Blockchain have been an interesting research area for a long time and the benefits it provides have been used by a number of various industries. Similarly, the healthcare sector stands to benefit ...immensely from the blockchain technology due to security, privacy, confidentiality and decentralization. Nevertheless, the Electronic Health Record (EHR) systems face problems regarding data security, integrity and management. In this paper, we discuss how the blockchain technology can be used to transform the EHR systems and could be a solution of these issues. We present a framework that could be used for the implementation of blockchain technology in healthcare sector for EHR. The aim of our proposed framework is firstly to implement blockchain technology for EHR and secondly to provide secure storage of electronic records by defining granular access rules for the users of the proposed framework. Moreover, this framework also discusses the scalability problem faced by the blockchain technology in general via use of off-chain storage of the records. This framework provides the EHR system with the benefits of having a scalable, secure and integral blockchain-based solution.
Lattice-based cryptography (LBC) is one of the most promising classes of post-quantum cryptography (PQC) that is being considered for standardization. This brief proposes an optimized schoolbook ...polynomial multiplication (SPM) for compact LBC. We exploit the symmetric nature of Gaussian noise for bit reduction. Additionally, a single field-programmable gate array (FPGA) DSP block is used for two parallel multiplication operations per clock cycle. These optimizations enable a significant <inline-formula> <tex-math notation="LaTeX">2.2\times </tex-math></inline-formula> speedup along with reduced resources for dimension <inline-formula> <tex-math notation="LaTeX">n=256 </tex-math></inline-formula>. The overall efficiency (throughput per slice) is <inline-formula> <tex-math notation="LaTeX">1.28\times </tex-math></inline-formula> higher than the conventional SPM, as well as contributing to a more compact LBC system compared to previously reported designs. The results targeting the FPGA platform show that the proposed design can achieve high hardware efficiency with reduced hardware area costs.
Clinical practice guideline: Bell's palsy Baugh, Reginald F; Basura, Gregory J; Ishii, Lisa E ...
Otolaryngology and head and neck surgery/Otolaryngology--head and neck surgery,
November 2013, Volume:
149, Issue:
3 Suppl
Journal Article
Peer reviewed
Open access
Bell's palsy, named after the Scottish anatomist, Sir Charles Bell, is the most common acute mono-neuropathy, or disorder affecting a single nerve, and is the most common diagnosis associated with ...facial nerve weakness/paralysis. Bell's palsy is a rapid unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause. The condition leads to the partial or complete inability to voluntarily move facial muscles on the affected side of the face. Although typically self-limited, the facial paresis/paralysis that occurs in Bell's palsy may cause significant temporary oral incompetence and an inability to close the eyelid, leading to potential eye injury. Additional long-term poor outcomes do occur and can be devastating to the patient. Treatments are generally designed to improve facial function and facilitate recovery. There are myriad treatment options for Bell's palsy, and some controversy exists regarding the effectiveness of several of these options, and there are consequent variations in care. In addition, numerous diagnostic tests available are used in the evaluation of patients with Bell's palsy. Many of these tests are of questionable benefit in Bell's palsy. Furthermore, while patients with Bell's palsy enter the health care system with facial paresis/paralysis as a primary complaint, not all patients with facial paresis/paralysis have Bell's palsy. It is a concern that patients with alternative underlying etiologies may be misdiagnosed or have unnecessary delay in diagnosis. All of these quality concerns provide an important opportunity for improvement in the diagnosis and management of patients with Bell's palsy.
