four female (non-users) as a control group were taken as sample of the study. Blood sample (5ml) was taken from all the subjects. Blood urea and bilirubin metabolism were estimated through kidney functional test and for the measurement of oxidative stress FRAP assay was used. The data obtained through kidney functional tests and FRAP assay were processed through statistical package for social sciences (SPSS, Version 23.0) Results: A significant difference was found between control and experimental subjects in FRAP values because (t (82) = 3.236, P <0.05). The mean value of subject was 110.54 and control was 137.95 in FRAP the mean value of subject is less than the mean value of control (509.3 <700.7). In case of bilirubin and serum albumin no difference was noted between control and experimental group as the value of significance is greater than 0.05. Conclusion: Based on the analysis, the researcher concluded that oral contraceptive pills produced significant rise in oxidative stress, thus affecting the overall health of elite female athletes.

Efficacy Of Different Dosage Regimens Of Carbimazole In The Treatment Of Primary Hyperthyroidism

OBJECTIVES

To compare the efficacy of Single dose with Divided dose regimen of Carbimazole for the induction of Euthyroidism in hyperthyroid patients.

METHODS

All consecutive hyperthyroidism patients from December 2018 to December 2019 fulfilling the inclusion criteria were included. They were allocated randomly into 2 groups: Group A - single dose of Carbimazole (OD-CMZ) and Group B - divided dose of Carbimazole (DD-CMZ). The therapeutic efficacy was measured at regular intervals (every 4 weeks) for 6 months. Their demographics and therapeutic management were analysed.

RESULTS

Of a total of 69 (n=34 in Group A, n=35 in Group B) patients, there was no significant difference in baseline concentrations of TSH and T4 as well as their cumulative rate of reductions (p-value, 0.023). Furthermore, no difference in achieving euthyroidism was noted at follow-up visits between Group A and B respectively ([0:0%; p-value 1.00, month 1], [70.6:74.3%; p value 0.22, month 2], [85.3:85.7%; p value 0.39, month 3], 97.1:82.9%; p-value 0.23, month 4], [100:91.4%; p-value 0.29, month 5], [100:100%%; p value 1.00, month 6] at monthly intervals. Cases of Hypothyroidism were reported more in the DD-CMZ (14.3%) and the difference was statistically significant (p-value 0.003).

CONCLUSIONS

Due to no significant difference in the efficacy and more chances of getting hypothyroid in divided dose regimen, we conclude that single dose regimen is more effective method for treating hyperthyroidism.

DISTRIBUTION OF CUTANEOUS LEISHMANIASIS BY SEX, AGE GROUPS AND RESIDENCE IN YEAR 2020 IN CUTANEOUS LEISHMANIASIS POPULATION OF DISTRICT D.I.KHAN, PAKISTAN

Background: Leishmaniasis is not an uncommon tropical disease. Cutaneous leishmaniasis is its most common form. The objectives of our study were to determine the distribution of cutaneous leishmaniasis by sex, age groups and residence in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from January 1, 2021 to January 23, 2021. The data for cutaneous leishmaniasis was retrieved from District Health Office, D.I.Khan for year 2020. A sample size of 419 was calculated from population at risk of 1,750,000 with 0.1034% margin of error, 95% confidence level and 0.01164% assumed prevalence of cutaneous leishmaniasis. Sex, age groups and residence were our three nominal variables. Distribution was analyzed by count and percentage with 95% confidence intervals. Three hypotheses for distribution were testified by chi-square goodness of Fit test. Results: Out of 419 positive cases of cutaneous leishmaniasis, 269 (64.20%) were men and 150 (35.80%) women, 254 (60.62%) were in age group up to 19 years, 101 (24.11%) in age group 20-39 years and 64 (15.27%) in age group ≥40 years, and 113 (26.97%) were urban and 306 (73.03%) rural. Our distribution by sex (p=0.01327), age groups (p=<0.0001) and residence (p=<0.0001) were not similar to expected. Conclusions: The prevalence of cutaneous leishmaniasis in year 2020 in cutaneous leishmaniasis population of District D.I.Khan, Pakistan was higher in men than women, highest in age group up to 19 years than age groups 20-39 and ≥40 years, and higher in rural than urban. The prevalence for men was higher than expected for men and prevalence for women was lower than expected for women. The prevalence for age group up to 19 years was highest than expected for this age group than age groups 20-39 and ≥40 years. The prevalence for rural was higher than expected for rural and the prevalence for urban was lower than expected for urban.

Alteration of Serum Liver Enzymes Level Caused by Cetirizine Hydrochloride in Exercise Performers

Background: Players regularly use cetirizine HCL for the prevention and treatment of various symptoms of allergy while playing in unfamiliar environments.    Objective: This research study was carried out to examine the effect of cetirizine HCL on liver function (ALT, ALP and AST) among the players. Methods: A descriptive study was carried out at Gomal University, Dera Ismail Khan from January 2019 to June 2019.Twenty male subjects 10 players using cetirizine HCL (one tablet of 10mg/day) as experimental group and 10 players not using cetirizine HCL as control group was selected voluntarily as participants of the study. Five ml blood was taken from all subjects after three hours of administration of cetirizine HCL for the assessment of ALT, ALP and AST.  The results obtained through liver functions test (LFTs) were analyzed through a statistical package for social sciences (SPSS, Version 24). Results: Significant difference was found in both groups (CG and EXG) in term of ALT (P = 000, 0.05>.000). There was significant difference between in both groups (CG and EXG) in term of ALP (P = 000, 0.05>.000). A significant difference was found between in both groups (CG and EXG) in term of AST (P = .001, 0.05>.000). Conclusion:  on the basis of finding, the researcher concluded that Cetirizine HCL (Tablet 10mg) produced a significant rise in liver enzymes and hence disturbing the normal functioning of liver.

