Estimation of instantaneous peak flows in Canadian rivers: an evaluation of conventional, nonlinear regression, and machine learning methods.

Instantaneous peak flows (IPFs) are often required to derive design values for sizing various hydraulic structures, such as culverts, bridges, and small dams/levees, in addition to informing several water resources management-related activities. Compared to mean daily flows (MDFs), which represent averaged flows over a period of 24 h, information on IPFs is often missing or unavailable in instrumental records. In this study, conventional methods for estimating IPFs from MDFs are evaluated and new methods based on the nonlinear regression framework and machine learning architectures are proposed and evaluated using streamflow records from all Canadian hydrometric stations with natural and regulated flow regimes. Based on a robust model selection criterion, it was found that multiple methods are suitable for estimating IPFs from MDFs, which precludes the idea of a single universal method. The performance of machine learning-based methods was also found reasonable compared to conventional and regression-based methods. To build on the strengths of individual methods, the fusion modeling concept from the machine learning area was invoked to synthesize outputs of multiple methods. The study findings are expected to be useful to the climate change adaptation community, which currently heavily relies on MDFs simulated by hydrologic models.

Development and content validation of a financial and functional outcomes tool for diabetes-related foot disease in patients undergoing major lower limb amputation: a prospective observational study from Pakistan.

OBJECTIVE: To develop and content validate a questionnaire to assess the financial and functional impact of major lower limb amputation in patients with diabetes-related foot disease. DESIGN: Prospective observational study. SETTING: This study was conducted at a tertiary care centre in Pakistan. PARTICIPANTS: We conducted a thorough literature review and a group interview with 10 participants, resulting in domain identification and item generation. The group included seven patients with diabetes-related foot disease who underwent major lower limb amputation and three caregivers. Subsequently, a focused group discussion was held to assess overlap and duplication among the items, and two rounds of content validation were carried out by five content and five lay experts in both English and Urdu. Question items with a Content Validity Index (CVI) score of >0.79 were retained, items with a CVI score between 0.70 and 0.79 were revised and items with a CVI score of <0.70 were excluded. RESULTS: The initial literature review and group interview resulted in 61 items in the financial and functional domains. After the focused group discussion, the questionnaire was reduced to 37 items. Following two rounds of content validation, the English questionnaire achieved the Scale-Content Validity Index/Average (S-CVI/Ave) of 0.92 and 0.89 on relevance and clarity, respectively. Similarly, the Urdu questionnaire achieved the S-CVI-Ave of 0.92 and 0.95, respectively. CONCLUSION: A 37-item multidimensional questionnaire was developed and rigorously content-validated to assess the financial and functional impact of major lower limb amputation in patients with diabetes-related foot disease. The questionnaire used in this study has shown robust content validity specifically for our population.

Biochar impacts on carbon dioxide, methane emission, and cadmium accumulation in rice from Cd-contaminated soils; A meta-analysis.

Climate change and cadmium (Cd) contamination pose severe threats to rice production and food security. Biochar (BC) has emerged as a promising soil amendment for mitigating these challenges. To investigate the BC effects on paddy soil upon GHG emissions, Cd bioavailability, and its accumulation, a meta-analysis of published data from 2000 to 2023 was performed. Data Manager 5.3 and GetData plot Digitizer software were used to obtain and process the data for selected parameters. Our results showed a significant increase of 18% in soil pH with sewage sludge BC application, while 9% increase in soil organic carbon (SOC) using bamboo chips BC. There was a significant reduction in soil bulk density (8%), but no significant effects were observed for soil porosity, except for wheat straw BC which reduced the soil porosity by 6%. Sewage sludge and bamboo chips BC significantly reduced carbon dioxide (CO2) by 7-8% while municipal biowaste reduced methane (CH4) emissions by 2%. In the case of heavy metals, sunflower seedshells-derived materials and rice husk BC significantly reduced the bioavailable Cd in paddy soils by 24% and 12%, respectively. Cd uptake by rice roots was lowered considerably by the addition of kitchen waste (22%), peanut hulls (21%), and corn cob (15%) based BC. Similarly, cotton sticks, kitchen waste, peanut hulls, and rice husk BC restricted Cd translocation from rice roots to shoots by 22%, 27%, 20%, and 19%, respectively, while sawdust and rice husk-based BC were effective for reducing Cd accumulation in rice grains by 25% and 13%. Regarding rice yield, cotton sticks-based BC significantly increased the yield by 37% in Cd-contaminated paddy soil. The meta-analysis demonstrated that BC is an effective and multi-pronged strategy for sustainable and resilient rice cultivation by lowering greenhouse gas emissions and Cd accumulation while improving yields under the increasing threat of climate change.

