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The current research focused on the designing of questionnaire for factors that impact student learning outcomes in tertiary educational system in underdeveloped nation Pakistan. A pilot study was conducted for the designing of questionnaire to collect data on perceived factors that impact student learning outcomes. The selected Higher Education Commission (HEC) recognized private educational institutions were contacted and permission of data collection was obtained from the authorities. Ninety eight students of final semester from HEC recognized tertiary universities at Bachelors level from the department of Science were approached for this study. Participants were informed that the data will be kept in a laptop under password protection. There were 41 total items in the questionnaire. It has been divided into 2 sections. Section A includes the demographic characteristics of participants and includes 7 questions. Section B is divided into 6 subsections, each section capturing the true essence of independent and dependent variables. The results of the study concluded that student perception questionnaire has good to excellent intra rater reliability and indicates that all components have factor loading exceeding 0.50 that also shows the importance of all components. Thus, the questionnaire can be used for the assessment of factors that impact student learning outcomes from educational institutes.

Education opens numerous revenues to register economic expansion all around the world with specific reference to developing nations. Advancement of Pakistan in education indicators has been severely insufficient during the previous decades. Decreased financing along with inefficiency in budget expenditure plus weak management system have crippled the education sector ensuing poor educational outcomes. Outcome-based Education (OBE) has recently gained much attention in Pakistan. OBE is used in education because it clearly focuses and organizes everything in an educational system around what is necessary for all students to be able to do at the end of their learning. OBE proposes an influential and interesting option of transforming and organizing medical education. Therefore, the basic aim of this review is to highlight the tertiary education system of Pakistan and the need to shift from teacher centered to Outcome Based Education system. The review also addresses the major factors that impact student learning outcomes. Data bases were searched including Cochrane and Medline. Search strategy was designed by combining Boolean operators and key terms related to review objectives. Seven studies were included in the paper regarding the effectiveness of Outcome Based Education in different disciplines of education. The findings suggested five important factors from the literature that impact student learning outcomes including, assessment strategies, learning objectives based on level of complexity, student preferred learning styles, English language competency and Employer requirements. However, limitations were recognized in the methodology section and further recommendations were given for future researchers.

The purpose of this survey study was to know faculty members' viewpoint about factors of research culture prevalent in the public sector universities of the Punjab. Survey solicited university faculty members' opinions on a five point Likert type scale yielding quantitative data. Population of the study was comprised of all the faculty members of 18 general public sector universities. Sample was selected through multistage random sampling technique. At the first stage seven universities were selected randomly out of total 18 public sector universities. All the faculty members in the departments of Education in the sampled universities were included in the study. One hundred and sixty faculty members willingly filled out the survey questionnaire. Survey questionnaire enlisted environmental, institutional and personal factors contributing to research culture. Data were analyzed by computing mean values and standard deviation of responses on each statement. Significance of difference between male and female faculty members' opinions was tested through t-test for independent samples. None of the environmental, institutional and personal factors was found to be favorable for research culture in public sector universities of the Punjab. The results of the study indicated that institutional factors and personal factors were perceived as relatively more influential for promotion of research culture as compared to environmental factors.

Purpose: This study aims to investigate the digital information needs and seeking behaviour of legal practitioners practising at the Lahore High Court in the Punjab province of Pakistan. Design/methodology/approach: This study adopts a quantitative approach based on an e-questionnaire survey to collect data from legal practitioners following a comprehensive census. Among the 9,933 registered legal practitioners, a random sample size of 370 respondents was determined, of whom 302 responded to the survey, resulting in a response rate of 81.6%. Findings: Legal practitioners prefer the Pakistan Law Site and law journals as primary sources of information acquisition, with a distinct inclination towards digital formats over traditional print. These resources are primarily used for court case preparation, significantly enhancing the research capabilities of legal practitioners and ensuring they remain current in their field. However, several challenges were identified, including time constraints, limited access to digital resources and inadequate availability of legal resources in digital format. These challenges emphasize the critical need for enhancing the digital infrastructure of law libraries. Research limitations/implications: The study calls for law libraries to adopt technological advancements and underscores the necessity of improving digital infrastructure to better serve the evolving information needs of legal practitioners. Originality/value: This study underscores the preferred information sources and formats of legal practitioners for seeking information, their purpose for using law resources and the impact of digital media on their information-seeking behaviour. In addition, this study reveals the challenges they face in seeking them. [ABSTRACT FROM AUTHOR]

This study explores the impact of social media usage on the academic performance of university students, with a specific focus on Pakistan. While social media platforms such as Facebook, WhatsApp, and Instagram provide opportunities for enhanced communication, collaboration, and information sharing, excessive or unregulated use can negatively affect students' academic achievements. Drawing on existing literature and a systematic review of relevant research, this study highlights both the positive and negative aspects of social media usage among students. The findings suggest that while social media can support academic engagement and networking, its overuse often leads to distractions, time mismanagement, and lower academic performance. The study underscores the importance of promoting balanced social media usage to maximize its benefits while minimizing its potential drawbacks for university students. Further research is recommended to develop strategies for improving social media's role in academic success. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance: Pelvic inflammatory disease (PID) is a frequently occurring gynecological disorder mainly caused by the inflammation of a woman's upper genital tract. Generally, antibiotics are used for treating PID, but prolonged use poses potential risks of gut bacterial imbalance, bacterial resistance, super bacteria production, and associated adverse reactions. Traditional Chinese medicine (TCM) has shown unique advantages in various ailments and has received widespread clinical research attention. Fuke Qianjin (FUKE) capsule is an approved National Medical Products Administration (NMPA License No. Z20020024) Chinese herbal prescription that has been widely used individually or in combination with other Western medicines for the treatment of various gynecological inflammatory diseases, including chronic cervicitis, endometritis, and chronic PID. Aim: This clinical trial was designed to assess the safety and efficacy of FUKE capsule in mild-to-moderate symptomatic PID patients. Materials and methods: This phase 2, randomized, double-blind, positive controlled clinical trial was conducted in mild-to-moderate symptomatic PID patients at a single center in Pakistan from 21 September 2021 to 11 March 2022. Eligible female participants were randomly assigned to a test and a control group with a ratio of 1:1. The test group subjects received two metronidazole (METRO) tablets and one doxycycline hyclate (DOXY) simulant at a time, twice daily for 14 days, and two Fuke Qianjin (FUKE) capsules, three times a day after a meal for 28 days. Subjects in the control group received two METRO tablets and one DOXY tablet at a time, twice daily for 14 days, and two FUKE simulant capsules, three times a day after meal for 28 days. The primary efficacy outcome was an improvement in pelvic pain symptoms assessed through a visual analog scale (VAS). The secondary outcomes were the improvement in secondary efficacy symptoms like local physical signs, clinical assessment of leucorrhea and cervical secretions through laboratory examination, and improvement in the maximum area of pelvic effusion assessed through gynecological ultrasound after the treatment. The safety outcomes were assessed through vital signs, laboratory tests, electrocardiogram findings, and adverse events/serious adverse events. Results: A total of 198 subjects with active PID were randomly assigned to a test group (n = 99) and a control group (n = 99). The baseline characteristics of the subjects in the two groups were similar. In the intention-to-treat analysis, the primary efficacy was 84.9% for the test group and 71.6% for the control group, with a statistically significant difference (p = 0.0370; 95% CI -0.2568 to -0.0088). The secondary clinical efficacy was 88.4% for the test group and 82.7% for the control group, with no significant difference (p = 0.2977; 95% CI -0.1632 to 0.0501). The improvement in local physical signs was 95.8% for the test group and 76.9% for the control group, with no significant difference (p = 0.0542; 95% CI -0.3697 to -0.0085). The inter-group non-inferiority comparison showed that the upper limit of the 95% CI was less than 0.15 and thus met the noninferiority requirements of the test group to the control group. The results of clinical signs of leucorrhea and cervical secretions showed that there was no difference in the rate of improvement between the test and control groups, indicating that FUKE was non-inferior to DOXY. A total of 14 adverse events in eight subjects were observed in the trial, with an incidence rate of 4.7%. Four subjects in each group experienced seven adverse events with 4.5% and 4.8% incidence rates of adverse reactions in the test and control groups, with no statistically significant differences (p = 0.2001). No serious adverse events occurred in the trial. Conclusion: The results of this trial indicate that the test drug (Fuke Qianjin capsule) is non-inferior to the control drug (doxycycline hyclate tablet) in treating mild-tomoderate PID patients with comparable efficacy, safety, and tolerability to the control drug. [ABSTRACT FROM AUTHOR]

