Effect of spirocyclization of xanthene dyes on linear and nonlinear optical properties by considering D-π-A and D-A-D Systems: DFT and TD-DFT approach

Spirocyclization, a unique feature of xanthene dyes, makes it a promising candidate for developing fluorescent ratiometric probes for sensing, imaging, tracking, and labeling. How will this feature of xanthene dyes influence the linear and nonlinear optical properties? To examine the effect of spirocyclization of xanthene dyes, we have selected both the open-close form of rhodamine B and π-extended xanthene dyes substituted with thienyl and thieno[3,2-b]thienyl group at position 3 and 6. Here, rhodamine B will serve as the (Donor)D-π-A(Acceptor) system and thiophene-substituted xanthene dyes will serve as the D-A-D system. The geometry optimization of the close-open form of xanthene dyes at B3LYP/6-311++G(d,p) and CAM-B3LYP/6-311++G(d,p) revealed that the open form is energetically more stable in the S0 state than the closed form. The vertical excitation energy (ΔE), from Time-Dependent-Density Functional Theory (TD-DFT) calculation at B3LYP/6-311++G(d,p), CAM-B3LYP/6-311++G(d,p), ωB97XD/6-311++G(d,p) revealed that (ΔE)open < (ΔE)close. Further, the open form of xanthene dyes displays red-shifted absorption compared to the closed form. The λVt of xanthene dyes (open-close forms) is mainly assigned to HOMO → LUMO transition (S0 → S1) with % orbital contribution for open form ∼ 90 % and close form ∼ 60 %. The oscillator strength of xanthene dyes is obtained in the range of 0.01 - 1.74. The λVt of xanthene dyes is in agreement with experimental absorption. The static polarizability (α0), first-order hyperpolarizability (β0), second-order hyperpolarizability (γ), molecular hyperpolarizability (µβ0), and frequency-dependent hyperpolarizability (β1064), of the open form of xanthene dyes, were found to be higher than the close form. Thus, the open form of xanthene dyes will show superior linear and nonlinear optical properties than the closed form. The thienyl[3, 2-b] thieno substituted xanthene dye with red-shifted absorption shows higher α0, β0, γ, µβ0, β1064, and γ values, show better linear and NLO properties than thienyl and diethylamine substituted xanthene dyes.

Management of acute colonic pseudo-obstruction: opportunities to improve care?

BACKGROUND

Acute colonic pseudo-obstruction (ACPO) is a functional bowel obstruction characterised by colonic dilatation in the absence of mechanical obstruction on imaging. Complications include bowel ischaemia, perforation and death. The aim of this study was to explore outcomes for patients treated for ACPO and to assess adherence to current ACPO treatment guidelines.

METHODS

This is a retrospective service evaluation and included patients with a diagnosis of ACPO between 1 March 2018 and 31 March 2023. Process measures were identified following discussion with the clinical team from published guidance. Patients were identified using clinical coding and radiological text reports. Cases were eligible for inclusion if they had radiologically confirmed ACPO. Data were collected following review of patient notes into Microsoft Excel. Descriptive analysis was performed with no formal statistical assessment.

RESULTS

A total of 45 patients were identified, of whom 13 were admitted under general surgery. All patients received admission bloods (n=45). Nearly all patients had computed tomography imaging (43/45, 96%). Only 3/45 (6.7%) of the patients received optimal conservative management (intravenous infusion, nil by mouth, flatus tube, treatment of reversible causes). In all, 11/45 (24%) required further treatment, of whom 7 received this within 72 h. The leading (11/45) complication following diagnosis of ACPO was hospital-acquired pneumonia. Mortality was seen in 9/45.

CONCLUSIONS

ACPO is often managed remotely by general surgeons. This may impact on the quality of conservative management, and timeliness of endoscopic or pharmacological intervention. Further work is needed to optimise management.

Molecular Marker-Assisted Mapping, Candidate Gene Identification, and Breeding in Melon (Cucumis melo L.): A Review

Melon (Cucumis melo L.) is an important crop that is cultivated worldwide for its fleshy fruit. Understanding the genetic basis of a plant's qualitative and quantitative traits is essential for developing consumer-favored varieties. This review presents genetic and molecular advances related to qualitative and quantitative phenotypic traits and biochemical compounds in melons. This information guides trait incorporation and the production of novel varieties with desirable horticultural and economic characteristics and yield performance. This review summarizes the quantitative trait loci, candidate genes, and development of molecular markers related to plant architecture, branching patterns, floral attributes (sex expression and male sterility), fruit attributes (shape, rind and flesh color, yield, biochemical compounds, sugar content, and netting), and seed attributes (seed coat color and size). The findings discussed in this review will enhance demand-driven breeding to produce cultivars that benefit consumers and melon breeders.

