Advanced Persistent Threat (APT) and intrusion detection evaluation dataset for linux systems 2024.

The novel dataset called Linux-APT Dataset 2024 captures Advanced Persistent Threat (APT) attacks along with other latest and sophisticated payloads. Existing datasets lacks latest attacker's techniques and procedures, APTs tactics and configuration to capture maximum Linux log sources to observe the working and behaviour of an APT in a detailed manner. The environment which supported us in capturing the logs is composed of Linux machines and a centralized logging system configured appropriately to captures and detect all possible events and logs for an APT and other complex intrusion. Unlike Microsoft Windows, Linux logging system are investigated enough and usually systems relies on limited log sources but for an APT, all possible log sources should be evaluated and added to completely analyse the behaviour, trajectory, and operation of an APT. To keep the dataset up to date and realistic, recent payloads and APTs are emulated in the environment. A well-known cyber-security framework 'MITRE ATT&CK' is utilised to map the behaviour and operation in a generalized manner after capturing the events and logs. This dataset can be used for training and conducting a variety of experiments to build as well as design the solutions for detecting most recent intrusions and APT attacks for Linux System.

Correction: Men's knowledge, attitude, and barriers towards emergency contraception: A facility based cross-sectional study at King Saud University Medical City.

[This corrects the article DOI: 10.1371/journal.pone.0249292.].

Frequency of Urinary Tract Infection Among Patients Undergoing Implant Fixation for Acute Trauma.

OBJECTIVE: This study aims to determine the frequency of urinary tract infection (UTI), identify the isolated bacteria, and assess antibiotic sensitivity in patients undergoing orthopedic implant fixation for hip fractures. METHODOLOGY: After ethical approval from the institutional review board, this retrospective cross-sectional study was conducted at the Orthopedic Surgery Department of Dow University Hospital Karachi from June 2022 to June 2023. Through non-probability consecutive sampling, 186 patients above 16 years of age, of either gender, presenting with hip fractures such as intracapsular or extracapsular fractures, who underwent surgical fixation, were included in the study. A urine sample for urinalysis of these patients was sent on admission. Patients who presented with open fractures or those treated with conservative management were excluded from the study. The fracture diagnosis was confirmed on radiographs. All other relevant baseline investigations were also performed before surgery, per protocol, and urine-detailed and cultured reports were followed. In addition, each patient was asked about common symptoms of UTI before surgery and then diagnosed with UTI on positive urine culture and sensitivity (CS). RESULTS: Out of 186 hip fracture patients, 98 (52.7%) were males and 88 (47.3%) were females, with a mean age of 61.03 ± 16.43 (16-96) years. Pre-operative UTI symptoms were reported by 79 patients, including dysuria (16; 20.3%), polyuria (19; 24.0%), and burning (44; 55.7%). UTI was diagnosed on culture and sensitivity report in 65 (34.9%) patients with Escherichia coli as commonly diagnosed bacteria 35 (53.8%), followed by Enterococcus 8 (12.4%), Klebsiella 7 (10.9%), Pseudomonas aeruginosa 3 (4.7%), and Acinetobacter 2 (3.1%) patients. E. coli was sensitive to amikacin, amoxicillin/clavulanic acid, ampicillin, cefixime, ceftriaxone, cefuroxime, ciprofloxacin, colistin, cotrimoxazole, fosfomycin, gentamycin, levofloxacin, meropenem, nitrofurantoin, polymyxin B, and piperacillin-tazobactam. CONCLUSION: Urinary tract infection is common in patients undergoing orthopedic implant fixation for hip fractures, which can lead to potentially serious outcomes. Overall, hygiene, prompt treatment, and standard protocol should be utilized to treat those infected and minimize the spread.

Clinical Impact of CDK4/6 Inhibitors in De Novo or PR- or Very Elderly Post-Menopausal ER+/HER2- Advanced Breast Cancers.

