Biomedical Research Horizons is an open-access, quarterly, and double-blind peer-reviewed journal covering all areas of medical and health sciences from basic research to clinical and experimental work. The Biomedical Research Horizons is committed to completing the double-blind peer-review process within one month and informing the author(s) accordingly. The Biomedical Research Horizons is published by the Institute for Excellence in Education and Research (IEER), duly registered with the Securities and Exchange Commission of Pakistan (SECP) under registration number 0224595.
EVALUATION OF NURSES’ COMPETENCE IN CENTRAL VENOUS CATHETER-ASSOCIATED INFECTION PREVENTION
Background: Central venous catheters (CVCs) are widely used in intensive care units for administering fluids, medications, nutrition, and for hemodynamic monitoring. Proper care of CVCs is critical, as they pose a significant risk for bloodstream infections. Objective: This study aimed to assess nurses’ knowledge and practices regarding the prevention of CVC-associated infections. Methodology: A descriptive cross-sectional study was conducted among nurses working in critical care settings. Data were analyzed using descriptive statistics, including frequency distributions, and normality checks. Results: Among the participants, 61 (41.2%) demonstrated poor knowledge of CVC infection prevention, while 53 (35.8%) exhibited suboptimal practices. Conclusion: The study highlights that a substantial proportion of nurses possess inadequate knowledge and engage in poor practices concerning CVC infection prevention. Targeted educational interventions and training programs are recommended to enhance adherence to evidence-based infection control practices.
COMPARATIVE SAFETY OF JAK INHIBITORS AND BIOLOGIC DMARDS IN RHEUMATOID ARTHRITIS: A RETROSPECTIVE COHORT ANALYSIS
Background: Ambulance personnel face demanding work conditions, including long hours, night shifts, and frequent weekend duties, which can adversely affect stress levels, emotional well-being, and work-life balance. Objective: This study aimed to examine the relationships among stress, emotional intelligence, and work-life balance in ambulance paramedics. Methods: A descriptive-correlational design was employed, involving 120 ambulance paramedics with at least two years of experience, recruited from two regional ambulance services. Data were collected via online self-assessment questionnaires between April and June 2023. Descriptive statistics (frequency, mean, SD) and inferential analyses were used to explore variable relationships. Results: Participants reported moderate stress levels (mean = 87.07) and compromised work-life balance (mean = 41.26), despite demonstrating high emotional intelligence. Work demands frequently intruded on personal life, contributing to fatigue and stress. Higher emotional intelligence was associated with slightly better coping, but it did not fully mitigate work-related strain. Conclusion: Ambulance personnel exhibit high emotional intelligence but remain vulnerable to stress and disrupted work-life balance due to the demanding nature of their work. Interventions aimed at stress management and work-life support are recommended.
INCIDENCE OF NEGATIVE APPENDECTOMIES IN A TERTIARY CARE HOSPITAL
Background: Acute appendicitis is a common surgical emergency, yet negative appendectomy rates remain high despite clinical scoring and imaging. This study evaluated the frequency of negative appendectomies in a tertiary care hospital in Peshawar. Methods: A prospective cross-sectional study was conducted at Holy Family Hospital from October 2024 to February 2025. A total of 305 patients aged 18–60 years, clinically diagnosed with acute appendicitis (Alvarado score ≥7) and, when needed, confirmed by ultrasound, underwent open appendectomy. Histopathology was used as the diagnostic gold standard. Results: Negative appendectomies occurred in 31 patients (10.2%), with women showing a higher rate than men (13.4% vs. 7.1%, p < 0.05). Mean Alvarado scores were significantly lower in the negative group (6.4 ± 1.0) compared to the positive group (8.1 ± 1.1, p = 0.001). Conclusion: A 10.2% negative appendectomy rate highlights the need for improved preoperative diagnostics. Refining clinical scoring thresholds and selectively employing advanced imaging can help reduce unnecessary surgeries.
