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Knowledge Management and Market Orientation have become buzzwords today owing to their importance for enhancing organizational performance. Innovation has become the strategic need of organizations at present in order to contend with the extreme market competition. The objective of this research was to examine the impact of knowledge management orientation on a firm's performance with the mediating role of organizational innovation and market orientation. Data was collected through personal survey-based questionnaire. Based on a survey of 343 employees from Telecom Sector of Pakistan, this study applied Structural Equation Modeling (SEM) Technique to observe the research model. The results of the study demonstrate that knowledge management orientation plays an affirmative role in the promotion of organizational performance. The organizational innovation has significant impact on the performance of the organization. It was also revealed that there is positive effect of market orientation on organizational performance. Moreover, innovation and market orientation were observed to have mediating role in the knowledge management orientation-organizational performance linkage. As, the global phenomenon exposes that if the knowledge management, market orientation and innovation in relation to performance are being practiced, then the results are promising, driving extensively in a constructive way as validated by the literature review. Consequently, this research is one the first attempts in Pakistan towards the perspective i.e. knowledge management orientation, organizational innovation, market orientation in relation to the performance of an organization. It will further contribute towards the local academic and viable arena of Pakistan.

The present study is aimed at analyzing the effects of peer tutoring on the academic achievement of students in the subject of biology at secondary level. The objectives of the study were: (1) To find out the effects of peer tutoring on the academic achievement of students in the subject of biology; and (2) To examine the effects of peer tutoring with respect to knowledge, comprehension and application levels in cognitive domain of Bloom Taxonomy. All 433,405 male students at secondary level of 10th grade of Khyber Pakhtunkhwa were the population of the study. Forty students were taken as the sample of the study from the Allied National Software Institute (ANSI) Mardan. The Posttest-Only Equivalent Group Design was used. The data collected from pretest and posttest were analyzed through an independent sample t-test. It was found that the mean score of the experimental group was significantly better than that of the control group. It was concluded that peer tutoring enhanced the academic achievement of students in the experimental group significantly as compared to the control group; hence, it was an effective method of instruction for teaching biology at secondary level. It was suggested that peer tutoring may be incorporated along with other teaching methodologies for the subject of biology and it may be given due consideration in all teacher education practices in the country.

Anthropogenic climate change induced weather and climate extremes have led to frequent heat waves, droughts and floods threatening water resources and food security for an agricultural country like Pakistan. Despite their significance, the trends and variability of extreme temperature and precipitation indices and associated large‐scale drivers in the agro‐ecological zones (AEZs) of Pakistan remain unknown and need urgent attention because of abrupt climate change. The present study documents the spatiotemporal variations of climate change indices together with the elevation‐dependent variability trends over various AEZs in Pakistan for the period of 42 years (1979–2020). Nonparametric Mann–Kendall (MK) and Sen's slope (SS) estimator tests have been employed for trend estimation. Results indicated linearly increasing (warming) and statistically significant trends in Tmean, TNx, WSDI and TR20 whereas significant decreasing (cooling) trends in cool nights (−1.73 days·decade−1) and cold spells (−1.28 days·decade−1). The spatial distribution of temperature indices trends depicts robust warming over southwestern and central zones while cooling trends over northern zones. Regarding precipitation extremes, all indices have shown increasing (wetter) trends with a significant increase in PRCPTOT and RX5day. The stations in northern and subhumid AEZs received more precipitation compared to other zones. Elevation‐dependent trends in temperature indices exhibited a statistically significant positive (negative) relationship with cold (warm) tails. Most of the extreme precipitation indices have a weak, but positive association with elevation except SDII. The weakening of South Asian subtropical upper‐level jet by a high‐pressure system over northeast Pakistan resulted in amplified land surface temperatures. However, the spatial patterns of zonal winds indicate a trough over Pakistan's southern and central parts, with warmer sea‐surface temperature, low sea‐level pressure and easterly anomalies, favour moisture transport and precipitation in Pakistan. The outcomes of present study will be useful in addressing various climate‐induced disasters occurring in various AEZs of Pakistan. [ABSTRACT FROM AUTHOR]