Classroom management is a vital aspect of teaching that greatly affects students’ learning experiences, particularly in secondary schools. This review paper examines the various strategies teachers use to maintain order and promote effective learning. In Pakistan, where classrooms often face challenges like large sizes and diverse student needs, teachers employ a range of techniques to keep students focused and engaged. These include establishing explicit guidelines, utilizing interactive teaching techniques, and fostering a positive environment. The article helps to find out the answers of these research questions: (1) how do different classroom management strategies impact student engagement and academic performance in secondary education? (2) To what extent do teacher preparation programs contribute to the development of effective classroom management skills for teachers working in diverse classrooms? The assessment also highlights the importance of teacher preparation programs and policies that support effective classroom management. It means that by understanding and implementing tried-and-true management techniques, educators can create a learning environment where every student has the opportunity to succeed. Since effective classroom management changes over time, it calls for ongoing effort. Enhancing the learning environment can be achieved through incorporating evidence-based practices, theoretical insights, and a thorough understanding of each student's needs. It encourages students' empowerment, academic advancement, and the growth of their interest in learning. [ABSTRACT FROM AUTHOR]

Background: Common symptoms of Chronic Non-atrophic Gastritis (CNAG) include nausea, stomach distension, and abdominal pain. The Houtou Jianweiling Tablet (HTJWT) is a chinese patent medicine (CN1368229A) and it has been used clinically for more than 20 years with proven clinical efficacy in treating CNAG, prompted us to establish the clinical efficacy and safety of HTJWT on patients with mild to moderate CNAG symptoms in Pakistani population. Methods: This phase II, double-blind, randomized, parallel-controlled trial was conducted in a single center between November 2022 and February 2023 in Pakistan. In a ratio of 1:1, total 240 CNAG patients with erosion identified by pathological biopsy and gastroscopy were randomly assigned to control (Omeprazole) group (n = 120) and the treatment (HTJWT) group (n = 120). Patients in the treatment group received orally four HTJWT (0.38g/tablet), three times a day and one placebo of Omeprazole enteric-coated tablet prior to breakfast, daily. On the other hand, patients in the control group received one Omeprazole enteric-coated tablet (20 mg/tablet) prior to breakfast and four placebo of HTJWT, thrice a day. The patients consumed the investigated drugs (i.e., treatment and control) treatment regimen was followed for a duration of 28 days. The safety of the patients were evaluated through adverse events, serious adverse events and laboratory tests such as blood biochemistry, urine analysis, liver and renal function tests. Vital signs like; blood pressure, pulse rate, body temperature, respiratory rate for all the patients were recorded. The cardiac status of the patients were assessed through electrocardiogram (ECG). The primary efficacy indicators were the improvement rate of gastric distention and gastralgia as the main clinical symptoms. Secondary indicators were visual analogue score (VAS); improvement rate of secondary clinical symptoms and signs; improvement rate of total clinical signs and symptoms; the disappearance/ remission rate of Gastric pain and, remission/disappearance time of gastric distension; and the negative conversion rate of Helicobacter pylori (H. pylori). The outcomes among each group were compared using the chi-square test. Results: Patients in both groups had good drug compliance (80%-120%), and there was no statistically significant difference in the patients' baseline characteristics. The clinical improvement rate was found to be 91.1% in the treatment group and 91.0% in the control group with negligible variation among the two groups (p = 0.9824; 95% confidence interval: -0.0781-0.0798). Similarly, hardly no difference was found in the negative conversion rate of H. pylori between the treatment group and the control group (i.e., 70.1% and 71.8% respectively, p = 0.8125). There were no significant differences in respiratory rate, vital signs, blood pressure, laboratory results for blood biochemistry, urine analysis, liver and renal function tests between the two groups. The ECG assessment carried out for the treatment and control group revealed no considerable difference. Margin variation in the disappearance time of gastric pain (p = 0.1860) and remission rate (p = 0.5784) between the two groups were observed. The control group exhibited a faster remission period for gastrointestinal discomfort indications as compared to treatment group (p = 0.0430). Only one patient in the control group experienced mild to moderate adverse events, namely; epigastric pain and dyspepsia. The results were consistent with the intention-to-treat and per-protocol analysis that included patients who were 100% compliant to the assigned therapy. Conclusion: The lower limit of confidence interval (CI, 95%) for the differences in the effective rate between the treatment and the control groups was found to be -0.0781 which is greater than -0.15, hence the treatment group is non-inferior to the control group. The therapeutic dosage used in the trial and treatment period did not cause any significant adverse event, and there were no obvious changes in the ECG profile, vital signs and biochemistry of the patients. Based on the clinical efficacy evaluation and reported adverse events, it can be concluded that the HTJWT is a safe and effective traditional chinese medicine for the treatment of patients suffering from chronic non-atrophic gastritis with mild to moderate symptoms. [ABSTRACT FROM AUTHOR]

Grounded in Social Cognitive Theory, this study examines entrepreneurial self-efficacy and identification with the leader as mediating mechanisms that account for the cross-level relationship between entrepreneurial leadership and entrepreneurial intentions. This study also establishes the moderating role of (a) individualism between entrepreneurial leadership and entrepreneurial intentions, and (b) collectivism between entrepreneurial leadership and personal identification with the leader. We collected data through self-administered questionnaires from IT professionals working in small and medium-sized IT solution provider firms. To enhance the generalizability, samples were selected from China (n = 234) and Pakistan (n = 209). Further, a multi-level research design was used for analysis. The results showed that entrepreneurial leadership has a significant positive relationship with entrepreneurial intentions. The results for the mediating effects showed that entrepreneurial self-efficacy and identification with the leader significantly mediated between entrepreneurial leadership and entrepreneurial intentions. The moderating effects results supported the moderating effects of (a) individualism on entrepreneurial leadership and entrepreneurial self-efficacy, and (b) collectivism on entrepreneurial leadership and personal identification with the leader. The conditional indirect effects of entrepreneurial leadership on entrepreneurial intentions via entrepreneurial self-efficacy and identification with the leader were high at high individualism and high collectivism, respectively. This study, for the first time, establishes relationships between entrepreneurial leadership and entrepreneurial intentions in Asian economies. Our study complements and extends the entrepreneurship and leadership literature in developing countries' contexts. [ABSTRACT FROM AUTHOR]

Past research has shown that rape myths can have damaging consequences for victims of sexual assault. This study investigated the predictive relationship of grandiose narcissism, psychopathic traits and rape myths acceptance with attitudes towards rape victims in the general population of Pakistan. The research employed a cross-sectional design and utilized a purposive sample of 416 participants with 178 males, 158 females and 80 non-binary individuals in the age range 18–68. It is pertinent to mention that non-binary individuals have only recently been added in research as a separate group especially with regard to the Pakistani culture. Therefore, little is known regarding their perspectives towards rape victims. G Power analysis was used for determining the sufficiency of the sample size. Data analysis was done using Pearson Product Moment Correlation, stepwise regression, MANOVA, and Moderated Mediation Analysis via SPSS 21.0. The findings showed that most positive attitudes towards rape victims were held by non-binary individuals followed by females with the attitudes of males being least favorable. Additionally, the results indicated that acceptance of rape myths, primary psychopathy, and grandiose narcissism had significant effects on attitudes towards rape victims, with the latter also showing a conditional indirect effect through primary psychopathy on the relationship between rape myths acceptance and attitudes towards rape victims. [ABSTRACT FROM AUTHOR]

This study determines librarians' perceptions of Virtual Reference Services (VRS) in university libraries in Pakistan. Based on the census, data was collected from 29 head librarians of Lahore through a questionnaire. The results show that short messaging, instant messaging, and ask a librarian are prominent VRS. Time-saving, 24/7 service, reduced workload, and easy access are significant merits. Increased users' expectations, staff training, and special skills to answer users' queries are the key challenges. Librarians with higher qualifications have a positive opinion and fewer challenges to offering VRS. This service is likely to become necessary in academic libraries in Pakistan. [ABSTRACT FROM AUTHOR]

