The Elderly's Limited Awareness of Advanced-Way Dental Procedures Hinders Access to Treatment, Resulting in Persistent Pain and Unmet Dental Needs in Pakistan.

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Impact of intraoperative fluid administration and complications in head and neck cancer free flap surgery at a tertiary care hospital of a low and middle-income country.

Perioperative fluid administration plays an essential role in head and neck cancer free flap surgery. The impact of intraoperative fluid administration on postoperative complications in head and neck cancer free flap surgery remains ill-defined. All adult patients who underwent a free flap surgery for head and neck cancer between January 2014 and December 2018 were included in the study. A total of 224 patients met the inclusion criteria. The mean age of patients was 45.0 years, and the majority were male (85.7%). Buccal mucosa squamous cell carcinoma (83%) was the most common diagnosis, and anterolateral thigh flap (46.4%) was the most routinely performed procedure. Perioperatively, ringer's lactate was used most abundantly (68.3%). A total of 101 complications were reported in the postoperative period, consisting of 67 medical complications and 34 surgical complications. In conclusion, there is no statistically significant association between the quantity of fluid administration and postoperative complications.

Seed nano-priming with multiple nanoparticles enhanced the growth parameters of lettuce and mitigated cadmium (Cd) bio-toxicity: An advanced technique for remediation of Cd contaminated environments.

Seed nano-priming can be used as an advanced technology for enhancing seed germination, plant growth, and crop productivity; however, the potential role of seed nano-priming in ameliorative cadmium (Cd) bio-toxicity under Cd stress has not yet been sufficiently investigated. Therefore, in this study we investigated the beneficial impacts of seed priming with low (L) and high (H) concentrations of nanoparticles including nSiO2 (50/100 mg L-1), nTiO2 (20/60 mg L-1), nZnO (50/100 mg L-1), nFe3O4 (100/200 mg L-1), nCuO (50/100 mg L-1), and nCeO2 (50/100 mg L-1) on lettuce growth and antioxidant enzyme activities aiming to assess their efficacy for enhancing plant growth and reducing Cd phytotoxicity. The results showed a significant increase in plant growth, biomass production, antioxidant enzyme activities, and photosynthetic efficiency in lettuce treated with nano-primed nSiH + Cd (100 mg L-1), nTiH + Cd (60 mg L-1), and nZnL + Cd (50 mg L-1) under Cd stress. Moreover, nano-priming effectively reduced the accumulation of reactive oxygen species (ROS) and malondialdehyde (MDA) in lettuce shoots. Interestingly, nano-primed nSiH + Cd, nTiH + Cd, and nZnL + Cd demonstrated efficient reduction of Cd uptake, less translocation factor of Cd with high tolerance index, ultimately reducing toxicity by stabilizing the root morphology and superior accumulation of critical nutrients (K, Mg, Ca, Fe, and Zn). Thus, this study provides the first evidence of alleviating Cd toxicity in lettuce by using multiple nanoparticles via priming strategy. The findings highlight the potential of nanoparticles (Si, Zn, and Ti) as stress mitigation agents for improved crop growth and yield in Cd contaminated areas, thereby offering a promising and advanced approach for remediation of Cd contaminated environments.

Enhancement of Thermal and Gas Barrier Properties of Graphene-Based Nanocomposite Films.

