A robust self-supervised approach for fine-grained crack detection in concrete structures.

This work addresses a critical issue: the deterioration of concrete structures due to fine-grained cracks, which compromises their strength and longevity. To tackle this problem, experts have turned to computer vision (CV) based automated strategies, incorporating object detection and image segmentation techniques. Recent efforts have integrated complex techniques such as deep convolutional neural networks (DCNNs) and transformers for this task. However, these techniques encounter challenges in localizing fine-grained cracks. This paper presents a self-supervised 'you only look once' (SS-YOLO) approach that utilizes a YOLOv8 model. The novel methodology amalgamates different attention approaches and pseudo-labeling techniques, effectively addressing challenges in fine-grained crack detection and segmentation in concrete structures. It utilizes convolution block attention (CBAM) and Gaussian adaptive weight distribution multi-head self-attention (GAWD-MHSA) modules to accurately identify and segment fine-grained cracks in concrete buildings. Additionally, the assimilation of curriculum learning-based self-supervised pseudo-labeling (CL-SSPL) enhances the model's ability when applied to limited-size data. The efficacy and viability of the proposed approach are demonstrated through experimentation, results, and ablation analysis. Experimental results indicate a mean average precision (mAP) of at least 90.01%, an F1 score of 87%, and an intersection over union threshold greater than 85%. It is evident from the results that the proposed method yielded at least 2.62% and 4.40% improvement in mAP and F1 values, respectively, when tested on three diverse datasets. Moreover, the inference time taken per image is 2 ms less than that of the compared methods.

Perceptions and experience of rural older people in oral health management in China: a qualitative study.

BACKGROUND: To explore the perceptions and experience of oral health management among rural older people in China. METHODS: Qualitative methodologies were used in this study. Face-to-face semi-structured interviews were conducted. Thirteen older adults in rural areas were purposively sampled at two metropolitan hospitals in Hunan, China. The data were transcribed and thematically analyzed, and MAXQDA software was used to assist with coding. RESULTS: Three overarching major themes and ten sub­themes capturing the perceptions and experience of oral health management among rural older people were identified. Three themes emerged from the thematic analysis: oral health cognitive bias, poor management behaviors, and limited oral health services. Oral health management as a whole is negative, oral health behaviors are poor, oral health service utilization is limited. CONCLUSIONS: Based on these findings, there is great scope here for improving the current status of oral health for rural older people around awareness, behavior, and access. Oral health education, improved oral health services and primary oral health promotion are warranted.

Network-based identification of key proteins and repositioning of drugs for non-small cell lung cancer.

BACKGROUND: NSCLC is a lethal cancer that is highly prevalent and accounts for 85% of cases of lung cancer. Conventional cancer treatments, such as chemotherapy and radiation, frequently exhibit limited efficacy and notable adverse reactions. Therefore, a drug repurposing method is proposed for effective NSCLC treatment. AIMS: This study aims to evaluate candidate drugs that are effective for NSCLC at the clinical level using a systems biology and network analysis approach. METHODS: Differentially expressed genes in transcriptomics data were identified using the systems biology and network analysis approaches. A network of gene co-expression was developed with the aim of detecting two modules of gene co-expression. Following that, the Drug-Gene Interaction Database was used to find possible drugs that target important genes within two gene co-expression modules linked to non-small cell lung cancer (NSCLC). The use of Cytoscape facilitated the creation of a drug-gene interaction network. Finally, gene set enrichment analysis was done to validate candidate drugs. RESULTS: Unlike previous research on repositioning drugs for NSCLC, which uses a gene co-expression network, this project is the first to research both gene co-expression and co-occurrence networks. And the co-occurrence network also accounts for differentially expressed genes in cancer cells and their adjacent normal cells. For effective management of non-small cell lung cancer (NSCLC), drugs that show higher gene regulation and gene affinity within the drug-gene interaction network are thought to be important. According to the discourse, NSCLC genes have a lot of control over medicines like vincristine, fluorouracil, methotrexate, clotrimazole, etoposide, tamoxifen, sorafenib, doxorubicin, and pazopanib. CONCLUSION: Hence, there is a possibility of repurposing these drugs for the treatment of non-small-cell lung cancer.

