The development of a multifunctional 9,10-dibromooctadecanoic acid-encapsulated heterostructure (Ag@Ag2O) as a nanocatalyst against water toxicity

Fatty acid derivatives capped Ag@Ag₂O CSN have been easily synthesized. Comparative catalytic degradation studies against various water contaminants, MB, MO and Cr(vi) have been performed. The experimental results are in favor of CSN, compared to simple fatty acid-coated nanoparticles.

Empirics on heterogeneous links among urbanization, the intensity of electric power consumption, water-based emissions, and economic progress in regional China

This study investigates the heterogeneous causal linkages between urbanization, the intensity of electric power consumption, water-based pollutant emissions, and GRP in regional China by developing an urbanization-augmented "Stochastic Impacts by Regression on Population, Affluence, and Technology" (STIRPAT) model. A whole country panel of 29 provinces as well as region sub-panels of China, for the period 1999 to 2018, are estimated employing common correlated effects mean group approach (CCEMGA), which offers robustness against heterogeneous characteristics and cross-sectionally dependent series. From the theoretic modeling aspect, the intensity of electric power consumption and urbanization have been introduced as the determinants of water-based pollutant emissions in the STIRPAT modeling framework. Based on empirical results, first, GRP growth has shown appealing behavior in the form of its heterogeneous impacts on water-based pollutant emissions growth in the case of different regions. For instance, its impact is noted to be positive and statistically significant for the western region, which turned positive but statistically insignificant for the intermediate region. And it further turned significantly negative in the case of the eastern region. We call this phenomenon as "development level-based emission mitigation effect." Second, in terms of the impact of GRP growth on urbanization, the "development-based urbanization ladder effect" has been found. Based on heterogeneous causal links, firstly, the existence of a positive bilateral causal link between the intensity of electric power consumption and GRP growth and urbanization and GRP growth has been validated. Secondly, a positive unidirectional causal link emerged from urbanization to the intensity of electric power consumption and water-based pollutant emissions growth. Thirdly, the causal connection between GRP growth and water-based pollutant emissions growth remained very interesting and of mixed nature. Based on empirical findings, useful policies are extended. Graphical abstract.

Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)-A Randomized Controlled Trial

BACKGROUND

There is a paucity of literature regarding the association of high oncotic priming solutions for pediatric cardiopulmonary bypass (CPB) and outcomes, and no consensus exists regarding the composition of optimal CPB priming solution. This study aimed to examine the impact of high oncotic pressure priming by the addition of 20% human albumin on outcomes.

METHODS

Double-blinded, randomized controlled study was done in the pediatric cardiac intensive care unit of a tertiary care hospital. Consecutive children with congenital heart diseases admitted for open-heart surgery were randomized into two groups, where the study group received an additional 20% albumin to conventional blood prime before CPB initiation.

RESULTS

We enrolled 39 children in the high oncotic prime (added albumin) group and 37 children in the conventional prime group. In the first 24-hour postoperative period, children in the albumin group had significantly lower occurrence of hypotension (28.2% vs 54%, P = .02), requirement of fluid boluses (25.6% vs 54%, P = .006), and lactate clearance time (6 vs 9 hours, P < .001). Albumin group also had significantly higher platelet count (×10³/µL) at 24 hours (112 vs 91, P = .02). There was no significant difference in intra-CPB hemodynamic parameters and incidence of acute kidney injury. In subgroup analysis based on risk category, significantly decreased intensive care unit stay (4 vs 5 days, P = .04) and hospital stay (5 vs 7 days, P = .002) were found in the albumin group in low-risk category.

CONCLUSION

High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.

Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during COVID-19 Pandemic

There is a global concern of increasing number of children presenting with inflammatory syndrome with clinical features simulating Kawasaki disease, during ongoing COVID-19 pandemic. The authors report a very similar case of 5-y-old boy from a COVID-19 hotspot area who presented in late April 2020 with acute febrile illness with abdominal pain and loose stools followed by shock. On examination, child had bulbar conjunctivitis and extremity edema. Initial investigations showed high inflammatory parameters, elevated serum creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis. He was treated with inotropic support, respiratory support with high flow nasal cannula, IV immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 d of hospital stay.