The CDK4/6 inhibitors significantly increase progression-free survival (PFS) in ER+/HER2- advanced breast cancer patients. In clinical trials, overall survival (OS) improvement has been demonstrated for ribociclib and abemaciclib but not for palbociclib. We undertook a real-world evaluation of PFS and OS in 227 post-menopausal patients who received first-line CDK4/6 inhibitors. There is no significant difference in median PFS (27.5 months vs. 25.7 months, p = 0.3) or median OS (49.5 months vs. 50.2 months, p = 0.67) in patients who received either palbociclib or ribociclib, respectively. De novo disease is significantly associated with prolonged median PFS and median OS compared with recurrence disease (47.1 months vs. 20.3 months (p = 0.0002) and 77.4 months vs. 37.3 months (p = 0.0003), respectively). PR- tumours have significantly reduced median PFS and OS compared with PR+ disease (19.2 months vs. 38 months (p = 0.003) and 34.3 months vs. 62.6 months (p = 0.02), respectively). In the very elderly (>80 years), median PFS and OS are significantly shorter compared with patients who are 65 years or below (14.5 months vs. 30.2 months (p = 0.01), and 77.4 months vs. 29.6 months (p = 0.009), respectively) in the palbociclib group. Our data suggest that the benefit in the very elderly is limited, and PR+/de novo disease obtains the maximum survival benefit.

Investigation of the effect of Ni and Cu variant MOF-74 in the Polydimethylsiloxane (PDMS)-based Mixed Matrix Membranes (MMMs) for efficient gas separation applications.

Mixed matrix membranes (MMMs) containing metal-organic frameworks (MOFs) have been an emerging and promising membrane technology to contribute to different gas separation applications including carbon dioxide (CO2) and oxygen (O2) separation, because of their large surface areas and distinctive gas adsorption features. In this work, the fabrication process of Polydimethylsiloxane (PDMS)-based MMMs was reported, in which 0.5 to 2 wt.% of each type of (Cu, Ni)-based MOF-74 variants were incorporated into a PDMS matrix in order to achieve high CO2/N2, O2/N2, and CO2/O2 separation efficiency. These MMMs and their nanofillers (MOF-74) were extensively characterized using scanning electron microscopy (SEM) along with Energy Dispersive X-Ray (EDX) mapping, X-ray Diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), a single gas permeation testing system, and an ultimate tensile strength testing (UTS) unit in order to gain insight into their properties in relation to their gas separation performance. The 1 wt.% of both (Cu and Ni)-MOF-74@PDMS were selected as the most optimum MMMs due to their uniform morphology and enhanced tensile strength, which exhibited high CO2 permeabilities of 4432 Barrer (37.9% increase) and 4288 Barrer (33.5% increase), respectively. Furthermore, in the case of 1 wt.% Ni-MOF-74@PDMS, the CO2/N2, O2/N2, and CO2/O2 selectivities were also enhanced to 36.2 (141.6% increase), 3.2 (21.9% increase), and 11.25 (98.1% increase), respectively. While, in the case of 1 wt.% Cu-MOF-74@PDMS the CO2/N2 and O2/N2 selectivities showed an increment up-to 94.7 (531.5% increase) and 6.47 (145% increase), respectively, Whereas, at 0.5 wt.%, Cu-MOF-74@PDMS showed the best CO2/O2 selectivity of 25.26 (344.7% increase).

Exploring the Indications, Levels, and Outcomes of Lower Extremity Amputation at a Tertiary Care Hospital in Pakistan.

BACKGROUND: Lower extremity amputation (LEA) is a surgical procedure performed to remove either a part or the entire lower limb due to medical conditions such as trauma, infection, peripheral vascular disease, or malignancy. The procedure is becoming increasingly common in Pakistan, with a bulk of patients presenting from rural areas in tertiary care centers. Understanding the indications, levels, and outcomes of LEA is essential for improving patient care and adopting preventive strategies, especially in developing countries. METHODOLOGY: This study was conducted at Dow University Hospital in Karachi, Pakistan. Retrospective data of 384 patients who underwent non-traumatic lower extremity amputations between January 2016 and December 2020 was collected to include relevant history and characteristics, amputation indication and level, type of anesthesia used, and outcome within hospital stay. The data was analyzed using descriptive statistics. RESULTS: The data is composed of a wide age range (18 to 91 years) of patients, including a male majority (76.3%, n = 293). The employment status of the patients was taken into consideration, with a reported high number of unemployed individuals (60.4%, n = 232). Diabetes mellitus (84.4%, n = 324) was a commonly reported past medical condition, followed by hypertension (4.4%, n = 17). Indications for amputation exceedingly recorded were diabetic foot ulcers (84.4%, n = 324), followed by infections (9.4%, n = 36) and peripheral arterial disease (3.6%, n = 14). The anesthetic approach that was observed most in these patients was regional anesthesia (74.7%, n = 287). Right-sided amputations (52.9%, n = 203) were dominant, with below-knee amputations leading by the level of amputation performed (42.5%, n = 163). Many patients delayed seeking treatment (71.6%, n = 275) and indicated denial of severity (18%, n = 69) as a reason for the delay. Regarding outcome, many patients were successfully discharged following treatment (85.9%, n = 330). CONCLUSION: Overall, LEAs are being frequently performed in developing countries, such as Pakistan, especially with a large population living with diabetes mellitus. The implications of this disease are reflected in this study population, with the majority of patients reporting delays in treatment due to reasons such as the unknown severity of the disease or financial burdens. The challenges faced by these individuals, especially in this country, can be tackled with widespread affordability and availability of care and education on early management.