ASSESSING NEONATAL COMPLICATIONS IN LATE PRETERM INFANTS RELATIVE TO TERM BIRTHS
Background: Late preterm infants (34–36 weeks gestation) are physiologically immature, increasing their risk of morbidity and mortality compared to term infants. This study evaluated neonatal outcomes and mortality risk factors in late preterm infants. Methods: A prospective cohort study was conducted on 200 neonates (100 late preterm, 100 term). Clinical and demographic variables were analyzed using chi-square and t-tests, while logistic regression identified predictors of mortality (p < 0.05). Results: Late preterm infants had lower birth weights (2.18 ± 0.53 kg vs. 2.97 ± 0.58 kg, p < 0.01) and APGAR scores (p < 0.01). Morbidities—including sepsis, respiratory distress, hypoglycemia, perinatal asphyxia, and need for mechanical ventilation—were significantly higher (p < 0.01). Mortality was also elevated (48% vs. 12%, p < 0.01). Mechanical ventilation emerged as a strong independent predictor of mortality (OR: 0.027, p < 0.001), while late preterm birth showed a non-significant trend (p = 0.094). Conclusion: Late preterm infants experience substantially higher morbidity and mortality. Close monitoring and timely interventions, particularly regarding respiratory support, are essential to improve outcomes.
ASSESSING THE FREQUENCY OF SUBCLINICAL HYPOTHYROIDISM AMONG WOMEN WITH PCOS
Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, often linked to metabolic complications. Subclinical hypothyroidism (SCH), though asymptomatic, shares features with PCOS, including insulin resistance, dyslipidemia, and menstrual irregularities. Objective: To determine the prevalence of SCH among women with PCOS at a tertiary care hospital. Methods: In this descriptive cross-sectional study, 158 women aged 20–50 years with PCOS (Rotterdam criteria) were recruited from Bahawal Victoria Hospital, Bahawalpur, between April and September 2024. Patients with known thyroid disorders or other endocrine conditions were excluded. Thyroid function tests were performed, with SCH defined as TSH >5.0 mIU/L and normal free T4 (0.91–1.55 ng/dL). Data were analyzed using SPSS v25; associations were assessed with Chi-square and Fisher’s exact tests (p ≤ 0.05). Results: SCH was observed in 36 patients (22.8%). Significant associations were found with elevated BMI, longer PCOS duration, and family history of thyroid disorders. Conclusion: SCH is prevalent in women with PCOS, supporting the need for routine thyroid screening to enable early management and improve outcomes.
NURSE–PHYSICIAN COLLABORATION AND PERCEPTIONS AT MMC MARDAN: A CROSS-SECTIONAL STUDY
Background: This cross-sectional study explores the perceptions of nurses and physicians regarding nurse–physician collaboration at Mardan Medical Complex, KPK, Pakistan, and how demographic factors (age, gender, education, experience, and department) influence these perceptions. Effective collaboration is essential for improving healthcare outcomes, and understanding these perceptions can help hospital administrators develop targeted interventions to enhance interdisciplinary teamwork. Objectives: a) To assess nurses' and physicians' perceptions of their collaboration. b) To examine the impact of demographic factors on these perceptions. Method: Using convenience sampling, 154 participants (74 nurses and 80 physicians) were surveyed via a structured questionnaire. The sample size was determined using Raosoft software. Data were analyzed to identify the influence of demographic factors on perceptions of collaboration. Results: Participants were mostly aged 20–30 (61.7%), with 58.4% male and 40.9% female. Educationally, 51.9% held MBBS degrees, 34.4% had BSN/Post RN, and 13.6% held nursing diplomas. Most (64.3%) had 1–5 years of experience, and 61.7% worked in general wards. Perception scores showed moderate variation (mean: 61.34), with 50.6% reporting negative and 49.4% positive views. BSN/Post RN holders had more positive perceptions than those with diplomas or MBBS, indicating education may influence collaborative attitudes. Conclusion: Interdisciplinary collaboration is crucial for efficient healthcare delivery. Positive perceptions among healthcare workers (HCWs) enhance staff satisfaction and patient outcomes. The study highlights the need for ongoing training to foster stronger nurse–physician collaboration in hospital settings.