The best method of reconditioning ceramic brackets to get an optimum shear bond strength compared with new ceramic brackets - Systematic review and meta-analysis of in vitro studies

PURPOSE

Bracket debonding is an undesirable problem during fixed orthodontic treatment. As ceramic brackets have no flexibility, there is no change in the slot dimension. So, reconditioning a ceramic bracket can be done without compromising the quality of treatment and could be a cost-effective measure. The objective of this systematic review is to deduce and validate the best method of reconditioning ceramic bracket in order to get optimum clinical shear bond strength.

MATERIAL AND METHODS

Studies such as randomized controlled trials (RCTs); In vitro studies comparing different interventions with control group, cross sectional studies were included. Electronic databases such as Cochrane database, PubMed, Web of Science, Embase were searched up to July 2022. Grey literature search and cross-referencing/snowballing methods were also used. Two reviewers independently selected studies and assessed the risk of bias using amalgamation of five tools for in vitro studies. Then meta-analysis was performed using random effects model.

RESULTS

Eleven studies were included in which ten studies were considered as good quality studies. According the meta-analysis performed, the best performance in terms of shear bond strength was of new brackets. Among the different reconditioning methods, the meta-analysis showed that the method with the closest bond strength to the new brackets was silicatisation with a mean difference of 6.35MPa (95% CI between 2.39 and 10.31) followed by sandblasting+silane application with a mean difference of 3.36MPa (95% CI between 0.3 and 6.96) compared to other methods.

CONCLUSIONS

Due to the lack of in vivo studies, only in vitro studies were evaluated. The data available from the in vitro studies was considered to be of good quality, leading to the conclusion that the best method for reconditioning debonded ceramic brackets is silicatisation followed by sandblasting and silane application.

Relative mutagenic effectiveness and efficiency of chemical mutagens (Caffeine and EMS) and heavy metals [(Pb(NO3)2 and Cd(NO3)2)] in developing chlorophyll and morphological mutants in lentil

Mutagenic effectiveness and efficiency are the utmost vital indices to determine the effective and efficient mutagenic concentrations for the generation of high frequency of desirable mutation in mutation breeding. Nevertheless, there are meager study are available for employing effective and efficient concentration of caffeine, EMS, Pb(NO3)2 and Cd(NO3)2 for the crop improvement. Thus, the current study was performed to assess the mutagenic effectiveness and efficiency of caffeine, EMS and heavy metals [Pb(NO3)2 Cd(NO3)2] and to determine the genetic variability of M2 and M3 lentil mutant lines. The frequency of different chlorophyll and chromophyll mutation was found highest at moderate and higher concentrations of chemical mutagens and heavy metals in M1 and M2 generation. The highest effectiveness was in 20 ppm Cd(NO3)2, followed by 20 ppm Pb(NO3)2, 0.10% EMS, and 0.10% caffeine. The present investigation also showed lower doses of caffeine, EMS, Pb(NO3)2, and Cd(NO3)2 were more efficient than higher concentrations, and caffeine was found more efficient followed by EMS, Pb(NO3)2, and Cd(NO3)2. Furthermore, a broad spectrum of viable mutations affecting different morphological characters of the plants viz., leaves, plant height, growth habits, flowers, pods, and seeds in M2 and M3 generation were recorded. Ten morphological mutants showing acceptable agronomic and horticultural features were identified, as genetic resources for further breeding.

ADVANCEMENTS IN MINIMALLY INVASIVE SURGERY: A COMPREHENSIVE ANALYSIS OF ROBOTIC SURGERY, ENDOSCOPIC TECHNIQUES, AND NATURAL ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY

The term "Natural Orifice Transluminal Endoscopic Surgery" (NOTES) defines a surgical approach that leverages the body's natural orifices to access the abdominal cavity, presenting a patient-centric perspective by highlighting its potential to eliminate abdominal wall aggression, mitigate postoperative discomfort, and offer benefits comparable to laparoscopic surgery. This comprehensive paper aims to not only review the existing landscape of NOTES techniques but also to propose advancements in flexible tools augmenting established endoscopic platforms, while also exploring the revolutionary concept of robotic structures grounded in micromechatronics and communication technologies. The thorough analysis encompasses the assessment of advantages and limitations associated with flexible devices and robotic platforms, coupled with an in-depth evaluation of the current array of devices used in NOTES, informed by pertinent literature. The authors' comprehensive approach entails scrutinizing technological breakthroughs and offering viable solutions, fostering a comprehensive understanding. Furthermore, the study encompasses an exhaustive evaluation and juxtaposition of state-of-the-art NOTES devices, supplemented by a nuanced discourse on the merits and demerits of flexible devices and robotic platforms, with a focused emphasis on their inherent strengths and weaknesses. Within this context, the discourse extends to strategic suggestions aimed at refining extant designs and cultivating robust, dependable autonomous robotic platforms purpose-built for NOTES. This narrative encapsulates the multifaceted exploration of benefits, challenges, and potential remedies directed towards enhancing prevailing designs and forging a dependable foundation for the future of NOTES.