The primary purpose of this guideline is to improve the accuracy of diagnosis for Bell's palsy, to improve the quality of care and outcomes for patients with Bell's palsy, and to decrease harmful variations in the evaluation and management of Bell's palsy. This guideline addresses these needs by encouraging accurate and efficient diagnosis and treatment and, when applicable, facilitating patient follow-up to address the management of long-term sequelae or evaluation of new or worsening symptoms not indicative of Bell's palsy. The guideline is intended for all clinicians in any setting who are likely to diagnose and manage patients with Bell's palsy. The target population is inclusive of both adults and children presenting with Bell's palsy. ACTION STATEMENTS: The development group made a strong recommendation that (a) clinicians should assess the patient using history and physical examination to exclude identifiable causes of facial paresis or paralysis in patients presenting with acute-onset unilateral facial paresis or paralysis, (b) clinicians should prescribe oral steroids within 72 hours of symptom onset for Bell's palsy patients 16 years and older, (c) clinicians should not prescribe oral antiviral therapy alone for patients with new-onset Bell's palsy, and (d) clinicians should implement eye protection for Bell's palsy patients with impaired eye closure. The panel made recommendations that (a) clinicians should not obtain routine laboratory testing in patients with new-onset Bell's palsy, (b) clinicians should not routinely perform diagnostic imaging for patients with new-onset Bell's palsy, (c) clinicians should not perform electrodiagnostic testing in Bell's palsy patients with incomplete facial paralysis, and (d) clinicians should reassess or refer to a facial nerve specialist those Bell's palsy patients with (1) new or worsening neurologic findings at any point, (2) ocular symptoms developing at any point, or (3) incomplete facial recovery 3 months after initial symptom onset. The development group provided the following options: (a) clinicians may offer oral antiviral therapy in addition to oral steroids within 72 hours of symptom onset for patients with Bell's palsy, and (b) clinicians may offer electrodiagnostic testing to Bell's palsy patients with complete facial paralysis. The development group offered the following no recommendations: (a) no recommendation can be made regarding surgical decompression for patients with Bell's palsy, (b) no recommendation can be made regarding the effect of acupuncture in patients with Bell's palsy, and (c) no recommendation can be made regarding the effect of physical therapy in patients with Bell's palsy.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The current research was carried out to identify dispositional predictors of work/family conflict and enrichment faced by working women. Purposive sampling strategy was used to collect a sample of ...265 working women, out of which 129 were married and 136 were unmarried, aged between 22 to 54 years ( M = 29.31, SD = 6.39). Data was collected via Big Five Inventory (BFI), Work/Family Conflict Self-Efficacy Scale, Work/Family conflict Scale and Work/Family Enrichment scale. Data was analyzed using correlation, MANOVA and multiple regression analysis. Results revealed that married women with children experienced higher levels of work/family conflict than unmarried working women and married women having one or no children. Moreover, women living in nuclear family system had higher levels of work to family conflict and women living in joint family system had higher levels of family to work conflict. Regression analysis showed conscientiousness, neuroticism and work/family conflict self-efficacy as salient predictors of work/family conflict and extraversion, agreeableness and work/family conflict self-efficacy to be significant predictors of work/family enrichment. These results have important implications for individuals as well as organizations as they demonstrate that dispositional factors do play a major role in determining the levels of work/family conflict and enrichment and will help in identifying women who are more or less prone to experiencing the negative side of work/family interface so that additional support may be provided to them in terms of family friendly workplace policy, social support, and employee counseling, etc.
Plain language summary The current research was carried out to explore the how the two most important domains of a women’s life, that is, work and family interact and influence each other and to identify individuals who might be more prone to experiencing the negative impact of work/family interface. A sample of 265 working women from diverse professions was selected and information was collected via questionnaires such as big five personality inventory, work/family enrichment scale, work/family self conflict scale and work/family conflict self-efficacy scale. Results show that there is higher incidence of work/family conflict among working women as compared to work/family enrichment. Moreover, having more children and living in extended family system make one more susceptible toward experiencing the negative side of the work/family interface. Additionally, results show that personality can play a role in increasing or decreasing the levels of work/family conflict and/or enrichment. These results have important implications for individuals as well as organizations as they demonstrate that dispositional factors do play a major role in determining the levels of work/family conflict and enrichment and will help in identifying women who are more or less prone to experiencing the negative side of work/family interface so that additional support may be provided to them in terms of family friendly workplace policy, enhancing self-efficacy, providing social support, and employee counseling, etc.