Hepatitis C Prevalence on the Rise but Screening at Safety Net Institutions Lagging behind.

Introduction: In the United States, the hepatitis C virus (HCV) is a leading contributor to liver-related illnesses and fatalities. Despite effective antiviral medications, acute infections have increased in recent years, likely due to IV drug use and the opioid epidemic. Previous guidelines recommended one-time screening for individuals born between 1945 and 1965. The CDC now recommends screening all adults over 18 unless there is a low prevalence in the area. Accurate measurement of HCV prevalence is essential for targeted prevention. In New York, over 100,000 individuals have HCV. We present data on HCV screening at a safety net hospital in Long Island, NY. Objective: To identify screening rates for hepatitis C and the exposure prevalence and specific demographics of a community in Long Island, NY. Methods: We performed a review of all patients seen in our hospital from 2012 to 2019. We identified patients born in the years 1945 to 1965 using our electronic medical record (EMR) system and subsequently analyzed those who were anti-HCV positive. We reviewed their demographics, including age, gender, and ethnicity, as well as their history of intravenous drug use and HIV coinfection status. Basic statistical analysis was used. Results: Our study identified 21,722 patients born between 1945 and 1965 and found that only 8.5% or 1,858 individuals were screened for hepatitis C. Among them, we found that 5.9% (109) tested positive for HCV antibody, with 3.0% (56) having an active infection. Demographic characteristics of those with HCV antibodies included 70.6% male, 53.2% Caucasian, 33.9% Black, and 15.6% persons who inject drugs (PWID). Conclusion: Our study findings suggest that a significant portion of patients in our community had missed opportunities for screening in our hospital. Our community had an estimated 5.9% prevalence, higher than the national and state averages. Caucasian men had higher prevalences. This study suggests the need for broader screening initiatives and more focused resource allocation, perhaps to safety net institutions, to decrease the burden of HCV.

Prediction of transient and permanent protein interactions using AI methods.

Protein-protein interactions (PPIs) can be classified as permanent or transient interactions based on their stability or lifetime. Understanding the precise details of such protein interactions will pave the way for the discovery of inhibitors and for understanding the nature and function of PPIs. In the present work, 43 relevant physicochemical, geometrical and structural features were calculated for a curated dataset from the literature, comprising of 402 protein-protein complexes of permanent and transient categories, and 5 different Supervised Machine Learning models were developed with Scikit-learn to predict transient and permanent PPI. Additionally, deep learning method with Artificial Neural Network was also performed using Tensor Flow and Keras. Predicted models achieved accuracy ranging from 76.54% to 82.71% and k-NN has achieved the highest accuracy. Detailed analysis of these methods revealed that Interface areas such as Percent interface accessible area, Interface accessible area and Total interface area and the parameters defining the shape of the PPI interface such as Planarity, Eccentricity and Circularity are the most discriminating factors between these two categories. The present method could serve as an effective tool to understand the mechanism of protein association and to predict the transient and permanent interactions, which could supplement the costly and time-consuming experimental techniques.

In-season assessment of agronomic nitrogen use efficiency and its components in winter wheat using critical nitrogen dilution curve.