Evaluation of 3 northwest European seaweed species on enteric methane production and lactational performance of Holstein-Friesian dairy cows

Seaweeds have been studied for their ability to reduce enteric methane emissions of ruminants when fed as a feed supplement. In vivo research with dairy cattle is mainly limited to the seaweed species Ascophyllum nodosum and Asparagopsis taxiformis, whereas in vitro gas production research covers a broader range of brown, red, and green seaweed species from different regions. The objective of the present study was to determine the effect of Chondrus crispus (Rhodophyta), Saccharina latissima (Phaeophyta), and Fucus serratus (Phaeophyta), 3 common northwest European seaweeds, on enteric methane production and lactational performance of dairy cattle. Sixty-four Holstein-Friesian dairy cattle (16 primiparous, 48 multiparous) averaging (mean ± standard deviation) 91 ± 22.6 d in milk and 35.4 ± 8.13 kg/d fat- and protein-corrected milk yield (FPCM) were randomly assigned to 1 of 4 treatments in a randomized complete block design. Cows were fed a partial mixed ration [54.2% grass silage, 20.8% corn silage, and 25.0% concentrate; dry matter (DM) basis] with additional concentrate bait in the milking parlor and the GreenFeed system (C-Lock Inc.). The 4 treatments consisted of a control diet without seaweed supplement (CON), or CON supplemented with 150 g/d (fresh weight of dried seaweed) of either C. crispus (CC), S. latissima (SL), or a 50/50 mix (DM basis) of F. serratus and S. latissima. Milk yield (28.7 vs. 27.5 kg/d, respectively), fat- and protein-corrected milk (FPCM) yield (31.4 vs. 30.2 kg/d, respectively), milk lactose content (4.57 vs. 4.52%, respectively), and lactose yield (1,308 vs. 1,246 g/d, respectively) increased for SL compared with CON. Milk protein content was lower for SL compared with the other treatments. Milk fat and protein contents; yields of fat, protein, lactose, and FPCM; feed efficiency; milk nitrogen efficiency; and somatic cell count did not differ between CON and the other treatments. Depending on week of experiment, milk urea content was higher for SL compared with CON and CC. No effects were observed of the treatments compared with CON for DM intake, number of visits to the GreenFeed, or gas emission (production, yield, or intensity) of CO₂, CH₄, and H₂. In conclusion, the seaweeds evaluated did not decrease enteric CH₄ emissions and did not negatively affect feed intake and lactational performance of dairy cattle. Milk yield, FPCM yield, milk lactose content, and lactose yield increased, and milk protein content decreased, with S. latissima.

Comparative analysis of dural substitute autologous vs. semisynthetic collagen-based dura graft

OBJECTIVE

The aim of the present study is to evaluate the success rate and safety of both auto-grafts and collagen-based semi-synthetic grafts in patients with dura defects.

PATIENTS AND METHODS

A prospective comparative study was conducted at the neurosurgery departments of different hospitals in Peshawar and Faisalabad. Patients were divided into two groups: A (autologous graft) and B (semi-synthetic graft). Dura graft autologous was applied in one group of patients with supratentorial brain surgery. Fascia lata was used, harvested from the lateral thigh, 3 to 5 cm long incision at the junction of the upper and middle one-third of the upper leg. A bone flap was implanted in the subcutaneous region in the abdominal part. Perioperative antibiotics were given to all the patients, and surgical drains placed intraoperatively were removed after 24 hours of surgery. In the second group, semi-synthetic dura grafts of 2.5x2.5 cm and 5x5 cm 7.5x7.5 cm sizes were used. Statistical analysis was performed using SPSS version v.20. Student's t-test was performed for the two groups to compare categorical variables, and the data were considered statistically significant at p > 0.05.

RESULTS

In this study, 72 patients of both genders were recruited. We observed that the Semi-synthetic collagen matrix had less surgical time. The mean difference in surgical duration was observed as 40 minutes. However, both groups reported statistically significant differences in terms of surgical duration (< 0.001). No case of infection was reported in both groups. The overall mortality ratio was 12%. Two male deaths were recorded due to cardiovascular disorders, while one death of a 42-year male was also recorded.

CONCLUSIONS

Based on the above findings, it may be concluded that using a semi-synthetic collagen substitute for dura repair is a simple, safe, and effective alternative to the autologous graft for dura repair in dura defects.

A qualitative study of sexual health and function of females with pelvic cancer

Background

Pelvic cancers are among the most common cancers, impacting millions of individuals worldwide annually. However, little is known about the impact of more rare pelvic cancers on the sexual health of females.

Aim

In this study we explored sexual health experiences of female pelvic cancer survivors (FPCS) and their healthcare providers (HCP) in order to identify the most salient impacts of pelvic cancer on sexual function.