Objective: To determine the effects of Tai Chi exercises on physical activity, pulmonary function, and rate of perceived exertion in post-coronary artery bypass grafting patients. Objectives: The objective of this research was to find out the demographic characteristics of drug-susceptible and drug-resistant Tuberculosis in Khyber Pakhtunkhwa, Pakistan. Material and methods: A retrospective survey was conducted on data from the TB Control Program Khyber Pakhtunkhwa recorded between 1st January 2021 to 3rd June 2022. 7 sentinel sites and 5 Programmatic Management of Drug-resistant Tuberculosis sites report the data to the TB control program. The data was entered into Excel and analyzed through frequency tables, histograms, and bar charts. Results: A total of 39,210 Tuberculosis cases were reported to TB control program KPK from 1st January 2021 to 3rd June 2022; 38,723 were drug-susceptible while 487 were drug-resistant TB cases. The highest percentage of TB was found in the age group 15-24 years. Males were more affected than females with drug-susceptible TB. In contrast, drug-resistant TB was affecting females more than males. 58% of cases were reported in the public sector while 42% cases in the private sector. The households of only 2,412 (6.22%) patients of drug-susceptible Tuberculosis were screened out of 38,723 patients. In 2815 Tuberculosis patients screened for HIV, 4 drug-susceptible and 5 drug-resistant cases were positive for HIV. 8.41% of drug-resistant TB patients were diabetic. Conclusion: The frequency of TB cases is high in Khyber Pakhtunkhwa, especially among 15-24-year-olds. Household contact screening is inadequate in Khyber Pakhtunkhwa. There is a high percentage of coexisting drug-resistant TB and diabetes. [ABSTRACT FROM AUTHOR]

Diarrhea is the second leading cause of death among children under five years of age and causes 53,000 child deaths in Pakistan annually. Lahore, being densely populated, is the most affected area compared to the other cities of Punjab. This cross-sectional survey was conducted in the urban areas of Lahore, in the surroundings of the Punjab University. A questionnaire was filled out by 100 participant mothers whose child was affected at least once. Several variables were evaluated, and significance was checked using Chi-square. Of the total of the participants, 85% of the mothers were aware and mainly educated. About two-thirds (63%) of children were vaccinated for Rotavirus. Hand washing habits and safe drinking were significantly reducing the incidence. Spreading more awareness through media, stopping the unnecessary use of medications, promoting hand washing practice and increasing awareness about the Rotavirus vaccine will help reduce the incidence and prevalence of diarrhea. [ABSTRACT FROM AUTHOR]

Almost all cities of Pakistan are economically affected by the electricity shortage due to the continuously increasing demand for electricity. To correctly forecast the seasonal fluctuations of the electricity consumption of Lahore city in Pakistan, we proposed the SDGPM(1,1,N) model, which is a seasonal discrete grey polynomial model combined with seasonal adjustment. We conducted an empirical analysis using the proposed model based on the seasonal electricity consumption data of Lahore city in Pakistan from 2014 to 2021. The findings from the SDGPM (1,1,N) model are compared with those collected through the original grey model DGPM(1,1,N) and other eight models. The comparison's findings demonstrated that the SDGPM(1,1,N) model is indeed capable of correctly identifying seasonal fluctuations of electricity consumption in Lahore city and its prediction accuracy is significantly higher than the original DGPM(1,1,N) model and the other seven models. The SDGPM(1,1,N) model's forecast findings for Lahore from 2022 to 2025 indicate that the city's energy consumption is expected to rise marginally, although there will still be significant seasonal fluctuations. It is predicted that the annual electricity consumption from 2022 to 2025 will be 26249, 26749, 27928, and 28136 with an annual growth rate of 7.18%. This forecast can provide policymakers ahead start in planning to ensure that supply and demand are balanced. [ABSTRACT FROM AUTHOR]

Accumulating evidence suggests the role of immune-inflammatory markers in early risk stratification and prognostication of COVID-19 patients. We aimed to evaluate their association with severity and the development of diagnostic scores with optimal thresholds in critical patients. This retrospective case study includes hospitalized COVID-19 patients from March 2019 to March, 2022, in the developing area teaching hospital in Pakistan. Polymerase chain reaction (PCR) positive patients, n = 467 were investigated for clinical outcomes, comorbidities and disease prognosis. The plasma levels of Interleukin-6 (IL-6), Lactate dehydrogenase (LDH), C-reactive protein (CRP), Procalcitonin (PCT), ferritin and Complete blood count markers were measured. Majority were males (58.8%) and patients with comorbidities had more severe disease. Hypertension and diabetes mellitus were the commonest comorbidities. Shortness of breath, myalgia and cough were the main symptoms. The hematological markers NLR, as well as the plasma levels of immune-inflammatory variables, IL-6, LDH, Procalcitonin, Erythrocyte sedimentation rate, Ferritin were markedly raised in severe and critical patients (p < 0.0001 for these markers). ROC analysis supports IL-6 as the most accurate marker with high prognostic relevance with proposed cut-off threshold (43 pg/ml), determining >90% of patients in terms of COVID-19 severity (AUC = 0.93, 91.7%, se; 90.3%sp). Furthermore, positive correlation with all other markers including NLR with cut-off = 2.99 (AUC = 0.87, se = 89.8%, sp = 88.4%), CRP with cut-offs at 42.9 mg/l, (AUC = 0.883, se = 89.3% and sp = 78.6%), LDH cut-off at 267μg/L, evidenced in >80% patients (AUC = 0.834 se = 84% and sp = 80%). Additionally, ESR and ferritin have the corresponding AUC 0.81 and 0.813 with cut-off at 55 mm/hr and 370, respectively. Investigating the immune-inflammatory markers can assist physicians in providing prompt treatment and ICU admission in terms of COVID-19 severity. As a result, which may reduce the overall mortality of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective: Berberis lycium is an indigenous plant of Pakistan that is known for its medicinal properties. In the current study, we investigated the anti-Alzheimer's effect of berberine isolated from Berberis lycium. Methods: Root extract of B. lycium was subjected to acetylcholinesterase inhibition assay and column chromatography for bioassays guided isolation of a compound. The neuroprotective and memory improving effects of isolated compound were evaluated by aluminium chloride induced Alzheimer's disease rat model, elevated plus maze (EPM) and Morris water maze (MWM) tests., Levels of dopamine and serotonin in rats brains were determined using HPLC. Moreover, western blot and docking were performed to determine interaction between berberine and β-secretase. Results: During fractionation, ethyl acetate and methanol (3:7) fraction was collected from solvent mixture of ethyl acetate and methanol. This fraction showed the highest anti-acetylcholinesterase activity and was alkaloid positive. The results of TLC and HPLC analysis indicated the presence of the isolated compound as berberine. Additionally, the confirmation of isolated compound as berberine was carried out using FTIR and NMR analysis. In vivo EPM and MWM tests showed improved memory patterns after berberine treatment in Alzheimer's disease model. The levels of dopamine, serotonin and activity of antioxidant enzymes were significantly (p<0.05) enhanced in brain tissue homogenates of berberine treated group. This was supported by decreased expression of β-secretase in berberine treated rat brain homogenates and good binding affinity of berberine with β-secretase in docking studies. Binding energies for interaction of β-secretase with berberine and drug Rivastigmine is -7.0 kcal/mol and -5.8 kcal/mol respectively representing the strong interactions. The results of docked complex of secretase with berberine and Rivastigmine was carried out using Gromacs which showed significant stability of complex in terms of RMSD and radius of gyration. Overall, the study presents berberine as a potential drug against Alzheimer's disease by providing evidence of its effects in improving memory, neurotransmitter levels and reducing β-secretase expression in the Alzheimer's disease model. [ABSTRACT FROM AUTHOR]

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The purpose of this paper is to address the basic question why does high absorptive training programmes are not always beneficial for individual level learning? Thus, we seek to understand when and how cognitive absorption is beneficial for individual learning. The proposed model was tested using data obtained in a field study (N = 371) and in an experiment (N = 119). For field study, data was obtained at two points in time from three data sources (co-workers, subordinates, supervisors) working at a private commercial bank operating in Pakistan. For laboratory experiment, data was collected from the business students of a private sector university in Pakistan. The obtained data for both studies were analysed for random coefficient models with Mplus. Based on the motivationability-opportunity theory of behaviour, we proposed a model. It was found that cognitive absorption and highest individual learning was contingent upon the individual level knowledge absorption capacity. It was further found that training programmes with high cognitive absorption are likely to produce high levels of individual learning when the participants also have both high level of knowledge absorption capacity and technological opportunity. With this research, we inform practitioners that in these learner-focused trainings, personal characteristics of the participants and technology play vital role in determining effectiveness for high level of individual learning. The research findings will help practitioners understand what they need to add in training programmes for high level individual learning experience. Doing so will bring best value in form of higher learning to the cost of trainings. [ABSTRACT FROM AUTHOR]