Testing environment Kuznets curve (EKC) hypothesis in different regions

This study examines the association between air pollution and economic growth based on the idea of environment Kuznets curve (EKC) hypothesis which suggests an inverted U-shaped link between air pollution and economic growth in six different regions including Latin America and the Caribbean, East Asia and the Pacific, Europe and Central Asia, South Asia, the Middle East and North Africa, and Sub-Saharan Africa over the period 2000 to 2018. This regional classification is done to investigate the regional differences of the EKC relationship for carbon emissions. Models based on panel data econometric models are employed to obtain empirical results. Random effect and fixed effect models are used in the present study. A multivariate framework is used in which carbon dioxide emission, per capita gross domestic product, trade openness, foreign direct investment, primary school enrollment, financial development indicator, and institutional quality that is measured by six indicators are included. The result is that the EKC hypothesis is supported in all the abovementioned regions except in the Sub-Saharan Africa region. Thus, the hypothesis that different regions have dissimilar EKC relationships is supported through the results of this research study.

Biosynthesized Iron Oxide Nanoparticles (Fe3O4 NPs) Mitigate Arsenic Toxicity in Rice Seedlings

Arsenic (As) contamination has emerged as a serious public health concern worldwide because of its accumulation and mobility through the food chain. Therefore, the current study was planned to check the effect of Bacillus subtilis-synthesized iron oxide nano particles (Fe₃O₄ NP) on rice (Oryza Sativa L.) growth against arsenic stress (0, 5, 10 and 15 ppm). Iron oxide nanoparticles were extracellular synthesized from Bacillus subtilis with a desired shape and size. The formations of nanoparticles were differentiated through UV-Visible Spectroscopy, FTIR, XRD and SEM. The UV-Visible spectroscopy of Bacillus subtilis-synthesized nanoparticles showed that the iron oxide surface plasmon band occurs at 268 nm. FTIR results revealed that different functional groups (aldehyde, alkene, alcohol and phenol) were present on the surface of nanoparticles. The SEM image showed that particles were spherical in shape with an average size of 67.28 nm. Arsenic toxicity was observed in seed germination and young seedling stage. The arsenic application significantly reduced seed germination (35%), root and shoots length (1.25 and 2.00 cm), shoot/root ratio (0.289), fresh root and shoots weight (0.205 and 0.260 g), dry root and shoots weight (6.55 and 6.75 g), dry matter percentage of shoot (12.67) and root (14.91) as compared to control. Bacillus subtilis-synthesized Fe₃O₄ NPs treatments (5 ppm) remarkably increased the germination (65%), root and shoot length (2 and 3.45 cm), shoot/root ratio (1.24) fresh root and shoot weight (0.335 and 0.275 mg), dry root and shoot weight (11.75 and 10.6 mg) and dry matter percentage of shoot (10.40) and root (18.37). Results revealed that the application of Fe₃O₄ NPs alleviated the arsenic stress and enhanced the plant growth. This study suggests that Bacillus subtilus-synthesized iron oxide nanoparticles can be used as nano-adsorbents in reducing arsenic toxicity in rice plants.

Surgical Excision of Carotid Body Tumor at an Early Stage Has Best Outcome: Result of 22 Cases along with Literature Review

Objective: The objective of this study is to share our experience of early surgical excision of highly vascular carotid body tumor (CBT) and to correlate it with current literature.

Materials and Methods: Data of all consecutive patients diagnosed with CBT from September 2011 to September 2018, who underwent surgical excision, was analyzed.

Results: Of the 22 cases with mean age of 42±standard deviation (SD) 6 years and female to male ratio of 1.2 : 1, 68.1% (n=15) of the tumors were on the right side. There were 13.6% (n=3) Shamblin I, 77.2% (n=17) Shamblin II, and 9% (n=2) Shamblin III tumors. Complete excision without vascular reconstruction was achieved in 63.6% (n=14), while patch plasty with Dacron graft was noted in 29.4% (n=5) and interposition Dacron grafting 13.6% (n=3). Peroperative vascular shunt was deployed in 13.6% (n=3) of cases. Transient neuropraxia of the hypoglossal nerve was noted in 13.6% (n=3) of cases, while permanent drooping of the lower lip was noted in 4.5% (n=1). There was no ischemic stroke. The mortality rate was zero, and no recurrence was recorded in mean follow-up of 24±SD 3 months.

Conclusion: Complete surgical excision of CBT at an early stage, regardless of size, is associated with the best outcome.

Efficient Mimics for Elucidating Zaxinone Biology and Promoting Agricultural Applications

Zaxinone is an apocarotenoid regulatory metabolite required for normal rice growth and development. In addition, zaxinone has a large application potential in agriculture, due to its growth-promoting activity and capability to alleviate infestation by the root parasitic plant Striga through decreasing strigolactone (SL) production. However, zaxinone is poorly accessible to the scientific community because of its laborious organic synthesis that impedes its further investigation and utilization. In this study, we developed easy-to-synthesize and highly efficient mimics of zaxinone (MiZax). We performed a structure-activity relationship study using a series of apocarotenoids distinguished from zaxinone by different structural features. Using the obtained results, we designed several phenyl-based compounds synthesized with a high-yield through a simple method. Activity tests showed that MiZax3 and MiZax5 exert zaxinone activity in rescuing root growth of a zaxinone-deficient rice mutant, promoting growth, and reducing SL content in roots and root exudates of wild-type plants. Moreover, these compounds were at least as efficient as zaxinone in suppressing transcript level of SL biosynthesis genes and in alleviating Striga infestation under greenhouse conditions, and did not negatively impact mycorrhization. Taken together, MiZax are a promising tool for elucidating zaxinone biology and investigating rice development, and suitable candidates for combating Striga and increasing crop growth.