Methods

In this qualitative study, semi-structured online interviews were conducted with 15 female patients with vulvar, vaginal, uterine, ovarian, endometrial, cervical, bladder, and/or colorectal cancers. Additionally, semi-structured online interviews were conducted with HCPs who treat pelvic cancers (n = 9). For data analysis, qualitative framework analysis was used.

Outcomes

We used the collected data and analysis of findings to establish recommendations including ways to improve sexual health and function in female survivors of pelvic cancer.

Results

Most FPCS experienced negative impacts on their sexual health and function through increased pain and dryness, bleeding due to atrophy, decreased libido, and psychosocial issues such as body dysmorphia. Females with the rarer vulvar and vaginal cancers faced additional challenges to their sexual health such as shortening of vaginal canals, high levels of neuropathy, lack of sexual activity with their partners, and suicidal ideation. FPCS had unmet sexual health needs, which can be attributed to lack of appropriate training by HCPs and lack of resources and availability of services. Although HCPs recognized the importance of providing sexual healthcare, they lacked confidence in their ability to facilitate a conversation on sexual health with their patients, and often avoided this topic.

Clinical implications

The sexual health outcomes of FPCS can be improved by providing targeted training for HCPs, developing standard resources for sexual health, and integrating tiers of support, including group interventions and counseling.

Strengths and limitations

The main strength of this study is that data were collected from HCPs as well as FPCS, thus providing a more in-depth overall picture of the current strengths and weaknesses of the resources for sexual health support available for this patient population. A limitation of this study is that the experiences of transgender men were not captured.

Conclusions

Sexual difficulties are very common in all FPCS, particularly survivors of vulvar and vaginal cancers. Improvement of sexual health outcomes is needed in this patient population, which can be achieved by providing more training for HCPs, developing robust resources for FPCS and their sexual health, and providing more opportunities for tiered support.

Can youth-engaged research facilitate equitable access to contraception in Canada? The qualitative study protocol for the Ask Us project

INTRODUCTION

There is little to no evidence in Canada on the barriers that youth face when accessing contraception. We seek to identify the contraception access, experiences, beliefs, attitudes, knowledge, and needs of youth in Canada, from the perspectives of youth and youth service providers.

METHODS AND ANALYSIS

This prospective, mixed-methods, integrated knowledge mobilisation study, the Ask Us project, will involve a national sample of youth, healthcare and social service providers, and policy makers recruited via a novel relational mapping and outreach approach led by youth. Phase I will centre the voices of youth and their service providers through in-depth one-on-one interviews. We will explore the factors influencing youth access to contraception, theoretically guided by Levesque's Access to Care framework. Phase II will focus on the cocreation and evaluation of knowledge translation products (youth stories) with youth, service providers, and policy makers.

ETHICS AND DISSEMINATION

Ethical approval was received from the University of British Columbia's Research Ethics Board (H21-01091). Full open-access publication of the work will be sought in an international peer-reviewed journal. Findings will be disseminated to youth and service providers through social media, newsletters, and communities of practice, and to policy makers through invited evidence briefs and face-to-face presentations.

Isocyanate induces cytotoxicity via activation of phosphorylated alpha synuclein protein, nitrosative stress, and apoptotic pathway in Parkinson's Disease model-SHSY-5Y cells

BACKGROUND

Neurotoxic disorders account for a significant portion of the diseases that influence the worldwide disease burden. Parkinson's disease is one such disease that is linked with environmental toxin exposure. Isocyanates are a highly reactive industrial intermediate used widely in manufacturing plastic products, paints, etc. This study aims to delineate the neurotoxic potential of isocyanate in Parkinson's cell model-SHSY-5Y cells.

METHODOLOGY

SHSY-5Y cells were treated with isocyanate analogue (N succinimidyl N methyl carbamate) in time and dose dependant manner. Different parameters were assessed like protein expression, nitrosative stress level, antioxidant enzymes level and apoptosis.

RESULTS

Our findings demonstrate that dose- and time-dependent isocyanate exposure increases reactive nitrogen species and decreases the glutathione, SOD, and catalase levels. Further, increased phosphorylated alpha-synuclein protein and activation of caspase 3 exert cytotoxicity in SHSY-5Y cells.

CONCLUSION

Our research reveals that widely used isocyanate induces cytotoxicity, apoptosis, nitrosative stress, and protein dysfunction, which might constitute a potential mechanism of neurodegeneration in Parkinsonism.

Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India

Background & objectives

A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present study estimated the proportion of heteroresistance among MTB in clinical samples of presumptive drug-resistant tuberculosis (TB) patients in Central India.

Methods

A retrospective analysis of data generated from line probe assay (LPA) at a tertiary care hospital in Central India between January 2013 and December 2018 was carried out. A heteroresistant MTB in a sample was indicated by the presence of both wild-type and mutant-type patterns on an LPA strip.