Spodoptera frugiperda, a polyphagous pest that is a member of the Noctuidae family and the Lepidoptera order, has become a significant problem for the economies of several nations, particularly Pakistan. One of the main strategies for controlling the FAW infestation in areas where maize is grown is chemical control. The current study was conducted to check the efficacy of some insecticides against 3rd instar larva of FAW under laboratory and greenhouse conditions. The mean mortality of FAW larvae was significantly different among the treatments. The average mean percentage mortality of larvae after 24, 48 and 72 hours of coragen application was 59.41 ± 4.32, 73.11 ± 4.72, and 85.90 ± 4.31, respectively. Among all tested insecticides, coragen was recorded as the most toxic chemical followed by tracer and imidacloprid. Coragen showed the highest larval mortality (80.95%) at 72 hours of application, followed by tracer (69.77%), and imidacloprid (55.33%). Only 1.20 percent mortality was recorded in the control treatment at 72 hours of application. The mortality of larvae was 30.3 and 44.11% at the first and second sprays of coragen, respectively, while 26 and 30.34% by the application of tracer in the greenhouse conditions. The outcome thus helped to highlight the important need to focus on screening newly recommended insecticides against S. frugiperda under controlled conditions and the potential to utilize each insecticide at farmers' fields conditions that some academician researchers did not take into consideration in the large scale of maize farm. [ABSTRACT FROM AUTHOR]

The purpose of this research is to determine the impact of innovation, economic growth, financial development, trade, foreign direct investment (FDI), electricity consumption, and urbanization on the environmental degradations in Pakistan. This study has employed the dynamic autoregressive distributed lag model (ARDL), to investigate the actual change in the independent variables and its impact on the dependent variable through graphs. The findings demonstrate that energy consumption, GDP growth, urbanization, and trade negatively influence the carbon emissions in the short term. On the other hand, the findings indicate that in the long term, only GDP growth and trade had a significantly negative impact on emissions. Urbanization has a positive and considerable impact on the emissions of carbon dioxide in the long run. On the other hand, financial development and foreign direct investment (FDI) help reduce the environmental degradation in the short term and long term. Moreover, innovation positively affects the carbon emissions in both the long and short run. Policy recommendations are given based on the findings of this study. [ABSTRACT FROM AUTHOR]

This article discusses the challenges of timely referral to rheumatologists in resource-scarce countries for the management of rheumatoid arthritis (RA). It emphasizes the importance of early diagnosis and treatment in order to preserve functionality and reduce morbidity. The article highlights the diagnostic and therapeutic delays in Pakistan and proposes a simple algorithm for general physicians to aid in the diagnosis and management of early RA. The algorithm was created through consensus and voting of rheumatologists in Pakistan and aims to refine the referral system in countries with limited rheumatologists. The article also provides guidance on picking arthritis/synovitis, interpreting laboratory tests, initiating treatment with disease-modifying drugs, and when to refer a patient to a rheumatologist. Regular monitoring and collaboration with a rheumatologist for long-term management are recommended. [Extracted from the article]

Globalization is a trendy, intriguing, and compelling term, but it is also divisive, contentious, and problematic. It is also one of the 21st century's most talked-about economic, political, social, and cultural phenomena. Globalization, according to several writers, is a multifaceted phenomenon. Internationalization and cosmopolitanism, assimilation and fragmentation, universalization and homogenization are all part of this process, which is essentially an unavoidable dialectical mechanism involving rapid social, cultural, political, and technical change. As a result, these changes are occurring concurrently in many directions, at various sizes, and in various regions, demonstrating the interdependence and interconnection of all these disciplines, sizes, and scenarios. There are various facets of globalization that are influencing the current world, and each of these dimensions is inextricably linked to the others. Interdependency and interconnectivity are the two main processes and key tools of globalization that are responsible for creating a homogenized and deterritorialized world. Pakistan attempted to cultivate excellent connections with the rest of the world immediately after independence in order to capitalize on the opportunities created by globalization. However, it is critical to determine whether Pakistan can make use of the prospects as a developing country or whether the opportunities are solely available to industrial and developed countries. It is also important to examine Pakistan's efforts to integrate into the global community and to investigate its repercussions. This research article is a case study of Pakistan to study the implications of globalization on local culture and common citizens. For this purpose, a simple and direct research methodology was adopted by using both primary (including scholarly works, research articles, reports, case studies, and dissertations) and secondary sources (qualitative and quantitative data supplied by other scholars and agencies). [ABSTRACT FROM AUTHOR]

Objective: To establish demographics of OSCC patients presenting to a major tertiary care hospital and identify different potential risk factors. Study Design: Descriptive Cross Sectional study. Setting: Department of Oral and Maxillofacial Surgery Mayo Hospital Lahore. Period: July 2021 to July 2022. Material & Methods: A total of 86 patients were included in the study. The diagnosis of OSCC was histo-pathologically confirmed. Patients of both gender and all ages were included in the study and a standard questionnaire was developed to collect data including bio-data, demographics and history of illicit habits. Results: Out of 86 patients 75.58% (n=65) were males and 24.41% (n=21) patients were females. The mean age of the patients was 47.02 years. Male to female ratio was 3.6:1. Well differentiated squamous cell carcinoma was most common (53.48%), Majority presented with stage 4 disease. Highest proportion of the patients (29.6%) was having no obvious predisposing factor. Most commonly involved site was tongue followed by buccal mucosa. Conclusion: The disease trends are changing in our population, as the disease is increasingly affecting younger age group, tongue is now increasing being involved more commonly as in majority of the previous studies the incidence of OSCC of buccal mucosa was much higher, the incidence of OSCC without any obvious risk factor is increasing which needs further investigation. [ABSTRACT FROM AUTHOR]

Sunflower (Helianthus annuus L.) growth and yield are severely compromised by boron (B) deficiency in alkaline calcareous soils of Pakistan. Biochar produced through low-temperature pyrolysis helps to maintain acidic functional groups in such soils. The aim of this study was to enhance B availability in biochar-amended alkaline calcareous soils in order to improve morpho-physiological and yield attributes of sunflower. In a pot experiment, sunflower was grown with three fertiliser treatments: diammonium phosphate (DAP) alone; simple B + DAP; and DAP coated with biochar and B (BC-BDAP). All treatments were grown in soil receiving no biochar, and the BC-BDAP treatment was also applied in soil amended with wheat straw biochar at 2% and 4%. Preparation with wheat straw biochar improved soil properties such that soil with 4% biochar showed highest levels of organic matter (0.97%), total nitrogen (0.08%), available phosphorus (6.21 mg/kg), extractable potassium (93.4 mg/kg) and available B (0.41 mg/kg). Furthermore, compared with DAP alone and B + DAP, BC-BDAP in 4% biochar-amended soil enhanced the concentrations of shoot B (by 64% and 35%) and root B (by 41% and 26%), respectively. This indicated sufficient B availability in soil for root absorption, which subsequently increased sunflower achene weight per plant (by 33% and 17%), protein content (by 29% and 18%) and oil content (by 17% and 10%). Thus, application of BC-BDAP fertiliser in 4% biochar-amended soil can be an efficient strategy for enhancing B availability in alkaline calcareous soils and increasing sunflower growth and yield. Boron is an essential micronutrient that stimulates plant metabolic and developmental processes. This study aimed to enhance boron availability through the development of biochar- and boron-coated diammonium phosphate (BC-BDAP) for use in biochar-amended alkaline calcareous soils. Data showed improved nutrient (boron and phosphorus) uptake with application of BC-BDAP in 2% and particularly 4% biochar-amended soil, which further improved the growth, yield and oil content of sunflower relative to DAP alone or boron + DAP without biochar amendment. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to assess mental health literacy (MHL) in the general population using six case vignettes related to depression, mania, psychosis, conversion disorder (CD), obsessive compulsion disorder (OCD) and post-traumatic stress disorder (PTSD). Design/methodology/approach: Each vignette had nine items related to MHL. The sample comprised 4,590 young adults conveniently selected from twin cities in Pakistan. Participants' responses were converted into percentages and percentiles to find MHL levels. Findings: The men had moderate MHL in depression and inadequate MHL in the remaining five illnesses. The women had adequate MHL in depression and moderate MHL in mania, psychosis, OCD and PTSD while inadequate in CD. Comparing item-wise understanding, the participants had an adequate understanding of identifying the illness, who could suffer and whether the illness was treatable. However, they struggled with naming the illness, knowing about it and how to treat and identify the person who can treat it. Research limitations/implications: The findings of this study are helpful for mental health professionals, policymakers and individuals who identify the target areas for engagement and improving MHL in the general population. Originality/value: This study provides data about MHL related to six mental illnesses, unlike previous studies focusing on a few illnesses. This study recommends awareness sessions, community workshops and engaging social and electronic media for improving MHL and seeking help from relevant health professionals for mental illnesses instead of spiritual healers and witchcraft. [ABSTRACT FROM AUTHOR]