Plant-Derived Smoke Affects Biochemical Mechanism on Plant Growth and Seed Germination

The role of plant-derived smoke, which is changed in mineral-nutrient status, in enhancing germination and post-germination was effectively established. The majority of plant species positively respond to plant-derived smoke in the enhancement of seed germination and plant growth. The stimulatory effect of plant-derived smoke on normally growing and stressed plants may help to reduce economic and human resources, which validates its candidature as a biostimulant. Plant-derived smoke potentially facilitates the early harvest and increases crop productivity. Karrikins and cyanohydrin are the active compound in plant-derived smoke. In this review, data from the latest research explaining the effect of plant-derived smoke on morphological, physiological, biochemical, and molecular responses of plants are presented. The pathway for reception and interaction of compounds of plant-derived smoke at the cellular and molecular level of plant is described and discussed.

Surface modification for osseointegration of Ti6Al4V ELI using powder mixed sinking EDM

Biomedical implant rejection due to micromotion and inflammation around an implant leads to osteolysis and eventually has an implant failure because of poor osseointegration. To enhance osseointegration, the implant surface modification both at the nano and micro-scale levels is preferred to result in an enhanced interface between the body tissue and implant. The present study focuses on the modification of the surface of Titanium (α+β) ELI medical grade alloy using powder-mixed electric discharge machining (PMEDM). Pulse current, on/off time, and various silicon carbide (SiC) powder concentrations are used as input parameters to comprehend desired surface modifications. Powder concentration is considered as the most important factor to control surface roughness and recast layer depth. A significant decrease in surface fracture density and roughness is observed using a 20 g/l concentration of SiC particles. Elemental mapping analysis has confirmed the migration of Si and the generation of promising surface texture and chemistry. Oxides and carbides enriched surface improved the microhardness of the re-solidified layer from 320 HV to 727 HV. Surface topology reveals nano-porosity (50-200 nm) which enhances osseointegration due to the absorption of proteins especially collagen to the surface.

Predictive Factors Associated With Fear Faced by Healthcare Workers During COVID-19 Pandemic: A Questionnaire-Based Study

Background

The coronavirus disease 2019 (COVID-19) since the beginning has been a reason of fear among healthcare workers (HCWs) due to the increased mortality, especially in the HCWs themselves. In this survey study, we aimed to explore the predictive factors associated with fear faced by HCWs during the COVID-19 pandemic and to identify the areas which need to be addressed to reduce it.

Methods

On May 14, 2020, we conducted an observational, cross-sectional survey using a self-administered questionnaire, consisting of the following two parts: (1) focused on factors associated with HCWs’ fear of getting an infection and being a source of carrying the infection to whom they care, and (2) focused on factors associated with HCWs’ fear of uncertainty and lack of support from concerned health authorities.

Results

The mean age of the participants was 40.04 ± 12.92 years with 79.3% being males. More than half (51.1%) of the participants were consultants. The most important factors associated with fear included getting infected (84.8%), quarantined (69.6%), not getting medical treatment (62%), losing a life (56.8%), and infecting family members (94.2%). Another major factor associated with HCWs' fear was lack of support from concerned health authorities, 80.2% thought of solatium, and 71.7% believed that the job should be given to eligible family members of the deceased. More than 82.2% were concerned about health expenses and around 97.6% felt an additional health risk allowance should be given.

Conclusion

Our results indicate that the risk of getting infection to themselves and their families, along with a lack of support from concerned health authorities, was strongly associated with fear among HCWs. We hope through these findings that the concerned health authorities will take notice and do something in this regard by developing appropriate policies and measures to make sure that HCWs and their families are cared for if they get infected.

Rapid HIV testing increases testing frequency among gay and bisexual men: a controlled before-after study

Background Rapid HIV testing was introduced at 12 clinics in New South Wales (NSW) for routine testing and promoted with social marketing. The effect of the availability of rapid HIV testing on testing frequency among gay and bisexual men (GBM) was evaluated.

METHODS

An observational design using patient data from 12 clinics was used. The primary outcome was the mean number of HIV tests in 12 months. The intervention group comprised GBM who had one or more rapid tests from October 2013 to September 2014 and this was compared with two control groups; a concurrent group (no rapid test in the same period) and a historical group (attended between July 2011 and June 2012). Independent sample t-tests were conducted to compare mean number of tests among men in the intervention, concurrent and historical groups. Multivariate logistic regression was used to assess the association between rapid HIV testing and testing frequency.

RESULTS

Men in the intervention group (n = 3934) had a mean of 1.8 HIV tests in 12 months, compared with 1.4 in the concurrent group (n = 5063; P < 0.001) and 1.4 in the historical group (n = 5904; P < 0.001); testing frequency was higher among men at increased risk of HIV in the intervention group compared with the other two groups (mean 2.2, 1.6 and 1.5 respectively; P < 0.001). Membership of the intervention group was associated with increased odds of having two or more HIV tests in 12 months (AOR = 2.5, 95%CI 2.2-2.8; P < 0.001) compared with the concurrent group, after controlling for demographic and behavioural factors.

CONCLUSION

Introducing and promoting rapid HIV testing in clinics in NSW was associated with increased HIV testing frequency among GBM.

Knowledge, Attitude, and Practices of Healthcare Workers Regarding the Use of Face Mask to Limit the Spread of the New Coronavirus Disease (COVID-19)

Introduction

Many countries including Pakistan are currently using face masks in their pandemic control plans. Being highly prevalent, the correct use of these masks is particularly important, as an incorrect use and disposal may actually increase the rate of transmission. The purpose of this study was to investigate the knowledge, attitude, and practices of healthcare workers (HCWs) in wearing a surgical face mask to limit the spread of the new coronavirus disease 2019 (COVID-19).