Clocked dynamics in artificial spin ice.

Artificial spin ice (ASI) are nanomagnetic metamaterials with a wide range of emergent properties. Through local interactions, the magnetization of the nanomagnets self-organize into extended magnetic domains. However, controlling when, where and how domains change has proven difficult, yet is crucial for technological applications. Here, we introduce astroid clocking, which offers significant control of ASI dynamics in both time and space. Astroid clocking unlocks a discrete, step-wise and gradual dynamical process within the metamaterial. Notably, our method employs global fields to selectively manipulate local features within the ASI. Sequences of these clock fields drive domain dynamics. We demonstrate, experimentally and in simulations, how astroid clocking of pinwheel ASI enables ferromagnetic domains to be gradually grown or reversed at will. Richer dynamics arise when the clock protocol allows both growth and reversal to occur simultaneously. With astroid clocking, complex spatio-temporal behaviors of magnetic metamaterials become easily controllable with high fidelity.

Spatiotemporal investigation of near-surface CH4 and factors influencing CH4 over South, East, and Southeast Asia.

Methane (CH4) is the second most abundant greenhouse gas after CO2, which plays the most important role in global and regional climate change. To explore the long-term spatiotemporal variations of near-surface CH4, datasets were extracted from Greenhouse gases Observing SATellite (GOSAT), and the Copernicus Atmospheric Monitoring Service (CAMS) reanalyzed datasets from June 2009 to September 2020 over South, East, and Southeast Asia. The accuracy of near-surface CH4 from GOSAT and CAMS was verified against surface observatory stations available in the study region to confirm both dataset applicability and results showed significant correlations. Temporal plots revealed continuous inflation in the near-surface CH4 with a significant seasonal and monthly variation in the study region. To explore the factors affecting near-surface CH4 distribution, near-surface CH4 relationship with anthropogenic emission, NDVI data, wind speed, temperature, precipitation, soil moisture, and relative humidity were investigated. The results showed a significant contribution of anthropogenic emissions with near-surface CH4. Regression and correlation analysis showed a significant positive correlation between NDVI data and near-surface CH4 from GOSAT and CAMS, while a significant negative correlation was found between wind and near-surface CH4. In the case of temperature, soil moisture, and near-surface CH4 from GOSAT and CAMS over high CH4 regions of the study area showed a significant positive correlation. However significant negative correlations were found between precipitation and relative humidity with GOSAT and CAMS datasets over high CH4 regions in South, East, and Southeast Asia. Moreover, these climatic factors showed no significant correlation within the low near-surface CH4 areas in our study region. Our study results showed that anthropogenic emissions, NDVI data, wind speed, temperature, precipitation, soil moisture, and humidity could significantly affect the near-surface CH4 over South, East, and Southeast Asia.

Aluminum phytotoxicity in acidic environments: A comprehensive review of plant tolerance and adaptation strategies.

Aluminum (Al), a non-essential metal for plant growth, exerts significant phytotoxic effects, particularly on root growth. Anthropogenic activities would intensify Al's toxic effects by releasing Al3+ into the soil solution, especially in acidic soils with a pH lower than 5.5 and rich mineral content. The severity of Al-induced phytotoxicity varies based on factors such as Al concentration, ionic form, plant species, and growth stages. Al toxicity leads to inhibited root and shoot growth, reduced plant biomass, disrupted water uptake causing nutritional imbalance, and adverse alterations in physiological, biochemical, and molecular processes. These effects collectively lead to diminished plant yield and quality, along with reduced soil fertility. Plants employ various mechanisms to counter Al toxicity under stress conditions, including sequestering Al in vacuoles, exuding organic acids (OAs) like citrate, oxalate, and malate from root tip cells to form Al-complexes, activating antioxidative enzymes, and overexpressing Al-stress regulatory genes. Recent advancements focus on enhancing the exudation of OAs to prevent Al from entering the plant, and developing Al-tolerant varieties. Gene transporter families, such as ATP-Binding Cassette (ABC), Aluminum-activated Malate Transporter (ALMT), Natural resistance-associated macrophage protein (Nramp), Multidrug and Toxic compounds Extrusion (MATE), and aquaporin, play a crucial role in regulating Al toxicity. This comprehensive review examined recent progress in understanding the cytotoxic impact of Al on plants at the cellular and molecular levels. Diverse strategies developed by both plants and scientists to mitigate Al-induced phytotoxicity were discussed. Furthermore, the review explored recent genomic developments, identifying candidate genes responsible for OAs exudation, and delved into genome-mediated breeding initiatives, isolating transgenic and advanced breeding lines to cultivate Al-tolerant plants.