Water is a fundamental and crucial natural resource for human survival. However, the global demand for water is increasing, leading to a subsequent decrease in water availability. This study addresses the critical need for improved water resource forecasting models amidst global water scarcity concerns exacerbated by climate change. This study uses the best weather and water resource forecasting model for sustainable development. Employing a Recurrent Neural Network–Long Short-Term Memory (RNN-LSTM) approach, the research enhances drought prediction capabilities by integrating secondary data of the rainfall, temperature, and ground and surface water supplies. The primary objective is to forecast water resources under changing climatic conditions, facilitating the development of early warning systems for vulnerable regions. The results from the LSTM model show an increased trend in temperature and rainfall patterns. However, a relatively unstable decrease in rainfall is observed. The best statistical analysis result was observed with the LSTM model; the model's accuracy was 99%, showing that it was quite good at presenting the obtained precipitation, temperature, and water data. Meanwhile, the value of the root mean squared error (RMSE) was about 13, 15, and 20, respectively. Therefore, the study's results highlight that the LSTM model was the most suitable among the artificial neural networks for forecasting the weather, rainfall, and water resources. This study will help weather forecasting, agriculture, and meteorological departments be effective for water resource forecasting. [ABSTRACT FROM AUTHOR]

Motorcycle crashes often result in severe injuries on roads that affect people's lives physically, financially, and psychologically. These injuries could be notably harmful to drivers of all age groups. The main objective of this study is to investigate the risk factors contributing to the severity of crash injuries in different age groups. This Objective is achieved by developing accurate machine learning (ML) based prediction models. This research examines the relationship between potential risk factors of motorcycle-associated crashes using (ML) and Shapley Additive explanations (SHAP) technique. The SHAP technique further helped interpreting ML methods for traffic injury severity prediction. It indicates the significant non-linear interactions between dependent and independent variables. The data for this study was collected from the Provincial Emergency Response Service RESCUE 1122 for the Rawalpindi region (Pakistan) over three years (from 2017 to 2020). The Synthetic Minority Oversampling Technique (SMOTE) is employed to balance injury severity classes in the pre-processing phase. The results demonstrate that age, gender, posted speed limit, the number of lanes, and month of the year are positively associated with severe and fatal injuries. This research also assesses how the modeling framework varies between the ML and classical statistical methods. The predictive performance of proposed ML models was assessed using several evaluation metrics, and it is found that Catboost outperformed the XGBoost, Random Forest (RF) and Multinomial Logit (MNL) model. The findings of this study will assist road users, road safety authorities, stakeholders, policymakers, and decision-makers in obtaining substantial and essential guidance for reducing the severity of crash injuries in Pakistan and other countries with prevailing conditions. [ABSTRACT FROM AUTHOR]

Library and information science has been at an infant stage in Pakistan, primarily in resource management, description, discovery, and access. The reasons are many, including the lack of interest and use of modern tools, techniques, and best practices by librarians in Pakistan. Finding a solution to these challenges requires a comprehensive study that identifies the current state of libraries in Pakistan. This paper fills this gap in the literature by reviewing the relevant literature published between 2015 and 2021 and selected through a rigorous search and selection methodology. It also analyzes the websites of 82 libraries in Pakistan through a theoretical framework based on various aspects. The findings of this study include: Libraries in Pakistan need a transition from traditional and limited solutions to more advanced information and communication technology (ICT)-enabled, user-friendly, and state-of-the-art systems to produce dynamic, consumable, and sharable knowledge space. They must adopt social semantic cataloging to bring all the stakeholders on a single platform. A libraries consortium should be developed to link users to local, multilingual, and multicultural collections for improved knowledge production, recording, sharing, acquisition, and dissemination. These findings benefit Pakistani libraries, librarians, information science professionals, and researchers in other developing countries. To the best of our knowledge, this is the first study of its kind providing insights into the current state of libraries in Pakistan through the study of their websites using a rigorous theoretical framework and in the light of the latest relevant literature. [ABSTRACT FROM AUTHOR]