Investigating the long-run interaction between electricity consumption, foreign investment, and economic progress in Pakistan: evidence from VECM approach

In this study, we attempt to investigate the relationship between electricity consumption, foreign direct investment (FDI) and economic progress in Pakistan during the period from 1997 to 2017. We applied the unit root tests to cointegration approach with the vector error correction model (VECM) approach. We also authenticated the robustness of the outcomes with the help of the regression methods. The main findings indicated that variables are cointegrated in the long-run and the VECM approach verified long-run causal links among the variables. The short-run causality is running from electricity consumption and economic development to FDI. The results remained uniform under the fully modified ordinary least squares (FMOLS), dynamic ordinary least squares (DOLS), and the autoregressive distributed lag (ARDL) estimations. Correspondingly, these three methods ratified that there is a significant long-run linkage between electricity consumption and the economic development of Pakistan. Additionally, the diagnostic assessments fixed that results are free from correlations and models are stable. Thus, based on these results, electricity generation and consumption, as well as FDI, is crucial for the economic progress of Pakistan. The priority should be given to promote the optimum use of available resources to generate energy, and FDI in the energy sector should be attracted through various incentives to support the economic advancement of Pakistan. Renewable energy resources are recyclable springs that can cut the intensity of carbon emissions and encourage to the promising magnitude of FDI and also certify sustainable and economic progression of Pakistan.

Climate disturbance impact assessment in West Africa: evidence from field survey and satellite imagery analysis

Extreme drought events from climate disturbances are weakening livelihood and limiting agriculture and livestock production in the Sahel region. The lack of relevant information to anticipate coping measures has exacerbated impacts leading to climate adaptation failure in most parts. In this regard, the current research paper has collected important datasets with an objective to assess the impact of extreme drought events on household's livelihoods for better understanding impacts, local people's perception, and the changes on vegetation cover in order to support a robust adaptation strategy to drought. The study conducted a household survey and collected satellite data for comparative analysis. The first survey was conducted in 2013 to collect data from 465 household heads through a structured questionnaire. Supplementary focus group discussions (FGDs) were also conducted in 2018 to collect qualitative information from targeted respondents such as village leaders and members of other key groups including women and youth. Descriptive statistics and correlation coefficient matrix were used to characterize the impact on households' main livelihoods and logistic regression to predict people's perception on pasture depletion over the last 20 years. Satellite data were used to derive spectral vegetation of land covers and unsupervised classification indexes. Both individual survey and focus group discussions identified drought as the main climate constraint which reduced crop production, water and pastures. The logistic analysis revealed that if the respondent's major occupation is livestock, the probability to perceive a depletion of pasture will increase by 28%. Concurrently, the satellite image observation in perfect agreement with the field survey showed 6.78% and 6.01% losses of water surface and vegetation cover respectively between 1986 and 2016 in the study area. These findings showed that logistic regression coupled with satellite information can inform on past and future impacts which are extremely crucial for sound adaptation planning in the Sahel region.

DISTRIBUTION OF DELIBERATE SELF-POISONING BY SOCIO-DEMOGRAPHIC FACTORS, PRECIPITATING EVENTS, TYPE OF SUBSTANCE AND MORTALITY IN POPULATION OF HAZARA DIVISION, PAKISTAN

Background: Deliberate self-poisoning is important cause of deaths in younger population. The objectives of this study were to determine the distribution of deliberate self-poisoning by 12 socio-demographic factors, precipitating events, type of substance and mortality in population of Hazara Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in the Department of Medicine, Ayub Medical College, Abbottabad, Pakistan from October 9, 2017 to December 28, 2018. 102 deliberate self-poisoning patients were selected consecutively from population at risk. Variables were 12 socio-demographic factors, precipitating events, type of substance and mortality. All variables being categorical were described by count and percentage for sample and by confidence intervals for proportion for population at 95% confidence level. RESULTS: Deliberate self-poisoning cases (n=102) were higher in women 80.39%, in age group 18-25 years 54.90%, similar in urban 49.02% and rural 50.98%, higher in non-Pathan 74.51%, in married 57.84%, in joint family 79.41%, in up to matric education 85.29% and in housewives 52.94%, 4.90% with previous history of self-harm, 1.96% with family history of self-harm and higher in lower socioeconomic group 81.37%. The most common precipitating event was interpersonal difficulties with spouse, family members or friends 56.86%, while the most common type of substance was organophosphate 62.75%. Mortality was 3.92%. Conclusion: Deliberate self-poisoning was more prevalent in women, younger age group, married, joint family, educated up to matric, housewives and lower socioeconomic status. Family conflict was most common precipitating factor. Organophosphate was most common type of substance and mortality was high 3.92%.

Not such a small diagnosis: small cell carcinoma of the prostate

Small cell carcinoma (SCC) is an aggressive malignancy most commonly described in the lung. We present a case of a 61-year-old male who presented with a neck swelling and was subsequently found to have metastatic SCC of the prostate. Clinicians should be aware that it metastasizes early. Unlike conventional prostate adenocarcinoma, it is not a prostate-specific antigen (PSA) secreting tumor hence serum levels do not correlate with disease severity, and a low PSA reading may give false reassurance. In the future, further studies on genomic typing and novel targeted therapies may achieve better clinical outcomes for patients with this aggressive type of prostate cancer.