Markers for meat provenance and authenticity with an account of its defining factors and quality characteristics - a review.

Provenance is becoming increasingly important in meat supply chains as it lends products higher perceived quality. However, its precise definition and interpretation along with its associated characteristics factors have remained somewhat elusive. This review meticulously defines meat provenance while dissecting the essential factors and associated quality attributes that constitute its essence and are subsequently employed to establish pertinent markers for provenance. Meat provenance emerges as a multi-dimensional construct stemming from the adept management of a constellation of factors relating to geographical origin, farm production system, traceability, and authenticity. Through intricate interactions, these factors unveil innate originality that not only forges a distinct reputation but also imparts a unique typicity to the meat product. Gaining insights into a meat product's provenance becomes attainable by scrutinizing its pertinent composition and organoleptic quality traits. Trace elements and stable isotopes stand out as provenance markers, forging a direct connection to both geographical origin and dietary sources. While somewhat less direct in linkage, other markers such as plant biomarkers, fatty acid composition, pH levels, flavour and aromatic compounds along with organoleptic characteristics contribute to the overall understanding of provenance. Additionally, the identification of animal species and breeds serves as key markers, particularly in the context of protected geographical indications. The study findings are useful for the various stakeholders of how the information for meat provenance can be linked with intrinsic and extrinsic factors for meat quality and protecting the integrity of the supply chain with special reference to traceability and authenticity. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Exploring Therapeutic Potential of Pleurotus ostreatus and Agaricus bisporus Mushrooms against Hyperlipidemia and Oxidative Stress Using Animal Model.

The mushrooms oyster (Pleurotus ostreatus) and white button (Agaricus bisporus) contain bioactive compounds that have potential beneficial effects on hypercholesterolemia and cardiovascular diseases. In this study, hypolipidemic and antioxidative potential of these mushrooms' extract were explored using hypercholesterolemic (HC) rats as animal model. For the study, 56 adult rats were divided into seven groups, i.e., G1 (negative control), G2 (positive control group), G3 (HC rats with statin drug orally), G4 and G5 (HC rats @ 100 and 200 mg/kg body weight (BW) dose of oyster mushroom extracts), and G6 and G7 (HC rats @ 100 and 200 mg/kg BW dose of white button mushroom extracts). The hypercholesterolemia was induced experimentally in fasted rats through a high-fat diet along with injection of triton WR-1339. After 48 h, the treatment groups were given extract for 28 days along with standard diet. At the trial termination, we analyzed the blood sugar levels, antioxidant parameters, lipid profile, and renal function, as well as conducting liver function tests of the rats. The results indicated that positive control group rats exhibited increased levels of total cholesterol (TC), triglycerides (TG), low-density level (LDL), and very-low-density level (vLDL) by 19%, 37%, 52%, and 32%, respectively, and 53% decrease in HDL, whereas treatment groups that received 200 mg oyster and white button mushroom extracts reported 15%, 34%, 22% reduction in TC, TG, vLDL, respectively, and 22% improvement in HDL level. The enzyme profiles of different groups showed non-significant differences, although both mushroom extracts provision reduced glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) levels. Overall, the results indicated that mushroom extracts were helpful in maintaining oxidative stress and have the potential to improve dyslipidemia in the tested rat animal model.

Clinical Characteristics and Outcomes of Neurosurgical Patients at a Level III Intensive Care Unit in Pakistan: A Retrospective Cohort Study.