A Platform for Addressing Individual Magnetite Islands Grown Epitaxially on Ru(0001) and Manipulating Their Magnetic Domains.

We have grown high-quality magnetite micrometric islands on ruthenium stripes on sapphire through a combination of magnetron sputtering (Ru film), high-temperature molecular beam epitaxy (oxide islands), and optical lithography. The samples have been characterized by atomic force microscopy, Raman spectroscopy, X-ray absorption and magnetic circular dichroism in a photoemission microscope. The magnetic domains on the magnetite islands can be modified by the application of current pulses through the Ru stripes in combination with magnetic fields. The modification of the magnetic domains is explained by the Oersted field generated by the electrical current flowing through the stripes underneath the magnetite nanostructures. The fabrication method is applicable to a wide variety of rock salt and spinel oxides.

GHz sample excitation at the ALBA-PEEM.

We describe a setup that is used for high-frequency electrical sample excitation in a cathode lens electron microscope with the sample stage at high voltage as used in many synchrotron light sources. Electrical signals are transmitted by dedicated high-frequency components to the printed circuit board supporting the sample. Sub-miniature push-on connectors (SMP) are used to realize the connection in the ultra-high vacuum chamber, bypassing the standard feedthrough. A bandwidth up to 4 GHz with -6 dB attenuation was measured at the sample position, which allows to apply sub-nanosecond pulses. We describe different electronic sample excitation schemes and demonstrate a spatial resolution of 56 nm employing the new setup.

Hybrid molecular graphene transistor as an operando and optoelectronic platform.

Lack of reproducibility hampers molecular devices integration into large-scale circuits. Thus, incorporating operando characterization can facilitate the understanding of multiple features producing disparities in different devices. In this work, we report the realization of hybrid molecular graphene field effect transistors (m-GFETs) based on 11-(Ferrocenyl)undecanethiol (FcC11SH) micro self-assembled monolayers (µSAMs) and high-quality graphene (Gr) in a back-gated configuration. On the one hand, Gr enables redox electron transfer, avoids molecular degradation and permits operando spectroscopy. On the other hand, molecular electrode decoration shifts the Gr Dirac point (VDP) to neutrality and generates a photocurrent in the Gr electron conduction regime. Benefitting from this heterogeneous response, the m-GFETs can implement optoelectronic AND/OR logic functions. Our approach represents a step forward in the field of molecular scale electronics with implications in sensing and computing based on sustainable chemicals.

Extracellular vesicles and exosome: insight from physiological regulatory perspectives

The current study highlights prospective mechanisms of biogenesis of extracellular vesicles (EVs) and potential involvement in cellular signaling and transport with great emphasis to illustrate their role as biomarkers in certain pathologies. The current review highlights EVs, the heterogeneous entities secreted by cells in highly conserved manner. A series of consensus terminologies for various types is yet to be organized. Exosomes, microvesicles and apoptotic bodies are major populations among EVs. EVs are key regulators in cellular physiological homeostasis, disease progression and evolve either from plasma membrane (microvesicles) or fusion of endosomes with exosomes. However, how vesicular inclusions elicit a plethora of biological responses is still not much clear. However, how these vesicular inclusions get packaged and delivered by these EVs shows great involvement in inter- and intracellular cellular signaling and channeling of multiple proteins, variety of RNAs and certain fat molecules. It’s worth to mention that EVs carry small non-coding RNAs (snRNAs) which are involved in multiple cellular molecular events at targeted sites. Moreover, snRNA trafficking through exosomes and microvesicles depicts remarkable potential as non-invasive biomarkers in different clinical disorders especially immune system pathologies, cardiovascular issues, and metabolic syndromes. (AU)

Outbreak investigation and identification of risk factors associated with the occurrence of foot and mouth disease in Punjab, Pakistan.