Accurate and timely nitrogen (N) scheduling requires knowledge of in-season crop N deficit. Therefore, understanding the association between crop growth and crop N demand during its growth period is imperative for fine-tuning N scheduling decisions to actual crop N demand and to enhance N use efficiency. The concept of the critical N dilution curve has been employed to assess and quantify the intensity and time of crop N deficit. However, research regarding the association between crop N deficit and N use efficiency in wheat is limited. The present study was carried out to determine whether there are relationships between the accumulated nitrogen deficit (Nand) and agronomic N use efficiency (AEN) as well as with its components (N fertilizer recovery efficiency (REN) and N fertilizer physiological efficiency (PEN)) of winter wheat and to explore the potential capacity of Nand for predicting AEN and its components. Data acquired from five variable N rates (0, 75, 150, 225, and 300 kg ha-1) field experiments using six winter wheat cultivars were used to establish and validate the relationships between Nand and AEN, REN, and PEN. The results indicated that plant N concentration in winter wheat was significantly affected by N application rates. Nand varied from -65.73 to 104.37 kg ha-1 after Feekes stage 6 under different N application rates. The AEN and its components were also affected by cultivars, N levels, seasons, and growth stages. A positive correlation was observed between Nand, AEN, and its components. Validation using an independent data set showed the robustness of the newly developed empirical models to accurately predict AEN, REN, and PEN with an RMSE of 3.43 kg kg-1, 4.22%, and 3.67 kg kg-1 and RRMSE of 17.53%, 12.46%, and 13.17%, respectively. This indicates that Nand has the potential to predict AEN and its components during the growth period of winter wheat. The findings will assist in improving in-season N use efficiency by fine-tuning N scheduling decisions in winter wheat cultivation.

Relationship Between Socio-Demographics, Study Skills and Distress Among Pakistani School Students: A Cross-Sectional Study in Riyadh, Saudi Arabia.

Purpose: The increasing prevalence of distress among students is of global concern. Several factors such as school and family environment and ineffective study skills could influence mental health. The study explored the rate of distress symptoms among school students' and its relationship with their study skills, stressors and demographic factors. Methods: In this cross-sectional analytical study, a sample of 215 students from a community school participated in the study. Three questionnaires, demographic questionnaire, Study Skills Inventory and the Kessler Psychological Distress Scale, were used for data collection. Data were analyzed using Student's t-test, ANOVA, Pearson's correlation coefficient and stepwise linear regression. Results: Response rate was 70% (n = 150). A high proportion of respondents (75%) was distressed (mean 27.28 ± 8.77). Correlation analysis showed that distress (K10 score) was negatively related to study skills (SSI total score) (r = -0.247, p = 0.002). The rate of distress symptoms was higher among female students (79%) compared to their male counterparts (72%). The factors associated with distress included negative association of teachers' level of help to develop competencies (p = 0.000, ß = -0.278, R2 = 0.249), unfavorable school environment (p = 0.000, ß = 0.285, R2 = 0.123), inability to cope with studies (p = 0.005, ß = 0.205, R2 = 0.038), family problems (p = 0.014, ß = 0.184, R2 = 0.173) and lower study skills (p = 0.031, ß = -0.164, R2 = 0.270). The overall regression analysis explained 33.6% of the variance (corrected R2 = 0.336). Conclusion: Higher than expected levels of distress (75%) was found in immigrant school students. Poor study skills have a significant relationship with distress. Learning environment and related stress factors were associated with distress among students. Based on the findings, it is recommended that stakeholders in education address the hidden curriculum, as it is usually unacknowledged and might affect students' wellbeing, and move from student centered to an interpersonal relation-centered education.

A molecular level understanding of antimony immobilization mechanism on goethite by the combination of X-ray absorption spectroscopy and density functional theory calculations.

A molecular level understanding of antimony (Sb) immobilization mechanism on Fe oxides is required to clarify the fate of Sb in the soil. In this study, macroscopic sorption experiments, combined with extended X-ray absorption fine structure (EXAFS) spectroscopy and density functional theory (DFT), were utilized to explore the interaction between Sb and goethite. The ion strength has no effect on Sb sorption on goethite, indicating the inner-sphere complex Sb formed on goethite. Goethite has the higher sorption potential to Sb(III) than Sb(V), consistent with the higher thermodynamic stability of the geometry for Sb(III) formed on goethite than Sb(V) revealed by DFT calculations. By comparing the Sb-Fe distances obtained by EXAFS spectroscopy and DFT, eight kinds of Sb(III) surface complexes and nine kinds of Sb(V) surface complexes were considered to be the possible geometries Sb formed on different crystal planes of goethite, including monodentate mononuclear, bidentate mononuclear, bidentate binuclear, tridentate mononuclear, tridentate binuclear, tridentate four-nuclear complexes. The structural and energetic details of these filtered geometries provide comprehensive information on Sb immobilization mechanism on goethite, helpful in clarifying the fate of Sb in soils.