Objective: To establish demographics of OSCC patients presenting to a major tertiary care hospital and identify different potential risk factors. Study Design: Descriptive Cross Sectional study. Setting: Department of Oral and Maxillofacial Surgery Mayo Hospital Lahore. Period: July 2021 to July 2022. Material & Methods: A total of 86 patients were included in the study. The diagnosis of OSCC was histo-pathologically confirmed. Patients of both gender and all ages were included in the study and a standard questionnaire was developed to collect data including bio-data, demographics and history of illicit habits. Results: Out of 86 patients 75.58% (n=65) were males and 24.41% (n=21) patients were females. The mean age of the patients was 47.02 years. Male to female ratio was 3.6:1. Well differentiated squamous cell carcinoma was most common (53.48%), Majority presented with stage 4 disease. Highest proportion of the patients (29.6%) was having no obvious predisposing factor. Most commonly involved site was tongue followed by buccal mucosa. Conclusion: The disease trends are changing in our population, as the disease is increasingly affecting younger age group, tongue is now increasing being involved more commonly as in majority of the previous studies the incidence of OSCC of buccal mucosa was much higher, the incidence of OSCC without any obvious risk factor is increasing which needs further investigation. [ABSTRACT FROM AUTHOR]

Antimicrobial stewardship is a systematic approach for promoting and monitoring responsible antimicrobial use globally. We conducted a prospective point prevalence survey of antimicrobial utilization among hospitalized adult patients during September 2021. The survey instrument was adapted from the WHO methodology for point prevalence surveys, and it was conducted at The Indus Hospital and Health Network, Karachi. Among the 300 admitted patients, 55% were males and the mean age was 44 (±18) years. At least 67% of the patients received one antimicrobial agent and the most common indication was surgical prophylaxis (40%). The most frequently used were antibacterial agents (97%) among all antimicrobials. Amoxicillin/Clavulanic acid and Ceftriaxone were the most frequently used antibacterial agents, i.e., 14% each. At least 56% of the antibacterial agents were amenable to antimicrobial stewardship when reviewed by infectious disease (ID) experts. Reasons for stewardship were: antibacterial not indicated (n = 39, 17.0%), unjustified prolonged duration of antibacterial (n = 32, 13.9%), extended surgical prophylaxis (n = 60, 26.2%), non-compliance to surgical prophylaxis guidelines (n = 30, 13.1%), and antibacterial not needed on discharge (n = 27, 11.7%). Median days of therapy (DOT) per agent was 3 days (IQR 2–4), while median DOT per patient was 2 days (IQR 1–4). These data have described the pattern of antimicrobial utilization in our institute. We found a higher prevalence of antimicrobial use overall as compared to the global figures, but similar to other low- and middle-income countries. Two important areas identified were the use of antimicrobials on discharge and extended surgical prophylaxis. As a result of these data, our institutional guidelines were updated, and surgical teams were educated. A post-intervention survey will help us to further determine the impact. We strongly recommend PPS at all major tertiary care hospitals in Pakistan for estimating antimicrobial utilization and identifying areas for stewardship interventions. [ABSTRACT FROM AUTHOR]

Traffic congestion, accidents, and pollution are becoming a challenge for researchers. It is essential to develop new ideas to solve these problems, either by improving the infrastructure or applying the latest technology to use the existing infrastructure better. This research paper presents a high-resolution dataset that will help the research community to apply AI techniques to classify any emergency vehicle from traffic and road noises. Demand for such datasets is high as they can control traffic flow and reduce traffic congestion. It also improves emergency response time, especially for fire and health events. This work collects audio data using different methods, and pre-processed them to develop a high-quality and clean dataset. The dataset is divided into two labelled classes one for emergency vehicle sirens and one for traffic noises. The developed dataset offers high quality and range of real-world traffic sounds and emergency vehicle sirens. The technical validity of the dataset is also established. Measurement(s) Ambulance Siren and Road Noises. (Recordings) Technology Type(s) Microphone Sample Characteristic - Environment Roads Sample Characteristic - Location Pakistan [ABSTRACT FROM AUTHOR]

A population of Aphelenchoides bougainvilli n. sp. was retrieved from soil sample collected around roots of paper flower (Bougainvillea spectabilis L.), thoroughly described and illustrated from village Sarai Naurang located in southern district Lakki Marwat, Khyber Pakhtunkhwa, Pakistan. The population was identified as new species and related with Group 2 of Aphelenchoides species, distinguished via length of female's body 428-444 µm (0.42-0.44 mm), cephalic region rounded and offset. Lateral field found with three incisures. Cuticle finely annulated, about 1µm apart. Stylet 10 µm (10±0), delicate with minute basal knobs. Excretory pore located 2 µm anterior to the metacarpus and 44 µm from cephalic end. Vulva anteriad, having slight elevated anterior and posterior lips. Post urine sac (PUS) short (15-20 µm), and covering 16.6-20% of vulva-anus distance. Tail small (24-26.5 µm), conical, about 3 times long to anal diameter and with a small, single mucro (1 µm). [ABSTRACT FROM AUTHOR]

Objective: To see the clinical and immunological profile of systemic lupus erythematosus (SLE) patients and their correlation with the central nervous system and renal involvement. Study Design: Cross-sectional study. Place and Duration of Study: Fauji Foundation Hospital Rawalpindi from Sep 2019 to Sep 2020. Methodology: One hundred forty patients were selected according to SLE ACR (American College of Rheumatology) criteria. Detailed history and examination, including dermatological examination, were done, and blood samples were taken for baseline investigations and SLE-related autoimmune profile. Statistical analysis was done using SPSS 23 to determine the correlation between skin, central nervous system and renal involvement. Results: In our study, among the lupus-specific lesions, photosensitivity was most frequent 119 (85%) finding followed by oral ulcers 114 (81.4%), alopecia 112 (80%) and malar rash 81 (57.9%). Among the immunological profile, antinuclear antibody (ANA) was the most frequent 116 (82.9%) finding, followed by anti-double stranded antibody 71 (51.7%). Hypocomplementemia and anti-Sm antibody was significantly associated with lupus nephritis (p-value <0.05). There was no correlation between skin and neuropsychiatric involvement and skin and nephritis. Conclusion: This study depicts the clinical immune profile of SLE patients in Pakistan. In our patients, autoimmune profile and complement levels could predict renal involvement. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the role of leader-member exchange (LMX) for selection-focused creativity. Thus, we seek to understand when subordinates develop high-quality relationships with their supervisors, do they also get their creative ideas validated by co-workers or not? The proposed model was tested using data obtained at two points in time from three data sources (co-workers, subordinates, and supervisors) working at a software solution provider operating in Pakistan. The obtained data were then analysed for random coefficient models with Mplus. It was found that having only quality LMX will not guarantee the validation of co-workers' ideas. The focal employee needs to signal to others that they also care about their co-workers and have quality LMX. Subordinates who maintain quality relationships with their supervisors also need to consider what they signal to their co-workers by their behaviours and actions at work. Co-workers are more likely to provide support for creativity to those who are more supportive at work. We extend novel benefits associated with high-quality LMX, that is, the validation of co-workers' ideas. Additionally, by focusing on social relationships for selection-focused creativity, we also extended creativity literature. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the bank specific determinants related to the performance of public and private sector banks in Pakistan. Using strongly balanced panel yearly data from 2010 to 2017, Pooled OLS, fixed effect, Random effect and Random Effect Mundlak Transformation (REMT) have been utilized to provide the empirical evidences in credit risk management in Pakistan. The identification of suitable explanatory variable that explains the banking profitability wisely is made possible by using the panel data techniques. In this study, impact of bank specific variables are: Return On Assets, Capital Ratio, Credit Risk, Credit deposit ratio, Liquidity Ratio, Interest expended to interest earned, bank size and ownership on the profitability of banks in Pakistan has been assessed using four different panel data techniques. Out of the four estimation strategies Random Effect with Mundlak (1978) transformation raises the overall variation of the baseline model to 63% that is explained by banking profitability. Ignoring the time-invariant characteristics in the model, credit deposit ratio and interest expanded to interest earned possess negative relationship with return on assets of banks. Size of the bank is positive and significant when with-in and between banks information is augmented in Radom effect method of estimation. However the size of banks may not affect the banking profitability by allowing correlation between unobservable heterogeneity using Random Effect with Mundlak (1978) transformation. [ABSTRACT FROM AUTHOR]

In developing countries, a child's human capital development often depends on a trade-off between attending school and engaging in work activities. While the emphasis placed by religion on education means that parents may assign more importance to schooling, parents engaging in time-consuming religious activities may require their children to work more to compensate. Given these countervailing forces, we conduct a field study in Pakistan to assess the impact of parental religiosity on children's educational attainment and work activities. We find that parental religiosity has a robust positive impact on children's school outcomes and reduces their work activity, and parents with less time-consuming religious practices drive these results. [ABSTRACT FROM AUTHOR]

