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Clinical pharmacy services are the specialized practices of pharmacists to provide pharmaceutical care. All these activities are documented as pharmacist interventions to avoid medication errors which occur during prescribing, dispensing, and administration. The purpose of this study is to conduct an economic analysis of the pharmacist interventions using integrated health system. A retrospective study was conducted in a tertiary care hospital. Pharmacist interventions were analyzed by an independent pharmacist. Cost-saving and cost avoidance analyses were carried out for drug-related interventions. Economic analysis was performed and tabulated both in PKR and USD. Out of 1330 interventions, 1250 (95%) interventions were accepted and changed the prescription upon the physician-pharmacist consultation while 71 (5%) were not accepted. Interventions related to prescribing and duplication errors were the highest of all (30 and 29% respectively). Pharmacist interventions were recorded with a 95% acceptance rate. Cost analysis showed that pharmacist interventions saved around 105,115.88 US dollars. Clinical pharmacy services provided by integrated health system are a cost saving program. The cost saved per intervention for our study is around USD 37 which is more than another similar study which quoted USD 30.35 per intervention. [ABSTRACT FROM AUTHOR]

We have described here proboscideans fossil remnants which belong to six species: Prodeinotherium pentapotamiae, Gomphotherium browni, Choerolophodon corrugatus, Protanancus chinjiensis, and Elephas planifrons. The described specimens are collected from six different localities of the Siwaliks. These localities are Bhilomar, Chinji type section, Lawa, Dhok Bun Ameer Khatoon (Chinji Formation), Ochri (Dhok Pathan Formation) and Rathian (Pinjor Formation), belongs to the Lower to Upper Siwaliks, district Chakwal and Jhelum, Punjab, Pakistan. The specimens were collected from these localities after extensive fieldwork from 2015 to 2020, which confirms the presence of large mammalian fauna during the Middle Miocene to Late Pleistocene. Prodeinotherium pentapotamiae is rare taxa in the Middle Siwaliks of Pakistan, first time discovered from new fossil section Satroma wali dhal in the vicinity of the Dhok Bun Ameer Khatoon locality. Bhilomar is a less explored fossil locality belongs to the Chinji Formation, Gomphotherium browni and Choerolophodon corrugatus is reported from the Chinji type section. A beautiful juvenile mandibular ramus of Protanancus chinjiensis has been recovered first time from Lawa and Elephas planifrons were recovered from Rathian which belongs to Pinjor Formation dated as Plio-Pleistocene age of Upper subgroup of Siwaliks. Based on palaeoenvironment and stratigraphy the age of these localities is suggested as Miocene to Pleistocene. The recovered proboscideans fossil fauna indicates about the climatic changes and confirms that more seasonal extensive grasslands and savannah like ecosystem were present at that time. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to determine the effect of task-oriented training on the dexterous movements of hands in Hemiplegic post-stroke patients.Methods: This study has been registered on site ClinicalTrial.gov with clinical trial number NCT05201196. The study was Randomized controlled trial, 18 patients were recruited that meet the inclusion criteria, randomly allocated to task-oriented training Group A (n = 9) and Conventional Therapy Group B (n = 9). Both exercise trainings were applied for 45 min/session, 5 times/week for 6 weeks. Fugl-Meyer Assessment Scale Motor, sensory and coordination portion, Wolf Motor Function Scale and Barthel Index were used as outcome measures, assessed patients at Baseline, after 3 weeks and 6 weeks after training. Data were analyzed by SPSS version 23.Results: The results suggested the mean Age was 60.78 ± 9.08 and 61.33 ± 6.78 for Group A and Group B, respectively. Average BMI was 23.66 ± 2.66 for Task-oriented group and 21.36 ± 2.46 for Conventional group. Fugl-Meyer scale shows significant P-value 0.03 post treatment compare to pre-treatment which was.283, Wolf Motor Function test and Barthel Index also showed significant P-values as 0.023 and 0.007, respectively, indicating that Task-oriented training shows more significant improvements than conventional group.Conclusion: Task-based training produced statistically significant as well as clinically meaningful enhancement in the dexterous hand movements of acute and subacute stroke patients than conventional therapy and ultimately improves the functional independence in their daily activities such as feeding, bathing and hygiene. [ABSTRACT FROM AUTHOR]