An LSTM-based Gesture-to-Speech Recognition System.

Fast and flexible communication options are limited for speech-impaired people. Hand gestures coupled with fast, generated speech can enable a more natural social dynamic for those individuals - particularly individuals without the fine motor skills to type on a keyboard or tablet reliably. We created a mobile phone application prototype that generates audible responses associated with trained hand movements and collects and organizes the accelerometer data for rapid training to allow tailored models for individuals who may not be able to perform standard movements such as sign language. Six participants performed 11 distinct gestures to produce the dataset. A mobile application was developed that integrated a bidirectional LSTM network architecture which was trained from this data. After evaluation using nested subject-wise cross-validation, our integrated bidirectional LSTM model demonstrates an overall recall of 91.8% in recognition of these pre-selected 11 hand gestures, with recall at 95.8% when two commonly confused gestures were not assessed. This prototype is a step in creating a mobile phone system capable of capturing new gestures and developing tailored gesture recognition models for individuals in speech-impaired populations. Further refinement of this prototype can enable fast and efficient communication with the goal of further improving social interaction for individuals unable to speak.

Model analysis on effect of temperature on the solubility of recycling of Polyethylene Terephthalate (PET) plastic.

The massive increase in the use of PET plastic bottles has raised the challenge of accumulated waste plastics disposal and its related environmental concerns. Reusing this plastic waste through a solvent-based recycling process seems to be an eco-friendly solution for eliminating waste plastic and converting them into high quality products. The selection of solvent with its temperature requirement for the dissolution of polymeric materials is crucial in the solvent-based recycling process. Therefore, an innovative MATLAB program named HSPs-TPT was designed and constructed in this work to evaluate the dissolving power of solvents. Through this program, the solubility of the waste PET polymer was examined in thirteen (13) different solvents at different temperatures. As a results, the degree of waste PET polymer dissolution in the solvents was presented as the polymer-solvent solubility diagram, which provided the information about the relative energy difference (RED) change with the temperature rise. The program also provided the temperature range effective for the dissolution of PET by indicating the minimum and maximum solubility point for each solvent, which was further validated by the experimental data found in the literature. The proposed MATLAB program can numerically analyse the solubility of a polymer in different solvents in a short time for the recycling process and fabrication of different value-added plastic products such as polymer monoliths and membrane filters.

Estimating the Impacts of Plant Internal Nitrogen Deficit at Key Top Dressing Stages on Corn Productivity and Intercepted Photosynthetic Active Radiation.

Accurate and timely appraisal of plant nitrogen (N) demand is imperative to regulate the canopy structure and corn production. The strength and time of plant N deficit can be quantified by critical N concentration. The study was aimed to analyze nitrogen nutrition index (NNI), nitrogen deficit content (NDC), plant nitrogen productivity (PNP), and a fraction of intercepted photosynthetic active radiation (FIPAR) across different N treatments and to develop NNI-NDC, NNI-PNP, NNI-FIPAR, NDC-PNP, and NDC-FIPAR relationships from V6 to V12 stages of corn to quantify the suitable PNP and FIPAR values under the optimal plant N condition. Four multi-N rates (0, 75, 90, 150, 180, 225, 270, and 300 kg N ha-1) field experiments were conducted with two cultivars of corn in Henan province of China. Results indicated that N fertilization affected yield, plant biomass, plant N content, and leaf area index. The values of NNI and NDC were from 0.54 to 1.28 kg ha-1 and from -28.13 to 21.99 kg ha-1 under the different treatments of N rate, respectively. The NDC and NNI showed significantly negative relationships from V6 to V12 stages. The values of PNP and FIPAR increased gradually with the crop growth process. The PNP values gradually declined while the FIPAR values of every leaf layer increased with the increase of N supply. The NDC-PNP and NNI-FIPAR relationships were significantly positive; however, the relationships between NNI-PNP and NDC-FIPAR were significantly negative during the vegetative period of corn. The coefficient of determination (R 2) based on NNI was better than that on NDC. The FIPAR values were ~0.35, 0.67, and 0.76% at the upper, middle, and bottom of leaf layers, respectively, and PNP values were ~39, 44, and 51 kg kg-1 at V6, V9, and V12 stages, respectively, when NNI and NDC values were equal to 1 and 0 kg ha-1, respectively. This study described the quantitative information about the effect of a plant's internal N deficit on plant N productivity and canopy light intercept. The projected results would assist in predicting the appropriate plant growth status during key N top-dressing stages of corn, which can optimize N application and improve N use efficiency.