CONTRACEPTIVE USE AND UNMET FAMILY PLANNING NEEDS IN DERA GHAZI KHAN
This study, conducted at AIMS Muzaffarabad (April–September 2024), compared 12 mg and 15 mg doses of bupivacaine for spinal anesthesia in elective cesarean sections. Maternal hypotension occurred in 16% of patients with 12 mg and 24% with 15 mg. Other complications like bradycardia, respiratory depression, nausea/vomiting, and patient discomfort were also assessed. The study concludes that 12 mg bupivacaine results in less hypotension, potentially reducing the need for interventions such as vasopressors or fluid overload
EFFECT OF ANTENATAL CORTICOSTEROIDS ON NICU ADMISSIONS IN PRETERM NEONATES: A PROSPECTIVE STUDY
Preterm birth remains the leading cause of neonatal morbidity and mortality globally. While antenatal corticosteroids (ANC) are well-established for promoting fetal lung maturity and reducing respiratory complications between 24 and 34 weeks of gestation, their role in late preterm births (34–36+6 weeks) is still being evaluated. This prospective observational study, conducted over six months at Akhtar Saeed Medical College, included 120 high-risk pregnant women between 34+0 and 36+6 weeks of gestation who received intramuscular betamethasone (12 mg for two consecutive days). The sample size was calculated using the WHO sample size calculator, and maternal demographics, delivery details, and neonatal outcomes—including NICU admission, respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and hypoglycemia—were recorded and analyzed using SPSS v26. The findings revealed a statistically significant reduction in NICU admissions (1.25 vs. 1.32 in historical controls) and improved respiratory outcomes in the ANC group, including reduced incidence of RDS and TTN and less need for invasive respiratory support. These results support the use of ANC in late preterm pregnancies and align with emerging clinical guidelines advocating for its inclusion in management protocols for pregnancies at risk of late preterm delivery.
Antenatal corticosteroids, Late preterm, NICU, Neonatal outcomes, RDS, TTN, Betamethasone
PREVALENCE OF DIABETES AND GLYCEMIC CONTROL IN CHILDREN WITH CELIAC DISEASE
Background: Celiac disease (CD) and type 1 diabetes (T1D) are autoimmune disorders, with children having CD at higher risk for T1D. Objective: To determine the incidence of T1D in children with CD and evaluate their glycemic control using postprandial glucose (PPG) and HbA1c levels. Methods: This cross-sectional study included 115 pediatric CD patients at CNH, Lahore (July 2023–Jan 2024). Clinical and lab data were collected, and patients were assessed by gastroenterologists and endocrinologists for medical history, diet adherence, and symptoms. Results: Among 115 children, 7% (n=8) were diagnosed with T1D based on PPG. Additionally, 10% (n=12) had HbA1c >6.5%, indicating poor glycemic control; 8 had T1D, 4 had elevated HbA1c without T1D diagnosis. Strict gluten-free diet adherence correlated with better glycemic control (mean HbA1c 5.8%) versus moderate (6.4%) or poor adherence (7.0%). Conclusion: Children with CD have increased T1D risk; regular diabetes screening via PPG and HbA1c is vital. Adherence to a gluten-free diet significantly improves glycemic control and may reduce diabetes risk.