Objective Neurosurgical patients account for the majority of cases across all surgical specialties that are admitted to the surgical intensive care unit (ICU) at our institution. The goal of this study was to analyze factors leading to ICU admission, type of neurosurgical intervention, length of ICU/hospital stays, and outcomes in terms of complications and ICU and in-hospital mortality. Methods This retrospective study conducted at the surgical ICU, Aga Khan University Hospital, investigated clinical data of neurosurgical patients admitted between January 2020 and June 2022. Quantitative data were collected regarding patients' characteristics, such as age, gender, comorbidities, type of surgical intervention, mode of surgery, source of admission to ICU, and type of osmotherapy. The primary and secondary outcomes were in terms of ICU and hospital mortality and complications. Results Among 321 patients admitted to the SICU, 197 were included according to inclusion/exclusion criteria. A total of 168 patients (85.3%) required surgical intervention, of whom 101 (60%) underwent elective surgery and 67 (40%) required emergency surgery. Thirteen patients died during the ICU or hospital stay, representing a mortality rate of 6.6%. The average length of stay in the ICU had a median IQR of 4 (4,6) days while the average hospital stay median IQR was 11 (12,18) days. Tracheostomy was performed in 77 patients (39%), and the median IQR day for tracheostomy was 4 (3,5) days. APACHE-II (Acute Physiology and Chronic Health Evaluation) score, length of ICU, and length of hospital stay were significantly higher in the deceased patients with a p-value of 0.042, 0.019, and 0.043, respectively. Conclusion In conclusion, this study on neurosurgical patients from the surgical intensive care unit of a low-middle-income country provided valuable insights about factors and their influence on outcomes. The study implies that a high APACHE-II score is linked to poorer outcomes for neurosurgical patients in this particular setting. Undertaking a large multicenter prospective study is vital for tailoring interventions and improving patient care in regions with limited resources where healthcare challenges may be distinct.

An Ensemble Approach for Robust Automated Crack Detection and Segmentation in Concrete Structures.

To prevent potential instability the early detection of cracks is imperative due to the prevalent use of concrete in critical infrastructure. Automated techniques leveraging artificial intelligence, machine learning, and deep learning as the traditional manual inspection methods are time-consuming. The existing automated concrete crack detection algorithms, despite recent advancements, face challenges in robustness, particularly in precise crack detection amidst complex backgrounds and visual distractions, while also maintaining low inference times. Therefore, this paper introduces a novel ensemble mechanism based on multiple quantized You Only Look Once version 8 (YOLOv8) models for the detection and segmentation of cracks in concrete structures. The proposed model is tested on different concrete crack datasets yielding enhanced segmentation results with at least 89.62% precision and intersection over a union score of 0.88. Moreover, the inference time per image is reduced to 27 milliseconds which is at least a 5% improvement over other models in the comparison. This is achieved by amalgamating the predictions of the trained models to calculate the final segmentation mask. The noteworthy contributions of this work encompass the creation of a model with low inference time, an ensemble mechanism for robust crack segmentation, and the enhancement of the learning capabilities of crack detection models. The fast inference time of the model renders it appropriate for real-time applications, effectively tackling challenges in infrastructure maintenance and safety.

Tuning the Magnetic Behavior of Zinc Ferrite via Cobalt Substitution: A Structural Analysis.

Cobalt-doped zinc ferrite is a contemporary material with significant structural and magnetic characteristics. Our study explores the magnetic properties of cobalt-substituted zinc ferrite (ZnxCo1-xFe2O4), synthesized via a simple sol-gel method. By varying the cobalt ratio from 0 to 0.5, we found that zinc substitution impacts both the magnetization and lattice parameters. FTIR analysis suggested the presence of functional groups, particularly depicting an M-O stretching band, within octahedral and tetrahedral clusters. X-ray diffraction analysis confirmed the phase purity and cubic structure. The synthesized materials exhibited an average particle size of 24-75 nm. Scanning electron microscopy revealed the morphological properties, confirming the formation of truncated octahedral particles. In order to determine the stability, mass loss (%), and thermal behavior, a thermal analysis (thermogravimetric analysis (TGA)/differential thermal analysis (DTA)) was performed. The magnetic properties of the synthesized ferrites were confirmed via a vibrating sample magnetometer (VSM). Finally, the highest saturated magnetization and lowest coercivity values were observed with higher concentrations of the cobalt dopant substituting zinc. The synthesized nanomaterials have good stability as compared to other such materials and can be used for magnetization in the near future.

Frequency of extra pulmonary complications in critically ill COVID-19 patients and their association with inflammatory markers and hypoxia: Retrospective analysis at a tertiary care hospital in Karachi, Pakistan.

