Prevalence and Risk Factors of Pressure Ulcers in Bedbound Diabetic vs. Non-diabetic Patients in a Lower-Middle-Income Country.

Introduction Pressure ulcers, also known as bedsores, are a significant concern for bedridden individuals, presenting both physical and socioeconomic challenges. Factors such as prolonged immobility, chronic medical conditions, and poor nutrition contribute to their development. Despite extensive research in some regions, studies comparing diabetic and non-diabetic populations remain limited, particularly in low-income settings. This study aimed to investigate the risk factors and frequency of pressure ulcers among bedridden patients, addressing this gap in understanding and guiding targeted interventions. Materials and methods A cross-sectional study was conducted across four government hospitals in Peshawar, Pakistan. A total of 388 bedridden patients with pressure ulcers were included, and data were collected through a questionnaire. The questionnaire covered demographics, comorbidities, duration of bedbound status, BMI, and caregivers' awareness of pressure ulcer care. Data analysis was performed using SPSS version 22.0 (Armonk, NY: IBM Corp.), with qualitative data presented as frequencies and percentages and quantitative data as mean and standard deviation. Chi-square tests were utilized for significance, with p<0.05 considered significant. Results Of the 388 patients analyzed, 230 (59.3%) were diabetic, highlighting the prevalence of diabetes among pressure ulcer cases. The majority of diabetic patients with ulcers were over 41 years old, and 293 (75.5%) had comorbidities. Surgical intervention was the primary cause of ulcers in 213 (54.8%) cases, followed by stroke in 77 (19.8%) cases. Notably, 252 (65%) of caregivers exhibited inadequate knowledge regarding ulcer care. Stage II ulcers were prevalent in both diabetic and non-diabetic cohorts. Conclusions Pressure ulcers are poorly controlled complications observed in bedridden individuals, highlighting a critical need for comprehensive preventive measures and caregiver education to alleviate the burden of pressure ulcers, especially in diabetic patients. Factors such as prolonged immobility, surgical interventions, and insufficient caregiver knowledge contribute to the development of pressure ulcers. Understanding these complexities is essential for implementing effective care approaches and mitigating the impact of pressure ulcers.

Intelligent model for the detection and classification of encrypted network traffic in cloud infrastructure.

This article explores detecting and categorizing network traffic data using machine-learning (ML) methods, specifically focusing on the Domain Name Server (DNS) protocol. DNS has long been susceptible to various security flaws, frequently exploited over time, making DNS abuse a major concern in cybersecurity. Despite advanced attack, tactics employed by attackers to steal data in real-time, ensuring security and privacy for DNS queries and answers remains challenging. The evolving landscape of internet services has allowed attackers to launch cyber-attacks on computer networks. However, implementing Secure Socket Layer (SSL)-encrypted Hyper Text Transfer Protocol (HTTP) transmission, known as HTTPS, has significantly reduced DNS-based assaults. To further enhance security and mitigate threats like man-in-the-middle attacks, the security community has developed the concept of DNS over HTTPS (DoH). DoH aims to combat the eavesdropping and tampering of DNS data during communication. This study employs a ML-based classification approach on a dataset for traffic analysis. The AdaBoost model effectively classified Malicious and Non-DoH traffic, with accuracies of 75% and 73% for DoH traffic. The support vector classification model with a Radial Basis Function (SVC-RBF) achieved a 76% accuracy in classifying between malicious and non-DoH traffic. The quadratic discriminant analysis (QDA) model achieved 99% accuracy in classifying malicious traffic and 98% in classifying non-DoH traffic.

Bouveret's syndrome: A rare case of gallstone causing gastric outlet obstruction.