The impact of alternate wetting and drying and continuous flooding on antimony speciation and uptake in a soil-rice system.

The accumulation of trace elements in rice, such as antimony (Sb), has drawn special attention owing to the potential increased risk to human health. However, the effects of two common irrigation methods, alternate wetting and drying and continuous flooding, on Sb behaviors and subsequent accumulation in rice is unclear. In this study a pot experiment with various Sb additions (0, 50, 200, 1000 mg Sb kg-1) was carried out with these two irrigation methods in two contrasting paddy soils (an Anthrosol and a Ferralic Cambisol). The dynamics of Sb in soil porewater indicated that continuous flooding generally immobilized more Sb than alternate wetting and drying, concomitant with a pronounced reduction of Sb(V) in porewater. However, a higher phytoavailable fraction of Sb was observed under continuous flooding. The content of Sb in the rice plant decreased in the order of root > shoot > husk > grain, and continuous flooding facilitated Sb accumulation in rice root and shoot as compared with alternate wetting and drying. The differences of Sb content in root, shoot, and husk between the two irrigation methods was smaller in aboveground parts, and almost no difference in Sb was observed in grain between the two methods. The findings of this study facilitates the understanding of Sb speciation and behavior in soils with these common yet different water management regimes.

Future advances and challenges of nanomaterial-based technologies for electromagnetic interference-based technologies: A review.

The emerging growth of the electronic devices applications has arisen the serious problems of electromagnetic (EM) wave pollution which resulting in equipment malfunction. Therefore, polymer-based composites have been considered good candidates for better EMI shielding due to their significant characteristics including, higher flexibility, ultrathin, lightweight, superior conductivity, easy fabrication processing, environmentally friendly, corrosion resistive, better adhesion with physical, chemical and thermal stability. This review article focused on the concept of the EMI shielding mechanism and challenges with the fabrication of polymer-based composites. Subsequently, recent advancements in the polymer composites applications have been critically reviewed. In addition, the impact of polymers and polymer nanocomposites with different fillers such as organic, inorganic, 2D, 3D, mixture and hybrid nano-fillers on EMI shielding effectiveness has been explored. Lastly, future research directions have been proposed to overcome the limitations of current technologies for further advancement in EMI shielding materials for industrial applications. Based on reported literature, it has been found that the low thickness based lightweight polymer is considered as a best material for excellent material for next-generation electronic devices. Optimization of polymer composites during the fabrication is required for better EMI shielding. New nano-fillers such as functionalization and composite polymers are best to enhance the EMI shielding and conductive properties.

Impact of preoperative sarcopenia in patients undergoing sacral tumor resection.

INTRODUCTION: Sacral tumor resection is known for a high rate of complications. Sarcopenia has been found to be associated with wound complications; however, there is a paucity of data examining the impact of sarcopenia on the outcome of sacral tumor resection. METHODS: Forty-eight patients (31 primary sarcomas, 17 locally recurrent carcinomas) undergoing sacrectomy were reviewed. Central sarcopenia was assessed by measuring the psoas:lumbar vertebra index (PLVI), with the 50th percentile (0.97) used to determine which patients were high (>0.97) versus low (<0.97). RESULTS: Twenty-four (50%) patients had a high PLVI and 24 (50%) had a low PLVI (sarcopenic). There was no difference (p > 0.05) in the demographics of patients with or without sarcopenia. There was no difference in the incidence of postoperative wound complications (odds ratio [OR] = 1.0, p = 1.0) or deep infection (OR = 0.83, p = 1.0). Sarcopenia was not associated with death due to disease (hazard ratio [HR] = 2.04, p = 0.20) or metastatic disease (HR = 2.47, p = 0.17), but was associated with local recurrence (HR = 6.60, p = 0.01). CONCLUSIONS: Central sarcopenia was not predictive of wound complications or infection following sacral tumor resection. Sarcopenia was, however, an independent risk factor for local tumor recurrence following sacrectomy and should be considered when counseling patients on the outcome of sacrectomy.