Stress, Work-Life Balance, EI, Paramedics
COMPARING EARLY AND DELAYED ILEOSTOMY REVERSAL IN INTESTINAL PERFORATION PATIENTS
Background: Ileostomy reversal after intestinal perforation restores gastrointestinal function, but optimal timing (early vs. delayed) remains debated. Objective: To compare outcomes of early versus delayed ileostomy reversal in intestinal perforation patients. Methods: A descriptive case series of 90 patients at Lahore General Hospital was divided into early (reversal ≤3 months) and delayed (>3 months) groups. Data were collected preoperatively, during surgery, at discharge, and during 30-day follow-up. Results: The early group (n=45) showed faster recovery with earlier return to normal activity (21.3 vs. 26.7 days, p=0.01) and work (35.2 vs. 42.1 days, p=0.04). Satisfactory recovery was higher (55.6% vs. 40%, p=0.05), along with better postoperative quality of life scores (80.4 vs. 75.3, p=0.03). No significant differences were found in complication rates, hospital stay, or pain. Conclusion: Early ileostomy reversal promotes faster recovery, higher satisfaction, and improved quality of life without increasing complications.
PARENTAL EMOTIONAL ABUSE, RESILIENCE, AND ACADEMIC PROCRASTINATION IN PAKISTANI MEDICAL STUDENTS
Limited research exists on parental emotional abuse, resilience, expressive suppression, and academic procrastination, especially in Pakistan. This cross-sectional study used purposive sampling to collect data from 18–35-year-old medical students across public and private institutions. Findings showed parental emotional abuse and expressive suppression positively correlated with academic procrastination, while resilience was negatively correlated. Mediation analysis found no significant role for expressive suppression, but resilience significantly moderated the link between emotional abuse and procrastination. The study suggests targeted interventions to improve medical students' well-being
NURSING INTERVENTIONS TO PROMOTE SELF-CARE IN CEREBRAL PALSY: A CROSS-SECTIONAL STUDY
Context: Cerebral Palsy (CP) is a non-progressive brain disorder causing motor impairments and related complications affecting health and development. Effective nursing care is essential to improve self-care skills in CP patients. Aim: To assess nurses’ knowledge, attitude, and practices (KAP) in managing CP to enhance self-care development in adolescents and adults, ultimately improving neonatal health outcomes in Pakistan. Method: A descriptive cross-sectional study involving 150 nurses assessed KAP regarding CP care and its impact on patients' self-care skills. Data analyzed correlations between nursing interventions and self-care improvements. Results: 85% correctly defined CP; 69% understood self-care interventions, revealing knowledge gaps. 82% believed CP patients could develop self-care with proper nursing support; 90% recognized nurses’ critical role. Nursing practices included assisting daily activities (90%), promoting mobility (87%), and family education (83%). Strong positive correlations (p < 0.001) were found between nursing interventions and patient self-care improvements. Conclusion: Nursing knowledge, attitudes, and practices significantly influence self-care development in CP patients. Enhancing nurse training can improve patient independence and quality of life, highlighting the critical role of nursing in CP management.
Nursing Interventions to Enhance Self-Care in Cerebral Palsy
KNOWLEDGE OF SCABIES IN A RURAL FEMALE POPULATION, LAHORE
Background: Scabies is endemic in many mountainous regions of Pakistan, and overcrowded, unhygienic conditions—such as in post-earthquake IDP camps—can trigger large-scale outbreaks. Objective: To assess knowledge of scabies among women in a rural community in Lahore. Methodology: A descriptive cross-sectional study was conducted among 75 women from the Gajjumata community in Lahore, selected via convenience sampling. Results: Among participants, 93.3% identified scratching as a cause of scabies, 73.3% recognized the skin as the main affected organ, and 86.7% were aware that nighttime itching and heat sensation are key symptoms. Conclusion: Women in the Gajjumata community demonstrated generally good knowledge of scabies, particularly regarding its symptoms and affected areas
SHARED GENETIC PATHWAYS IN HEPATITIS B/C AND CIRRHOSIS: A NETWORK-BASED GENE EXPRESSION ANALYSIS