Fifty five percent of the Pakistani population is still unvaccinated with the two-dose protocol of COVID-19 vaccines. This study was undertaken to determine the seroconversion rate and antibody titers following the two-dose BBIBP-CorV protocol, and to compare these variables in unvaccinated, COVID-19 recovered individuals (total n = 180) at Indus Hospital and Health Network, Karachi. Pseudotyped lentivirus antibody neutralization assays and SARS-CoV-2 IgG Quant II (Abbott) immunoassays were performed 4-8 weeks following the second dose of the BBIBP-CorV or PCR positivity/onset of symptoms of COVID-19. Seroconversion rate, using neutralization assays, in vaccinated individuals was lower (78%) than that in unvaccinated, COVID-19-recovered individuals with moderate to severe infection (97%). Prior PCR positivity increased serocoversion rate to 98% in vaccinated individuals. Immunoassays did not, however, reveal significant inter-group differences in seroconversion rates (≥95% in all groups). Log10 mean antibody neutralizing titers following the two-dose BBIBP-CorV protocol (IC50 = 2.21) were found to be significantly less than those succeeding moderate to severe COVID-19 (IC50 = 2.94). Prior SARS-CoV-2 positivity significantly increased post-vaccination antibody titers (IC50 = 2.82). Similar inter-group titer differences were obtained using the immunoassay. BBIBP-CorV post-vaccination titers may, thus, be lower than those following natural, moderate to severe infection, while prior SARS-CoV-2 exposure increases these titers to more closely approximate the latter. [ABSTRACT FROM AUTHOR]

Objectives: To assess the clinical, environmental, and socio-demographic characteristics leading to gender disparity in tuberculosis in Pakistan. Study Design: Prospective Comparative study. Study Setting and Duration: The Indus Hospital, Karachi Pakistan, from Jul 2020 to Dec 2020. Methodology: A sample of 200 patients with diagnosed tuberculosis (detected on an acid-fast bacillus (AFB) smear with radiographic abnormalities) irrespective of gender, sensitivity, or site of tuberculosis, were included in the study. Data of gender, personal history, substance abuse history, and dietary habits was documented. Results: Pulmonary tuberculosis was significantly more common in female patients than in males (p<0.001). The mean age of male patients was 30.16 ± 9.47 years. Male patients were significantly older than their female counterparts (p=0.003). The diabetes mellitus in male patients was significantly higher than in female patients with TB (p=0.01). Similarly, substance abuse history was more frequently positive in male patients as compared to female patients, 28 (40.60%) vs 9 (6.70%); p-value <0.001. There was no significant difference in the occurrence of drug-resistance tuberculosis between the two genders. However, pulmonary tuberculosis was significantly more common in female patients than in males (p<0.001). Conclusion: We reported some distinctive differences between male and female tuberculosis patients. Young females had more predilections toward tuberculosis as compared to men. Diabetes mellitus and substance abuse history were more common in male tuberculosis patients than in females. [ABSTRACT FROM AUTHOR]

Downsizing due to COVID-19 (COV-DS) and its consequences on laid-off employees has attracted the attention of many researchers, around the globe. However, the underlying mechanisms that explain the effects of COVID-19 downsizing (COV-DS) on the employees who have survived cutoffs remain underexplored. Grounded in the conservation of resources theory, this manuscript aims to study the causal path through which COV-DS reduces the survivors' affective commitment. The current study proposes the mediation of survivors' job uncertainty, stress, and organizational identification between COV-DS and survivors' affective commitment. This study also posits the moderating role of transformational leadership between COV-DS and both the mediators. The extant study has employed WARPED partial least square WARP PLS 7 and Hayes Process Macro to test the hypothesized relationships. Using the sample of 274 employees from the private sector of Pakistan, it was found that job uncertainty's stress strongly mediates the relationship between COV-DS and survivors' affective commitment. While mediation of survivors' organizational identification was not proven to be significant. However, with the moderation of transformational leadership, both the mediators were proven to be significant. [ABSTRACT FROM AUTHOR]

Background: Sociocultural norms and gender biases may result in surgeon gender preferences among the general public. This study aimed to understand preferences and perceptions related to surgeon gender among the general population in Pakistan, a lower-middle-income country. Methods: A cross-sectional study was conducted by the Aga Khan University, Karachi, among the adult general population in Pakistan. Sequential mixed-mode data collection was performed via online dissemination on social media platforms and in-person surveying at different geographic locations in Karachi. Results: Among 1604 respondents, 50% did not report having surgeon gender preferences in general. Among respondents with gender preferences, there was a highly significant preference for gender concordance across all surgical subspecialties (p <0.001) except cardiothoracic surgery and neurosurgery. Exceptions where women preferred a male surgeon were neurosurgery (59.7% vs. 40.3%; p <0.001) and cardiothoracic surgery (53.1% vs. 46.9%; p <0.001). Moreover, respondents felt more comfortable communicating with (67.6%) and being examined by (73.3%) gender concordant surgeons. Men more commonly perceived male surgeons as more competent (26% vs. 14.5%; p <0.001) and warmer (18.3% vs. 9.8%; p <0.001) than female surgeons. Nevertheless, the most important factors influencing selection of a surgeon were the surgeon's reputation (69.6%) and experience (50.5%). Most respondents (84.5%) believed that more females should practice surgery. Conclusion: While around half of respondents do not have gender preferences, a significant proportion prefers a gender concordant surgeon across subspecialties. In a society where conservative sociocultural norms play a significant role when seeking health care, this makes yet another compelling argument for gender parity in surgery. [ABSTRACT FROM AUTHOR]

Background: Mutations in the Rv0678, pepQ and atpE genes of Mycobacterium tuberculosis (MTB) have been reported to be associated with reduced antimycobacterial susceptibility to bedaquiline (BDQ). Resistance conferring mutations in treatment naïve MTB strains is likely to have implications for BDQ based new drug regimen that aim to shorten treatment duration. We therefore investigated the genetic basis of resistance to BDQ in MTB clinical isolates from BDQ naïve TB patients from Pakistan. In addition, mutations in genes associated with efflux pumps were investigated as an alternate mechanism of resistance. Methods: Based on convenience sampling, we studied 48 MTB clinical isolates from BDQ naïve TB patients. These isolates (from our strain bank) included 38 MDR/pre-XDR/XDR (10 BDQ resistant, 8 BDQ intermediate and 20 BDQ susceptible) and 10 pan drug susceptible MTB isolates. All strains were subjected to whole genome sequencing and genomes were analysed to identify variants in Rv0678, pepQ, atpE, Rv1979c, mmpLS and mmpL5 and drug resistance associated efflux pump genes. Results: Of the BDQ resistant and intermediate strains 44% (8/18) had variants in Rv0678 including; two reported mutations S63R/G, six previously unreported variants; L40F, R50Q and R107C and three frameshift mutations; G25fs, D64fs and D109fs. Variants in efflux pumps; Rv1273c (G462K), Rv0507c (R426H) and Rv1634c (E198R) were found to be present in drug resistant isolates including BDQ resistant and intermediate isolates. E198R in efflux pump gene Rv1634c was the most frequently occurring variant in BDQ resistant and intermediate isolates (n = 10). Conclusion: We found RAVs in Rv0678 to be commonly associated with BDQ resistance. Further confirmation of the role of variants in efflux pump genes in resistance is required so that they may be incorporated in genome-based diagnostics for drug resistant MTB. [ABSTRACT FROM AUTHOR]

Mercury (Hg) bioaccumulation in fish poses severe threats to the food safety and human health. This study was conducted to assess Hg bioaccumulation in fish (n = 24) and scalp hair (n = 77) of the fishing communities at up- and downstream of the river Swat, Pakistan. The mean Hg concentration in upstream fish Salmo trutta fario (Brown trout) and Schizothorax plagiostomus (Swati fish) species was 34.7±18 μg kg−1 and 29.4±15 μg kg−1, respectively. The mean Hg concentration in downstream Swati fish, Crossocheilus diplochilus (Spena deqa), and Garra gotyla (Tora deqa) was 65±21 μg kg−1, 123±33 μg kg−1, and 326±53 μg Kg−1, respectively. The mean Hg concentration in scalp hair of the up- and downstream fishing communities was 658±125 μg kg−1 and 3969±791 μg kg−1, respectively. Independent T-test showed significant difference (p < 0.001) in the mean Hg concentration in scalp hair of the up- and downstream communities. The most prevalent health problems found in the fishing community were muscle pain, headache, visual impairment, arterial blood pressure, anemia, and kidney dysfunction. Multiple linear regression indicated that daily and weekly consumption of the fish significantly increase Hg accumulation in human scalp hair. Regular consumption of fruits and cruciferous and leafy vegetables were found to reduce Hg toxicity in the population. Further studies are recommended to identify the sources of Hg and welfare impact of fish contamination on the fishing community of river Swat. [ABSTRACT FROM AUTHOR]