Results

Data analysis was carried out on interpretable 11,788 LPA results. Heteroresistance in MTB was detected in 637 (5.4%) samples. Of these, heteroresistance in MTB was detected in 413 (64.8%), 163 (25.5%) and 61 (9.5%) samples with respect to rpoB, katG and inhA genes, respectively.

Interpretation & conclusions

Heteroresistance is considered a preliminary step in the development of drug resistance. Delayed or suboptimal anti-tubercular therapy in patients with heteroresistance of MTB may elicit full clinical resistance and negatively impact the National TB Elimination Programme. Further studies are, however, needed to determine the impact of heteroresistance on treatment outcomes in individual patients.

Relationship of sexual quality of life and mental well-being in undergraduate women in a Canadian university

As young women transition from adolescence to adulthood, they begin to explore their sexual identities and sexual relationships. The current literature supports the relationship between sexual quality of life (QOL) and mental well-being. However, this relationship has not yet been replicated in undergraduate women. In order to address this gap, the authors assessed the correlation between sexual QOL and mental well-being among a sample of women undergraduate students in Canada. The study design was cross-sectional in nature, and demographic information was collected, along with the completion of validated measures of sexual QOL and mental well-being. A total of 157 individuals participated. After removing those who did not meet inclusion criteria and those with > 90% incomplete responses, 124 valid survey responses remained for analysis. A hierarchical multivariable linear regression was conducted while controlling for age, sexual orientation, exercise, history of nonconsensual sexual contact, household income, and self-perceived health status. Every one-unit increase in sexual QOL was associated with a 0.35 increase in mental well-being (95% CI 0.105–0.428, p = .002). A history of unwanted or nonconsensual sexual activity had a significant negative correlation with mental well-being ( p = .027). The authors’ findings suggest a significant relationship between sexual QOL and mental well-being. There is a strong opportunity for universities to bolster the support services available to students, with a required focus on women with a history of nonconsensual sexual contact.

Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft with Fixation Using Endobutton at Femoral End and Bioabsorbable Screw at Tibial End

Anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. It can be repaired and reconstructed by open and endoscopic method, the gold standard is, however, endoscopic reconstruction. It is usually reconstructed using bone patellar tendon bone (BPTB) or Hamstring autograft. The graft is supported using endobutton at the femoral end while bioabsorbable interference screw at the tibial end. This study aimed to determine how a certain fixation procedure for quadrupled hamstring autografts worked out. This prospective observational study duration period was 1 year in which 40 patients with ACL injury were treated with arthroscopic reconstruction using hamstring autograft from January 2020 to December 2020 with 6 months follow up after surgery. On the femoral side, an endobutton was used to secure the graft, while the tibial end was secured using a bioabsorbable screw. The International Knee Documentation Committee (IKDC) scoring system was used for prospective evaluation. According to subjective IKDC scoring, 20(50.0%) results were very good, 14(35.0%) were good, 4(10.0%) were satisfactory and 2(5.0%) were bad. In 95.0% patients the state of knee joint is very good compared to preoperative state. Of all the 40 patients underwent ACL reconstruction, 38(95.0%) patients are satisfied with the results of the operation.

Scoping Review of Existing Evaluations of Smokeless Tobacco Control Policies: What Is Known About Countries Covered, Level of Jurisdictions, Target Groups Studied, and Instruments Evaluated?

OBJECTIVE

The implementation of smokeless tobacco control policies lags behind those for smoking. This scoping review summarizes the studies that evaluated public policies on smokeless tobacco regulation (SLT) and provides an overview of the jurisdictional level, target groups, and policy instruments.

METHODS

Seven databases were systematically searched for studies reporting on public policies regulating SLT. Two reviewers independently screened all studies. Data extraction was performed using a predefined extraction form. Extraction was replicated for 10% of the identified studies for quality assurance. A narrative synthesis of the included studies was used to analyze and interpret the data. The protocol was published beforehand with the Open Science Foundation (OSF).

RESULTS

Fourty articles comprising 41 studies were included. Most of the studies reported in the articles were conducted in the United States (n = 17) or India (n = 14). Most studies reported outcomes for students (n = 8), retailers/sellers (n = 8), and users/former users (n = 5). The impact of public policies on smokeless tobacco use, in general, was most frequently assessed (n = 9), followed by the impact of taxes (n = 7), product bans (n = 6), sales/advertising bans near educational institutions (n = 4), and health warnings (n = 3) on consumer behavior.

CONCLUSIONS

There are significant gaps in the evaluation of smokeless tobacco regulation studies that need to be filled by further research to understand the observed outcomes. WHO reporting on Framework Convention on Tobacco Control (FCTC) implementation should be linked to studies evaluating smokeless tobacco control measures at all levels of jurisdictions and in countries not members of the WHO FCTC or do not provide data.