Key Clinical Message: The case highlights the importance of decisive action in addressing large gallstones causing gastric outlet obstruction. The chosen single-stage surgical approach reflects the need to manage both obstruction and the gallstone simultaneously. Abstract: Bouveret's syndrome is a rare cause of gastric outlet obstruction secondary to gallstones entering the enteric system through an acquired cholecystoduodenal fistula. Here, we present the case of an 85-year-old female who presented to our emergency department with gastric outlet obstruction secondary to a large gallstone in the third part of the duodenum. Abdominal X-ray did not demonstrate air-fluid levels but revealed a dilated gastric shadow, suggesting gastric outlet obstruction. EGD showed a dilated stomach and a hard, golf ball-sized gallstone in the duodenum. CT scan showed a distended stomach with a large gallstone obstructing the DJ junction and air in the biliary tree. Findings were suggestive of perforation of the gallbladder with stone impaction in the duodenojejunal (DJ) junction. The patient was managed surgically with a one-stage procedure comprising enterotomy, fistula closure, and cholecystectomy. Although Bouveret's syndrome is rare, it is important for practicing surgeons to have a high index of suspicion for this condition due to the high mortality associated with it.

Global dynamics and computational modeling for analyzing and controlling Hepatitis B: A novel epidemic approach.

Hepatitis B virus (HBV) infection is a global public health issue. We offer a comprehensive analysis of the dynamics of HBV, which can be successfully controlled with vaccine and treatment. Hepatitis B virus (HBV) causes a significantly more severe and protracted disease compared to hepatitis A. While it initially presents as an acute disease, in approximately 5 to 10% of cases, it can develop into a chronic disease that causes permanent damage to the liver. The hepatitis B virus can remain active outside the body for at least seven days. If the virus penetrates an individual's body without immunization, it may still result in infection. Upon exposure to HBV, the symptoms often last for a duration ranging from 10 days to 6 months. In this study, we developed a new model for Hepatitis B Virus (HBV) that includes asymptomatic carriers, vaccination, and treatment classes to gain a comprehensive knowledge of HBV dynamics. The basic reproduction number [Formula: see text] is calculated to identify future recurrence. The local and global stabilities of the proposed model are evaluated for values of [Formula: see text] that are both below and above 1. The Lyapunov function is employed to ensure the global stability of the HBV model. Further, the existence and uniqueness of the proposed model are demonstrated. To look at the solution of the proposed model graphically, we used a useful numerical strategy, such as the non-standard finite difference method, to obtain more thorough numerical findings for the parameters that have a significant impact on disease elimination. In addition, the study of treatment class in the population, we may assess the effectiveness of alternative medicines to treat infected populations can be determined. Numerical simulations and graphical representations are employed to illustrate the implications of our theoretical conclusions.

Robust Output Feedback Stabilization and Tracking for an Uncertain Nonholonomic Systems with Application to a Mobile Robot.

This paper presents a novel robust output feedback control that simultaneously performs both stabilization and trajectory tracking for a class of underactuated nonholonomic systems despite model uncertainties, external disturbance, and the absence of velocity measurement. To solve this challenging problem, a generalized normal form has been successfully created by employing an input-output feedback linearization approach and a change in coordinates (diffeomorphism). This research mainly focuses on the stabilization problem of nonholonomic systems that can be transformed to a normal form and pose several challenges, including (i) a nontriangular normal form, (ii) the internal dynamics of the system are non-affine in control, and (iii) the zero dynamics of the system are not in minimum phase. The proposed scheme utilizes combined backstepping and sliding mode control (SMC) techniques. Furthermore, the full-order high gain observer (HGO) has been developed to estimate the derivative of output functions and internal dynamics. Then, full-order HGO and the backstepping SMC have been integrated to synthesize a robust output feedback controller. A differential-drive type (2,0) the wheeled mobile robot has been considered as an example to support the theoretical results. The simulation results demonstrate that the backstepping SMC exhibits robustness against bounded uncertainties.

Unraveling the Enigma of Aortic Dissection: From Genetics to Innovative Therapies.

Aortic dissection (AD) presents a critical medical emergency characterized by a tear in the aortic wall, necessitating prompt recognition and management to mitigate catastrophic complications. Despite advancements in medical technology and therapeutic interventions, AD remains a formidable challenge, often resulting in severe morbidity and mortality. This narrative review provides a comprehensive overview of AD, encompassing its clinical presentation, diagnostic modalities, and management strategies, while also exploring emerging trends and innovations in its management. Genetic predispositions significantly influence AD pathogenesis, with over 30 contributory genes identified, emphasizing the importance of genetic screening and counseling. Classification systems such as Stanford and DeBakey, alongside their revised counterparts, aid in categorizing AD and guiding treatment decisions. Advancements in diagnostic imaging, including transesophageal echocardiography and computed tomography angiography, have enhanced diagnostic precision, augmented by artificial intelligence and machine learning algorithms. Pharmacological innovations focus on optimizing medical therapy, while surgical and endovascular approaches offer minimally invasive treatment options. Hybrid procedures and aortic valve-sparing techniques broaden treatment avenues, while bioresorbable stent grafts hold promise for tissue regeneration. Collaborative efforts and ongoing research are essential to address remaining challenges and improve outcomes in managing AD. This review contributes to the understanding of AD's complexity and facilitates informed decision-making in clinical practice, underscoring the imperative for continued innovation and research in AD management.