Background and Objective: This study aimed to determine the incidence of extra pulmonary complications among critically ill COVID-19 patients requiring invasive mechanical ventilation and association of these complications with various inflammatory markers and degree of hypoxia. Methods: A retrospective cohort study was conducted among 173 adults in Karachi having COVID-19 and were admitted to ICU in a tertiary care private hospital between August 2020 to July 2021. Results: The median age of patients included in the analysis was 61 years (IQR; 16). Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most frequent extra pulmonary complications with proportion of 65.3% (n=113), 63.6% (n=110), 61.8% (n=107) and 33.5% (n=58). Statistically significant differences in the median serum levels of ferritin were observed among male versus female, critically ill covid patients with and without ICU mortality as well as patients with and without hospital mortality (p-value <0.05). Significantly higher serum levels of d-dimer were noted among patients who developed acute liver injury or NSTEMI, or had ICU stay of > 3 days or received mechanical ventilation for >2 days. Conclusion: Acute kidney injury, septic shock, cardiac injury, and electrolytes imbalance were the most common extra pulmonary complications among mechanically ventilated COVID-19 patients with ARDS. Higher serum d-dimer levels were associated with acute liver injury, NSTEMI, ICU stay longer >3 days and invasive mechanical ventilation >2 days. Higher serum ferritin levels are associated with male sex and serve as an important predictor of ICU as well as hospital mortality.

Incidence of Vitamin D Deficiency and Its Association With Microalbuminuria in Patients With Type 2 Diabetes Mellitus.

Background Vitamin D (VD) deficiency is common in patients with type 2 diabetes mellitus (T2DM). VD deficiency and its associated factors are understudied in Pakistan. This study aimed to estimate the incidence of VD deficiency and its association with microalbuminuria in patients with T2DM. Methods This descriptive cross-sectional study was performed on 110 patients diagnosed with T2DM aged between 30 and 65 years in the outpatient department clinic of diabetes in Benazir Bhutto Hospital, Rawalpindi, for around eight months from November 2022 to June 2023. Non-probability sampling technique and established inclusion and exclusion criteria were used for patient recruitment. Ethical approval and informed consent were also waived before data collection. Data collection was done by an interview-based and self-designed questionnaire. Data analysis was carried out via descriptive statistics along with chi-square, independent-samples t-test, and Pearson correlation in Statistical Package for the Social Sciences (SPSS) version 25 (Armonk, NY: IBM Corp.). Results The means of the study population for age, serum VD, and UACR (urine spot for albumin-to-creatinine ratio) were 48.50±15.67 years, 28.16±15.34 ng/mL, and 29.69± 87.22 µg/mg, respectively. The incidences of VD deficiency and microalbuminuria in the study population were 43.64% and 28.20%, respectively. VD deficiency was significantly associated with age group (p=0.002), gender (p=0.008), and albuminuria status (p=0.004). The comparison of means of UACR between the VD deficiency group and the non-VD deficiency group was also significant (0.001). VD deficiency was higher among older age groups, female gender, and patients with microalbuminuria. A significant negative correlation between serum VD level and UACR (microalbuminuria) (p=0.002) was present. Conclusion VD deficiency incidence was notably high in the study population. Older age, female gender, and microalbuminuria were found to elevate the VD deficiency to a crucial level. Serum VD deficiency and microalbuminuria were significantly and negatively correlated. Therefore, VD level should be monitored intermittently in T2DM, so that we could prevent the progression of T2DM timely.

Cancer incidence in Khyber Pakhtunkhwa, Pakistan, 2020.

