Fabrication of a New Rationally Designed Mussel-Inspired Cationic Amphiphilic Terpolymer to Enhance the Separation and Anti-Fouling Performance of Membranes.

Polyvinylidene fluoride (PVDF) membrane-based systems for treating oily wastewater are prone to fouling. Herein, we introduced a novel mussel-inspired cationic amphiphilic terpolymer consisting of monomers N,N-diallyldimethylammonium chloride (DADMAC), N,N-diallyltetradecan-1-ammonium chloride (DTDAC), and mussel-inspired N,N-diallyldopamine hydrochloride (DADAHC) to improve the performance and characteristics of the PVDF membranes for oil-in-water emulsion separations. The cationic terpolymer, poly(DADMAC-co-DTDAC-co-DADAHC), shortened as PDDD, was synthesized in excellent yields via free radical polymerization and has good compatibility with the PVDF owing to the presence of hydrophobic long alkyl chains in DTDAC. The presence of dopamine motifs helps stabilize the PDDD-PVDF membrane by chelating with Fe3+ ions. The water contact angle on the PDDD-incorporated PVDF membranes was reduced from 87.6 to 54.6°, demonstrating improved hydrophilicity than pristine PVDF (M-0). The incorporation of PDDD into the PVDF improved the separation efficiencies of the membrane, which reached up to 99% while treating the oil-in-water emulsions. Incorporating PDDD into PVDF has significantly enhanced the anti-fouling characteristics of the membranes, which are indicated by their remarkable flux recovery ratio (FRR) (up to 92%). The hydrophobic and hydrophilic groups worked synergetically to enhance the performance of the fabricated membrane.

Stakeholders' Perspectives Regarding Supply Chain System of Pharmaceuticals and Vaccines in Pakistan: A Qualitative Study.

The present study was undertaken to assess the current supply chain system of pharmaceuticals and vaccines in Pakistan in terms of structure, process, and outcomes, as well as related barriers and solutions for an effective supply chain system. A qualitative study was designed to explore stakeholders' perceptions selected using the snowball sampling technique. A semi-structured interview guide was used to interview these respondents at a convenient time and place. After data collection, recorded interviews were transcribed verbatim and subjected to thematic analysis. The results highlighted that the standard operating procedures (SOPs), checklists, and government guidelines were available at different levels, except for community pharmacies. Timely delivery of quality products and services along with market reputation, experience, and authorization were the key criteria used for supplier selection and evaluation. Good inventory management, financial models, effective coordination, training, and skill development programs were identified as key factors responsible for an efficient supply chain process. Availability of vaccines, their appropriate temperature monitoring, and transportation are also highly compromised in Pakistan. The results of the present study concluded that the current supply chain system in Pakistan is not up to the mark; major factors include poor forecasting and inventory control, delayed order placement, lack of training, inadequate involvement of professionally qualified staff, inadequate financing and procurement processes, and poor coordination and integration among all stakeholders.

A sorbent containing pH-responsive chelating residues of aspartic and maleic acids for mitigation of toxic metal ions, cationic, and anionic dyes.

t-Butyl hydroperoxide-initiated cycloterpolymerization of diallylaminoaspartic acid hydrochloride [(CH2[double bond, length as m-dash]CHCH2)2NH+CH(CO2H)CH2CO2H Cl-] (I), maleic acid (HO2CH[double bond, length as m-dash]CHCO2H) (II) and cross-linker tetraallylhexane-1,6-diamine dihydrochloride [(CH2[double bond, length as m-dash]CHCH2)2NH+(CH2)6NH+ (CH2CH[double bond, length as m-dash]CH2)2 2Cl-] (III) afforded a new pH-responsive resin (IV), loaded with four CO2H and a chelating motif of NH+⋯CO2 - in each repeating unit. The removal of cationic methylene blue (MB) (3000 ppm) at pH 7.25 and Pb(ii) (200 ppm) at pH 6 by IV at 298, 313, and 328 K followed second-order kinetics with E a of 33.4 and 40.7 kJ mol-1, respectively. Both MB and Pb(ii) were removed fast, accounting for 97.7% removal of MB within 15 min at 313 K and 94% of Pb(ii) removal within 1 min. The super-adsorbent resin gave respective q max values of 2609 mg g-1 and 873 mg g-1 for MB and Pb(ii). IV was also found to trap anionic dyes; it removed 91% Eriochrome Black T (EBT) from its 50 ppm solutions at pH 2. The resin was found to be effective in reducing priority metal contaminants (like Cr, Hg, Pb) in industrial wastewater to sub-ppb levels. The synthesis of the recyclable resin can be easily scaled up from inexpensive starting materials. The resin has been found to be better than many recently reported sorbents.