Assessing the potential of nano-formulated chlorfenapyr and clothianidin insecticides-treated sugar baits against Anopheles funestus, Anopeles coluzzii and Culex quinquefasciatus mosquitoes.

Mosquitoes serve as vectors for various diseases like malaria, dengue fever, yellow fever, and lymphatic filarial diseases causing significant global health problems, highlighting the importance of vector control. The study was conducted to assess the effectiveness of nanoformulated clothianidin and chlorfenapyr insecticides treated with ATSB in controlling three mosquito strains. The development of a natural thiolated polymer-coated ATSB nano formulation involved incorporating nano-carriers to deliver insecticides. Field- collected mosquito strains were subjected to laboratory-based bioassays using 1 % and 1.5 % concentrations of each conventionally used and nanoformulated insecticide with ATSB solution. Adult mosquitoes were left overnight to contact with N-ATSB and efficacy was recorded after 36 and 72 h. The results showed that nanoformulated chlorfenapyr was significantly more effective as compared to clothianidin against An. funestus and Cx. quinquefasciatus but the results were not significantly different against An. coluzzii (100 %). An. coluzzii was found to be the most susceptible strain followed by An. funestus and showed 100 % and ∼ 98 % mortality against nanoformulated chlorfenapyr (1.5 %). Nanoformulated clothianidin induced more than 92 % and ∼ 100 % mortality against An. funestus and An. coluzzii respectively. However, Cx. quinquefasciatus significantly showed less mortality against nanoformulated clothianidin (88 %) and chlorfenapyr (>95 %) as compared to Anopheline strains. Furthermore, results indicate that nanoformulated insecticides significantly caused greater and prolonged fatality as compared to conventional form, suggesting effective and suitable strategies for vector management.

Killing vector fields of locally rotationally symmetric Bianchi type V spacetime.

The classification of locally rotationally symmetric Bianchi type V spacetime based on its killing vector fields is presented in this paper using an algebraic method. In this approach, a Maple algorithm is employed to transform the Killing's equations into a reduced evolutive form. Subsequently, the integration of the Killing's equations is carried out subject to the constraints provided by the algorithm. The algorithm demonstrates that there exist fifteen distinct metrics that could potentially possess Killing vector fields. Upon solving the Killing equations for all fifteen metrics, it is observed that seven out of the fifteen metrics exclusively exhibit the minimum number of Killing vector fields. The remaining eight metrics admit a varying number of Killing vector fields, specifically 6, 7, or 10. The Kretschmann scalar has been computed for each of the obtained metrics, revealing that all of them possess a finite Kretschmann scalar and thus exhibit regular behavior.

Behavioural impacts of following administration of Ficus carica leaves extract in animal model of acute and chronic unpredictable mild stressed exposed rats.

Stress is described as a noxious stimulus that affects the health of an individual and alters body homeostasis resulting in changes the individual behavioural and metabolic condition. Synthesis of drug from plants has main interest due the significant medicinal values. The recent investigation was designed to examine the pharmacological impacts of Ficus carica leaves extract on stress. In this experiment, the rodents were randomly distributed as (n=6) control rats were kept at standard condition, second group of rats were exposed with different stressors and Third group of rodents was exposed to stress and treated with extract of ficus carica leaves at the dose of 100 mg/kg. Acute behavioural alteration was observed after 7 days and prolonged impact was monitored after the 28 days. The current finding showed that administration of Ficus carica leaves extract produced anxiolytic behaviours and decreased depression like symptoms in CUMS treated rats. It also increased stimulatory, ambulatory, locomotor activity and enhanced spatial working memory and recognition memory in CUMS exposed rats. So, it can be concluded from recent study that leaves of Ficus carica can be utilized as secure drug for curing physiological stress with less side effect profile.