The sites of Chinji type locality, Dhok Bun Ameer Khatoon, Lawa and Markhal are highly fossiliferous in the Chinji and Dhok Pathan formations, dated from middle and late Miocene (15.97–5.33 Ma), in the Lower and Middle Siwalik subgroups of the Pakistan. In these studied localities fossils of suids, tragulids, bovids (including caprins), giraffids, proboscideans, and rhinocerotids are reported. The main focus of current study is on family Suidae and the collected specimens show strong similarities with the previously discovered species of Listriodon pentapotamiae, Conohyus sindiensis, Propotamochoerus hysudricus, and Propotamochoerus sp. Here we present comparative data of suids from the Siwaliks and we notably present first remains of L. pentapotamiae incisors and C. sindiensis from Dhok Bun Ameer Khatoon; P. hysudricus from Markhal and Propotamochoerus sp. from Chinji type section. The material described here enhances our knowledge about the diversification and evolution of suid fossil species in the Siwaliks of Pakistan. [ABSTRACT FROM AUTHOR]

In this study, the degradation of MO (Methyl orange) dye using visible light irradiation and Ag2Se photo-catalyst was investigated. The Ag2Se photo-catalyst was synthesized via a wet chemical technique and characterized by using X-ray diffraction (XRD) for structural analysis, scanning electron microscopy (SEM) for surface morphology, transmission electron microscopy (TEM) for inner structure, Raman and UV-Vis spectroscopy for the study of its optical properties. The results showed that the Ag2Se photo-catalyst has a well-defined cubic crystal structure with a typical particle size of 50 to 76.5 nm. The UV-Vis absorption spectrum of the Ag2Se photo-catalyst revealed a strong absorption in the visible light region, indicating its potential as visible light photo-catalyst. The photocatalytic degradation of MO dye was carried out under visible light irradiation using the synthesized Ag2Se photo-catalyst. The results showed that the degradation efficiency of MO dye reached 95% after 150 min of irradiation. The degradation of MO dye was attributed to the generation of reactive oxygen species (ROS) and the formation of Ag nanoclusters on the surface of the Ag2Se photo-catalyst. The stability of the Ag2Se photo-catalyst was also examined, and the results exhibited that the photo-catalyst was stable and could be reused for subsequent photocatalytic degradation experiments. The Ag2Se photo-catalyst showed an outstanding photo catalytic activity for the degradation of MO dye underneath visible light irradiation. The study proposes that the Ag2Se photo-catalyst can be used for the treatment of wastewater containing organic pollutants. [ABSTRACT FROM AUTHOR]

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This study aims to evaluate the impacts of international tourism development and green technology innovation on economic growth and carbon dioxide emissions in the top 10 GDP countries between 1995 and 2018. Our preliminary findings reject the preposition of data normality, which instigate us to apply a novel method of moments quantile regression. The overall results suggest that international tourism development facilitates economic growth and increases carbon dioxide emissions asymmetrically across the different levels of economic growth and carbon dioxide emissions. Specifically, the economic growth impacts are relatively large for the comparatively more developed nations while the adverse environmental impacts are relatively larger for the comparatively less-polluted nations; thus, the tourism led-economic growth hypothesis is verified. On the other hand, green technology innovation is found to facilitate economic growth and mitigate carbon dioxide emissions, especially in the context of the relatively more developed and polluted economies. [ABSTRACT FROM AUTHOR]

Drawing on the self-control perspective, this study investigated the buffering effect of emotional suppression in reducing the harmful influence of workplace ostracism on employee performance. The research also studied the mediating role of employee silence and voice behaviors based on social exchange theory. We performed moderated mediation analysis on responses received from 159 employees working in the financial industry of the Southern Punjab region of Pakistan. The results showed that workplace ostracism harms employee performance via employee silence and voice behaviors. Furthermore, emotional suppression moderated the mediated relationship between workplace ostracism and employee performance. The results indicated that if ostracized employees adopt voice behavior, emotional suppression cannot aid them in performing better as compared to those who remain silent and regain their self-esteem. Our findings highlight the importance of emotional suppression capability in reducing the damaging outcomes of ostracism in organizational settings. [ABSTRACT FROM AUTHOR]