The current study investigated wild plant resources and health risk assessment along with northern Pakistan's mafic and ultramafic regions. Ethnobotanical data was collected through field visits and semi-structured questionnaire surveys conducted from local inhabitants and healers. Six potentially toxic elements (PTEs) such as lead (Pb), cadmium (Cd), nickel (Ni), chromium (Cr), manganese (Mn), and zinc (Zn) were extracted with acids and analyzed using atomic absorption spectrophotometer (AAS, Perkin Elmer-7000) in nine selected wild medicinal plants. Contamination factor (CF), pollution load index (PLI), estimated daily intake (EDI), target hazard quotient (THQ), and hazard index (HI) were used to determine the health risk assessment of the studied medicinal plants. The results showed that the selected medicinal plants were used for the treatments of cough, joint swelling, cardiovascular disorders, toothaches, diabetes, and skin pimples by the local inhabitants due to their low-cost and easy accessibility. The concentrations of Pb (3.4–53 mg kg–1), Cd (0.03–0.39 mg kg–1), Ni (17.5–82 mg kg–1), Cr (29–315 mg kg–1), Mn (20–142 mg kg–1), and Zn (7.4–64 mg kg–1) in the studied medicinal plants were found above the safe limits (except Zn) set by WHO/FAO/USEPA (1984/2010). The Pb contamination factor was significantly (p < 0.05) higher in A. modesta (7.84) and D. viscosa (6.81), and Cd contamination factor was significantly higher in C. officinalis (26.67), followed by A. modesta (8.0) mg kg–1. Based on PTE concentrations, the studied plants are considered not suitable for human consumption purposes. Pollution load index values for A. modesta, A. barbadensis, A. caudatus, A. indica, C. procera (2.93), D. viscosa (2.79), and C. officinalis (2.83), R. hastatus (3.12), and Z. armatum were observed as 1.00, 2.80, 2.29, 2.29, 2.93, 2.79, 2.83, 3.12 and 2.19, respectively. Hazard index values were in order of R. hastatus (1.32 × 10–1) ˃ C. procera (1.21 × 10–1) ˃ D. viscosa (1.10 × 10–1) ˃ A. caudatus (9.11 × 10–2) ˃ A. barbadensis (8.66 × 10–2) ˃ Z. armatum (7.99 × 10–2) ˃ A. indica (6.87 × 10–2) ˃ A. modesta (5.6 × 10–2) ˃ C. officinalis (5.42 × 10–2). The health risk index values suggested that consumption of these plants individually or in combination would cause severe health problems in the consumers. Pearson's correlation results showed a significant correlation (p ≤ 0.001) between Zn and Mn in the studied medicinal plants. The current study suggests that wild medicinal plants should be adequately addressed for PTEs and other carcinogenic pollutants before their uses in the study area. Open dumping of mining waste should be banned and eco-friendly technology like organic amendments application should be used to mitigate PTEs in the study area. [ABSTRACT FROM AUTHOR]

Logistics centers (LCs) have become a critical component of supply chain networks, playing an essential role in the development and implementation of logistics and supply chain management strategies. Recognizing the importance of LCs, Pakistan and China have initiated an extensive plan to establish and expand an LC system as part of the China–Pakistan Economic Corridor (CPEC) initiative. However, the implementation of this plan has faced challenges due to the inadequate prioritization of factors used to identify LCs. This research proposes a structured framework for selecting LC locations, employing a combination of fuzzy logic and the technique for order of preference by similarity to the ideal solution (TOPSIS). These widely used methods address various challenges encountered in location selection. The findings highlight crucial logistics hubs in China and Pakistan, emphasizing factors such as port accessibility, freight demand, and transportation costs. The prioritization of criteria for LC selection is determined through the evaluation of variables and alternatives. The proposed framework enhances decision-making based on multiple criteria by addressing uncertainty and subjective assessments. [ABSTRACT FROM AUTHOR]

The present study's aim is to find the prevalence of two of the common indicators of mental health - depression and anxiety – and any correlation with socio-demographic indicators in the Pakistani population during the lockdown from 5 May to 25 July 2020. A cross-sectional survey was conducted using an online questionnaire sent to volunteer participants. A total of 1047 participants over 18 were recruited through convenience sampling. The survey targeted depression and anxiety levels, which were measured using a 14 item self-reporting Hospital Anxiety and Depression Scale (HADS). Out of the total sample population (N=354), 39.9% suffered from depression and 57.7% from anxiety. Binary logistical regressions indicated significant predictive associations of gender (OR=1.410), education (OR=9.311), residence (OR=0.370), household income (OR=0.579), previous psychiatric problems (OR=1.671), and previous psychiatric medication (OR=2.641). These were the key factors e associated with a significant increase in depression. Increases in anxiety levels were significantly linked to gender (OR=2.427), residence (OR=0.619), previous psychiatric problems (OR=1.166), and previous psychiatric medication (OR=7.330). These results suggest depression and anxiety were prevalent among the Pakistani population during the lockdown. Along with other measures to contain the spread of COVID-19, citizens' mental health needs the Pakistani government's urgent attention as well as that of mental health experts. Further large-scale, such as healthcare practitioners, should be undertaken to identify other mental health indicators that need to be monitored. [ABSTRACT FROM AUTHOR]