IMPLICATION

Large gaps in the evaluation of SLT control policies exist. For some countries, WHO FCTC evaluations are available for different levels of jurisdictions. In countries with a strong federal structure, there is a lack of data beyond the national level to provide a more detailed look at compliance, indirect effects, or implementation gaps. More research is needed at all levels of jurisdictions, which add to the work of the WHO to understand what works for which target group, how the different levels of jurisdiction interact, how the real-world context can be incorporated, and what indirect effects may occur.

Assessment of attitude and hesitancy toward vaccine against COVID-19 in a Pakistani population: A mix methods survey

Objective

The objective of this study was to assess the attitude and hesitancy toward vaccine against COVID-19 in a Pakistani Population.

Materials and methods

A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate. The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15th September to 30th November 2020.

Results

The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62 ± 10.47 years. The majority of participants were females; 60.9% (n = 611). 57.02% (n = 572) of the participants were employed at the time of survey. Overall, 70.68% (n = 709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n = 49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n = 392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P < 0.001).

Conclusion

This study demonstrated that majority of the participants showed positive attitude toward considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population toward COVID-19 vaccination.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Effects of public policies in the prevention of cardiovascular diseases: a systematic review of global literature

OBJECTIVES

Given the growing interest worldwide in applying public policies to improve human health, we undertook a systematic review of studies investigating whether public policies targeting unhealthy products could reduce cardiovascular diseases.

STUDY DESIGN

This study was a systematic review of the literature.

METHODS

We searched research studies published in 2000-2020 from major databases, including MEDLINE and Embase. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and narratively synthesized the studies based on vote counting and direction of the intervention effect.

RESULTS

Ninety-eight studies, mostly from high-income countries, met the inclusion criteria. Most studies were on public policies targeting sugar-sweetened beverages and tobacco, followed by alcohol, sugar, salt, and junk foods. Overall, many reported that several fiscal, regulatory, and educational policies generated beneficial effects of reducing the diseases. Those studies that reported no or limited effects highlighted several sociodemographic and health risk characteristics and design and implementation aspects of the policy interventions as factors limiting the policy effects; most of these are modifiable with appropriate policy interventions. For instance, low magnitude of tax, substitution with other unhealthy products, firms' competitive response strategies, pre-existence of smoking bans, incremental enactment of smoking regulations, degree of enforcement, and various sociocultural factors minimized the effects of the policies.

CONCLUSION

The literature supports a growing consensus on the beneficial effects of public policy for improving human health. The design and implementation of public policies must address various impeding factors and incorporate appropriate remedial measures. Further research is needed from low- and middle-income countries and on whether and how multiple policy instruments work in tandem.

Prevalence of insect pests on maize crop in District Mansehra, Khyber Pakhtunkhwa, Pakistan

The maize crop is used as food for humans, livestock and poultries forms, it is also used in bread making, corn flakes, corn syrup, corn starch and corn oils. The field study consisted of one experimental trial, about the incidence of that insect pest complex on maize cultivar Azam during the Kharif season 2020 at the Agricultural, Research Station, Baffa, Mansehra. The trial was laid out in the Randomized Complete Block Design (RCBD), and then it was divided into three replications. The result obtained from the trial showed that a number of the pest species were recorded during the experimental period; however, the population was noticed at a low level. The obtained insect species were corn leaf aphid (6.90 ± 5.5) per square inch, corn leafhopper (1.32 ± 0.63), maize stem borer (0.63 ± 0.29), corn flea beetle (0.43 ± 0.28), Thrips (0.38 ± 0.22), Hairy caterpillar (0.21 ± 0.22), Grasshopper (0.17 ± 0.11) and shoot fly (0.11 ± 0.08) throughout the season.

A comprehensive review on the documented characteristics of four Reticulitermes termites (Rhinotermitidae, Blattodea) of China

Termites are known as social insects worldwide. Presently in China 473 species, 44 genera and 4 families of termites have been reported. Of them, 111 Reticulitermes species are widely spread in different zones of China. The dispersion flight season of these Chinese Reticulitermes species are usually started from February to June, but in some regions different species are distributed, sharing their boundaries and having overlapping flight seasons. These reasons become important sources of hybridization between two different heterospecific populations of termites. It was confirmed that the fertilized eggs and unfertilized eggs of some Reticulitermes termites have the capacity of cleavage. While the unfertilized eggs of R. aculabialis, R. chinensis and R. labralis cleaved normally and the only R. aculabialis unfertilized eggs develop in embryos. While, the R. flaviceps and R. chinensis were observed with their abnormal embryonic development, and not hatching of eggs parthenogenetically. They were reported more threatening to Chinese resources as they propagate with parthenogenesis, hybridization and sexual reproduction. Eggshell and macrophiles of eggs play important roles in species identification and control. Although, they are severe pests and cause a wide range of damages to wooden structures and products in homes, buildings, building materials, trees, crops, and forests in China's Mainland.