Diabetic peripheral neuropathy is one of the most prevalent complications of diabetes mellitus. It is the most common type of neuropathy characterized by decreased sensory functions in the lower extremities and substantial neuropathic pain. Based on clinical characterization, it is classified into symmetric and asymmetric neuropathy. The pathological changes and neuronal function impairment during diabetes are associated with various pathways, including polyol pathway activation, advanced glycation end-products formation, oxidative stress, protein kinase C activation, poly ADP-ribose polymerase, and hexosamine pathways. Demyelination, axonal atrophy, nerve fibre loss, reduced regeneration, and loss of neurovascular interactions are hallmarks. Although some symptomatic and supportive therapies, such as tricyclic agents, antiarrhythmics, opioid analgesics, incretin, aldose reductase, and protein kinase C inhibitors, are in practice, the outcome is not promising. To fill this gap, natural product-based therapy can prove prodigious as an effective alternative. This review aims to comprehend the available literature on the role of various biological molecules in ameliorating diabetic peripheral neuropathy. These molecules play a key role in reducing oxidative-nitrosative stress, aldose reductase activity, and neuronal apoptosis. They control glucose and HbA1c% levels and improve nerve conduction velocity, axonal regeneration, and antioxidant species (catalase, superoxide dismutase, malondialdehyde). They are known for their attenuating thermal and mechanical hyperalgesia and tactile allodynia. Therefore, there is a need to evaluate these molecules at the pre-clinical and clinical levels for efficacy. Hence, natural molecules may act as promising players against diabetic peripheral neuropathy and are a ray of hope for suffering individuals. [ABSTRACT FROM AUTHOR]

"Richard Potter, Beatrice Webb's Father and Corporate Capitalist" by Geoffrey Channon is a well-written and meticulously researched biography that explores the life and work of Richard Potter, a wealthy Victorian businessman. The book delves into Potter's early life, his successes and setbacks, and his rise to become a prominent figure in the railway industry. Channon also examines Potter's personal life, including his relationships with his children and his forward-thinking views on gender equality. The biography offers valuable insights into Victorian capitalists, business, and management, making it a recommended read for business historians. [Extracted from the article]

Individual entrepreneurial orientation training is a promising psychological intervention based on the Theory of Action Regulation that has contributed to the success of small business owners of developing countries. However, training transfer literature warns about the decay in trained behaviour and business outcomes over time. The factors that help in the maintenance of post-training effects are still not extensively researched leaving a huge question mark on acclaimed outcomes. We employed a rigorous combination of an experimental and longitudinal approach for testing the impact of individual entrepreneurial orientation training among 1189 small business owners (Training group = 587, Control group = 602) in Pakistan across multiple follow-up waves (T0 = before training, T1 = at training, T2 = 1 month after training, T3 = 6 months after training, T4 = 20 months after training). We specifically examined the role of deliberate practice development in post-training behaviour maintenance as well as the subsequent business success. Time-lagged mediation, growth modelling, and mediated moderation analyses were done. The findings revealed that though an individual's entrepreneurial orientation behaviour declined after training, however, deliberate practice development enhanced its maintenance. Moreover, the small business owners who had a positive trend in the development of deliberate practice over measurement waves had higher success rates through the display of individual orientation behaviour. [ABSTRACT FROM AUTHOR]

Host factors impact vaccine efficacy: implications for seasonal and universal influenza vaccine programs. Recently, a systematic review and meta-analysis revealed that the correlation between sex and COVID-19 vaccine efficacy and safety should be considered in enhancing vaccine decision-making programs [[29]]. Studies on influenza vaccines have shown that women's immunological response to half-dose vaccines is the same as men's to full-dose vaccines [[25]]. In the pandemic era, global immunization programs against COVID-19 are being implemented. [Extracted from the article]