Background: People from South Asia are at increased risk of type 2 diabetes (T2D). There is an urgent need to develop approaches for the prevention of T2D in South Asians that are cost-effective, generalisable and scalable across settings.Hypothesis: Compared to usual care, the risk of T2D can be reduced amongst South Asians with central obesity or raised HbA1c, through a 12-month lifestyle modification programme delivered by community health workers.Design: Cluster randomised clinical trial (1:1 allocation to intervention or usual care), carried out in India, Pakistan, Sri Lanka and the UK, with 30 sites per country (120 sites total). Target recruitment 3600 (30 participants per site) with annual follow-up for 3 years.Entry Criteria: South Asian, men or women, age 40-70 years with (i) central obesity (waist circumference ≥ 100 cm in India and Pakistan; ≥90 cm in Sri Lanka) and/or (ii) prediabetes (HbA1c 6.0-6.4% inclusive).Exclusion Criteria: known type 1 or 2 diabetes, normal or underweight (body mass index < 22 kg/m2); pregnant or planning pregnancy; unstable residence or planning to leave the area; and serious illness.Endpoints: The primary endpoint is new-onset T2D at 3 years, defined as (i) HbA1c ≥ 6.5% or (ii) physician diagnosis and on treatment for T2D. Secondary endpoints at 1 and 3 years are the following: (i) physical measures: waist circumference, weight and blood pressure; (ii) lifestyle measures: smoking status, alcohol intake, physical activity and dietary intake; (iii) biochemical measures: fasting glucose, insulin and lipids (total and HDL cholesterol, triglycerides); and (iv) treatment compliance.Intervention: Lifestyle intervention (60 sites) or usual care (60 sites). Lifestyle intervention was delivered by a trained community health worker over 12 months (5 one-one sessions, 4 group sessions, 13 telephone sessions) with the goal of the participants achieving a 7% reduction in body mass index and a 10-cm reduction in waist circumference through (i) improved diet and (ii) increased physical activity. Usual care comprised a single 30-min session of lifestyle modification advice from the community health worker.Results: We screened 33,212 people for inclusion into the study. We identified 10,930 people who met study entry criteria, amongst whom 3682 agreed to take part in the intervention. Study participants are 49.2% female and aged 52.8 (SD 8.2) years. Clinical characteristics are well balanced between intervention and usual care sites. More than 90% of follow-up visits are scheduled to be complete in December 2020. Based on the follow-up to end 2019, the observed incidence of T2D in the study population is in line with expectations (6.1% per annum).Conclusion: The iHealth-T2D study will advance understanding of strategies for the prevention of diabetes amongst South Asians, use approaches for screening and intervention that are adapted for low-resource settings. Our study will thus inform the implementation of strategies for improving the health and well-being of this major global ethnic group.Irb Approval: 16/WM/0171 TRIAL REGISTRATION: EudraCT 2016-001350-18 . Registered on 14 April 2016. ClinicalTrials.gov NCT02949739 . Registered on 31 October 2016, First posted on 31/10/2016. [ABSTRACT FROM AUTHOR]

Introduction: Outbreak of corona virus disease in 2019 (COVID‐19) has resulted in significant morbidity and mortality worldwide. Our aim is to document hematological parameters of patients with COVID‐19 during initial stage of diagnosis and to identify early hematological indicators of severe infection. Materials and methods: This retrospective study was conducted at Shifa International Hospital, Pakistan from April to November 2020. Patients hospitalized with COVID‐19, diagnosed on RT‐PCR and had a complete blood count (CBC) done within 48 hours of diagnosis were included. Data was analyzed using IBM® SPSS Statistics. Results: A total of 425 patients were included in this study out of whom 272(64%) were males. The mean age was 55.61 ± 17.84 years. 95 patients (22.4%) had normal blood counts within 48 hours of COVID‐19 diagnosis. Cytopenias were seen in 193(45.4%) patients. There were 75(17.6%) mortalities during the study period. Chi‐square test showed that thrombocytopenia, lymphopenia and neutrophilic leucocytosis were significantly associated with mortality (P =.037, P <.001, P <.001 respectively) and need for ventilator (P =.009, P <.001, P <.001, respectively). Neutrophilia was also associated with development of Acute Respiratory Distress Syndrome (P <.001). On ROC analysis, Neutrophil‐to‐Lymphocyte Ratio yielded an area under the curve (AUC) of 0.693 and 0.660 for the outcomes mortality and need for ventilator, respectively. For a subset of 288 patients who had D‐dimer levels checked within 48 hours of COVID‐19 diagnosis, the AUC for mortality and ventilator need was 0.708 and 0.671, respectively. Conclusion: Hematological indices are vital indicators in the prognosis and risk stratification of COVID‐19 during initial stages of disease. [ABSTRACT FROM AUTHOR]

Background: COVID-19 crisis affected the medical education throughout the world. During the infectious outbreak, closure of universities was the only solution to prevent the spread of virus. However, adoption of e-Learning helped in sustaining the medical educational activities. Objective: The current study focus on e-Learning acceptance among medical students during the COVID-19 crisis in Pakistan. Study type, settings & duration: This cross-sectional study was conducted at the four different medical institutes of Punjab from January 2021 to March 2021. Methodology: The random sample technique was used to include 314 medical students by using the sample section criteria suggested by Krejcie and Morgan. We also proposed a self-proposed conceptual model supported by Media System Dependency Theory. Results: Findings indicated that despite e-Learning has some limitations for the medical students, still we found a strong significant relationship between students' positive perceptions towards e-Learning during the Covid-19. i.e., the significance for H1, e-Learning and its Impact was (ß =0.266, p <0.011), for H2, e-Learning as a Substitute, (ß= 0.144, p<0.00), and the H3, the Perceptions of students towards e-Learning was (ß =0.2121, p <0.000). Conclusion: We concluded that, e-Learning is a potential solution to sustain the educational activities and balance the cessation of ward rotations during the lockdown. Using e-Learning during the COVID-19 not only depicted the role of internet-based learning, it also highlighted the greater dependence on new media technology. [ABSTRACT FROM AUTHOR]

In this study, the theoretical and empirical effects of foreign investment, openness to trade, urbanization, and economic development on carbon dioxide emission levels (CO2) in Pakistan were examined. Annual time series for 38 years 1970-2018 were utilized. The Auto Regressive Distributed Lag (ARDL) bound test has been used to estimate the model which indicates the presence of cointegration among the variables. Long-run and short-run relationships were observed between Foreign Direct Investment (FDI) and CO2 emission levels revealing that increase in FDI results in increased CO2 emission levels contributing to environmental degradation. This endorses the theory of Pollution Haven Hypothesis (PHH) in the case of Pakistan. To achieve the goal of sustainable economic development, it is imperative to consider the possible negative effects of foreign investment on the environment. The study suggests limiting CO2 emissions by adopting more advanced low carbon technologies to ensure growth and a sustainable environment. Strict implementation of environmental laws for foreign and domestic firms both by defining CO2 emission limits, installation of proper waste management plants, and imposing a pollution tax are crucial steps for the improvement of environmental quality. [ABSTRACT FROM AUTHOR]

Objective: To describe the demographic, clinical, serological and radiological scores in patients with rheumatoid arthritis (RA) presenting in a tertiary hospital in Pakistan. Study Design: Cross sectional study. Place and Duration of Study: Department of Rheumatology, Fauji Foundation Hospital (FFH), Rawalpindi, from Sep 2018 to Feb 2019. Methodology: The study included 52 female patients with RA between the ages of 18 and 80 years. Data were obtained from FFH Rawalpindi's outpatient department. Demographic details, reference data, and serological status were recorded. The joints involved in the onset of the disease, joint deformities, clinical disease activity index (CDAI) and overall functional status were evaluated. Extra-articular manifestations of rheumatoid arthritis have also been examined during a detailed physical examination. The patient's bone mineral density was calculated by the use of dual energy absorptiometry (DEXA scan). Radiological scores were evaluated using modified sharp score. Results: Mean age of the patient was 55.08 ± 8.79 and mean duration of disease 9.73 ± 7.54. The most common co-morbidity in rheumatoid arthritis patients was hypertension 20 (38.5%). Twenty four (11.7%) patients had osteoporosis. Wrist was the first joint involved in 17 (32.7%) patients. Ulnar deviation was the most common deformity in 12 (23.1%) patients. Sharp score for joint space narrowing was 61.09 ± 36.90 and sharp score joint erosions were 36.90 ± 42.41. Most common extra articular manifestation was anemia. Conclusion: Rheumatoid arthritis as a variable spectrum of disease with different manifestations. Patients had radiological damage as demonstrated by high sharp score even before starting the appropriate treatment. [ABSTRACT FROM AUTHOR]