Pharmacological profile of agmatine: An in-depth overview.

Agmatine, a naturally occurring polyamine derived from arginine via arginine decarboxylase, has been shown to play multifaceted roles in the mammalian body, impacting a wide range of physiological and pathological processes. This comprehensive review delineates the significant insights into agmatine's pharmacological profile, emphasizing its structure and metabolism, neurotransmission and regulation, and pharmacokinetics and function. Agmatine's biosynthesis is highly conserved across species, highlighting its fundamental role in cellular functions. In the brain, comparable to established neurotransmitters, agmatine acts as a neuromodulator, influencing the regulation, metabolism, and reabsorption of neurotransmitters that are key to mood disorders, learning, cognition, and the management of anxiety and depression. Beyond its neuromodulatory functions, agmatine exhibits protective effects across various cellular and systemic contexts, including neuroprotection, nephroprotection, cardioprotection, and cytoprotection, suggesting a broad therapeutic potential. The review explores agmatine's interaction with multiple receptor systems, including NMDA, α2-adrenoceptors, and imidazoline receptors, elucidating its role in enhancing cell viability, neuronal protection, and synaptic plasticity. Such interactions underpin agmatine's potential in treating neurological diseases and mood disorders, among other conditions. Furthermore, agmatine's pharmacokinetics, including its absorption, distribution, metabolism, and excretion, are discussed, underlining the complexity of its action and the potential for therapeutic application. The safety and efficacy of agmatine supplementation, demonstrated through various animal and human studies, affirm its potential as a beneficial therapeutic agent. Conclusively, the diverse physiological and therapeutic effects of agmatine, spanning neurotransmission, protection against cellular damage, and modulation of various receptor pathways, position it as a promising candidate for further research and clinical application. This review underscores the imperative for continued exploration into agmatine's mechanisms of action and its potential in pharmacology and medicine, promising advances in the treatment of numerous conditions.

Unveiling the Genetic Tapestry: Exploring Rhizoctonia solani AG-3 Anastomosis Groups in Potato Crops across Borders.

The current study was carried out to screen 10 isolates (ARS-01-ARS-10) of Rhizoctonia. solani from potato tubers cv. Kuroda, which were collected from various potato fields in Multan, Pakistan. The isolates were found to be morphologically identical, as the hyphae exhibit the production of branches at right angles and acute angles often accompanied by septum near the emerging branches. Anastomosis grouping showed that these isolates belonged to AG-3. A pathogenicity test was performed against the susceptible Kuroda variety and among the isolates, ARS-05 exhibited the highest mean severity score of approximately 5.43, followed by ARS-09, which showed a mean severity score of about 3.67, indicating a moderate level of severity. On the lower end of the severity scale, isolates ARS-06 and ARS-07 displayed mean severity scores of approximately 0.53 and 0.57, respectively, suggesting minimal symptom severity. These mean severity scores offer insights into the varying degrees of symptom expression among the different isolates of R. solani under examination. PCoA indicates that the severe isolate causing black scurf on the Kuroda variety was AG-3. A comprehensive analysis of the distribution, genetic variability, and phylogenetic relationships of R. solani anastomosis groups (AGs) related to potato crops across diverse geographic regions was also performed to examine AG prevalence in various countries. AG-3 was identified as the most widespread group, prevalent in Sweden, China, and the USA. AG-5 showed prominence in Sweden and the USA, while AG-2-1 exhibited prevalence in China and Japan. The phylogenetic analysis unveiled two different clades: Clade I comprising AG-3 and Clade II encompassing AG-2, AG-4, and AG-5, further subdivided into three subclades. Although AGs clustered together regardless of origin, their genetic diversity revealed complex evolutionary patterns. The findings pave the way for region-specific disease management strategies to combat R. solani's impact on potato crops.

Outcomes of Haematopoietic Stem Cell Transplantation in Beta Thalassemia Major with Fully Matched Parents as Donor.