The present study focused on evaluating the influence of ultrasonic-assisted pasteurization (UAP) on the quality and shelf stability of jambul squash. Squash was analyzed for physicochemical characteristics during a storage period of 4 months. There was a significant effect (p <.05) of storage period on the acidity, DPPH radical scavenging activity, and flavonoids of jambul squash with a significant increase in acidity and DPPH radical scavenging activity and decrease in flavonoids with the corresponding increases in sonication time and pasteurization temperature during storage. The microbial content of jambul squash during storage remained lower than untreated samples. Microstructure evaluation of jambul squash showed de-shaped middle lamella and cell wall after UAP treatment. Outcomes of the current study revealed that squash samples with increased sonication time and pasteurization temperature had less microbial content than untreated samples. [ABSTRACT FROM AUTHOR]

Our present study was a qualitative investigation intending to explore the emotional journey of wives whose spouse has been diagnosed with Bipolar I Disorder, using a phenomenological design. Semi-structured face to face interviews were conducted with 5 wives of already diagnosed Bipolar I Disorder patients to uncover their lived experience in terms of the emotional journey they had had. For data analysis, we used Hycner's explicitation process. Moreover, for data verification we employed the strategies of frequent debriefing sessions peer review and member checks. Our analysis revealed six major themes encapsulating the participants emotional journey. These included Shock, Betrayal and the Incomprehensible, Apprehensions and Uncertainty, Anger and Irritability, Loneliness and Helplessness, Compassion and Acceptance and Reconciliation. It became clear to us that wives of individuals diagnosed with Bipolar I Disorder are on a continuous emotional journey dealing with the burden, stress, complications, uncertainty and making many sacrifices along the way. Our study highlighted many culture specific factors of the phenomenon. This insightful exploration has opened up new horizons to conceptualize the challenges of wives dealing with an ailing spouse in the context of a Pakistani society. [ABSTRACT FROM AUTHOR]

In the present study, a series of azo derivatives (TR-1 to TR-9) have been synthesised via the diazo-coupling approach between substituted aromatic amines with phenol or naphthol derivatives. The compounds were evaluated for their therapeutic applications against alpha-glucosidase (anti-diabetic) and pathogenic bacterial strains E. coli (gram-negative), S. aureus (gram-positive), S. aureus (gram-positive) drug-resistant strain, P. aeruginosa (gram-negative), P. aeruginosa (gram-negative) drug-resistant strain and P. vulgaris (gram-negative). The IC50 (µg/mL) of TR-1 was found to be most effective (15.70 ± 1.3 µg/mL) compared to the reference drug acarbose (21.59 ± 1.5 µg/mL), hence, it was further selected for the kinetic studies in order to illustrate the mechanism of inhibition. The enzyme inhibitory kinetics and mode of binding for the most active inhibitor (TR-1) was performed which showed that the compound is a non-competitive inhibitor and effectively inhibits the target enzyme by binding to its binuclear active site reversibly. [ABSTRACT FROM AUTHOR]

This study analyzes the effects of increased income and renewable energy on environmental quality, which has been ignored in the existing literature. An important contribution of this study is to analyze the role of renewable and nonrenewable energy in relation to the rising level of carbon emissions in the leading emitting countries. This research further examines the heterogeneous impacts of rising income levels and EKC investigation for CO2 emissions. The Kao cointegration, generalized method of moments (GMM), random effects, fixed effect (FE) regression models, and panel causality techniques are employed for panel data estimations. The empirical outcomes mention that an increase in income moderates the ratio of consumption of renewable energy to CO2 emissions. Increased income contributes more to the energy mix, which contributes to environmental pollution, through nonrenewable energy. This research reports policy-relevant critical masses beyond which an increase in income negatively affects the link between renewable energy and CO2 emissions. [ABSTRACT FROM AUTHOR]