BACKGROUND: To present the population-based cancer statistics for Khyber Pakhtunkhwa (KP), Pakistan, an incidence study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan, in 2023. METHODS: Records from various centres on new cancers diagnosed among residents of KP between January and December 2020 were gathered. Both active and passive methods of data collection were applied, and the information was saved in a central repository at SKMCH&RC. The incidence rates were computed by age group and sex and presented per 100,000 population. RESULTS: Among children (0-14 years), the Age-Standardised Incidence Rate (ASIR) was 4.0 in girls and 6.1 in boys, and haematologic malignancies were more prevalent; in adolescents (15-19 years), the ASIR was 7.7 in females, 9.4 in males, and bone tumours, haematologic malignancies, and neurological cancers were prominent; in adult females (> / = 20 years), the ASIR was 84.9, and cancers of the breast, digestive system, and reproductive organs were predominant; and adult males, the ASIR was 73.0, and cancers of the gastrointestinal tract, lip/oral cavity/pharynx, prostate, and Non-Hodgkin Lymphoma (NHL) were common. CONCLUSIONS: It is crucial to investigate the aetiology of these diseases at the community level because dietary elements, infectious diseases, and tobacco use all appear to be significant contributors. Prospective studies could play a key role in highlighting the factors linked to these diseases. Therefore, cancer registration must continue in conjunction with the exploration of risk factors.

Perioperative Hypertensive Response In A Patient With Implanted Deep Brain Stimulation Device: A Case Report.

This case report features unique anaesthetic management of a patient with implanted deep brain stimulation (DBS) device undergoing abdominal surgery. It features the intraoperative measures taken for this patient for the implanted DBS. After turning off the DBS preoperatively, the patient showed an exaggerated sympathetic response which was very much resistant to medicines. It was unique to this patient that restarting the device alleviated refractory hypertension. The report also includes review of literature for anaesthetic management of patients with implanted DBS.

Enhanced nonlinear optical response of alkalides based on stacked Janus all-cis-1,2,3,4,5,6-hexafluorocyclohexane.

Significant efforts are continuously exerted by the scientific community to explore new strategies to design materials with high nonlinear optical responses. An effective approach is to design alkalides based on Janus molecules. Herein, we present a new approach to remarkably boost the NLO response of alkalides by stacking the Janus molecules. Alkalides based on stacked Janus molecule, M-n-M' (where n = 2 & 3 while M and M' are Li/Na/K) are studied for structural, energetic, electrical, and nonlinear optical properties. The thermodynamic stability of the designed complexes is confirmed by the energetic stabilities, which range between -14.07 and -28.77 kcal/mol. The alkalide character of alkali metals-doped complexes is confirmed by the NBO charge transfer and HOMO(s) densities. The HOMO densities are located on the doped alkali metal atoms, indicating their alkalide character. The absorptions in UV-Vis and near IR region confirm the deep ultraviolet transparency of the designed complexes. The maximum first static and dynamic hyperpolarizabilities of 5.13 × 107 and 6.6 × 106 au (at 1339 nm) confirm their high NLO response, especially for K-2-M' complexes. The NLO response of alkalides based on stacked Janus molecules is 1-2 orders of magnitude higher than the alkalide based on Janus monomer. The high values of dc-Kerr and electric field-induced response e.g., max ∼107 and 108 au, respectively have been obtained. These findings suggest that our designed complexes envision a new insight into the rational design of stable high NLO performance materials.

Efficient Fault Detection of Rotor Minor Inter-Turn Short Circuit in Induction Machines Using Wavelet Transform and Empirical Mode Decomposition.

This paper introduces a novel approach for detecting inter-turn short-circuit faults in rotor windings using wavelet transformation and empirical mode decomposition. A MATLAB/Simulink model is developed based on electrical parameters to simulate the inter-turn short circuit by adding a resistor parallel to phase "a" of the rotor. The resulting high current in the new phase indicates the presence of the short circuit. By measuring the rotor and stator three-phase currents, the fault can be detected as the currents exhibit asymmetric behavior. Fluctuations in the electromagnetic torque also occur during the fault. The wavelet transform is applied to the rotor current, revealing an effective analysis of sideband frequency components. Specifically, changes in amplitude and frequency, particularly in d7 and a7, indicate the presence of harmonics generated by the inter-turn short circuit. The simulation results demonstrate the effectiveness of wavelet transformation in analyzing these frequency components. Additionally, this study explores the use of empirical mode decomposition to detect faults in their early stages, observing substantial changes in the instantaneous amplitudes of the first three intrinsic mode functions during fault onset. The proposed technique is straightforward and reliable, making it suitable for application in wind turbines with simple electrical inputs.