Synthesis of a biomimetic zwitterionic pentapolymer to fabricate high-performance PVDF membranes for efficient separation of oil-in-water nano-emulsions.

Oily wastewater from industries has an adverse impact on the environment, human and aquatic life. Poly(vinylidene fluoride) (PVDF) membrane modified with a zwitterionic/hydrophobic pentapolymer (PP) with controlled pore size has been utilized to separate oil from water from their nano-emulsions. The PP has been synthesized in 91% yield via pentapolymerization of four different diallylamine salts [(CH2=CHCH2)2NH+(CH2)x A-], bearing CO2-, PO3H-, SO3-, (CH2)12NH2 pendants, and SO2 in a respective mol ratio of 25:36:25:14:100. Incorporating PP into PVDF has shown a substantially reduced membrane hydrophobicity; the contact angle decreased from 92.5° to 47.4°. The PP-PVDF membranes have demonstrated an excellent capability to deal with the high concentrations of nano-emulsions with a separation efficiency of greater than 97.5%. The flux recovery ratio (FRR) of PP-5 incorporated PVDF membrane was about 82%, which was substantially higher than the pristine PVDF.

Do economic policy uncertainty and environment-related technologies help in limiting ecological footprint?

Economic policies related to energy and the environment are found uncertain in developing economies. Renewable energy sources are gradually increasing in energy structure (ES) with the adoption of environment-related technologies (ERT). However, least attention is paid to investigating the nexus of economic policy uncertainty (EPU), ERT, ES, and ecological footprint (EF). Therefore, this study is an effort to examine the EPU, ERT, ES, and interaction of EPU and ERT on EF for BRICS economies under the umbrella of the STIRPAT model. By using the data from 1992 to 2020, findings are estimated through "cross-sectional dependence (CD test); CIPS and CADF unit root test; Westerlund's co-integration; and CS-ARDL, AMG, and CCEMG." Findings unveiled the negative role of EPU on EF. Furthermore, the role of RE and ERT is positive and substantial in decreasing the environmental degradation in BRICS. Therefore, the BRICS economies are suggested to be consistent on economic policies to catch the positive impact of ERT. Findings are robust to the policy implications.

The role of ICT in energy consumption and environment: an empirical investigation of Asian economies with cluster analysis.

The development of societies has led information and communication technology (ICT) to play a gradually important role in people's lives, transforming the way societies and economies function. ICTs are often associated with the path to reducing CO2 emissions; however, do they lead to that path? Or are they themselves a growing source of energy consumption and emissions? The current study estimates the effect of ICT, trade, economic growth, financial development, and energy consumption on carbon emissions in South and Southeast Asian (SSEA) region for the period of 1990-2014. Moreover, the study also tried to validate the environmental Kuznets curve (EKC) hypothesis between GDP per capita and CO2 emissions. Cluster analysis was used to identify two groups (potential and advanced countries) based on their social development score. The long-run connection between the variables was examined and the long-run elasticities of ICT, financial development, energy consumption, trade, and economic growth with respect to CO2 emissions were estimated. Besides, individual country-wise long-run coefficients were found. Results show that financial development and ICT deteriorated the environment quality in the SSEA region, suggesting ICT goods and services are not energy-efficient in both potential and advanced countries and that most of the financial investment was made in non-friendly environmental projects, in potential countries. On the contrary, in advanced countries, financial development mitigates CO2 emissions. In addition, results also confirmed an inverted U-shaped relationship for all the considered three panels such as potential, advance, and full-countries panels, confirming EKC. Causality findings showed a bidirectional causality between CO2 emissions and energy consumption as well as unidirectional causality from trade, economic growth, financial development, and ICT to CO2 emissions. Policymakers should be aware of the ICT impact on energy consumption and strengthen the regulation of their manufacture to facilitate the integration of energy efficiency into user routines. Due to the increasing use of standby mode and Wi-Fi assistive devices, the rapid implementation of legislation regulating these technologies to make them more efficient is recommended.