A Rare Case of Lithium-induced Partial Nephrogenic Diabetes Insipidus

Chronic lithium therapy in patients with bipolar disorder and other psychiatric illnesses can lead to a very common side effect of complete or partial nephrogenic diabetes insipidus. After confirmation of hypotonic polyuria, water deprivation test with desmopressin injection is used to make the diagnosis. Incomplete response to desmopressin suggests partial nephrogenic diabetes insipidus. We report a rare case of a 58-year-old patient who presented with hypernatremia and hypotonic polyuria secondary to chronic lithium therapy. She was diagnosed with partial nephrogenic diabetes insipidus secondary to chronic lithium therapy and was treated with amiloride resulting in improvement.

Fatty Acid Composition, Functional Group Analysis and Antioxidant Activity of Nymphia alba and Lupinus polyphyllus Seed Extracts

Seed extracts of Nymphia alba Linn. and Lupinus polyphyllus Lindl. were analyzed for fatty acid composition, functional group analysis and antioxidant activity. The petroleum ether extract of seeds were found dominant in unsaturated fatty acids with oleic acid (39.9%) and linoleic acid (29.6%) in L. polyphyllus and linoleic (37.5%) and oleic acid (10.9%) in N. alba. All the defatted seed extracts of N. alba and L. polyphyllus found to have powerful DPPH, ABTS, H₂O₂ and NBT antioxidant radical scavenging activity with reference to butylated hydroxy toluene (BHT). The defatted seed extracts were further analyzed with functional group analysis through FTIR found to contain numerous functional groups which may be responsible for their antioxidant activity.

Comparing the Effect of Incentive Spirometry with Acapella on Blood Gases in Physiotherapy After Coronary Artery Bypass Graft

Objective

To compare the effect of incentive spirometry with Acapella (Smiths Medical Inc, Carlsbad, California) in physiotherapy after coronary artery bypass surgery.

Methods

A randomized controlled trial comparing incentive spirometry with Acapella was conducted in the intensive care unit of Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC) Multan. The study began from December 2017 to August 2019 after getting approval from the ethical committee of the hospital. Informed written consent was taken from all 270 patients who were included in the study. Patients who underwent coronary artery bypass graft (CABG) were divided into two groups by the lottery method. The primary end-point of the study was to check the blood gases on Day 3 after the procedure at room air and compare it with the baseline and with blood gases immediately after the procedure. SPSS 23 (IBM Corp., Armonk, NY) was used to analyze the data of this study. For qualitative variables in data such as gender, place of living, patients with any comorbidities, and education status were statistically analyzed in percentage and frequencies. For numerical variables, such as age, body mass index, blood gases values, distance covered in a six-minute walk test, and spirometry values were analyzed and statistically measured as mean and standard deviation. A P-value of less than .05 was considered significant.

Results

The mean partial pressure of oxygen (PaO2) of incentive spirometry was 58.1±2.31 and 67.2±3.24 after extubation and after three days, respectively. While the PaO2 of Acapella was 56.3±3.43 and 66.4±3.54 after extubation and after three days, respectively. The mean PCO2 of incentive spirometry was 41.4±3.26 and 36.1±2.11 after extubation and after three days, respectively. While the partial pressure of carbon dioxide (PCO2) of Acapella was 39.4±2.55 and 37.5±3.58 after extubation and after three days, respectively. The differences were statistically significant at p-value ≤0.05.

Conclusion

It was concluded that both Acapella and incentive spirometry treatment after coronary artery bypass graft improved blood gases.

Waseela Foundation: Accounting for Zakat

The case focusses on the issues faced by Waseela Foundation in its accounting system, specifically in recording the receipt of zakat donations and utilization thereof. The existing accounting system is simple and puts all types of donations into one pool. Expenses are paid out of that pool indiscriminately. It is not acceptable to some zakat donors who have different interpretations regarding the use of zakat funds. Mr Mustafa was given the task of redesigning the accounting system which would assure the donors that their zakat was being managed and disposed of as per their instructions. Accounting for donations in non-profits requires an elaborate system of recording and reporting that can distinguish between different sources of donations and their utilization. This is important because some donations have to be spent on specific purposes. Hence, unlike for-profit organizations, non-profit organizations have to keep different sources of funds separate for recording and reporting purposes. Zakat poses special accounting challenges because there are variations in interpretations of different schools of thought with regard to avenues of spending the zakat. The case thus provides students with an excellent opportunity to understand the intricacies of fund accounting for non-profits.