Ease of Intubation with McGrath Videolaryngoscope and Incidence of Adverse Events During Tracheal Intubation in COVID-19 Patients: A Prospective Observational Study.

Background: Tracheal intubation in critically ill patients remains high-risk despite advances in equipment, technique, and clinical guidelines. Many patients with COVID-19 were in respiratory distress and required intubation that is considered an aerosol-generating procedure (AGP). The transition to videolaryngoscopy as a routine first line option throughout anesthetic and ICU practice has been reported. We evaluated the ease of intubation, success rate, use of accessory maneuvers and adverse outcomes during and 24 hours after intubation with the McGrath videolaryngoscope. Methods: This was a prospective, observational single center study conducted at non-operating room locations that included all adults (>18 years old) with suspected or confirmed COVID-19 infection and were intubated by McGrath videolaryngoscope. The anesthesiologist performed tracheal intubation were requested to fill online data collection form. A co-investigator was responsible to coordinate daily with assigned consultants for COVID intubation and follow up of patients at 24 hours after intubation. Results: A total of 105 patients were included in our study. Patients were predominantly male (n=78; 74.3%), their COVID status was either confirmed (n=97, 92.4%) or suspected (n=8, 7.6%). Most were intubated in the COVID ward (n=59, 56.2%) or COVID ICU (n=23, 21.9%). The overall success rate of intubation with McGrath in the first attempt was 82.9%. The glottic view was either full (n=85, 80.95%), partial (n=16, 15.24%) or none (n=4, 3.81%). During intubation, hypoxemia occurred in 18.1% and hypotension in 16.2% patients. Within 24 hours of intubation, pneumothorax occurred in 1.9%, cardiac arrest and return of spontaneous circulation in 6.7% and mortality in 13.3% of patients. Conclusion: These results illustrate the ease and utility of the McGrath videolaryngoscope for tracheal intubation in COVID-19 patients. Its disposable blade is of significant value in protectin during tracheal intubation.

Antidiabetic, Antioxidative and Antihyperlipidemic Effects of Strawberry Fruit Extract in Alloxan-Induced Diabetic Rats.

Strawberry (Fragaria × ananassa) is one of the accomplished sources of bioactive compounds, including anthocyanin, phenolic acids, flavonols, ellagitannins, and a diverse range of minerals and vitamins that can help to boost human health. This study was carried out to explore the antidiabetic, antioxidative and antihyperlipidemic potential of strawberry extracts against alloxan-induced (100 mg/kg body weight) diabetic rats. Accordingly, rats were categorized into six groups including control (G0), positive control (G1), treatment groups (G2, G3, and G4) given strawberry extract at 250, 500, and 750 mg/kg of body weight, respectively, and G5 provided metformin @70 mg/kg BW for 28 days with ad libitum diet. At the trial termination, the rats were sacrificed and were subjected to analysis including body weight, blood glucose level and glycemic indicators, antioxidant parameters, lipid profile, renal function test (RFT), liver function test (LFT) and histopathology for pancreatic tissues. The results indicated that treatment of diabetic rats with strawberry extract at 500 mg/kg body weight (BW) resulted in significant reductions in blood glucose level, serum urea, and creatinine as well as significant increases in body weight, insulin activity, and protein levels. In addition, the diabetic rats that did not receive strawberry extract (control) exhibited an increase in plasma glucose, urea, uric acid, creatinine, and a decrease in body weight and insulin levels. Briefly, it is reported that strawberry fruit extracts reduced blood sugar levels, possess hypolipidemic potential, and helped to maintain antioxidant levels in alloxan-induced diabetic rats.

Management Of Endotracheal Tube Air Leak-A Simple Yet An Effective Manoeuver.

The management and maintenance of an airway can prevent life threatening complications. The handling of airway, especially in difficult airway and trauma patients, requires extreme caution. We have demonstrated a simple technique in the management of emergency airway, who was getting hypoxic due to severed endotracheal tube (ETT) cuff inflation line. A 20 G intravenous cannula was used, the leak was stopped, and the ETT balloon was inflated. Hence, the leakage and eventually hypoxia settled. We were able to manage emergency airway with this peculiar technique. The use of 20 G intravenous cannula can help to inflate a damaged ETT cuff inflation line. This is an inexpensive and effective manoeuver.