Hepatitis B and C (HBV, HCV) are major global contributors to liver disease and often lead to cirrhosis. This study explored shared genetic features linking HBV/HCV infections to cirrhosis using a network-based analysis of gene expression data. Transcriptomic profiles from GEO datasets (GSE121248, GSE55092, GSE89377, GSE139602) were integrated, identifying 47 commonly upregulated genes associated with disease progression. Functional enrichment and pathway analysis were conducted using R, while a protein-protein interaction (PPI) network was constructed via the STRING plugin in Cytoscape. Ten hub genes (CDC20, CCNB2, MELK, AURKA, PRC1, TOP2A, CDCA5, PTTG1, TYMS, UBE2C) were identified as key modulators. Additional interaction networks—TF–miRNA and drug–gene—were developed using NetworkAnalyst. This systems biology approach highlights the molecular complexity underlying hepatitis-related cirrhosis and identifies candidate genes for potential therapeutic targeting, pending further validation
TENS FOR POSTOPERATIVE PAIN AFTER CABG: A RANDOMIZED CONTROLLED TRIAL
Background: Managing postoperative pain after Coronary Artery Bypass Graft (CABG) surgery remains challenging, with limited evidence on effective interventions. This trial evaluated the impact of Transcutaneous Electrical Nerve Stimulation (TENS) on post-CABG pain. Methodology: A single-blind, two-arm randomized controlled trial was conducted with 68 CABG patients aged 40–70 years. Patients with serious cardiac or pulmonary conditions were excluded. Participants were randomly assigned to Group A (TENS + standard care, n=34) or Group B (standard care only, n=34). TENS was applied twice daily for 30 minutes over 5 days. Pain was measured using the Visual Analogue Scale (VAS) before and after intervention. Data were analyzed with SPSS 25, and chi-square tests determined significance (p ≤ 0.05). Results: Group A showed a significant reduction in pain compared to Group B (p < 0.001). Notably, 61.8% of Group A reported no pain post-treatment, while 44.1% of Group B experienced moderate pain. Conclusion: TENS combined with standard care significantly reduces postoperative pain after CABG and offers a cost-effective, efficient pain management option
MANAGING MAJOR DEPRESSION WITH BORDERLINE PERSONALITY TRAITS: THERAPEUTIC INSIGHTS
The co-occurrence of Major Depressive Disorder (MDD) and borderline personality traits presents clinical challenges marked by emotional instability and interpersonal difficulties. This case-based study examines a multimodal therapeutic approach combining cognitive-behavioral techniques with positive psychology interventions—such as strengths identification, gratitude, hope-building, and self-compassion. Psychoeducation and family involvement further supported communication and social functioning. The integrated approach led to improvements in mood stability, interpersonal skills, and self-efficacy. Findings highlight the value of strength-based, holistic models in treating individuals with MDD and borderline traits.
NON-ENDOSCOPIC ASSESSMENT OF ESOPHAGEAL VARICES IN LIVER CIRRHOSIS
Objective: To determine the frequency and non-endoscopic predictors of esophageal varices in liver cirrhosis patients at a tertiary care hospital. Study Design: Cross-sectional. Setting & Duration: Department of Gastroenterology, Liaquat University of Medical and Health Sciences, Jamshoro. Methodology: This observational study included 109 liver cirrhosis patients. Each underwent clinical assessment, laboratory tests, portal vein Doppler, and upper GI endoscopy to confirm esophageal varices. Data were analyzed using SPSS v26. Quantitative variables were expressed as mean ± SD; qualitative variables as frequencies and percentages. Results: Mean age was 45 ± 14.32 years; 65.1% were male. Child-Pugh classification showed 36% Class A, 30.4% Class B, and 33.6% Class C. Ascites (80%) was the most common cirrhosis presentation. Esophageal varices were found in 52.2% of patients, with Grade III being most common. Significant non-endoscopic predictors included age, gender, Child-Pugh class, splenomegaly, portal vein diameter, serum albumin, bilirubin, platelet count, and Hepatitis B/C status. Conclusion: Non-invasive clinical, biochemical, and radiological markers can help predict esophageal varices, potentially reducing the need for routine endoscopy.