Abstract
Salt tolerant wheat cultivars may be used as genetic resource for wheat breeding to ensure yield stability in future. The study was aimed to select salt tolerant cultivar(s) to identify ...novel source of salt tolerance in local wheat germplasm. Initially, 40 local wheat cultivars were screened at 150 mM NaCl stress at seedling stage. Selected salt-tolerant (three; S-24, LU-26S and Pasban-90) and salt-sensitive (four; MH-97, Kohistan-97, Inqilab-91 and Iqbal-2000) wheat cultivars were further evaluated using growth, yield, biochemical and physiological attributes. Growth and yield of selected cultivars were reduced under salt stress due to decline in plant water status, limited uptake of macronutrients (N, P and K), reduced K
+
/Na
+
ratio, photosynthetic pigments and quantum yield of PSII. Wheat plants tried to acclimate salt stress by osmotic adjustment (accumulation of total soluble sugars, proline and free amino acids). Degree of salinity tolerance in cvs. S-24 and LU-26S found to be associated with maintenance of K
+
/Na
+
ratio, osmo-protectant and photosynthetic activity and can be used as donor for salt tolerance in wheat breeding program at least in Pakistan. These cultivars can be further characterized using molecular techniques to identify QTLs/genes for salt exclusion, osmo-protectant and photosynthetic activity for molecular breeding.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Multiferroic materials have grabbed great attention of researchers due to their distinctive feature of magnetoelectric coupling with vast applicability in advanced multifunctional devices. To achieve ...considerable value of magnetoelectric coupling, the samples of La-doped BiFeO
3
and MgFe
2
O
4
, which were initially synthesized via hydrothermal method, were then embedded into the (1–
x
)Bi
0.9
La
0.1
FeO
3
+
x
MgFe
2
O
4
composites using a ball-milling process. The presence of rhombohedrally distorted cubic perovskite structure of La-doped BiFeO
3
having
R3c
space group symmetry and spinel cubic structure of MgFe
2
O
4
with
Fd-3m
space group symmetry was confirmed using X-ray diffraction analysis. The microscopic images of the composite samples show a slight variation in grain size with least porosity observed for the composite of
x
= 0.5. The elemental mapping assured the presence of all elements in the prepared composites that were in accordance with the stoichiometric ratios. The ferroelectric analysis exposed that the
x
= 0.2 composition had shown the highest efficiency of 52% for energy storage devices. The linear magnetoelectric response of the composite samples along with small values of switching charge density observed at
x
= 0.3 inferred this particular composite quite preferable for data storage applications.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
β-Thalassemia is a widespread autosomal recessive blood disorder found in most parts of the world. Fetal hemoglobin (HbF), a form of hemoglobin is found in infants, replaced by adult hemoglobin (HbA) ...after birth. Hydroxyurea (HU) is one of the most effective HbF inducer used for the treatment of anemic diseases. We aimed to improve the understanding of HU therapy in β-thalassemia by metabonomics approach using
H NMR spectroscopy. This study includes 40 cases of β-thalassemia before and after HU therapy along with 40 healthy as controls. Carr-Purcell-Meiboom-Gill (CPMG) sequence was used to identify forty-one putative metabolites. Generation of models like partial least square discriminant analysis (PLS-DA) and orthogonal projections to latent structures discriminant analysis (OPLS-DA) based on different metabolites including lipids, amino acids, glucose, fucose, isobutyrate, and glycerol revealed satisfactory outcomes with 85.2% and 91.1% classification rates, respectively. The concentration of these metabolites was altered in β-thalassemia samples. However, after HU treatment metabolic profile of same patients showed closeness towards healthy. Deviant metabolic pathways counting lipoprotein changes, glycolysis, TCA cycle, fatty acid and choline metabolisms were identified as having significant differences among study groups. Findings of this study may open a better way to monitor HU treatment effectiveness in β-thalassemia patients, as the results suggested that metabolic profile of β-thalassemia patients shows similarity towards normal profile after this therapy.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Breast cancer (BCa) is the most common cause of cancer death in Pakistan. In 2019, Pakistan saw the highest global BCa-associated death rate. But do Pakistani women know about the various aspects of ...BCa? And how prevalent are BCa screening methods amongst Pakistani females? These questions formed the basis for our study.