OBJECTIVE: To determine the outcome of beta thalassemia major (BTM) patients undergoing haematopoietic stem cells (HSCT), with fully matched parents as donors vs. matched sibling donors (MSD). STUDY DESIGN: Observational Study. Place and Duration of the Study: Department of Clinical Haematology and Bone Marrow Transplantation Centre, Rawalpindi, Pakistan, from January 2013 to July 2023. METHODOLOGY: Group A consisted of BTM patients who underwent HSCT with fully matched siblings as donors, and Group B consisted of BTM patients who underwent HSCT with fully matched parents as donors. Study data included the age and gender of both recipients and donors, source and dose of stem cells infused, and stage and grades of acute and chronic graft versus host disease (GvHD). All patients received Myeloablative conditioning regimen (MAC). Data were collected to assess patients' demographics, response to HSCT, remission rate, disease free survival (DFS), relapse, and GvHD free survival (GRFS), and overall survival (OS). RESULTS: The mean age of the 54 patients was 5.90 ± 3.29 years. The mean TNC and CD34 doses were 4.99 + 1.13 and 5.42 + 3.70, respectively. Mean time for neutrophil engraftment in both groups was 14.88 + 4.51 days and platelets engraftment was 23.0 + 5.35 days. Most common cause of death was neutropenic sepsis followed by aGVHD. Seven patients had graft rejection. There was no significant association found between graft rejection with donor relation though graft rejection was higher in OS in this study was 70.4%. OS was equal in both groups. Disease free survival was superior in MSD (63%) than parent group (57.7%). CONCLUSION: Allogenic bone marrow transplantation with parents as donors in BTM patients yields outcomes comparable to those with matched sibling donors. This finding is especially relevant in regions like Pakistan, where donor registries and high-resolution HLA typing may be limited. KEY WORDS: Beta thalassemia major, Haematopoietic stem cell transplant, Post-transplant outcome.

Impact of haemodialysis on plasma carnitine concentrations in haemodialysis patients.

Objective: To evaluate the impact of haemodialysis on plasma carnitine levels. METHODS: The cross-sectional study was conducted from April 20, 2020 to May 10, 2022, at the dialysis unit of the nephrology ward of Jinnah Postgraduate Medical Centre, Karachi, and the Pakistan Navy Ship Shifa Hospital, Karachi, in collaboration with the Department of Biochemistry, University of Karachi, and comprised patients of either gender aged >18 years. They were divided into chronic kidney disease group A and end-stage renal disease group B. Control group C included subjects from the general population. Free carnitine and total carnitine values were detected using enzyme-linked immunosorbent assay. Acyl carnitine was estimated by applying the standard formula, and the ratio between acyl carnitine and free carnitine was calculated for accurate assessment of the carnitine status. Data was analysed using SPSS 23. RESULTS: Of the 203 subjects, 143(70.44%) were cases and 60(29.55%) were controls. Among the cases, 120(84%) were recruited from Jinnah Postgraduate Medical Centre and 23(16%) from Pakistan Navy Ship Shifa Hospital. There were 60(29.55%) patients in group A, 83(40.88%) in group B and 60(29.55%) in group C. The mean age in group A was 47.90 5.±65 years, it was 44.10 ±8.92 years in group B and 40.90 ± 6.73 years in group C. There was a significant difference related to free carnitine, total carnitine, acyl carnitine values and the ratio between acyl carnitine and free carnitine values in groups A and B compared to control group C (p<0.05). Conclusion: Patients on maintenance haemodialysis developed were found to have developed carnitine deficiency.

Assessment of Nano-Formulated Conventional Insecticide-Treated Sugar Baits on Mosquito Control and the Effect on Non-Target Aphidophagous Coccinella septempunctata.