Foot-and-mouth disease (FMD) is a highly contagious viral disease of domesticated and wild ruminants and pigs that causes enormous economic losses through morbidity, mortality, and trade restrictions. Although the disease is endemic in Pakistan, seasonal outbreaks occur every year throughout the country. This study aimed to investigate FMD outbreaks and to identify the risk factors associated with FMD outbreaks between January and April 2019 in the Punjab province. We performed outbreak investigations (n = 64) for FMD in nine districts of the Punjab province through Divisional Disease Diagnostic Laboratories, Livestock and Dairy Development Department Punjab. Subsequently, we conducted a case-control study including 128 livestock farms (case to control ratio = 1). The data on various plausibly associated factors were collected using a structured questionnaire from each farm. The FMD outbreaks started during the month of January, culminated in February (n = 36, 56.25%) and stopped during the month of April 2019. The most common serotype was O (45.83%), followed by Asia1 (29.17%) and A (13.89%); however, some case farms had mixed infection with serotypes A and O (9.72%) and serotypes O and Asia1 (1.39%). Multivariable analysis revealed that the history of introducing a new animal with unknown FMD vaccination status in the herd (OR =11.51, 95% CI = 3.28 - 40.47), not practicing regular vaccination against FMD (OR = 20.81, 95% CI = 4.59 - 94.35), history of the visit of an animal broker (OR = 9.06, 95% CI = 2.31 - 35.61), distance of the farm to a nearby livestock farm (OR = 6.13, 95% CI = 1.39 - 27.01) and large herd size (OR = 20.79, 95% CI = 2.45 - 176.27) were significantly associated with the occurrence of FMD outbreaks in Punjab province during 2019. In conclusion, improving biosecurity measures, avoiding the introduction of animals without FMD vaccination history and regular vaccination against FMD can significantly reduce the occurrence of the disease on livestock farms in Pakistan.

Extracellular vesicles and exosome: insight from physiological regulatory perspectives.

The current study highlights prospective mechanisms of biogenesis of extracellular vesicles (EVs) and potential involvement in cellular signaling and transport with great emphasis to illustrate their role as biomarkers in certain pathologies. The current review highlights EVs, the heterogeneous entities secreted by cells in highly conserved manner. A series of consensus terminologies for various types is yet to be organized. Exosomes, microvesicles and apoptotic bodies are major populations among EVs. EVs are key regulators in cellular physiological homeostasis, disease progression and evolve either from plasma membrane (microvesicles) or fusion of endosomes with exosomes. However, how vesicular inclusions elicit a plethora of biological responses is still not much clear. However, how these vesicular inclusions get packaged and delivered by these EVs shows great involvement in inter- and intracellular cellular signaling and channeling of multiple proteins, variety of RNAs and certain fat molecules. It's worth to mention that EVs carry small non-coding RNAs (snRNAs) which are involved in multiple cellular molecular events at targeted sites. Moreover, snRNA trafficking through exosomes and microvesicles depicts remarkable potential as non-invasive biomarkers in different clinical disorders especially immune system pathologies, cardiovascular issues, and metabolic syndromes.

Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C) under the Setting of COVID-19: A Review of Clinical Presentation, Workup and Management.