Today, China is the second-largest, fastest-growing economy in the world. This study analyzes asymmetric and time-varying impact of world energy prices (including world energy prices index, world coal prices, world crude oil prices and world natural gas prices) on China's CO2 emissions. We used a non-linear ARDL (NARDL) model and wavelet analysis using monthly data from 1992 to 2017. The results based on the NARDL estimate show that world energy prices have an asymmetric impact on CO2 emissions. However, the results of wavelet pairwise correlation and wavelet-transform coherence suggest that the relationship between world energy prices and CO2 emissions differs over time and across sectors (i.e. short-term, medium-term, long-term and very long-term). Evidence suggests that ignoring fundamental non-linearities can lead to misleading outcomes. Such empirical results are expected to have a high importance for the efficient design and implementation of world energy prices and Chinese environmental policies. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop heparin sodium loaded microneedle patches using different compositions of polyvinyl alcohol polymer and sorbitol. A vacuum micromolding technique was used to fabricate microneedle patches while heparin sodium was loaded into needle tips. Physical features of patches were evaluated by measuring thickness, width, folding endurance and swelling percentage. Patches were also characterised by optical microscopy and scanning electron microscopy to determine the microneedle length and surface morphologies. A preliminary assessment of the microneedle performance was studied by examining the in-vitro insertion to the parafilm and recording the in-vitro drug release profile. In-vivo activity of patches was confirmed by measuring activated partial thromboplastin time and histological examination of the micropierced skin tissues. Prepared patches were clear, smooth; uniform in appearance; with sharp pointed microprojections and remained intact after 1000 folding. The microneedles were stiffer in nature, as they reproduce microcavities in the parafilm membrane following hand pushing without any structural loss. Insertion study results showed successful insertion of microneedles into the parafilm. Disrupted stratum corneum evident from histological examination confirmed successful insertion of the microneedle without affecting the vasculature. In-vitro release study confirmed ∼92% release of the loaded drug within 120 min. A significant prolongation of activated partial thromboplastin time (4 folds as compared to negative control) was recorded following the application of heparin sodium loaded microneedle patch onto rabbit skin. In conclusion microneedles are a valuable drug delivery system, benefiting the patients with minimal skin invasion and also allowing self-administration of heparin sodium in a sustained release manner for the management of chronic ailments. [ABSTRACT FROM AUTHOR]

Embedding environmental concepts in the minds of young students within a traditional classroom setting poses challenges due to the abstract nature of these concepts and the temporal dilemma associated with environmental change, as students are unable to observe the immediate consequences of their actions directly. To address this, innovative instructional methods incorporating technology were explored. Based on socio-constructivism, a quasi-experimental study employed a web tool to teach environmental concepts. The experimental group utilized the 7E constructivist learning model, while the control group followed traditional instruction. The results of the data analysis indicated a statistically significant disparity in students' motivation levels to learn about environmental challenges, with active learning strategies receiving the highest scores due to engaging students in online discussions and collaborative tasks. The active and constructive learning techniques encouraged collaboration and cooperation and also embraced the students' autonomy. Furthermore, students felt motivated to act and solve community issues, fostering civic responsibility for long-term growth and a sustainable future. The learning performance in the posttest significantly increased for the experimental group. These findings suggest the importance of integrating technology and active learning approaches to enhance environmental education among young students. [ABSTRACT FROM AUTHOR]

Introduction: Concern has been expressed in recent times whether medical schools have adapted sufficiently to cater for the increasing demand of physician-scientists. Studies have shown that research involvement at the undergraduate level is vital to accommodate this growing need. Enhanced communication skills, improved problem-solving abilities and better future employment opportunities are among the other many benefits of undergraduate research (UR). Herein, we report projects run by a unique student driven undergraduate research committee (URC) at Alfaisal University, Riyadh, Saudi Arabia aimed at providing the future generation of physicians training opportunities for pursuing a research intensive career. Methods: The article describes the unique structure of the URC and provides an in-depth description of the various programs and activities used in promoting students' research activities. We analyzed students' perception of URC activities via a questionnaire and analyzed research-output of the first graduating batches through their publication record. Results: Overall, more than 60% of the graduating students were involved in the various research programs offered by the URC and around 50% published in peer-reviewed journals with an average impact factor of 2.4. Conclusions: Research involvement by medical students is an essential need of the twenty-first century and models like URC could provide crucial platform for research training to the new generation of physician-scientists. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the use of multiple choice questions for the assessment of medical students.