We conducted this review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. On September 1, 2023, we searched PubMed, Embase, Scopus, and Google Scholar, and performed a citation search to search for eligible studies published in 2010 or after, using the following terms: "breast cancer" and "Pakistan". Observational studies that evaluated BCa awareness and/or practice amongst Pakistani females who were not associated with medicine were eligible. We used the National Institutes of Health quality assessment tool to assess the risk of bias. We conducted a proportion meta-analysis to calculate pooled prevalences for variables.
Responses from 9766 Pakistani women across 18 included studies showed alarmingly low levels of BCa knowledge: risk factors, 42.7% (95% CI: 34.1%-51.4%); symptoms, 41.8% (95% CI: 26.2%-57.5%); diagnostic modalities, 36.3% (95% CI: 23.1%-49.4%); treatments, 46.6% (95% CI: 13.5%-79.8%). Prevalence of breast self-examination (BSE) and ever having undergone a clinical breast exam (CBE) was 28.7% (95% CI: 17.9%-39.6%) and 15.3% (95 CI: 11.2%-19.4%), respectively. BCa knowledge was significantly associated with better educational status, age, and socioeconomic status.
On average, only two in five Pakistani women are aware of one or more risk factors, symptoms, or diagnostic modalities. Approximately one in two women know about possible BCa treatment. Less than one in three women practice regular BSE, and less than one in five women have ever undergone a CBE.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Alloyed-transition metal dichalcogenide (TMD) coatings have been under investigation as multi-environment lubricants for the past few decades. These coatings display very low coefficient of friction ...properties at elevated temperatures. Studies on the annealing of these low-friction coatings are missing in the literature. For the first time, in this study, the annealing of the W-S-N dry lubricant coatings was carried out to study its effects on the composition, morphology, crystal structure and hardness of the coatings. The W-S-N coatings were deposited by direct current (DC) reactive magnetron sputtering. The analysis was carried out for as-deposited, 200 °C and 400 °C annealed coatings. The as-deposited coatings have N content in the range of 0–25.5 at. %. The coatings are compact and the densification increased with the increase in N-alloying. All the coatings are crystalline except the highest N-alloyed coating which is X-ray amorphous. A maximum hardness of 8.0 GPa was measured for the coating alloyed with 23 at. % N. Annealing did not affect the composition and morphology of the coatings, while some variations were observed in their crystal structure and hardness. The maximum hardness increased from 8 GPa to 9.2 GPa after 400 °C annealing of the 23 at. % N-alloyed coating.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
PTEN is the second most frequently mutated tumor suppresser gene in cancers after p53. Genetic and epigenetic alterations in the PTEN gene and its regulatory regions have been reported in various ...studies. PTEN is a crucial downregulator of the pro-survival phosphoinositide 3-kinase/Akt/mammalian target of rapamycin pathway and also suppresses insulin signaling. Failure to regulate these pathways leads to increase in cell proliferation and migration which in turn promotes tumorigenesis. PTEN underexpression is mediated by a variety of cytokines and stress kinases which seem to collectively induce the RAS/mitogen-activated protein kinase (MAPK)/extracellular signal–regulated kinase (ERK) pathway. In the context of hepatocellular carcinoma, reduced expression of PTEN is seen in nearly half of the cases on average. In some cases, PTEN has been observed to be either mutated or methylated which can also lead to reduced expression or in some cases, complete loss of expression. On the cellular level, PTEN is also a target in the pathogenic pathway of hepatitis C virus core protein and hepatitis B virus X protein. These viruses appear to alter PTEN regulation and pro-apoptotic ability to enhance the process of tumor formation. In perspective of the crucial role PTEN plays in balancing proliferation and apoptosis, we propose PTEN as a valuable marker in the diagnosis, assessment of tumor grade, and disease stage in hepatocellular carcinoma patients.
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