In recent decades, water scarcity is a significant constraint for socioeconomic development and threatens livelihood in an agriculture-based developing country like Pakistan. The water crisis in the country is projected to exacerbate in the coming years, especially in the southern parts. This dire situation calls for an investigation of major droughts, associated water scarcity, and changes in teleconnection patterns over Southern Pakistan. Moderate to low Southeastern monsoon (SEM) precipitation triggered the extreme drought episode (2017--2020) over Southern Pakistan and intensified the water scarcity. This study explored the severity of the respective drought event, underlying mechanisms, and changes in water scarcity over Southern Pakistan. To investigate the future changes (1980--2050) in water scarcity, coupling models (global hydrological models (GHMs)-global climate models (GCMs)) have been used to achieve the interannual performance of water availability and total water consumption. Besides, future scenarios used in this study are the combinations of SSPs and RCPs, including middle-of-the-road (SSP1-RCP4.5) and fossil-fueled development (SSP2-RCP8.5). The findings indicated a precipitation deficit of 45% during the 4-year (2017--2020), depicting the worst events in the past 50 years. South Pakistan observed the worst SEM droughts over the last 50 years, as 2000--2005 was the worst drought (precipitation deficit of 75%), followed by 2017--2020 with a 49% of precipitation deficit. Water scarcity was exacerbated by the extreme dry spells that developed over most of southern Pakistan between 2017 and 2020 as a result of moderate-to- exceptionally low SEM precipitation. Furthermore, this drought episode was accompanied by the cool phase in the Pacific and equatorial Indian Oceans. The future changes in water scarcity over the southern regions of Pakistan present a sharp increase under the SSP2-RCP8.5 scenario and are anticipated to be intensified in already stressed regions. This research is essential for environmentalists, and water resources managers, and provided crucial information to identify the hot spot areas in the target region so that water scarcity problems could be reduced in the future. [ABSTRACT FROM AUTHOR]

Income and prices are important factors that determine and decide households consumption decisions and behavior. This paper aims to examine fruits' demand elasticities in Pakistan by using the Linear Approximate Almost Ideal Demand System (LA/AIDS). For this purpose, data from the Household Integrated Economic Survey (HIES) 2018–2019 part of Pakistan Living Standard and Measurement is used for the selected fruits. Marshallian, Hicksian, and expenditures elasticities were calculated through the estimated parameter from the Linear Approximate Almost Ideal demand system. The results show that all the estimated expenditure elasticities of the selected fruits for Pakistan are positive. The magnitude of expenditure elasticities for bananas, malta, apple, grapes, watermelon, plum, and almonds, is less than unity, and are thus categorized as normal food items. The estimated uncompensated own price demand elasticities for all fruits are less than unity (inelastic) for Pakistan and thus categorized as necessities. Based on the cross-price uncompensated demand elasticities eighteen fruits are reported as gross complements and three fruits are gross substitutes. Most of the fruits are categorized as neutral fruits having no cross-price effect on each other's demand as their estimated elasticities are closer to zero. Only apples with grapes and almonds are found to be notable substitutes. As most of the price elasticities of fruits are inelastic, any change in their price would result in a massive increase in expenditure on these fruits. As a result, the government may adopt policies for the stabilization of fruit prices to meet the minimal daily food requirements of the lower segments of society. This study is an attempt to estimate demand elasticities for individual fruit as very little research is available in the study area for individual commodities. [ABSTRACT FROM AUTHOR]

Pakistan liberalized its trade in different regimes and the recent trade reforms is CPEC project which is expected to reduce wages inequality of skilled and unskilled labor. This study forecasts wages inequality as a result of trade openness in Pakistan by using artificial neural network approach for the period 1991–2017. The empirical outcomes revealed that trade liberalization is influential factor for reducing wages inequality in Pakistan, and the forecasting results for 2019–2026 show a dynamic trend of wages inequality in the response to trade liberalization; however, in many of the years, the positive implication has been witnessed for the inequality. [ABSTRACT FROM AUTHOR]

Background: Phubbing, a phenomenon of ignoring others in face-to-face conversations due to mobile phone use, can be assessed using a Phubbing Scale (PS). Recently, the PS has been shortened into an eight-item version, the PS-8. However, psychometric properties of the PS-8 among Iranian, Bangladeshi and Pakistani individuals remain understudied, especially using advanced psychometric testing, such as Rasch and network analyses. Methods: Participants residing in Iran, Bangladesh, and Pakistan (n = 1902; 50.4% females; mean age = 26.3 years) completed the PS-8 and the Internet Disorder Scale-Short Form (IDS9-SF) via an online survey. Network analysis was used to examine if PS-8 items were differentiated from IDS9-SF items; confirmatory factor analysis (CFA) was used to examine the factor structure and measurement invariance of the PS-8; Rasch modeling was used to examine the dimensionality of the PS-8 and differential item functioning (DIF). Results: Network analysis showed that PS-8 items were clustered together with a distance to the IDS9-SF items. The CFA results supported a two-factor structure of the PS-8, and the two-factor structure was found to be invariant across countries and women and men. Rasch model results indicated that the two PS-8 subscales were both unidimensional and did not display DIF across countries and gender/sex. Conclusion: The PS-8 is a feasible and robust instrument for healthcare providers, especially mental health professionals, to quickly assess and evaluate individuals' phubbing behaviors. [ABSTRACT FROM AUTHOR]