Poly(vinyl alcohol) (PVA), a naturally occurring and rapidly decomposing polymer, has gained significant attention in recent studies for its potential use in pollution preventive materials. Its cost-effectiveness and ease of availability as well as simple processing make it a suitable material for various applications. However, the only concern about PVA's applicability to various applications is its hydrophilic nature. To address this limitation, PVA-based nanocomposites can be created by incorporating inorganic fillers such as graphene (G). Graphene is a two-dimensional carbon crystal with a single atom-layer structure and has become a popular choice as a nanomaterial due to its outstanding properties. In this study, we present a simple and environmentally friendly solution processing technique to fabricate PVA and graphene-based nanocomposite films. The resulting composite films showed noticeable improvement in barrier properties against moisture, oxygen, heat, and mechanical failures. The improvement of the characteristic properties is attributed to the uniform dispersion of graphene in the PVA matrix as shown in the SEM image. The addition of graphene leads to a decrease in water vapor transmission rate (WVTR) by 79% and around 90% for the oxygen transmission rate (OTR) as compared to pristine PVA films. Notably, incorporating just 0.5 vol % of graphene results in an OTR value of as low as 0.7 cm m-2 day-1 bar-1, making it highly suitable packaging applications. The films also exhibit remarkable flexibility and retained almost the same WVTR values even after going through tough bending cycles of more than 2000 at a bending radius of 2.5 cm. Overall, PVA/G nanocomposite films offer promising potential for PVA/G composite films for various attractive pollution prevention (such as corrosion resistant coatings) and packaging applications.

Influence of Zirconium (Zr4+) Substitution on the Crystal Structure and Optical and Dielectric Properties of Sr0.8Mg0.2(Sn1-xZrx)O3 Ceramics.

In this work, new compositions of Sr0.8Mg0.2(Sn1-xZrx)O3 0.00 ≤ x ≤ 0.06 ceramics are designed and synthesized by the conventional solid-state route. The influence of Zr doping on the phase, microstructural, optical, and dielectric properties is thoroughly investigated. The peaks (0 0 4) and (1 1 0) are observed to shift toward lower 2θ values, due to the variation of the ionic radius between Zr4+ and Sn4+. X-ray diffraction patterns reveal the orthorhombic structure with the space group Pbnm. Scanning electron microscopy images reveal the presence of pores and particles with a high degree of agglomeration. The functional groups and modes of vibration are determined by Fourier transform infrared spectroscopy of the prepared metal oxide samples. The existence of green emission of all the synthesized samples around 554.91 nm is identified by photoluminescence spectroscopy. The dielectric properties of the fabricated samples are measured by using an impedance analyzer. The values of the tangent loss and relative permittivity are found to decrease with increasing frequency.

Green-Mediated Synthesis of NiCo2O4 Nanostructures Using Radish White Peel Extract for the Sensitive and Selective Enzyme-Free Detection of Uric Acid.

The ability to measure uric acid (UA) non-enzymatically in human blood has been demonstrated through the use of a simple and efficient electrochemical method. A phytochemical extract from radish white peel extract improved the electrocatalytic performance of nickel-cobalt bimetallic oxide (NiCo2O4) during a hydrothermal process through abundant surface holes of oxides, an alteration of morphology, an excellent crystal quality, and increased Co(III) and Ni(II) chemical states. The surface structure, morphology, crystalline quality, and chemical composition were determined using a variety of analytical techniques, including powder X-ray diffraction (XRD), scanning electron microscopy (SEM), high-resolution transmission electron microscopy (HR-TEM), and X-ray photoelectron spectroscopy (XPS). The electrochemical characterization by CV revealed a linear range of UA from 0.1 mM to 8 mM, with a detection limit of 0.005 mM and a limit of quantification (LOQ) of 0.008 mM. A study of the sensitivity of NiCo2O4 nanostructures modified on the surface to UA detection with amperometry has revealed a linear range from 0.1 mM to 4 mM for detection. High stability, repeatability, and selectivity were associated with the enhanced electrochemical performance of non-enzymatic UA sensing. A significant contribution to the full outperforming sensing characterization can be attributed to the tailoring of surface properties of NiCo2O4 nanostructures. EIS analysis revealed a low charge-transfer resistance of 114,970 Ohms that offered NiCo2O4 nanostructures prepared with 5 mL of radish white peel extract, confirming an enhanced performance of the presented non-enzymatic UA sensor. As well as testing the practicality of the UA sensor, blood samples from human beings were also tested for UA. Due to its high sensitivity, stability, selectivity, repeatability, and simplicity, the developed non-enzymatic UA sensor is ideal for monitoring UA for a wide range of concentrations in biological matrixes.