Earlier in its course, SARS-CoV-2 was primarily identified to cause an acute respiratory illness in adults, the elderly and immunocompromised, while children were known to be afflicted with milder symptoms. However, since mid-April of 2020, latent effects of the virus have begun emerging in children and adolescents, which is characterised by a multisystem hyperinflammatory state; thus, the term Multisystem Inflammatory Syndrome in Children (MIS-C) was introduced by the WHO and CDC. The syndrome manifests itself approximately 4 weeks after COVID-19 infection, with symptoms mimicking Kawasaki Disease and Kawasaki Disease Shock Syndrome. Demographically, MIS-C peaks in children aged 5 to 14 years, with clusters in Europe, North and Latin America seen, later followed by Asia. Although the exact pathophysiology behind the syndrome is unknown, recent studies have proposed a post-infectious immune aetiology, which explains the increased levels of immunoglobulins seen in affected patients. Patient presentation includes, but is not limited to, persistent fever, rash, gastrointestinal symptoms and cardiac complications including myocarditis. These patients also have raised inflammatory markers including C reactive protein, ferritin and interleukin-6. In poorly controlled patients, the syndrome can lead to multiorgan failure and death. The mainstay of treatment includes the use of intravenous immunoglobulins, steroids, immune modulators and aspirin. Adjunct therapy includes the use of low molecular weight heparin or warfarin for long term anticoagulation. Currently very little is known about the syndrome, highlighting the need for awareness amongst healthcare workers and parents. Moreover, with increased cases of COVID-19 as a result of the second wave, it is essential to keep MIS-C in mind when attending patients with a past history of COVID-19 exposure or infection. Additionally, once these patients have been identified and treated, strict follow-up must be done in order carry out long term studies, and to identify possible sequelae and complications.

Cutaneous Leishmaniasis in Pakistan: a neglected disease needing one health strategy.

BACKGROUND: Cutaneous Leishmaniasis (CL) is a neglected tropical disease, which mainly affects poor communities. It is one of the major vector-borne disease and endemic in Pakistan. METHODS: A case-control study to evaluate potential risk factors of human-CL was conducted in Khewra region, District Jhelum, Pakistan from January-April 2014. Case data about 90 cases registered during October 2012 to November 2013 was retrieved from Municipal Hospital. Controls were matched (1,1 ratio) on the date of registration with cases from same hospital. Both cases and controls were invited to participate and data was collected in a face-to-face interview. A prospective study of canine leishmaniasis (canine-CL) was also conducted at Civil Veterinary Hospital in the same area. Suspected dogs with skin ulceration signs were included in the study and blood samples were collected. Statistical analyses were conducted to determine association between various parameters and outcome of interest. RESULTS: The ages of cases ranged from 1 to 76 years (median = 15 years) and proved to be protective factor i.e. increase in each year in age reduced the likelihood of being infected with human-CL [Odds Ratio (OR) = 0.4, 95% Confidence Interval (CI) = 0.25-0.76]. People sleeping outsides in an open area were more likely to become a case (OR = 8.7, 95% CI = 2.90-26.37) than a control. Poor sanitary condition inside the house (OR = 3.3, 95% CI 1.03-10.56) and presence of other animals in house (livestock, poultry) (OR = 3.6, 95% CI = 1.07-12.12) also identified as risk factors of high significance. The proportion of positive dogs with canine-CL was 21.05% and was significantly associated with human-CL cases in the same area (p < 0.05). CONCLUSIONS: We concluded that adopting self-protections measures against sand-fly, and maintaining good hygiene may lower the risk of human-CL. One-Health Strategy is suggested to control leishmaniasis in human and dog population.

Comparison of Metformin and Repaglinide Monotherapy in the Treatment of New-Onset Type 2 Diabetes Mellitus.