EXPLORING POSTPARTUM DEPRESSION AND ITS ASSOCIATED RISK FACTORS IN PRIMIPAROUS WOMEN ATTENDING OUTPATIENT DEPARTMENTS
Objectives 1.To assess the prevalence of post-partum depression in primiparous women. 2.To identify demographic, and psychosocial, risk factors associated with PPD. Methodology A Cross sectional study was conducted at Liaquat University Hospital Hyderabad/Jamshoro. Sample size of the study was 240. Data was collected through EPDS, analyzed through SPSS. Results Results of this study revealed 68.8% prevalence of PPD, Significant positive association were found between socio-economic status, occupation of participants and PPD(p=0.00), significant negative correlation were found between participant’s residency, ethnic group and PPD. Conclusion In current study prevalence of PPD was high. From study findings it is concluded that prevalence of PPD is highly associated with risk factors like, Unemployment and low socio-economic status.
EFFICACY OF ANTENATAL MAGNESIUM SULPHATE IN REDUCING CEREBRAL PALSY RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS
Background: Cerebral palsy (CP) is a leading cause of lifelong disability among preterm infants. Antenatal magnesium sulphate (MgSO₄) has emerged as a candidate neuroprotective intervention, but the magnitude and consistency of its effects remain debated. Objective: To systematically assess the efficacy and safety of antenatal MgSO₄ in reducing CP incidence among preterm infants, through meta-analysis of randomized controlled trials (RCTs). Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. Electronic databases (MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov) were searched through June 2025 for RCTs evaluating antenatal MgSO₄ in women at risk of preterm birth (<37 weeks gestation). Two reviewers independently screened studies, extracted data, and assessed risk of bias. The primary outcome was the incidence of cerebral palsy. Secondary outcomes included neonatal mortality and adverse maternal effects. Random-effects models were used to pool risk ratios (RRs), and certainty of evidence was assessed via GRADE. Results: Eight RCTs comprising 6,145 infants met inclusion criteria. Antenatal MgSO₄ significantly reduced the risk of cerebral palsy (RR 0.70; 95% CI 0.56–0.87; I² = 22%). There was no significant increase in neonatal mortality (RR 1.01; 95% CI 0.89–1.15). Maternal side effects (e.g., flushing, hypotension) were transient and manageable. Overall certainty of evidence was rated high. Conclusion: Antenatal magnesium sulphate confers a substantial neuroprotective effect in preterm infants, significantly lowering the risk of cerebral palsy without elevating mortality risk. Clinical guidelines should endorse its routine use in cases of imminent preterm birth.
LEVEL OF LIFE SATISFACTION AMONG PATIENTS OF END STAGE RENAL DISEASE (ESRD) UNDERGOING HEMODIALYSIS: A CROSS-SECTIONAL STUDY
Objective: The present study aims to investigate the Level of Life satisfaction among patients of End Stage Renal Disease (ESRD) undergoing hemodialysis. Methodology: A total of 100 patients with End Stage Renal Disease (ESRD) were included in this cross-sectional study. Participants were categorized into two age groups: above 45 and below 45. Both genders were included, and all participants resided in Islamabad or Rawalpindi. The demographic data collected included gender, family system, and socioeconomic status. Descriptive frequency and Chi-square tests were used for the analysis of the results. Results: Analysis showed that 28% of patients were under 45 years old, while the remaining 72% of patients were over 45 years old. Dissatisfaction was frequent, indeed: 22% were dissatisfied, and 29% were slightly dissatisfied, versus 11% slightly satisfied, 11% satisfied, and 10% very satisfied. Conclusion:The results indicate that Level of Life Satisfaction was inadequate {dissatisfied (22%) and slightly dissatisfied (29%)}. Findings concluded that patients with End Stage Renal Disease (ESRD) were not experiencing an adequate level of life satisfaction due to chemical changes in the kidneys and the physiological distress associated with ESRD
patients of End Stage Renal Disease (ESRD) & undergoing hemodialysis