Materials and Methods

This survey was conducted by interviewing HCWs using a questionnaire consisting of the basic demographic characteristics, and the knowledge, attitude, and practices regarding the use of surgical face mask to limit the new COVID-19 exposure. Each correct answer was scored 1 and each incorrect answer scored 0. The total number of questions was 16, and the final score was calculated and then labeled according to the percentage (out of 16) of correct responses as good (>80%), moderate (60-80%), and poor (<60%).

Results

A total of 392 participants with a mean age of 42.37 ± 13.34 years (341 males and 51 females) were included in the study. The overall final results were good in 138 (35.2%), moderate in 178 (45.4%), and poor in 76 (19.3%). Around 43.6% of participants knew about the correct method of wearing the masks, 68.9% knew that there are three layers, 53% stated that the middle layer act as a filter media barrier, and 75.5% knew the recommended maximum duration of wearing it. The majority (88.2%) of participants knew that a cloth face mask is not much effective, around 79.8% knew that used face mask cannot be re-used, and 44.8% knew about the yellow-coded bag for disposal.

Conclusions

Knowledge, attitude, and practice of HCWs regarding the use of face masks were found to be inadequate. Studied HCWs had a positive attitude but moderate-to-poor level of knowledge and practice regarding the use of face mask. HCWs and general public awareness campaigns regarding the proper use of face mask by utilizing all social media available resources would be helpful during this pandemic.

Distal Revascularization And Interval Ligation Procedure For The Treatment Of Dialysis Access Induced Steal Syndrome

BACKGROUND

We aim to share our experience of the efficacy of Distal Revascularization and Interval Ligation (DRIL) in alleviating ischemic symptoms of dialysis access induced steal syndrome (DAISS) while preserving the original access.

METHODS

In this multicentre study, all consecutive patients with DAISS undergoing DRIL over a period of 3 years were included.

RESULTS

A total of 25 DRILs were included. Mean age was 37.8±SD 7.8 years and 52% (n=13) were females. Out of 25 patients; 88% (n=22) had more than one of the following ischemic symptoms: coolness (96%), pain (88%), paresthesia (80%), and discoloration (44%). Significant improvement following DRIL was noted in paraesthesia (86%, p-value 0.00), pain (85%, P value 0.00), coolness (83%, p-value 0.00). There was significant improvement in distal blood flow following DRIL, reflected by increase in the Aggregate Peak Systolic Velocities (PSV) in forearm vessels (PSV aggregate pre-op 39cm/s: PSV aggregate post-op 58 cm/s; p-value 0.01). The cumulative patency of DRIL graft was 96% at 3 months, 84% at 6 months and 76% at 1 year.

CONCLUSION

Distal Revascularization and Interval Ligation significantly improves circulation to the distal limb and reduce ischemic symptoms thus making it a procedure of choice for treatment of DAISS.

Comprehensive analysis on orthopedic drilling: A state-of-the-art review

Bone drilling is a well-known internal fixation procedure to drill a hole, fixing the bone fragments to reduce the susceptibility of permanent paralysis. The success of bone drilling is evaluated based on the extent of osteonecrosis in terms of heat generation, tissue damage, quality of hole, and drilling forces. The appropriate control of cutting conditions, drill geometric parameters, and bone-specific parameters offer bone drilling a viable solution through conventional and non-conventional drilling techniques. The majority of the published research work considers only limited parameters and tries to optimize the drilling parameters and performance measures. However, bone drilling involves numerous conventional and non-conventional drilling parameters and technologies. In order to develop a better understanding of all the studied parameters and performance measures, there is a dire need to develop a framework. The key objective of this review study is to establish a hierarchy of the framework by collecting almost all the parameters studied until now and addressed the relationship between parameters and performance measures to diminish the controversies in the published literature. Therefore, this framework is novel in nature, organizing all the parameters, performance measures, logical comparisons, and limitations of studies. This holistic review can help medical surgeons and design engineers to understand the complicated relationship among parameters and performance measures associated with this state-of-art technologies. Also, modeling, simulations, and optimization techniques are included to explore the application of such techniques in recent advancements in orthopedic drilling.

Role of halotolerant and chitinolytic bacteria in phytoremediation of saline soil using spinach plant

Novel technologies are required for rapid reclamation of saline soils. The halotrophic and chitinolytic bacterial strains were used for phytoremediation of saline soils using spinach plants (Spinacia oleracea L.). The previously isolated chitinolytic bacteria showed high antifungal potential against Fusarium oxysporum, and Alternaria spp. The halotolerant bacterial strains were previously isolated showing a salt tolerance of up to 20% in culture media. Specially designed microcosms were used here to investigate the reclamation of saline soil by bacteria. The soil salinity was reduced by both types of bacteria (from 6.5 to 2 dS/m). A decline in Na contents from 22-24 to 9-12 meq/L and in sodium adsorption ratio from 10-11 to 7-8 was also observed in saline soils. The Ca/Mg contents increased from 24 to 30-33 meq/L. The bioassays were performed to evaluate the effect of the bacteria on the phytoremediation. The shoot, root weights (both fresh (1.927 g, 0.244 g) and dry (0.387 g, 0.104 g)) increased by bacterial inoculation as compared to control in saline soils. The Na/K ratio decreased in plant tissues. Here we report the increased efficacy of phytoremediation by combined inoculation of chitinolytic and halotolerant bacterial strains in soil which has never been reported before.