Objectives We intend to investigate the feasibility of using repaglinide as initial therapy in patients with newly diagnosed type 2 diabetes mellitus naive to the oral anti-hyperglycemic agents by validating the effects of repaglinide on glycemic control (HbA1c) in comparison with metformin monotherapy. Methodology This parallel-controlled, randomized study was carried at the outpatient department of a tertiary care hospital. Two-hundred patients of both genders with newly diagnosed type 2 diabetes mellitus were included. After taking relevant history and physical examination, we drew venous blood samples of each patient and sent them to the institutional laboratory for analysis of fasting blood sugar (FBS) levels, HbA1c, and lipid profile. We divided the patients into two subgroups based on the lottery method. Group A was prescribed metformin, and group B was prescribed repaglinide, while the dosages were adjusted according to the blood sugar levels. All data were analyzed using SPSS Software 25.0 (SPSS Inc., Chicago, USA). We reported the data as means along with the standard error. Results All patients completed the study. There was a decline in fasting blood glucose levels after three months of therapy, both in the metformin (135 mg/dl ± 6 mg/dl versus 115 mg/dl ± 7 mg/dl, p < 0.01) and repaglinide groups (145 ± 6 mg/dl versus 122 ± 6 mg/dl, p < 0.01). Similarly, significant reductions in HbA1c were seen in both metformin (7.12 ± 0.15% versus 6.67 ± 0.06%, p < 0.01) and repaglinide treatment groups (7.83 ± 0.67% versus 6.81 ± 0.07%, p < 0.01). After three months of treatment, body mass index (BMI) was significantly decreased in the metformin group (26.87±1.1 kg/m2 versus 25.11 ± 0.44 kg/m2, p < 0.05). However, the patients in repaglinide group demonstrated a very slight decrease in BMI (27.11 ± 1.6 kg/m2 versus 26.47 ± 0.40 kg/m2). On follow-up, we found a significant decrease in triglyceride levels in both groups (p < 0.01 and p < 0.05. respectively). We also found that only the patients in metformin group showed some improvements in total cholesterol and low-density lipoprotein (LDL) levels (p < 0.05). Conclusion Our study concluded that both metformin and repaglinide have similar anti-hyperglycemic effects. Repaglinide can be prescribed as an alternative drug to metformin in patients with new-onset diabetes mellitus.

Hyponatremia and Its Correlation With Hepatic Encephalopathy and Severity of Liver Disease.

Background and objective Hepatic cirrhosis is one of the leading causes of morbidity and mortality worldwide. Patients with cirrhosis frequently develop complications such as ascites, variceal bleeding, and hepatic encephalopathy (HE). The clinical manifestations of HE range from the mildly altered level of sensorium to severely altered consciousness levels, difficulty in judgment, the day-night reversal of sleep, flapping tremor of hands, and irrelevant talking or speech. Patients with hyponatremia are at a higher risk of developing HE and electroencephalographic abnormalities. The severity of hyponatremia is directly related to the deterioration in terms of grades of HE. Our study sought to determine the frequency of hyponatremia in cirrhotic patients and its correlation with the frequency and severity of HE. Methodology This study was carried out at the inpatient department of medicine in a tertiary care hospital in Pakistan. A total of 260 patients of both genders with hepatic cirrhosis were approached. After taking relevant history and physical examination, the venous blood sample of each patient was drawn and sent to the institutional laboratory for estimation of serum electrolytes, liver function tests (LFTs), renal parameters (RPMs), prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR). We classified the HE according to the West Haven classification system. Mild to moderate encephalopathy was classified under grades I-II, while severe encephalopathy was classified under grades III-IV. We documented the severity of liver disease according to the Child-Pugh score criteria. All data were analyzed by using SPSS Statistics version 25.0 (IBM, Armonk, NY). We reported the data as means along with the standard error. Results Overall, the serum sodium levels of the subjects ranged from 115 to 142 meq/L with a mean of 129.11 ±6.53 meq/L. In patients with hyponatremia, it ranged from 115 to 127 meq/L (mean 121.41 ±5.17 meq/L). Hyponatremia was present in 96 (36.9%) patients. Among these, 51 (53.12%) were male and 45 (46.8%) were female; 24 (9.2%) patients had mild hyponatremia, 56 (21.5%) had moderate, and 16 (6.2%) had severe hyponatremia. HE was present in 176 (67.7%) patients. HE grade I was present in 54 (20.8%), grade II in 62 (23.8%), grade III in 32 (12.3%), and grade IV in 28 (10.8%) patients. In 96 patients with hyponatremia, 84 were found to have HE (p-value: <0.001). Conclusion Based on our findings, cirrhotic patients with chronic hepatitis infections have a variable presence of low sodium levels. Sodium levels of <130 meq/L were associated with higher morbidity and mortality rate. Moreover, patients with lower levels of sodium had higher grades of HE.

Divergent consequences of different biochar amendments on carbon dioxide (CO2) and nitrous oxide (N2O) emissions from the red soil.