Limosilactobacillus reuteri consumption significantly reduces the total cholesterol concentration without affecting other cardiovascular disease risk factors in adults: A systematic review and meta-analysis.

As one of the most significant probiotics, Limosilactobacillus reuteri (L. reuteri) has been exploited as a nutritional supplement. We hypothesized that L. reuteri consumption might improve the significant risk factors of cardiovascular disease, including blood pressure, blood lipid, and blood glucose. However, previous clinical studies have shown controversial results. This study aims to explore the effect of L. reuteri consumption on these risk factors. PubMed, Embase, Scopus, the Cochrane Library, and Web of Science were searched for eligible randomized controlled trials published before May 2022. A total of 6 studies with 4 different L. reuteri strains and including 512 participants were included. The results showed that L. reuteri consumption significantly reduced total cholesterol (TC) by -0.26 mmol/L compared with the control group. In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides. Subgroup analysis showed a significant reduction in TC when participants were <55 years old, had a body mass index between 25 and 30, or had hypercholesterolemia. In addition, TC decreased significantly when L. reuteri supplementation was >5 × 109 colony-forming unit or the length of the intervention was <12 weeks. Strain subgroup analysis showed that L. reuteri NCIMB 30242 significantly reduced TC and LDL-C. In conclusion, L. reuteri consumption has a significant TC-lowering effect, which can effectively reduce the risks of cardiovascular disease associated with hypercholesterolemia. However, the results do not support the effectiveness of L. reuteri consumption on other metabolic outcomes. Further examination of larger sample sizes is needed to confirm these findings.

National Cancer Registry of Pakistan: First Comprehensive Report of Cancer Statistics 2015-2019.

OBJECTIVE: To compile a comprehensive national cancer registry report of Pakistan by merging and analysing cancer registration data received from major functional cancer registries in various parts of Pakistan. STUDY DESIGN: Observational study. Place and Duration of the Study: Health Research Institute (HRI), National Institutes of Health (NIH), Islamabad, from 2015-2019. METHODOLOGY: Data from major cancer registries which included 'Punjab Cancer Registry (PCR), 'Karachi Cancer Registry (KCR)', 'Pakistan Atomic Energy Commission (PAEC) Cancer Registry', Armed Forces Institute of Pathology (AFIP) Cancer Registry, Nishtar Medical University Hospital Multan (NMH), and Shifa International Hospital, Islamabad (SIH) registries were pooled, cleared, and analysed at HRI. RESULTS: A total of 269,707 cancer cases were analysed. Gender-wise 46.7% were males and 53.61% were females. As per province-wise distribution, 45.13% of cases were from Punjab, 26.83% from Sindh, 16.46% from Khyber Pakhtunkhwa (KP), and 3.52% from Baluchistan. Both genders combined, 'breast cancer' 57633 (21.4%) was the most common cancer. In males, the top-5 cancers in order of frequency/percenatages were 'oral' 14477 (11.6%), 'liver' 8398 (6.73%), colorectal 8024 (6.43%), 'lung' 7547 (6.05%) and 'prostate' 7322 (5.87% cancers). In females, causes of the top-5-cancers included 'breast' 56250 (38.8%), 'ovary' 8823 (6.09%), 'oral' 7195 (4.97%), 'cervix' 6043 (4.17%), and 'colorectal' 4860 (3.36%) cancers. In children 'Leukemia' 1626 (14.50%) and in adolescents 'Bone' 880 (14%) were the leading malignancies. CONCLUSION: Breast cancer is the most common cancer in females touching epidemic proportions while 'oral cancer' which is the leading cancer in males ranks third in frequency in females. Like 'oral cancer' which shows a strong correlation with chewing, other common cancers in Pakistan including liver cancer, lung cancer, and cervical cancer are also largely preventable as showed a strong correlation with hepatitis B and C, smoking, and high-risk human papillomavirus. KEY WORDS: National Cancer Registry, Health Research Institute - NIH, Islamabad, Pakistan.