The purpose of this research is the segmentation of lungs computed tomography (CT) scan for the diagnosis of COVID-19 by using machine learning methods. Our dataset contains data from patients who are prone to the epidemic. It contains three types of lungs CT images (Normal, Pneumonia, and COVID-19) collected from two different sources; the first one is the Radiology Department of Nishtar Hospital Multan and Civil Hospital Bahawalpur, Pakistan, and the second one is a publicly free available medical imaging database known as Radiopaedia. For the preprocessing, a novel fuzzy c-mean automated region-growing segmentation approach is deployed to take an automated region of interest (ROIs) and acquire 52 hybrid statistical features for each ROIs. Also, 12 optimized statistical features are selected via the chi-square feature reduction technique. For the classification, five machine learning classifiers named as deep learning J4, multilayer perceptron, support vector machine, random forest, and naive Bayes are deployed to optimize the hybrid statistical features dataset. It is observed that the deep learning J4 has promising results (sensitivity and specificity: 0.987; accuracy: 98.67%) among all the deployed classifiers. As a complementary study, a statisticalwork is devoted to the use of a new statistical model to fit the main datasets of COVID-19 collected in Pakistan. [ABSTRACT FROM AUTHOR]

The production phenomenon of fungal feeding nematode Aphelenchus avenae have been thoroughly examined in vitro system by ensuring Potato Dextrose Agar (PDA). Two fungal species Fusarium oxysporum and Aspergillus niger were examined for their aptitude to assist the population rate of the said species. Nematodes were collected from soil around the rhizospheres of sponge gourd (Luffa cylindrical L.) field in the vicinity of National Nematological Research Centre, University of Karachi and further processed by Cobb's sieving and Baermann's funnel techniques. Specimens were killed, fixed and identified up to species level under light microscope. Afterward, hundred fresh handpicked nematodes were inoculated on both fully grown fungal species at 25°C. The nematode attraction and mass culture were appeared on Fusarium oxysporum only. On the first week, propagation rate was noted approximately 2.5x10? followed by 3.9x10? on the second week and finely after three weeks incubation period the greatest multiplication rate estimated up to 8.9x10?; however, the same did not appeared on Aspergillus niger and result was found negative. The main purpose of captioned study was to report mass culturing of parasitic Aphelenchus avenae and their relationship and further explore these nematodes under field circumstances to control many pathogenic soil-borne fungi because this is the first study conducted on the subject experiment in Pakistan. [ABSTRACT FROM AUTHOR]

This study explores the asymmetric effects of both aggregate and disaggregate forms of energy consumption along with economic growth on environmental quality for Pakistan covering the period from 1971 to 2014. We have employed unit root test with breaks for stationary checks, BDS test for nonlinearity check and nonlinear autoregressive distributed lag (NARDL) approach for assessing the asymmetric co-integrating relationships among the variables by decomposing them into positive and negative shocks. The empirical findings for aggregate consumption reveal that only negative shocks have a significant impact on ecological footprint. Similarly, different sources of energy consumption have diverse asymmetric effects on ecological footprint. The positive (negative) shocks to oil and gas consumption increase (decrease) ecological footprint. Thus, an increase in oil consumption has a deteriorating impact on environmental quality while a decrease in gas consumption has a favorable impact on environmental quality. The asymmetric relationships also hold between coal consumption, electricity consumption, and ecological footprint. The positive shocks to coal and electricity consumption are negatively related with environmental quality while negative shocks are positively related with environmental quality. [ABSTRACT FROM AUTHOR]

This study proposes an approach based on machine learning to forecast currency exchange rates by applying sentiment analysis to messages on Twitter (called tweets). A dataset of the exchange rates between the United States Dollar (USD) and the Pakistani Rupee (PKR) was formed by collecting information froma for exwebsite as well as a collection of tweets from the business community in Pakistan containing finance-related words. The dataset was collected in raw form, and was subjected to natural language processing by way of data preprocessing. Response variable labeling was then applied to the standardized dataset, where the response variables were divided into two classes: "1" indicated an increase in the exchange rate and "-1" indicated a decrease in it. To better represent the dataset, we used linear discriminant analysis and principal component analysis to visualize the data in three-dimensional vector space. Clusters that were obtained using a sampling approach were then used for data optimization. Five machine learning classifiers--the simple logistic classifier, the random forest, bagging, naïve Bayes, and the support vector machine--were applied to the optimized dataset. The results show that the simple logistic classifier yielded the highest accuracy of 82.14% for the USD and the PKR exchange rates forecasting. [ABSTRACT FROM AUTHOR]

A prospective cohort study was conducted at the Indus Hospital Karachi, Pakistan between March and June 2020 to estimate the in-hospital mortality among hospitalized COVID-19 patients and its determinants. A total of 170 adult patients were enrolled and all-cause mortality was found to be 39% (67/170). Most non-survivors were above 60 years of age (64%) while gender distribution was quite similar in both groups (males: 77% vs 78%). Most (80.6%) non-survivors came with peripheral oxygen saturation less than 93% while 95% of them had critical disease on arrival. Use of non-invasive ventilation in emergency room was higher among non-survivors (56.7%) versus survivors (26.2%). Median Interleukin-6 levels were higher among non-survivors (78.6: IQR = 33.8–49.0) compared to survivors (21.8: IQR = 12.6–36.3). Most patients in the non-survivor group (86.6%) required invasive ventilator support during hospital stay compared to 7.8% in the survivors. The median duration of ICU stay was longer for non-survivors (9: IQR = 6–12) compared to survivors (5: IQR = 3–7) days. Univariable binary logistic regression showed that age above 60 years, oxygen saturation below 93%, Neutrophil to lymphocyte ratio above 5, procalcitonin above 2ng/ml, unit increase in SOFA score and arterial lactate levels were associated with mortality. We also found that a unit decrease in Pao2/FiO2 ratio and serum albumin were associated with mortality in our patients. Multivariable regression showed that age above 60 years (aOR = 3.4: 95% CI = 1.6–6.9), peripheral oxygen saturation below 93% (aOR = 3.5:95% CI = 1.6–7.7) and serum pro-calcitonin above 2ng/ml (aOR = 4.8; 95% CI = 1.9–12.2) were associated with higher odds of mortality when adjusted by month of admission. Most common cause of death was multisystem organ failure in 35 (56.6%) non-survivors while 22 (35.5%) died due to respiratory failure. Larger prospective studies are needed to further strengthen these findings. [ABSTRACT FROM AUTHOR]

A comprehensive life cycle assessment (LCA) was conducted for the matchsticks industry in the Khyber Pakhtunkhwa province of Pakistan to quantify environmental footprint, water footprint, cumulative energy use, and to identify improvement opportunities in the matchsticks manufacturing process. One carton of matchsticks was used as reference unit for this study. Foreground data was collected from the matchsticks industry through questionnaire surveys, personal meetings, and field measurements. The collected data was transformed into potential environmental impacts through the Centre for Environment Studies (CML) 2000 v.2.05 method present by default in the SimaPro v.9.1 software. Water footprint was calculated using methodology developed by Hoekstra et al., 2012 (water scarcity index) V1.02 and cumulative energy demand by SimaPro v.9.1 software. The results showed that transport of primary material (wood logs), sawn wood for matchsticks, red phosphorous, acrylic varnish, and kerosene fuel oil contributed to the overall environmental impacts. Transport of primary materials and sawn timber for matchsticks contributed significantly to abiotic depletion, global warming, eutrophication potential, ozone depletion, corrosion, human toxicity, and aquatic ecotoxicity effects. The total water footprint for manufacturing one carton of matchsticks was 0.265332 m3, whereas the total cumulative energy demand was 715.860 Mega Joules (MJ), mainly sourced from non-renewable fossil fuels (708.979 MJ). Scenario analysis was also conducted for 20% and 30% reduction in the primary material distance covered by trucks and revealed that reducing direct material transport distances could diminish environmental impacts and energy consumption. Therefore, environmental footprint could be minimized through diverting matchsticks industries freight from indigenous routes to high mobility highways and by promoting industrial forestry close to industrial zones in Pakistan. Many industries did not have emissions control systems, exceeding the permissible limit for emissions established by the National Environmental Quality Standards (NEQS) of Pakistan. Thus, installation of emissions control system could also diminish emissions from match industry in Pakistan. [ABSTRACT FROM AUTHOR]