Trans-generational response of TiO2 nanoparticles in inducing variability and changes in biochemical pool of lentil F2 progenies

Investigations were carried out to analyze the role of anatase nanoparticles in inducing genetic variability in lentils (Lens culinaris Medik.) for yield improvement and subsequent involvement in development, quality, and biochemical response of second-generation seedlings through their lifecycle. Trans-generational alterations in the morphological and biochemical pool of the plant system were evaluated over a range of concentrations (25-200 µg/mL). Analysis of F₂ seedlings showed an increase in yield parameters at the lowest concentration (25 µg/mL). Biochemical studies revealed that the F₂ plants experienced lower oxidative stress as compared with previous generation plants. Quality analysis of seeds revealed a slight positive shift in the mean values of seed protein content at the lowest concentration. The effect of nanoparticles on the growth parameters was antagonistic except at the lowest concentration, where the growth parameters were found to be slightly higher than in the controls. The variability present in different traits in the F₂ populations was quantified as phenotypic variability and its components, which is a measure of the transmissibility of variations of the so-called mutated populations as a result of nanoparticle application.

Tumors of the Acromion Process—A Pictorial Review

Introduction  Acromion is essential for stabilizing the shoulder complex. Tumors of the acromion are rare. We report the largest series of acromion tumor and tumor-like lesion.

Materials and Methods  A retrospective review of the oncology and radiology database within our tertiary center for orthopaedic oncology was performed to identify all tumors of the acromion over the past 30 years and imaging was reviewed.

Results  We identified a total of 31 lesions arising in the acromion and chondrosarcoma was the commonest.

Conclusion  One needs to be aware of tumor and tumor-like lesions of acromion.

Modulation of host epigenome by coronavirus infections and developing treatment modalities for COVID-19 beyond genetics

The recent Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak has resulted in coronavirus disease 2019 (COVID-19) pandemic worldwide, affecting millions of lives. Although vaccines are presently made available, and vaccination drive is in progress to immunize a larger population; still the risk of SARS-CoV-2 infection and related mortality is persistent amid threats of the third wave of the ongoing pandemic. In the scenario of unavailability of robust and efficient treatment modalities, it becomes essential to understand the mechanism of action of the virus and deeply study the molecular mechanisms (both at the virus level and the host level) underlying the infection processes. Recent studies have shown that coronaviruses (CoVs) cause-specific epigenetic changes in the host cells to create a conducive microenvironment for replicating, assembling, and spreading. Epigenetic mechanisms can contribute to various aspects of the SARS-CoV-2 multiplication cycle, like expressing cytokine genes, viral receptor ACE2, and implicating different histone modifications. For SARS-CoV-2 infection, viral proteins are physically associated with various host proteins resulting in numerous interactions between epigenetic enzymes (i.e., histone deacetylases, bromodomain-containing proteins). The involvement of epigenetic mechanisms in the virus life cycle and the host immune responses to control infection result in epigenetic factors recognized as emerging prognostic COVID-19 biomarkers and epigenetic modulators as robust therapeutic targets to curb COVID-19. Therefore, this narrative review aimed to summarize and discuss the various epigenetic mechanisms that control gene expression and how these mechanisms are altered in the host cells during coronavirus infection. We also discuss the opportunities to exploit these epigenetic changes as therapeutic targets for SARS-CoV-2 infection. Epigenetic alterations and regulation play a pivotal role at various levels of coronavirus infection: entry, replication/transcription, and the process of maturation of viral proteins. Coronaviruses modulate the host epigenome to escape the host immune mechanisms. Therefore, host epigenetic alterations induced by CoVs can be considered to develop targeted therapies for COVID-19.

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan

Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour-joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity (π) of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 <0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the values 2.02535, 0.01468, and 0.71862 of Tajima's D, Fu, & Li's F* and D* respectively, demonstrating that the CMV population is under balancing selection.

Evaluation of the Chilli veinal mottle virus CP gene expressing transgenic Nicotiana benthamiana plants for disease resistance against the virus

Vegetables are an important source of income and high-value crops for small farmers. Chilli (Capsicum spp.) is one of the most economically important vegetables of Pakistan and it is grown throughout the country. It is a rich source of nutrition especially vitamins A, B, C and E along with minerals as folic acid, manganese (Mn), potassium (K) and molybdenum (Mo). Chilli possesses seven times more amount of vitamin C than an orange. Vitamin A, C and beta-carotenoids are strong antioxidants to scavenge the free radicals. Chilli production is restricted due to various biotic factors. Among these viruses, Chilli veinal mottle virus (ChiVMV) is one of the most destructive and menacing agents that inflicts heavy and colossal losses that accounted for 50% yield loss both in quality and quantity. Pathogen-Derived Resistance (PDR) approach is considered one of the effective approaches to manage plant viruses. In this study, ChiVMV was characterized on a molecular level, the coat protein (CP) gene of the virus was stably transformed into Nicotiana benthamiana plants using Agrobacterium tumefaciens. The transgenic plants were challenged with the virus to evaluate the level of resistance of plants against the virus. It was observed that the plants expressing CP gene have partial resistance against the virus in terms of symptoms' development and virus accumulation. Translation of this technique into elite chilli varieties will be resulted to mitigate the ChiVMV in the crop as well as an economic benefit to the farmers.