Climate change due to greenhouse gas (GHG) emissions is one of the global environmental matters of the 21st century. Biochar (BC) amendments have been proposed as a potential solution for improving soil quality and to mitigate GHGs emissions. Therefore, we evaluated the influence of different BCs on soil CO2 and N2O emissions in an outdoor pot experiment. The soil was mixed with three different types of BCs; bamboo, hardwood, and rice straw BCs as BB, BH, and BR, respectively, and control as B0 with four levels (0, 5, 20, and 80 g kg-1 of soil). Gas samples were collected on a bi-monthly basis for six months. A polyvinyl chloride (PVC) static chamber was placed on each replicate to collect the gas samples at 15, 30, 45, and 60 min, respectively. Compared to B0, the lowest cumulative N2O emissions were observed in BH80 (11%) followed by BH20, BH5, and BR80. However, for cumulative CO2 emissions, B0 and BC treatments showed no significant differences except for BB80 (>11%) and BB5 (<2%). BC type and level both had a significant (P < 0.001) impact on the cumulative N2O emissions with a significant interaction (P < 0.001). However, cumulative CO2 emissions were unaffected by BC type but BC level showed a significant influence on cumulative CO2 emissions (P < 0.05) and there was a significant (P < 0.001) interaction between the BC type and level on cumulative CO2 emissions. Overall, higher doses of BR and BB showed a pronounced effect on soil pH over BH. The soil pH and moisture showed a negative correlation with N2O emissions whereas soil temperature showed a positive correlation with the cumulative fluxes of N2O. Our results demonstrate that BC incorporation to soil may help to mitigate GHGs emissions but its influence may vary with BC type and level under different conditions and soil type.

Assessment of Patient Satisfaction in a Military and Public Hospital: A Comparative Study.

BACKGROUND: In recent times, the assessment of patient satisfaction has become an essential tool for measuring the effectiveness of healthcare delivery. However, not a lot of work has been done in Pakistan, even less so in comparing it across different hospital systems in the country. This research aims to fill that gap and be the first to compare satisfaction levels in a military and public hospital. OBJECTIVE: To assess patient satisfaction in different hospital systems of Pakistan and compare their outcomes. METHODS: A cross-sectional study was undertaken between October 2019 and April 2020 among 376 patients; 193 from Combined Military Hospital, Lahore (CMH) and 183 from Jinnah Hospital, Lahore. The questionnaire used for the study was the Short-Form Patient Satisfaction Questionnaire - 18, and convenience sampling was used to select participants. Data was entered and analysed on Statistical Product and Service Solutions (SPSS) version 21 (IBM Corp., Armonk, NY). RESULTS: The majority of participants were male (71.2%), entitled to free healthcare (58.4%), and employed (59.7%). It was found that CMH Lahore scored better in all seven domains of patient satisfaction (p<0.03 individually), with significant differences in six: general satisfaction, interpersonal manner, communication, financial aspects, time spent with the doctors, and accessibility and convenience. Overall, waiting times and entitlement to free healthcare were established to be major determinants of satisfaction, with CMH having shorter waiting times and providing free treatment to a larger number of patients. The mode waiting time in CMH was 1 - 15 minutes (44.9%) as compared to 15 - 30 minutes (50.9%) in Jinnah Hospital. Additionally, 78.2% of patients were entitled to free healthcare in CMH, compared to 35.5% in Jinnah Hospital.  Conclusion: Patient satisfaction was found to be significantly better in CMH in six out of seven domains studied. Further work needs to be done in its assessment, as well as in its role in healthcare policies.

On the Promotion of Catalytic Reactions by Surface Acoustic Waves.

Surface acoustic waves (SAW) allow to manipulate surfaces with potential applications in catalysis, sensor and nanotechnology. SAWs were shown to cause a strong increase in catalytic activity and selectivity in many oxidation and decomposition reactions on metallic and oxidic catalysts. However, the promotion mechanism has not been unambiguously identified. Using stroboscopic X-ray photoelectron spectro-microscopy, we were able to evidence a sub-nanosecond work function change during propagation of 500 MHz SAWs on a 9 nm thick platinum film. We quantify the work function change to 455 µeV. Such a small variation rules out that electronic effects due to elastic deformation (strain) play a major role in the SAW-induced promotion of catalysis. In a second set of experiments, SAW-induced intermixing of a five monolayers thick Rh film on top of polycrystalline platinum was demonstrated to be due to enhanced thermal diffusion caused by an increase of the surface temperature by about 75 K when SAWs were excited. Reversible surface structural changes are suggested to be a major cause for catalytic promotion.