Mosquitoes, as disease vectors causing global morbidity and mortality through diseases like malaria, dengue, and Zika, necessitate mosquito population control methods. This study investigated the efficacy of nano-formulated insecticide-based sugar baits in controlling Anopheles gambiae populations and assessed their potential non-target impact on Coccinella septempunctata. This laboratory-based study employed thiolated polymer-coated attractive toxic sugar bait (ATSB) nano-formulations, delivering pesticides via nano-carriers. Adult and larvae populations of insects were collected from rice and cotton fields subjected to bioassays with 0.5% and 1% concentrations of each nano-formulated and conventional insecticide within ATSB solution, alongside a control 100% attractive sugar bait (ASB). Mosquitoes interacted overnight with insecticide-treated baits, and mortality was assessed. Further observations up to 72 h were conducted for potential delayed toxic effects. Results highlighted nano-ATSB carbosulfan's effectiveness, particularly among organophosphates and pyrethroids. Among pyrethroids, nano-ATSB cypermethrin exhibited high efficacy, while Deltamethrin displayed lower mortality. Among organophosphates, nano-ATSB chlorpyrifos induced substantial mortality. The nano-formulations of insecticide were harmless against C. septempunctata compared to their conventional form. Nano-formulations demonstrated enhanced mortality rates and prolonged efficacy against mosquitoes, having a benign impact on non-target beetles. We expect these results to aid in developing effective plant protection products suitable for IPM practices.

Structural and thermal investigation of lignocellulosic biomass conversion for enhancing sustainable imperative in progressive organic refinery paradigm for waste-to-energy applications.

The depletion of finite fossil fuel reserves and the severe environmental degradation resulting from human activities have compelled the expeditious development and application of sustainable waste to energy technologies. To encapsulate energy and environment in sustainability paradigm, bio waste based energy production is need to be forged in organic bio refinery setup. According to world bioenergy association, biomass can cover 50 % of the primary energy demand of the world. Therefore, the present study focuses on reforming the energy mix for a clean energy generation, where, sample composition of cotton stalk was acidified in dilute (5% wt.) hydrochloric acid (HCL) for analyzing material burnout patterns in biomass conversion systems utilized in organic bio refinery sector. Advanced thermochemical burning technique, which includes pyrolysis and combustion was applied at four different leaching times from 0 to 180 min under nitrogen environment from 0 °C to 500 °C and air from 500 °C to 900 °C, respectively. Different analyses including proximate, ultimate, gross calorific value (GCV), thermos-gravimetric, kinetic, XRD, FTIR, SEM-EDS were used for analyzing the degradation of demineralized cotton stalk at different treatment rates. Proximate study demonstrated that cotton stalk leaching for 180 min has efficiently infused HCL, leading in a significant increase in fixed carbon and higher heating value of 20.23 % and 12.48%, respectively, as well as a reduction in carbon footprint of around 54.80%. The findings of proximate was validated by GCV analysis and CHNS analysis as value of carbon and hydrogen has shown increasing behavior with the time delay in demineralization Thermo-gravimetric and derivative thermo-gravimetric data analyses shows an increasing trend of conversion efficiency, with the maximum increase of 98 % reported for sample 3H.TT.DEM. XRD characterization has reported 23° to 25° angle for all the observed peaks. Sample 3H.TT.DEM has shown maximum angle inclination along with matured crystalline peak. The latter observations has been validated by FTIR spectroscopy as sample 3H.TT.DEM has reported maximum O-H group formation. Sample 3H.TT.DEM has reported lowest activation energy of 139.51 kJ*mole-1 and lowest reactivity of 0.000293649%*min 0C, due to moderate and stable reactiveness. In SEM examination, increment in pore size and number of pores within the structural matrix of cotton stalk was observed with the enhancement in acidulation process. Furthermore, in EDS analysis, 3H.TT.DEM has shown most balanced distribution of the elements. In this research, sustainable transformation of biomass is envisioned to improve the waste bio refinery system, significantly contributing to the achievement of Sustainable Development Goals 7, 12 and 13.

Adjuvant Radiofrequency Ablation Along With Stenting Versus Stenting Alone for Biliary Tree Drainage in Patients With Malignant Biliary Strictures: A Systemic Review and Meta-analysis.