Effect of foliar application of nanoparticles on growth, physiology, and antioxidant enzyme activities of lettuce (Lactuca sativa L.) plants under cadmium toxicity.

Nanotechnology has attracted the interest of scientists due to its wide range of application specifically in agriculture. Nanoparticles (NPs) may act as a promising materials to alleviate cadmium (Cd) stress in plants. This study aims to assess the impact of multiple nanoparticles including nSiO2 (50 mg L-1:100 mg L-1), nTiO2 (20 mg L-1:60 mg L-1), nZnO (50 mg L-1:100 mg L-1), nFe3O4 (100 mg L-1:200 mg L-1), nCuO (50 mg L-1:100 mg L-1), and nCeO2 (50 mg L-1:100 mg L-1) in combination with CdCl2 (5 µM) to mitigate Cd toxicity in lettuce through foliar application in hydroponic solution. Current findings indicate that foliar application of nSiL + Cd (50 mg L-1), nZnL + Cd (50 mg L-1), and nTiL + Cd (20 mg L-1) is more effective in improving growth, biomass, root architecture, and elevated photosynthetic efficiency, which might be attributed to the increasing uptake of essential micronutrient (K, Mg, Ca, Fe, Zn) under Cd stress. Similarly, treatment with nanoparticles leads to reduced accumulation of ROS and MDA in lettuce, while enhancing the SOD, POD, CAT, and APX activities. The results showed that nanoparticles have high tolerance against Cd as depicted by the inhibition in Cd accumulation by 3.2-58% and 10-72% in roots as well as edible parts of lettuce, respectively. In addition, Cd alone reduces the morphological traits, antioxidant enzyme activity, and photosynthetic activity, while increasing the ROS, MDA, and Cd accumulation in lettuce. This comprehensive study suggests the role of nanoparticles in reducing Cd toxicity in lettuce, signifying their importance as stress mitigation agents. However, long-term pot, priming, and field trials are needed to identify the optimal nanoparticle for the lettuce under variable environmental conditions.

Highly Heterogeneous Morphology of Cobalt Oxide Nanostructures for the Development of Sensitive and Selective Ascorbic Acid Non-Enzymatic Sensor.

The surface tailored metal oxide nanostructures for the development of non-enzymatic sensors are highly demanded, but it is a big task due to the wide range of complexities during the growth process. The presented study focused on the surface modification of the heterogeneous morphology of cobalt oxide (Co3O4) prepared by the hydrothermal method. Further surface modification was conducted with the use of sodium citrate as a reducing and surface modifying agent for the Co3O4 nanostructures through the high density of oxygenated terminal groups from the citrate ions. The citrate ions enabled a significant surface modification of the Co3O4 nanostructures, which further improved the electrochemical properties of the Co3O4 material toward the design of the non-enzymatic ascorbic acid sensor in a phosphate buffer solution of pH 7.4. The morphology and crystal arrays of the Co3O4 nanostructures were studied by scanning electron microscopy (SEM) and powder X-ray diffraction (XRD) techniques. These physical characterizations showed the highly tailored surface features of Co3O4 nanostructures and a significant impact on the crystal properties. The electrochemical activity of Co3O4 was studied by chronoamperometry, linear sweep voltammetry, and cyclic voltammetry (CV) for the detection of ascorbic acid. The linear range of the proposed sensor was measured from 0.5 mM to 6.5 mM and a low limit of detection of 0.001 mM was also estimated. The presented Co3O4 nanostructures exhibited significant surface roughness and surface area, consequently playing a vital role toward the selective, sensitive, and stable detection of ascorbic acid. The use of a low cost surface modifying agent such as sodium citrate could be of great interest for the surface roughness and high surface area of nanostructured materials for the improved electrochemical properties for the biomedical, energy storage, and conversion systems.

Association Between the Site of Infection and Mortality Analysis in Critically Ill Surgical Patients.