The effects of deforestation and urbanization on sustainable growth in Asian countries.

This study aims to determine the effects of deforestation, economic growth, and urbanization on carbon dioxide (CO2) emissions levels in the South and Southeast Asian (SSEA) regions for the 1990-2014 period. The data was divided into five sub-panels. Three of them are income-based groups (namely low-, middle- and high-income panels), and the remaining two are South and Southeast Asian regions. The Pedroni cointegration test confirms a long-run relationship between deforestation, economic growth, urbanization, and CO2 emissions in the SSEA regions. Further, empirical results reveal the existence of a U-shaped relationship between CO2 emissions and economic growth for all panels (excepting low-income countries). This means that these countries can grow in a sustainable path, but they must be aware of long-term risks of this economic growth, as this sustainable path could be compromised when reaching the turning point of the "U". Moreover, our results suggest that deforestation and urbanization can aggravate environmental pollution in these regions and can further affect sustainable development in the long run. Besides, the most appropriate and cost-effective method to minimize CO2 emissions is found to be through the improvement of forest activities.

Urothelial carcinoma in children, case report with review of literature.

Urothelial carcinoma is the third most prevalent malignancy in adults, accounting for 2.1 % of all cancerrelated deaths. The highest incidence in the 6th decade of life but it is rare in the paediatric population and its incidence is less than 1% constituting a very rare disease. We report the case of a 13 years old boy, who presented to the outpatient department at The Indus Hospital, Karachi, in May 2017, with the complaint of painless gross haematuria.

Post operative pain control in percutaneous nephrolithotomy.

OBJECTIVE: To evaluate post-surgery pain relief in percutaneous nephrolithotomy cases. METHODS: The case-control study was conducted at Indus Hospital, Karachi, from July 2014 to July 2015, and comprised patients undergoing percutaneous nephrolithotomy. The patients were randomized by snose protocol into two equal groups of cases and controls. The cases were given peri-tubal local anaesthetic infiltration of 0.25% bupivacaine, while the controls were given 10ml 0.9% normal saline infiltration. Post-operative pain was assessed using visual analogue scale. RESULTS: Of the 68 patients, there were 34(50) in each of the two groups. Pain score was significantly less in the intervention group post-operatively at 6th and 12th hours (p<0.05). Also, total consumption of analgesics and demand of analgesic medication were also significantly low among the cases (p<0.05). CONCLUSIONS: Bupivacaine infiltration into the peri-tubal track significantly reduced post-operative pain.

Development, validity and reliability of an URDU version of the International Prostate Symptom Score.

OBJECTIVE: To develop and validate the Urdu version of the International Prostate Symptoms Score. METHODS: The prospective study was conducted at Indus Hospital, Karachi, from January to April 2014, and comprised interviews of subjects at baseline and at 2 weeks for assessing the test-retest reliability. Patients presenting with lower urinary track symptoms and who were able to read Urdu were recruited as subjects. The reliability of the Urdu version of the International Prostate Symptoms Score was assessed by determining the internal consistency, and by assessing the test-retest reliability. RESULTS: There were 58 subjects with a mean age of 61.53+/-9.99 years. There was no statistically significant difference in self-administered and assister filling total score (p=0.145) and quality of life (p=0.201). For reliability analysis, Cronbach's alpha coefficient was 0.756 total score and 0.622 for quality of life. CONCLUSIONS: The Urdu version of the International Prostate Symptoms Score stood validated for assessing lower urinary track symptoms.