Nanoformulation of C-18 long fatty acid-capped silver nanoparticles with exploration of photocatalytic and antibacterial activities

C-18 fatty acid-coated silver nanoparticles are synthesized using a facile and worthwhile chemical method.

Silver nanoparticles and silver salt (AgNO3) elicits morphogenic and biochemical variations in callus cultures of sugarcane

The research work was arranged to check the role of AgNPs and silver ions on callus cells of sugarcane (Saccharum spp. cv CP-77,400). AgNPs were synthesized chemically and characterized by UV-Vis spectra, XRD and SEM. AgNPs and silver ions were applied in various concentrations (0, 20, 40, 60 ppm) to sugarcane calli and the induced stress was characterized by studying various morphological and biochemical parameters. AgNPs and silver ions treatments produced high levels of malondialdehyde, proline, proteins, TP and TF contents. Similarly, CAT, SOD and POX activity was also significant in both treatments. The lower concentration of AgNPs and silver ions (20 ppm) provided maximum intracellular GSH level. This work mainly showed effects of AgNPs and silver ions on sugarcane calli in terms of morphological aberrations and cell membrane damage due to severe oxidative stress and production of enhanced levels of enzymatic and non-enzymatic antioxidants as self-defence to tolerate oxidative stress by scavenging reactive oxygen species. These preliminary findings will provide the way to study ecotoxicity mechanism of the metal ions and NPs in medicine industry and in vitro toxicity research. Furthermore, silver ions alone and their chemically synthesised AgNPs can be used for various biomedical applications in future.

Copper(ii)-based coordination polymer nanofibers as a highly effective antibacterial material with a synergistic mechanism

Nanofibers of a copper(ii)-based coordination polymer [Cu(HBTC)(H₂O)₃] were synthesized via a microwave-assisted hydrothermal process, while macroparticles and bulk crystals were prepared via a hydrothermal method. X-ray analysis revealed that this compound possesses one-dimensional zig-zag chains, in which the coordination polyhedron of the copper(ii) center is a five-coordinate distorted square-pyramid. The width of the as-prepared nanofibers was about 150 nm, while the size of the macroparticles was about 200 μm. The antibacterial activities of the nanofibers and macroparticles against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) were evaluated by determining the minimal inhibitory concentration (MIC), the growth curve of the bacteria and the bacterial reduction assay. The nanofibers showed higher antibacterial performance as compared with macroparticles, commercial copper nanoparticles, and pure ligands alone. The bacteriostatic rates of nanofibers and macroparticles were up to 99.9% and 96.7% against E. coli, while 99.1% and 96.2% against S. aureus, respectively, when the concentration was 250 μg mL^-1. The synergistic antibacterial mechanism was also proposed based on the generation of reactive oxygen species (ROS) and the release of Cu²⁺ ions.

Neurally Adjusted Ventilatory Assist: An Early Clue to Diagnosis of Congenital Central Hypoventilation Syndrome

Congenital central hypoventilation syndrome (CCHS) is characterized by shallow breathing during sleep due to negligible ventilatory sensitivity to hypercarbia and hypoxemia. It is diagnosed using a genetic test for PHOX2B mutation, which is not easily available. Neurally adjusted ventilatory assist (NAVA) is a spontaneous ventilatory mode that was designed basically for better adapting the ventilator to the patient by using electrical activity of diaphragm (EAdi) signals. We report a case of a 6-month-old infant who presented with recurrent apneas, where differential decrease in EAdi discharges during sleep using NAVA served as an early clue to the diagnosis of CCHS. Definitive diagnosis was later confirmed by genetic testing.

The Role of Firm’s Unique Resource in Developing Sustainable Competitive Advantage from Strategy Inimitability and its Effect on Firm Performance of Mining Companies in Indonesia

The positive relationship between unique resources and sustainable competitiveness of the company has been well understood and applies to almost all businesses. However, little is known about the specific effects of the uniqueness of resources and business strategies in this relationship. Using resource-based view (RBV), Porter's five-factor theory, and game theory, as well as imitation theory between companies, this study explains how the influence of company-specific resources and the uniqueness of the company's strategy as a sustainable competitive advantage affect performance. Analysis of data collected from surveys on 101 mining companies in Indonesia shows companies with distinctive resources are able to produce unique business strategies and insofar as they cannot be replicated, companies can enjoy sustainable competitive advantage. This implies that mining companies need to avoid their resources and business strategies to be imitated by their competitors if the company still wants to maintain competitive advantage and performance.