Background Sepsis remains a critical global health concern, leading to a high mortality rate. Existing literature suggests a potential correlation between infection site and mortality. Mortality data from Pakistan, especially in the context of the infection site, is notably scarce. Purpose The study aimed to explore the relationship between the site of infection and clinical features in deceased septic patients in the surgical intensive care unit. Methods In this retrospective study conducted at the Aga Khan University Hospital, data from patients admitted to the surgical intensive care unit and meeting Sepsis 3 criteria over a five-year period (2016-2020) were analyzed. We analyzed the relation between the infection site and clinical characteristics using analysis of variance (ANOVA), chi-square, or Fisher's exact tests. Multivariable logistic regression models were applied using stepwise forward selection. A p-value of ≤ 0.05 was considered statistically significant. Results A total of 2472 ICU admissions were screened, out of which 170 patients were included in this study. Demographic analysis showed a predominantly male population with a mean age of 47 years. The most prevalent site of infection was the abdomen. Logistic regression analysis identified on-admission septic shock and high Acute Physiology and Chronic Health Evaluation (APACHE) II scores as significant risk factors for 48-hour mortality while colistimethate sodium usage and admission through the operating room were protective. Conclusion Our study provides a comprehensive analysis, outlining infection sites and identifying early mortality-influencing factors within our region. The distinct demographic profile, characterized by younger age, and the prevalence of abdominal infections in the Pakistani cohort contradict established medical literature. Early initiation of broad-spectrum antibiotics, coupled with prompt source control, confers a protective effect upon individuals afflicted with sepsis.

Drug-Related Problems in Pulmonary Hypertension with Valvular Heart Disease.

Purpose: The occurrence of drug-related problems (DRPs) and their causes specifically among pulmonary hypertension (PH) with valvular heart disease (VHD) has not been evaluated and is unknown. Therefore, this study aimed to determine the percentage of occurrence, types, and causes of DRPs among PH with VHD patients. Patients and Methods: An observational retrospective study was conducted at Cardiology Centre, Hospital Serdang, from 1st January to 30th April 2021. Data were collected from medication charts, medical progress notes, laboratory and operative charts through electronic Health Information System (eHIS). The types and causes of DRPs were identified and classified based on Pharmaceutical Care Network of Europe's (PCNE) classification system V9.02. The data were analyzed using descriptive statistics. Results: All patients (100%) experienced at least one DRP. Total number of DRPs identified was 120 encounters which were associated with 503 causes. The majority of problems were related to treatment effectiveness (59.1%) and treatment safety (33.4%). The causes of DRPs are mainly related to inappropriate monitoring including therapeutic drug monitoring (18.6%), inappropriate combination of drugs, or drugs and dietary/herbal supplement (10.3%), drug dose was too high (8.9%), drug dose was too low (8.2%) and inappropriate timing of administration or dosing intervals (7.7%). Conclusion: The percentage of DRP occurrence was high in the studied population. Treatment effectiveness and treatment safety issues were the main DRPs identified with various preventable causes. The findings may be useful to guide the planning of measures to prevent and solve future DRPs in the population.

Photoperiodic Modulation in Immune and Reproductive Systems in Japanese Quails (Coturnix japonica): A Morphometric Perspective.

The present study was designed to elucidate a relationship between lymphoid organs and reproductive activity in male Japanese quails (Coturnix japonica) bred in a temperate region of Pakistan (30.3753° N, 69.3451° E) in response to photoperiodic changes. The research focused primarily on the relative morphological changes in primary (thymus and bursa of Fabricius) and secondary (spleen) lymphoid organs with respect to seasonal variations in the histomorphometry of testicular tissue. For this purpose, a comparable number of clinically healthy Japanese quails were exsanguinated during active (April-May), regressive (September-October) and inactive (January-February) reproductive phases. Following an extensive gross measurement of lymphoid and reproductive organs, a histomorphometric analysis was performed on sampled tissues by employing ImageJ® software. Blood was collected for hormonal and leukocytic analysis. One-way ANOVA was used for statistical comparison. Testes had the highest parenchymal development in the active phase (80.66 ± 21.22 µm) and the lowest in the inactive phase (27.80 ± 7.22 µm). Conversely, a percentage change was evident in the sizes of primary (bursa: 61.5%, thymus: 46.9%) and secondary (spleen: 23.9%) lymphoid organs during inactive and active reproductive phases. This study demonstrated that a physiological trade-off is imperative between immune and reproductive systems for optimum survivability and reproductive performance.