81 Integrating A Front Door Frailty Service in the Emergency Department: Results of A Pilot Study

Introduction

Increasing old age and frailty is putting pressure on health services with 5–10% of patients attending the emergency department (ED) and 30% of patients in acute medical units classified as older and frail. National Health Service improvement mandates that by 2020 hospital trusts with type one EDs provide at least 70 hours of acute frailty service each week.

Methodology

A two-week pilot (Monday–Friday 8 am-5 pm) was undertaken, with a “Front Door Frailty Team” comprising a consultant, junior doctor, specialist nurse and pharmacist, with therapy input from the existing ED team. They were based in the ED seeing patients on arrival, referrals from the ED team and patients in the ED observation ward—opposed to the usual pathway of referral from the ED team to medical team. Data was captured using “Cerner” electronic healthcare records. A plan, do, study, act methodology was used throughout with daily debrief and huddle sessions.

Results

95 patients were seen over two weeks. In the over 65 s, average time to be seen was 50 minutes quicker than the ED team over the same period, with reduced admission rate (25.7% vs 46.5%). The wait between decision to admit and departure was shortened by 119 minutes. Overall, this led to patients spending on average 133 minutes less in the ED. 64 patients were discharged, of which 44 had community follow-up (including 37.5% of 64 referred to acute elderly clinic and 25% to rapid response). 47 medications were stopped across 25 patients.

Conclusion

The pilot shows that introduction of an early comprehensive geriatric assessment in the ED can lead to patients being seen sooner, with more timely decisions over their care and reduction in hospital admissions. It allowed for greater provision of acute clinics and community services as well as prompt medication review and real time medication changes.

Dental public health in action: foundation dentists' delivery of an oral health promotion outreach project for people experiencing homelessness in London

Dental public health in action: foundation dentists' delivery of an oral health promotion outreach project for people experiencing homelessness in London.Within a decade, the UK has seen a dramatic increase in homelessness. This is defined as being without an available home that could reasonably be occupied. The increase has been driven by increasing poverty, welfare reform, cuts to public services and lack of affordable housing (Bramley et al., 2015; Fitzpatrick et al., 2013; Fitzpatrick et al., 2018). Rough sleeping in England alone has increased by 2,909 people or 165% since 2010 (Ministry of Housing, Communities and Local Government, 2018). This increase has been particularly visible in London (National Audit Office, 2018), where approximately a quarter of the country's rough sleepers reside (Ministry of Housing, Communities and Local Government, 2018).

A preliminary study assessing the effect of isocyanate in neuroblastoma brain cells in vitro

Isocyanate is an intermediate compound used in the manufacturing of a number of pesticides. The aim of this study is to understand the mechanism of isocyanate in SHSY‑5Y neuroblastoma cells in vitro. Cells were treated with a chemical equivalent of isocyanate, i.e., N‑succinimidyl N‑methylcarbamate (NSNM). Cell cytotoxicity, as well as qualitative and quantitative alpha‑synuclein protein levels were analyzed using different molecular techniques. NSNM at a concentration of 0.005 μM significantly increased cell death, in a time‑dependent manner, as well as levels of alpha‑synuclein protein in SH‑SY5Y cells. These findings demonstrate the ability of low doses of isocyanate to increase neuronal vulnerability b y inducing cell cytotoxicity and protein dysfunction in vitro.

Diagnostic approaches and potential therapeutic options for coronavirus disease 2019

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan city of China in late December 2019 and identified as a novel coronavirus. Due to its contagious nature, the virus spreads rapidly and causes coronavirus disease 2019 (COVID-19). The global tally of COVID-19 was 28 million in early September 2020. The fears and stress associated with SARS-CoV-2 has demolished the socio-economic status worldwide. Researchers are trying to identify treatments, especially antiviral drugs and/or vaccines, that could potentially control the viral spread and manage the ongoing unprecedented global crisis. To date, more than 300 clinical trials have been conducted on various antiviral drugs, and immunomodulators are being evaluated at various stages of COVID-19. This review aims to collect and summarize a list of drugs used to treat COVID-19, including dexamethasone, chloroquine, hydroxychloroquine, lopinavir/ritonavir, favipiravir, remdesivir, tociluzimab, nitazoxanide and ivermectin. However, some of these drugs are not effective and their use has been suspended by WHO.