ASSOCIATION BETWEEN BODY IMAGE SATISFACTION AND SELF-ESTEEM AMONG VITILIGO PATIENTS
Objective: The present study aims to investigate the association between body image satisfaction and self-esteem among vitiligo patients. Methods: This study included 100 patients (Male = 46 and Female = 54) diagnosed with vitiligo, and age ranged from 18 to 75 years. Sociodemographic characteristics of the participants were collected and hypo pigmented lesion involvement regions were recorded to identify types of vitiligo. The Body Image Satisfaction Scale (BIS), andState Self-Esteem Scale were completed for the investigation of variable of study. Results: Results revealed that body image satisfaction and self-esteem significantly negative correlated (p = < 0.00) Conclusion: Patients' Self-Esteem and Body Image Satisfaction may suffer as a result of vitiligo. We may conclude that the disease's unpleasant skin look affects patients' BIS and SE, but more research is needed to determine how it relates to neurobiological causes. Further psychological interventions are needed to work with body image satisfaction and self-esteem of vitiligo patients.
IMPACT OF NANO-SILICA ON THE MECHANICAL BEHAVIOR OF GEOPOLYMER CONCRETE
There is an enormous use of Portland cement concrete which presents serious environmental issues such as high levels of carbon emission, thus the use of sustainable alternatives such as geopolymer concrete (GPC). Nevertheless, GPC has exhibited irregular mechanical strength especially early-age strength that restrains its use to a greater extent. Although nano-silica has been funded in impacting positively into cementitious composites, its impact on GPC is not fully exploited particularly with regard to optimization of dosage and microstructural interactions. To fill this gap research was conducted to study the effect of nano-silica (0 4% by fly ash weight) on mechanical and microstructural properties of GPC. Controlled experimental design was undertaken, whereby compressive, tensile, and flexural strength tests as well as SEM and XRD tests were carried out. ANOVA, Tukey, HSD, and regression were used in statistical assessment. The findings showed that 3% nano-silica produced the maximum compressive strength (39.66 + 0.91 MPa, *p* < 0.001) which was 24.2 percent higher than that of the control whereas tensile and flexural strength were increased by 32.4 and 24.2 percent, respectively. By microstructural examination, more dense matrices with lower porosity (8.5 percent at 3 percent nano-silica as compared to 12.5 percent control) were observed. But the workability decreased in a linear manner as the dosages increased (slump: 81.22 +/- 2.03 mm to 69.01 +/- 1.49 mm). At 2 3%, the dosage provided the best combination between strength improvement and ease of handling, beyond which effects on agglomeration were found. These empirical results support the use of nano-silica in sustainable construction showing its effectiveness in enhancing the performance of GPC. The research can fill the existing severe knowledge gaps in nano-modified GPC, providing practical solutions in material optimization and low-carbon infrastructural construction.
Geopolymer concrete, nano-silica, mechanical properties, microstructure, sustainable construction
IDENTIFICATION AND CLASSIFICATION OF FOODBORNE DISEASE OUTBREAKS
Foodborne disease is commonly caused by consuming contaminated food and beverages so the identification and classification of foodborne disease outbreaks is necessary to prevent and reduce the risk of illness and death. The purpose of this research is to identify the causative agents of disease as soon as possible to improve the food safety to prevent from illnesses and deaths. The useful patterns have been identified with analysis on dataset and also determine the large number of outbreaks occurs in year, food, location and species. The classification is done in Decision Tree, Naïve Bayes and Random Forest classifiers. The experiments on the dataset have proven the efficiency of purposed approach for identification and classification of outbreak patterns.
Classification, Foodborne, Outbreaks, Causative Agents, Naïve Bayes, Decision Tree, Random Forest