Rapid Changes in Composition and Contents of Cuticular Hydrocarbons in Sitobion avenae (Hemiptera: Aphididae) Clones Adapting to Desiccation Stress.

Cuticular hydrocarbons (CHCs) are diverse in insects, and include variable classes of cuticular lipids, contributing to waterproofing for insects under desiccation environments. However, this waterproofing function of CHCs is still not well characterized in aphids. In this study, we compared CHC profiles for desiccation-resistant and nonresistant genotypes of the grain aphid, Sitobion avenae (Fabricius), in responses to desiccation. Our result showed that a total of 27 CHCs were detected in S. avenae, and linear alkanes (e.g., n-C29) were found to be the predominant components. Long-chain monomethyl alkanes were found to associate closely with water loss rates in S. avenae in most cases. Resistant genotypes of both wing morphs had higher contents of short-chain n-alkanes under control than nonresistant genotypes, showing the importance of short-chain n-alkanes in constitutive desiccation resistance. Among these, n-C25 might provide a CHC signature to distinguish between desiccation-resistant and nonresistant individuals. Compared with linear alkanes, methyl-branched CHCs appeared to display higher plasticity in rapid responses to desiccation, especially for 2-MeC26, implying that methyl-branched CHCs could be more sensitive to desiccation, and play more important roles in induced desiccation-resistance. Thus, both constitutive and induced CHCs (linear or methyl-branched) can contribute to adaptive responses of S. avenae populations under desiccation environments. Our results provide substantial evidence for adaptive changes of desiccation resistance and associated CHCs in S. avenae, and have significant implications for aphid evolution and management in the context of global climate change.

Contrasting effects of maize residue, coal gas residue and their biochars on nutrient mineralization, enzyme activities and CO2 emissions in sandy loess soil.

Mismanagement of crop straw and coal gas residue threatens the atmosphere and the economy. Nevertheless, thermal-pyrolysis is an option for management that turns bio-waste into biochar; its viability and adoption by the public as soil amendments is dependent on the agronomic and environmental values compared between biochar and the raw materials. We undertook a 60-day short-term analysis to assess the impact of various wastes and biochars, as well as inorganic nutrients (N), on carbon dioxide (CO2) fluxes, soil enzyme activities, soil fertility status, and microbial activities. There were eight treatments of soil amendments: without an amendment (CK), Nutrients (N), straw + nutrients (S+N), straw biochar + nutrients (SB+N), coal gas residue + nutrients (C+N), coal gas residue biochar + nutrients (CB+N), straw + straw biochar + nutrients (S+SB+N) and coal gas residue waste + coal gas residue biochar + nutrients (C+ CB +N). The results indicated that soil EC, pH, nitrate N (NO3 -- N), SOC, TN and available K were significantly (p < 0.05) increased coal gas residue biochar and combined with coal fly ash as compared to maize straw biochar and combined with maize straw and N treatments. The higher concentrations of soil MBC and MBN activities were increased in the maize straw application, while higher soil enzyme activity such as, invertase, urease and catalase were enhanced in the coal fly ash derived biochar treatments. The higher cumulative CO2 emissions were recorded in the combined applications of maize straw and its biochar as well as coal gas residue and its biochar treatment. Our study concludes, that maize straw and coal fly ash wastes were converted into biochar product could be a feasible substitute way of discarding, since land amendment and decreased CO2 fluxes and positive changes in soil microbial, and chemical properties, and can be confirmed under long-term conditions for reduction of economical and environment issues.

Incidence of acute kidney injury among COVID-19 patients in Egypt.