OBJECTIVE: This metanalysis aims to assess the efficacy and safety of biliary stenting along with radiofrequency ablation compared with stents alone to treat malignant biliary obstruction (MBO) due to extrahepatic biliary strictures secondary to cholangiocarcinoma, pancreatic cancer, and metastatic cancer. METHODS: A systemic search of major databases through April 2022 was done. All original studies were included comparing radiofrequency ablation with stenting versus stenting alone for treating malignant biliary strictures. The primary outcomes of interest were the difference in the mean stent patency and overall survival (OS) days between the 2 groups. The secondary outcome was to compare the adverse events of the 2 groups. The mean difference in the stent patency and OS days was pooled by using a random-effect model. We calculated the odds ratio to compare the adverse events between the 2 groups. RESULTS: A total of 13 studies with 1339 patients were identified. The pooled weighted mean difference in stent patency was 43.50 days (95% CI, 25.60-61.41), favoring the RFA plus stenting. Moreover, the pooled weighted mean difference in OS was 90.53 days (95% CI, 49.00-132.07), showing improved survival in the RFA group. Our analysis showed no statistically significant difference in adverse events between the 2 groups OR 1.13 (95% CI, 0.90-1.42). CONCLUSION: Our analysis showed that RFA, along with stent, is safe and is associated with improved stent patency and overall patient survival in malignant biliary strictures. More robust prospective studies should assess this association further.

Evaluation of soil texture classification from orthodox interpolation and machine learning techniques.

The current investigation examines the effectiveness of various approaches in predicting the soil texture class (clay, silt, and sand contents) of the Rawalpindi district, Punjab province, Pakistan. The employed techniques included artificial neural networks (ANNs), kriging, co-kriging, and inverse distance weighting (IDW). A total of 44 soil specimens from depths of 10-15 cm were gathered, and then the hydrometer method was adopted to measure their texture. The map of soil grain sets was formulated in the ArcGIS environment, utilizing distinct interpolation approaches. The MATLAB software was used to evaluate soil texture. The gradient fraction, latitude and longitude, elevation, and soil texture fragments of points were proposed to an ANN. Several statistical values, such as correlation coefficient (R), geometric mean error ratios (GMER), and root mean square error (RMSE), were utilized to evaluate the precision of the intended techniques. In assessing grain size and spatial dissemination of clay, silt, and sand, the effectiveness and precision of ANN were superior compared to kriging, co-kriging, and inverse distance weighting. Still, less than a 50% correlation was observed using the ANN. In this examination, the IDW had inferior precision compared to the other approaches. The results demonstrated that the practices produced acceptable results and can be used for future research. Soil texture is among the most central variables that can manipulate agriculture plans. The prepared maps exhibiting the soil texture groups are imperative for crop yield and pastoral scheduling.

Spatio-temporal analysis of land use land cover change and its impact on land surface temperature of Sialkot City, Pakistan.

The dynamic interplay between urbanization and its impacts on climate is a subject of recent concern, particularly in rapidly urbanizing cities of Pakistan. This research investigated the spatio-temporal effects of urban growth in terms of Land Use Land Cover changes on the thermal environment (Land Surface Temperature) of the Sialkot city, Pakistan using satellite data spanning four distinct time periods (1989, 2000, 2009 and 2020) and predicted changes for year 2030 by employing Cellular Automata Markov Chain Model. Satellite imagery (Landsat 5, 7 and 8) was processed, and maximum likelihood supervised classification was done to generate LULC maps for each of the aforementioned years. In addition to LULC classification, thermal bands of satellite data (for summer and winter) were processed to compute Land Surface Temperature (LST) of the city. The prediction of LULC changes and LST was done for year 2030 using Cellular Automata Markov Chain Model. The accuracy of classified and prediction maps was checked using Kappa Index. The LULC analysis revealed 4.14% increase in the built-up area and 3.43% decrease in vegetation cover of the city during 1989 to 2020. Both land covers are expected to change in the future (year 2030) by + 1.31% (built-up) and - 1.1% (vegetation). Furthermore, a declining trend in the barren land and water bodies was also observed over time. These LULC changes were found affecting the LST of study area. The transformation of vegetation cover into built-up area resulted in an increase in LST over time. A notable rise of 4.5 °C (summer) and 5.7 °C (winter) in the mean LST of Sialkot was observed during 1989 to 2020 and further increases are anticipated in year 2030. This study calls for attention of the policy makers to reduce human impact on the local climate of the city. The study will also help city developers in analyzing the urban population growth trend, finding suitable location to built new infrastructure by governmental authorities and how the rising temperature can affect energy demand and agriculture production of the city in future.