Prevalence of insomnia and related psychological factors with coping strategies among medical students in clinical years during the COVID-19 pandemic.

We explored the prevalence of insomnia, confirm the associated psychological factors and current coping strategies among undergraduate medical during their clinical years. This cross-sectional, quantitative, descriptive study was conducted at the department of medical education, college of medicine, King Saud University (KSU), Riyadh, Saudi Arabia. The participants (n = 463) were the 3rd to 5th year, and intern medical clinical students. We collected responses about sleep, using the Insomnia Severity Index (ISI). We also used Kessler-10 (K10), Psychological Distress and the Patient Health Questionnaire (PHQ-9). Items related to Coping strategies were also used from our previously published study and COVID-19 issues were explored using a self-developed questionnaire. According to the ISI ranking, 162 (34.9 %) of the participants had insomnia, among them 57.4% of females and 42.6% were males. Age groups between 22 and 25 have more sleeping disorder (43.2%) as compared to other age groups. 3rd-year students have more insomnia 36.41% as compared to other years. Individuals with insomnia symptoms were more likely (1.67 times higher) to be female students (OR = 1.67; P = 0.005) as compared to male students. A significantly high prevalence (3.37 times high) of insomnia was noted for those students or interns who have attended their clinical training irregularly as compare to regularly attending participants (OR = 2.32; P = 0.12) during COVID-19. Transition time i.e. year 3 of medical program was more stressful for the students and female students perceived stress and insomnia more than their male counterparts. It is important to address identified disorder early in order to reduce psychological morbidity and its harmful implications for medical students and young physicians.

Exploring the Impacts of Genotype-Management-Environment Interactions on Wheat Productivity, Water Use Efficiency, and Nitrogen Use Efficiency under Rainfed Conditions.

Wheat production under rainfed conditions is restrained by water scarcity, elevated temperatures, and lower nutrient uptake due to possible drought. The complex genotype, management, and environment (G × M × E) interactions can obstruct the selection of suitable high yielding wheat cultivars and nitrogen (N) management practices prerequisite to ensure food security and environmental sustainability in arid regions. The agronomic traits, water use efficiency (WUE), and N use efficiencies were evaluated under favorable and unfavorable weather conditions to explore the impacts of G × M × E on wheat growth and productivity. The multi-N rate (0, 70, 140, 210, and 280 kg N ha-1) field experiment was conducted under two weather conditions (favorable and unfavorable) using three wheat cultivars (AUR-809, CHK-50, and FSD-2008) in the Pothowar region of Pakistan. The experiments were laid out in randomized complete block design (RCBD), with split plot arrangements having cultivars in the main plot and N levels in the subplot. The results revealed a significant decrease in aboveground biomass, grain yield, crop N-uptake, WUE, and N use efficiency (NUE) by 15%, 22%, 21%, 18%, and 8%, respectively in the unfavorable growing season (2014-2015) as compared to favorable growing season (2013-2014) as a consequence of less rainfall and heat stress during the vegetative and reproductive growth phases, respectively. FSD-2008 showed a significantly higher aboveground biomass, grain yield, crop N-uptake, WUE, and NUE as compared to other wheat cultivars in both years. Besides, N140 appeared as the most suitable dose for wheat cultivars during the favorable growing season. However, any further increase in N application rates beyond N140 showed a non-significant effect on yield and yield components. Conversely, the wheat yield increased significantly up to 74% from N0 to N70 during the unfavorable growing season, and there was no substantial difference between N70-N280. The findings provide opportunities for maximizing yield while avoiding excessive N loss by selecting suitable cultivars and N application rates for rainfed areas of Pothowar Plateau by using meteorological forecasting, amount of summer rainfall, and initial soil moisture content.