BACKGROUND: Despite the fact that the fundamental characteristics of coronavirus disease-2019 (COVID-19) are respiratory manifestations, multi-organ failure including the kidney has been documented. There are no clear comparisons of COVID-19 cases with and without acute kidney injury (AKI) to show whether there are aspects of acute kidney injury progression path or outcome that are unique to this disease. METHODS: In this work, we analyzed the data of 734 COVID-19 cases admitted to the Ahmad Maher Teaching Hospital in Cairo, Egypt, between June 6 and July 25, 2020. Data on demographics, comorbidities, laboratory results, and outcomes were assessed. To assess the incidence rate of AKI in Egyptian COVID-19 patients, comparisons were carried out between home-isolated COVID-19 patients, hospitalized COVID-19 patients, and ICU COVID-19-patients with or without AKI. RESULTS: AKI was more common in hospitalized mild COVID-19 patients than in home-isolated and ICU COVID-19 patients (15.0% versus 10.8% and 14.2%, respectively). The overall occurrence rate of AKI was significantly higher in COVID-19 patients (n=91, 14%). Hemodialysis, on the other hand, was required in 76% of the extreme ICU COVID-19 patients who developed AKI (22/29). The absolute number of patients with AKI COVID-19 who required hemodialysis was 34 (37%). This accounted for 5.2% of all COVID-19 patients and 37% of those with AKI. The mortality rate in COVID-19 patients with or without AKI was 15.4% and 4.8%, respectively. CONCLUSION: AKI in our COVID-19 patients is associated with a high mortality rate in ICU-COVID-19 patients. Our findings suggest that COVID-19 patients, particularly ICU COVID-19 patients, should be closely monitored for the development of AKI. Early identification of AKI, as well as prompt intervention, can improve COVID-19 patient outcomes.

Risk factors related with high sodium intake among Malaysian adults: findings from the Malaysian Community Salt Survey (MyCoSS) 2017-2018.

BACKGROUND: High sodium intake was an established risk factor for stroke and cardiovascular diseases. The objective of this study was to investigate factors associated with high sodium intake based on 24-h urinary sodium excretion from the MyCoSS study. METHODS: The cross-sectional survey was conducted among adults aged 18 years and above in Malaysia. A multi-stage stratified sampling was used to represent nationally. Twenty-four-hour urine was collected from a total of 900 respondents. Indirect ion-selective electrode (ISE) method was used to measure sodium intake. Descriptive and logistic regression analysis was applied to determine factors associated with high sodium intake based on 24-h urinary sodium excretion. RESULTS: A total of 798 respondents (76% response rate) completed the 24-h urine collection process. Logistic regression revealed that high sodium intake associated with obese [aOR 2.611 (95% CI 1.519, 4.488)], male [aOR 2.436 (95% CI 1.473, 4.030)], having a waist circumference of > 90cm for adult males [aOR 2.260 ( 95% CI 1.020, 5.009) and >80cm for adult females [aOR 1.210 (95% CI 0.556, 2.631)], being a young adult [aOR 1.977 (95% CI 1.094, 3.574)], and living in urban areas [aOR 1.701 (95% CI 1.094, 2.645)]. CONCLUSION: Adults who are obese, have a large waist circumference, of male gender, living in urban areas, and belonging to the young adult age group were found to have higher sodium intake than other demographic groups. Hence, reduction of salt consumption among these high-risk groups should be emphasised to reduce the risk of cardiovascular diseases.

Gender-based outcomes of impeller pumps percutaneous ventricular assist devices.