Infusion Jet Flow Control in Neonatal Double Lumen Cannulae

Clinical success of extracorporeal membrane oxygenation (ECMO) depends on the proper venous cannulation. Venovenous (VV) ECMO is the preferred clinical intervention as it provides a single-site access by utilizing a VV double lumen cannula (VVDLC) with a higher level of mobilization and physical rehabilitation. Concurrent venous blood drainage and oxygenated blood infusion in the right atrium at the presence of the cannula makes the flow dynamics complex where potential mixing of venous and oxygenated blood can drastically decrease the overall performance of ECMO. There are no studies focusing on the neonatal and pediatric populations, in which the flow related effects are critical due to the small atrium size. In this study, fluid dynamics of infusion outflow jet for two commercially available neonatal VVDLC is analyzed using particle image velocimetry (PIV). Moreover, six new designs are proposed for the infusion channel geometry and compared. Important flow parameters such as flow turning angle (FTA), velocity decay, potential core, and turbulent intensity are investigated for the proposed models. The experiments showed that the outflow parameters of commercial cannulae such as FTA are strongly dependent on the operating Re number. This may result in a drastic efficiency reduction for cannula operating at off-design flow conditions. Moreover, the infusion outlet tip structure and jet internal guiding pathway (JIGP) was observed to greatly affect the outflow flow features. This is of paramount importance since the anatomical positioning of the cannula and the infusion outlet is strongly dependent on the outflow properties such as FTA.

The Apocarotenoid Zaxinone Is a Positive Regulator of Strigolactone and Abscisic Acid Biosynthesis in Arabidopsis Roots

Carotenoids are ubiquitous precursors of important metabolites including hormones, such as strigolactones (SLs) and abscisic acid (ABA), and signaling and regulatory molecules, such as the recently discovered zaxinone. Strigolactones and ABA are key regulators of plant growth and development, adaptation to environmental changes and response to biotic and abiotic stress. Previously, we have shown that zaxinone, an apocarotenoid produced in rice by the enzyme zaxinone synthase (ZAS) that is common in mycorrhizal plants, is required for normal rice growth and development, and a negative regulator of SL biosynthesis. Zaxinone is also formed in Arabidopsis, which lacks ZAS, via an unknown route. In the present study, we investigated the biological activity of zaxinone in Arabidopsis, focusing on its effect on SL and ABA biosynthesis. For this purpose, we quantified the content of both hormones and determined the levels of related transcripts in Arabidopsis (Arabidopsis thaliana), roots upon zaxinone treatment. For SL quantification, we also employed Striga seed germination bioassay. Results obtained show that zaxinone application to hydroponically grown Arabidopsis seedlings enhanced transcript levels of key biosynthetic genes of both hormones, led to higher root ABA and SL (methyl carlactonoate, MeCLA) content, and increased SL release, even under sufficient phosphate supply. Using the SL insensitive (max2-1) and the ABA deficient (aba1-6, aba2-1, and nced3) mutants, we also show that zaxinone application reduced hypocotyl growth and that this effect is caused by increasing ABA content. Our results suggest that zaxinone is a regulatory metabolite also in Arabidopsis, which triggers the biosynthesis of both carotenoid-derived hormones, SLs and ABA, in roots. In the non-mycotrophic plant Arabidopsis, zaxinone does not increase growth and may be perceived as a stress signal, while it acts as a growth-promoting metabolite and suppressor of SL biosynthesis in rice.

A New Series of Carlactonoic Acid Based Strigolactone Analogs for Fundamental and Applied Research

Strigolactones (SLs) are a group of carotenoid derived plant hormones that play a key role in establishing plant architecture and adapting it to environmental changes, and are involved in plants response to biotic and abiotic stress. SLs are also released into the soil to serve as a chemical signal attracting beneficial mycorrhizal fungi. However, this signal also induces seed germination in root parasitic weeds that represent a major global threat for agriculture. This wide spectrum of biological functions has made SL research one of the most important current topics in fundamental and applied plant science. The availability of SLs is crucial for investigating SL biology as well as for agricultural application. However, natural SLs are produced in very low amounts, and their organic synthesis is quite difficult, which creates a need for efficient and easy-to-synthesize analogs and mimics. Recently, we have generated a set of SL analogs, Methyl Phenlactonoates (MPs), which resemble the non-canonical SL carlactonoic acid. In this paper, we describe the development and characterization of a new series of easy-to-synthesize MPs. The new analogs were assessed with respect to regulation of shoot branching, impact on leaf senescence, and induction of seed germination in different root parasitic plants species. Some of the new analogs showed higher efficiency in inhibiting shoot branching as well as in triggering parasitic seed germination, compared to the commonly used GR24. MP16 was the most outstanding analog showing high activity in different SL biological functions. In summary, our new analogs series contains very promising candidates for different applications, which include the usage in studies for understanding different aspects of SL biology as well as large scale field application for combating root parasitic weeds, such as Striga hermonthica that devastates cereal yields in sub-Saharan Africa.

Towards Optimization of Surface Roughness and Productivity Aspects during High-Speed Machining of Ti-6Al-4V

Nowadays, titanium alloys are achieving a significant interest in the field of aerospace, biomedical, automobile industries especially due to their extremely high strength to weight ratio, corrosive resistance, and ability to withstand higher temperatures. However, titanium alloys are well known for their higher chemical reactive and low thermal conductive nature which, in turn, makes it more difficult to machine especially at high cutting speeds. Hence, optimization of high-speed machining responses of Ti–6Al–4V has been investigated in the present study using a hybrid approach of multi-objective optimization based on ratio analysis (MOORA) integrated with regression and particle swarm approach (PSO). This optimization approach is employed to offer a balance between achieving better surface quality with maintaining an acceptable material removal rate level. The position of global best suggested by the hybrid optimization approach was: Cutting speed 194 m/min, depth of cut of 0.1 mm, feed rate of 0.15 mm/rev, and cutting length of 120 mm. It should be stated that this solution strikes a balance between achieving lower surface roughness in terms of R_a and R_q, with reaching the highest possible material removal rate. Finally, an investigation of the tool wear mechanisms for three studied cases (i.e., surface roughness based, productivity-based, optimized case) is presented to discuss the effectiveness of each scenario from the tool wear perspective.

Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

BACKGROUND

Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it.

METHODS

New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for 6 months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured.

RESULTS

Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of 6 months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase.

CONCLUSION

Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.

Hemodynamics of neonatal double lumen cannula malposition

Objective:

Malposition of dual lumen cannula is a frequent and challenging complication in neonates and plays a significant role in shaping the in vitro device hemodynamics. This study aims to analyze the effect of the dual lumen cannula malposition on right-atrial hemodynamics in neonatal patients using an experimentally validated computational fluid dynamics model.

Methods:

A computer model was developed for clinically approved dual lumen cannula (13Fr Origen Biomedical, Austin, Texas, USA) oriented inside the atrium of a 3-kg neonate with normal venous return. Atrial hemodynamics and dual lumen cannula malposition were systematically simulated for two rotations (antero-atrial and atrio-septal) and four translations (two intravascular movements along inferior vena cava and two dislodged configurations in the atrium). A multi-domain compartmentalized mesh was prepared to allow the site-specific evaluation of important hemodynamic parameters. Transport of each blood stream, blood damage levels, and recirculation times are quantified and compared to dual lumen cannula in proper position.

Results:

High recirculation levels (39 ± 4%) in malpositioned cases resulted in poor oxygen saturation where maximum recirculation of up to 42% was observed. Apparently, Origen dual lumen cannula showed poor inferior vena cava blood–capturing efficiency (48 ± 8%) but high superior vena cava blood–capturing efficiency (86 ± 10%). Dual lumen cannula malposition resulted in corresponding changes in residence time (1.7 ± 0.5 seconds through the tricuspid). No significant differences in blood damage were observed among the simulated cases compared to normal orientation. Compared to the correct dual lumen cannula position, both rotational and translational displacements of the dual lumen cannula resulted in significant hemodynamic differences.

Conclusion:

Rotational or translational movement of dual lumen cannula is the determining factor for atrial hemodynamics, venous capturing efficiency, blood residence time, and oxygenated blood delivery. Results obtained through computational fluid dynamics methodology can provide valuable foresight in assessing the performance of the dual lumen cannula in patient-specific configurations.

Effect of D-ring C-3' methylation of strigolactone analogs on their transcription regulating activity in rice

Strigolactones (SLs) are a well-known class of plant hormones, which are involved in a number of developmental and adaptation processes and mediate different interspecific interactions. In spite of the growing knowledge on SL biosynthesis and signal transduction, effects of structural modifications on the activity and efficiency of SLs and their analogs remain largely elusive. SLs are characterized by the presence of a lactone ring (D-ring) that is connected by an enol ether bridge to a second moiety. In this study, we investigated the effect of additional D-ring methylation of SL analogs on their transcription regulating activity. For this purpose, we compared the SL analogs MP13 and AR8, which differ only by the presence of a methyl group at the C-3' atom in the latter. Transcription regulating activity was determined by quantitative real-time PCR measurement of transcript levels of SL-dependent, feed-back regulated genes in treated wild type and ccd7 mutant rice seedlings. Results obtained indicate that C-3' methylation reduces the transcription regulating activity, as shown by the more pronounced suppression of the SL biosynthesis genes DWARF27 (D27) and CAROTENOID CLEAVAGE DIOXYGENASES (CCD7 and CCD8) and higher induction of the SL signaling repressor gene DWARF53 (D53) in MP13 treated seedlings. These results are consistent with a recent study on the biological activities of MP13 and AR8.

Evaluating the effect of micro-lubrication in orthopedic drilling

Achievement of low temperature, thrust force, and clean operating zone under with/without irrigation-assisted drilling is still a challenge in orthopedic surgery owing to substantial bone-tissue damage that extends the healing time. In order to mitigate the above challenges, a new micro-lubrication technique-a low-pressure cold mist impinged on the tool-bone joint interface and penetrating well into the bone surface to improve the cooling/lubrication efficiency-has been proposed in bone drilling. In this study, the aims are to characterize the effect of micro-cooling/lubrication on temperature and thrust force at different levels of cutting speed, feed rate, drill diameter, and coolant flow rate. For that purpose, a fresh calf bone was drilled through commercially available drill tool on three-axis mini-machine. The response surface methodology was applied to get the design of experiments, and the analysis of variance at p-values < 0.5 was used. Moreover, the empirical models were developed to examine the simultaneous effect of all the parameters on performance measures. The employed cooling-lubrication technology has shown a percentage reduction in temperature ranging from 34.3% to 48.3%, and 26.8%-35.9% under irrigation with respect to without-irrigation mode. For cutting force, these reductions are 13%-47.6% and 14.5%-44.2%, respectively. Furthermore, analysis of variance has highlighted the cutting speed and feed rate as the two most prominent parameters for temperature and thrust force under all the drilling modes. Relatively high-pressure cold mist in micro-lubrication has offered a lower temperature, thrust force, and clean operating zone under micro-lubrication mode than with/without-irrigation modes. Henceforth, the micro-lubrication technique has been found as a suitable cooling technique for drilling of bone in the viewpoint of temperature and thrust force.

Bacillus Cereus Enhanced Phytoremediation Ability of Rice Seedlings under Cadmium Toxicity

Cadmium (Cd+2) is a highly toxic metal, which significantly alters different biochemical and metabolic processes in plants. Massive amounts of Cd+2 is being released into the environment by different anthropogenic activities. In the present study, plant growth promoting activities of bacterial strain Bacillus cereus was evaluated under Cd+2 stress in two rice cultivars Basmati-385 and Shaheen Basmati. Cd+2 stress significantly decreased plant growth and biomass production in both cultivars. However, with the inoculation of B. cereus under Cd+2 treatments, reduced Cd+2 uptake and increased antioxidant enzymes activities in rice cultivars lead to enhanced plant growth, biomass production, photosynthetic pigments, micronutrients, and lowered electrolytes leakage. This study suggests that B. cereus has the ability to alleviating Cd toxicity and increased phytoremediation efficiency of rice seedling under Cd stress.