Leiomyoma of the urinary bladder.

Leiomyoma of urinary bladder is a rare tumour with an incidence of < 0.5% of all the bladder tumours. We report a case of leiomyoma of bladder after taking written and informed consent from a 38 years old female, after obtaining the permission of the institutional review board (IRB). She presented in November 2015, with symptoms of obstructive lower urinary tract for 1 year followed by acute urinary retention. Physical examination was unremarkable. Ultrasound showed well circumscribed polypoidal growth in the bladder with mild hydronephrosis on the left side. CT scan abdomen and pelvis with contrast was done, which revealed well circumscribed, rounded soft tissue lesion of 4.4 x 4.5 cm at the posterior inferior surface of the bladder near the bladder neck. Initially TURBT was done but after 6 months patient again went into urinary retention so local excision of the tumour was done. Histopathology confirmed the diagnosis of leiomyoma of the bladder. The diagnosis and management of leiomyoma of the bladder is presented along with review the literature.

An interactive environmental model for economic growth: evidence from a panel of countries.

This study aims to determine an interactive environmental model for economic growth that would be supported by the "sustainability principles" across the globe. The study examines the relationship between environmental pollutants (i.e., carbon dioxide emission, sulfur dioxide emission, mono-nitrogen oxide, and nitrous oxide emission); population growth; energy use; trade openness; per capita food production; and it's resulting impact on the real per capita GDP and sectoral growth (i.e., share of agriculture, industry, and services in GDP) in a panel of 34 high-income OECD, high-income non-OECD, and Europe and Central Asian countries, for the period of 1995-2014. The results of the panel fixed effect regression show that per capita GDP are influenced by sulfur dioxide emission, population growth, and per capita food production variability, while energy and trade openness significantly increases per capita income of the region. The results of the panel Seemingly Unrelated Regression (SUR) show that carbon dioxide emission significantly decreases the share of agriculture and industry in GDP, while it further supports the share of services sector to GDP. Both the sulfur dioxide and mono-nitrogen oxide emission decreases the share of services in GDP; nitrous oxide decreases the share of industry in GDP; while mono-nitrogen oxide supports the industrial activities. The following key growth-specific results has been obtained from the panel SUR estimation, i.e., (i) Both the food production per capita and trade openness significantly associated with the increasing share of agriculture, (ii) food production and energy use significantly increases the service sectors' productivity; (iii) food production decreases the industrial activities; (iv) trade openness decreases the share of services to GDP while it supports the industrial share to GDP; and finally, (v) energy demand decreases along with the increase agricultural share in the region. The results emphasize the need for an interactive environmental model that facilitates the process of sustainable development across the globe.

Gallbladder perforation: a rare complication of acute cholecystitis.

Gallbladder perforation is a rare but potentially fatal disease and therefore is a dilemma for early diagnosis. It is usually a complication of acute cholecystitis with or without gallstones. We present a case of 70-year-old female with abdominal pain and fever. Initial ultrasound revealed cholelithiasis with possible acute cholecystitis. Clinical condition of the patient worsened and suspicion of gallbladder perforation was entertained. Hence, a repeat ultrasound and CT scan was done. Following this a gallbladder perforation was confirmed intra operatively.

Superior gluteal artery aneurysm.

To report the successful coil embolization of a rare gluteal artery aneurysm and review therapeutic options for this rare condition. We report a case of pseudo-aneurysm of superior gluteal artery initially diagnosed as gluteal abscess. They can be diagnosed by Doppler ultrasound, computed tomography or magnetic resonance imaging. Mainstay of the diagnosis is by angiography and the preferred management with good clinical results is with angiographic embolization. This report reviews the literature and addresses the incidence, aetiology, and treatment of gluteal artery aneurysms.