BACKGROUND: There is paucity of data focusing on females' outcomes after the use of impeller pumps percutaneous ventricular assist devices (IPVADs). METHODS: Patients who received IPVADs during the period of October 1st, 2015-December 31, 2017, were identified from the United States National Readmission Database. A 1:1 propensity score matching was used to compare the outcomes between females and males. RESULTS: A total of 19,278 (Female = 5,456; Male = 13,822) patients were included in the current analysis. After propensity score matching and among all-comers who were treated with IPVADs, females had higher in-hospital major adverse events (MAEs) (38 vs. 32.6%, p < .01), mortality (31 vs. 28%, p < .01), vascular complications (3.3 vs. 2.1%, p < .01), major bleeding (7.8 vs. 4.8%, p < .01), nonhome discharges (21.6 vs. 16.3%; p < .01), and longer length of stay (7 days [IQR 2-12] vs. 6 days [IQR 2-12], p = .02) with higher 30-day readmission rate compared to males (20.5 vs.16.4%, p < .01). Furthermore, among patients who received the IPVADs for high-risk percutaneous coronary intervention (HRPCI), females continued to have worse MAEs, which was driven by high rates of major bleeding. However, among patients who received IPVADs for cardiogenic shock (CS) the outcomes of females and males were comparable. CONCLUSIONS: Among all-comers who received IPVADs, females suffered higher morbidity and mortality compared to males. Higher morbidity driven mainly by higher rates of major bleeding was seen among females who received IPVADs for the hemodynamic support during HRPCI and comparable outcomes were observed when the IPVADs were used for CS.

Insight into single-element nobel metal anisotropic silver nanoparticle shape-dependent selective ROS generation and quantification.

The biocidal action mechanism of single element noble metal anisotropic nanoparticles has remained a perplexing challenge. Herein, we investigated the photogenerated anisotropic AgNP ROS production kinetics and each ROS species' direct impact on Gram-negative and Gram-positive bacteria. Three shapes (Triangular, Cubes, Rods) of AgNP with excellent morphology were fabricated via plasmon mediated synthesis. The results demonstrated a distinct bactericidal capacity of each NP shape where Ag-Tri outperformed Ag-Cub and Ag-Rod by displaying complete bacterial mutilation at a very low dose of 18 µg mL-1 for the shortest exposure time of 180 min. In contrast, Ag-Cub needed 66.6% higher NP concentration, while Ag-Rod was unable to achieve complete bacterial mutilation. In contrast to O2˙-, (Ag-Tri 69 ± 3.2, Ag-Cub 72 ± 2.9, Ag-Rod 68.5 ± 3.7 µM), the amount of ˙OH production was considerably lower (Ag-Tri 11 ± 1.6, Ag-Cub 10.4 ± 1.9, Ag-Rod 11.3 ± 2.2 µM), while 1O2 remained undetected for all NP shapes. Moreover, antimicrobial activity of selective ROS species revealed O2˙- as a dominant species among ROS. However, O2˙- was not found as a decisive factor in microbial mutilation. SEM images affirmed the significance of the specific geometrical shape and its resultant attachment to bacterial surface to be of paramount significance. The sharp-tip morphology with high-atom density active {111} facets played a pivotal role in physically deteriorating bacterial cells. Ag-Tri morphology in synchronization with ROS species assisted its wedging into the bacterial cell, translating into superior and multifaceted antibacterial performance.

Workplace bullying, knowledge hiding and time theft: Evidence from the health care institutions in Pakistan.

AIM(S): This paper examined the impact of workplace bullying (WPB) on mild aggressive deviant behaviour, such as knowledge hiding and employee time theft, in Pakistani health care institutions. Additionally, this study investigated the mediating role of negative emotions on the relationship between WPB and its outcomes. BACKGROUND: Although mild deviant behaviour has been proven to affect the health care sector, its antecedents are still untapped. METHOD: Data were collected from 233 nurses working in hospitals located across Pakistan via self-administered questionnaires in three time lags to test both the direct and indirect effects of WPB. The hypothesized correlations were tested using structural equation modelling (SEM). RESULTS: The results revealed that WPB increased knowledge hiding and employee time theft amongst nurses. The indirect effect of negative emotions was established on the aforementioned relationships. CONCLUSION: This study contributes to the existing literature by concentrating on predictors that trigger deviant behaviour amongst nurses. It also assessed the mediating impact of emotions, wherein such endeavour is essential for researchers and practitioners. IMPLICATIONS FOR NURSING MANAGEMENT: The study outcomes are significant for the hospital sector to improve their strategies, such as implementing resilience during stressful events to address WPB and deviant behaviour amongst nurses.