In situ Impact of the Antagonistic Fungal Strain, Trichoderma gamsii T30 on the Plant Pathogenic Fungus, Rhizoctonia solani in Soil

Rhizoctonia solani is a soil-borne fungus causing a wide range of plants diseases. Trichoderma gamsii strain T30 has previously been reported as antagonistic against R. solani. Although there are a few studies about the influence of Trichoderma strains on the R. solani density in a pathosystem in the presence of plant hosts, this report for the first time comprehensively describes in situ effects of a T. gamsii strain on the population density of R. solani in the soil microcosmic conditions. The population dynamics of R. solani were followed in the autoclaved and non-autoclaved soils in artificially prepared microcosms up to day 25 after co-inoculation with T. gamsii in the variable ratios (R1/T1; R1/T0.1; R1/T0.01 of R. solani/T. gamsii). The population density of R. solani was evaluated by qPCR. In the autoclaved soil, target DNA copies of R. solani increased in the control samples from 1 × 10⁵ to 6.5 × 10⁶. At R1/T0.01, the number of target DNA copies were not significantly changed until day 11; however, it decreased by around five times at day 25. At R1/T0.1 and R1/T1, the number of DNA copies was reduced to 2.1 × 10⁶ and 7.6 × 10⁵ at day 11, respectively and the reduction was as much as 17 times at day 25. In the non-autoclaved soil, the number of the fungal cells decreased at day 25 whether inoculated or not with Trichoderma indicating a general suppression by the soil microbiome. In brief, T. gamsii significantly inhibited the growth of R. solani in the soil in situ and there was a general suppressive effect of the natural microbiome.

Somatic mutations in non-small cell lung cancer and their correlation with overall survival, tumor mutation burden, and programmed-death cell ligand-1 (PD-L1) status

e14752

Background: In recent years, treatments for non-small cell lung cancer (NSCLC) have expanded to include targeted therapies and immune checkpoint inhibitors in addition to traditional treatments. These newer modalities of treatment require testing with next-generation sequencing (NGS) testing, which offers testing for hundreds of somatic mutations, both with known and unknown significance. Tumor mutation burden (TMB), which is the number of mutations per coding sequence, is also reported on NGS. Patients with targetable mutations or a high TMB have been found to have improved survival and higher responses to immunotherapy, respectively. We wanted to investigate whether the total number of mutations (both with known and unknown significance) had any association with PD-L1 status, TMB and overall survival. Methods: This was a single institution, retrospective study of 51 patients with stage I-IV NSCLC. Results: In our study, we found that there was a significant correlation between the number of mutations and TMB in all patients with NSCLC (p = 0.001), including adenocarcinoma (p = 0.005). We found that the number of known mutations, mutations of unknown significance and total overall mutations did not have a significant correlation with survival (p = 0.708, p = 0.808, and p = 0.639, respectively) or PD-L1 status (p = 0.214). In a subset analysis of patients with metastatic NSCLC, there was also no correlation between the total number of mutations and overall survival (p = 0.821). Conclusions: In our study, we determined that there was a positive correlation between TMB and higher number of mutations, though the number of mutations did not correlate with PD-L1 status or overall survival. As TMB is associated with higher immunogenic responses, this data may have future therapeutic implications. Additional investigation of the most frequent mutations is ongoing.

Surgical Fixation of Atypical Femur Fractures in Bisphosphonate-treated Patients

Objective

To evaluate the outcomes of the surgical fixation of atypical femoral fractures in bisphosphonate-treated patients with an intramedullary device.

Materials and methods

This multicentric study was carried out at the department of orthopedics, Dr. Ruth Phau Civil Hospital and Medicare Hospital, Karachi, Pakistan, between 2013 and 2018. In this retrospective observational study, we reviewed 10 bisphosphonate-treated patients, fixed surgically with an intramedullary nail after presenting with radiologically characteristic atypical femur fractures identified according to the American Society for Bone and Mineral Research criteria. We excluded patients with fractures sustained by high-energy trauma, road traffic accidents, fall from a height, and those associated with underlying malignancy.

Results

A total of 11 atypical femoral fractures in 10 patients were included, all of whom were females with a mean age of 68.6 (range 57-82) years. Out of 11 fractures, 81.8% (n=9) were located in the subtrochanteric region and two were located in the femoral shaft. The mean bisphosphonate use was 58.3 months. All patients were treated with intramedullary devices; an intramedullary interlocking nail in two cases and proximal femoral nail antirotation in nine cases. The mean follow-up duration was 12 months. All fractures were united in an average time of 9.9 months (range 6 - 16 months). Implant failure and/or nonunion were not observed, whereas delayed union was noted in five patients.

Conclusion

Intramedullary fixation is a reliable method for the treatment of atypical femur fractures in bisphosphonate-treated patients owing to its intramedullary placement. These devices act as an internal splint and can provide much more axial stability, reducing the risk of implant fatigue failure due to a delay in fracture healing from prolonged bisphosphonate use.

Production, characterization and antimicrobial activities of bio-pigments by Aquisalibacillus elongatus MB592, Salinicoccus sesuvii MB597, and Halomonas aquamarina MB598 isolated from Khewra Salt Range, Pakistan

Hypersaline ecosystems offer unique habitats to microbial populations capable of withstanding extreme stress conditions and producing novel metabolites of commercial importance. Herein, we have characterized for the first time the production of bioactive pigments from newly isolated halophilic bacterial species. Halophilic bacteria were isolated from Khewra Salt Range of Pakistan. Three distinctly colored isolates were selected for pigment production. Selected colonies were identified as Aquisalibacillus elongatus MB592, Salinicoccus sesuvii MB597, and Halomonas aquamarina MB598 based on morphological, biochemical, and physiological evidences as well as 16S rRNA analysis. The optimum pigment production observed at mesophilic condition, nearly neutral pH, and moderate salinity was validated using response surface methodology. Different analytical techniques (UV spectroscopy, infrared spectroscopy, and HPLC) characterized these purified pigments as derivatives of bacterioruberin carotenoids. Antioxidant activity of pigments revealed up to 85% free-radical scavenging activity at the concentration of 30 µg ml^-1. Pigments also showed significant antimicrobial activity against Bacillus subtilis, Bacillus pumilus, Enterococcus faecalis, Bacillus cereus, Klebsiella pneumoniae, Alcaligenes faecalis, Pseudomonas geniculata, Enterococcus faecium, Aspergillus fumigatus, Aspergillus flavus, Fusarium solani, and Mucor spp., suggesting potential biomedical applications.

Genome-wide association studies of seven agronomic traits under two sowing conditions in bread wheat

BACKGROUND

Wheat is a cool seasoned crop requiring low temperature during grain filling duration and therefore increased temperature causes significant yield reduction. A set of 125 spring wheat genotypes from International Maize and Wheat Improvement Centre (CIMMYT-Mexico) was evaluated for phenological and yield related traits at three locations in Pakistan under normal sowing time and late sowing time for expose to prolonged high temperature. With the help of genome-wide association study using genotyping-by-sequencing, marker trait associations (MTAs) were observed separately for the traits under normal and late sown conditions.

RESULTS

Significant reduction ranging from 9 to 74% was observed in all traits under high temperature. Especially 30, 25, 41 and 66% reduction was observed for days to heading (DH), plant height (PH), spikes per plant (SPP) and yield respectively. We identified 55,954 single nucleotide polymorphisms (SNPs) using genotyping by sequencing of these 125 hexaploid spring wheat genotypes and conducted genome-wide association studies (GWAS) for days to heading (DH), grain filled duration (GFD), plant height (PH), spikes per plant (SPP), grain number per spike (GNS), thousand kernel weight (TKW) and grain yield per plot (GY). Genomic regions identified through GWAS explained up to 13% of the phenotypic variance, on average. A total of 139 marker-trait associations (MTAs) across three wheat genomes (56 on genome A, 55 on B and 28 on D) were identified for all the seven traits studied. For days to heading, 20; grain filled duration, 21; plant height, 23; spikes per plant, 13; grain numbers per spike, 8; thousand kernel weight, 21 and for grain yield, 33 MTAs were detected under normal and late sown conditions.

CONCLUSIONS

This study identifies the essential resource of genetics research and underpins the chromosomal regions of seven agronomic traits under normal and high temperature. Significant relationship was observed between the number of favored alleles and trait observations. Fourteen protein coding genes with their respective annotations have been searched with the sequence of seven MTAs which were identified in this study. These findings will be helpful in the development of a breeder friendly platform for the selection of high yielding wheat lines at high temperature areas.

Fixation of Metacarpal Fractures Using Intramedullary Headless Compression Screws: A Tertiary Care Institution Experience

Introduction

Metacarpal fractures account for the majority of hand fractures. Inadequate management can cause functional deficit which can lead to loss of fine hand movements. Adequate management has proven to give good outcomes. The use of intramedullary screws has given better results than the use of Kirschner wires (K-wires).

Method

This study was conducted at Dr. Ruth Phau Civil Hospital, Karachi (CHK) between August 1, 2018 and January 31, 2019. A total of 32 patients presented with metacarpal fractures. They were surgically managed with intramedullary headless screw fixation. Post-operatively, grip strength, range of motion, and presence of any disabilities were recorded. Patients were followed up to three months.

Results

Out of 32 patients, six were females. Mean age was found to be 29.1 ± 10.5 years. Post-operatively the mean grip strength was found to be 37.8 ± 7.3 kilograms. The mean total active range of motion was found to be 242.8 ±14.5 degrees. The mean days to return back to work were 25 ± 5.4 days. The mean patient satisfaction score was 8.1 ± 0.79. Three patients developed post-operative stiffness of the joint.

Conclusion

Patients with intramedullary screw fixation have good post-operative results with early return to work.

Investigations of Machining Characteristics in the Upgraded MQL-Assisted Turning of Pure Titanium Alloys Using Evolutionary Algorithms

Environmental protection is the major concern of any form of manufacturing industry today. As focus has shifted towards sustainable cooling strategies, minimum quantity lubrication (MQL) has proven its usefulness. The current survey intends to make the MQL strategy more effective while improving its performance. A Ranque–Hilsch vortex tube (RHVT) was implemented into the MQL process in order to enhance the performance of the manufacturing process. The RHVT is a device that allows for separating the hot and cold air within the compressed air flows that come tangentially into the vortex chamber through the inlet nozzles. Turning tests with a unique combination of cooling technique were performed on titanium (Grade 2), where the effectiveness of the RHVT was evaluated. The surface quality measurements, forces values, and tool wear were carefully investigated. A combination of analysis of variance (ANOVA) and evolutionary techniques (particle swarm optimization (PSO), bacteria foraging optimization (BFO), and teaching learning-based optimization (TLBO)) was brought into use in order to analyze the influence of the process parameters. In the end, an appropriate correlation between PSO, BFO, and TLBO was investigated. It was shown that RHVT improved the results by nearly 15% for all of the responses, while the TLBO technique was found to be the best optimization technique, with an average time of 1.09 s and a success rate of 90%.