The increasing prevalence of warmer trends and climate extremes exacerbate the population's exposure to urban settlements. This work investigated population exposure changes to mean and extreme climate events in different Agro‐Ecological Zones (AEZs) of Pakistan and associated mechanisms (1979−2020). Spatiotemporal trends in mean and extreme temperatures revealed significant warming mainly over northern, northeastern, and southern AEZs. In contrast, mean‐to‐extreme precipitation changes showed non‐uniform patterns with a significant increase in the northeast AEZs. Population exposure to mean (extreme) temperature and precipitation events increased two‐fold during 2000–2020. The AEZs in urban settlements (i.e., Indus Delta, Northern Irrigated Plain, and Barani/Rainfall) show a maximum exposure to extreme temperatures of about 70–100 × 106 (person‐days) in the reference period (1979−1999), which increases to 140–200 × 106 person‐days in the recent period (2000−2020). In addition, the highest exposure to extreme precipitation days also increases to 40–200 × 106 person‐days during 2000–2020 than 1979−1999 (20–100 × 106) person‐days. Relative changes in exposure are large (60%–90%) for the AEZs across northeast Pakistan, justifying the spatial population patterns over these zones. Overall, the observed changes in exposure are primarily attributed to the climate effect (50%) over most AEZs except Northern Irrigated Plain for R10 and R20 events, where the interaction effect takes the lead. The population exposure rapidly increased over major AEZs of Pakistan, which could be more vulnerable to extreme events due to rapid urbanization and population growth in the near future. Plain Language Summary: This study investigates the impact of climate change on population in different AEZs of Pakistan from 1979 to 2020. The findings depict widespread warming trends in northern, northeastern, and southern AEZs of Pakistan, whereas changes in precipitation patterns are non‐uniform, with a notable increase in the northeast zone. The study reveals that population exposure to temperature and precipitation events doubled between 2000 and 2020. Urban AEZs such as the Indus Delta, Northern Irrigated Plain, and Barani/Rainfall exhibit the largest exposure to extreme temperatures and precipitation, with exposure increasing over time. The northeast zones of Pakistan experience the highest relative changes in exposure, highlighting the vulnerability of these AEZs to climate events. Climate effect account for the majority of observed exposure changes in AEZs, except Northern Irrigated Plain, where interaction effect plays a key role. The findings suggest that as urbanization and population growth continue, major AEZs in Pakistan are becoming increasingly susceptible to extreme climate events in the future. Key Points: Spatiotemporal trends in mean to extreme temperature (precipitation) events reveal widespread warming across Agro‐Ecological ZonesPopulation exposure to mean (extreme) temperature and precipitation events increases two‐fold in recent climate periodObserved changes in population exposure are primarily attributed to the climate effect (50%) over major Agro‐Ecological Zones [ABSTRACT FROM AUTHOR]

The Internet Disorder Scale–Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction. [ABSTRACT FROM AUTHOR]

Background: Child mortality is a major challenge to public health in Pakistan and other developing countries. Reduction of the child mortality rate would improve public health and enhance human well-being and prosperity. This study recognizes the spatial clusters of child mortality across districts of Pakistan and identifies the direct and spatial spillover effects of determinants on the Child Mortality Rate (CMR). Method: Data of the multiple indicators cluster survey (MICS) conducted by the United Nations International Children's Emergency Fund (UNICEF) was used to study the CMR. We used spatial univariate autocorrelation to test the spatial dependence between contiguous districts concerning CMR. We also applied the Spatial Durbin Model (SDM) to measure the spatial spillover effects of factors on CMR. Results: The study results showed 31% significant spatial association across the districts and identified a cluster of hot spots characterized by the high-high CMR in the districts of Punjab province. The empirical analysis of the SDM confirmed that the direct and spatial spillover effect of the poorest wealth quintile and MPI vulnerability on CMR is positive whereas access to postnatal care to the newly born child and improved drinking water has negatively (directly and indirectly) determined the CMR in Pakistan. Conclusion: The instant results concluded that spatial dependence and significant spatial spillover effects concerning CMR exist across districts. Prioritization of the hot spot districts characterized by higher CMR can significantly reduce the CMR with improvement in financial statuses of households from the poorest quintile and MPI vulnerability as well as improvement in accessibility to postnatal care services and safe drinking water. [ABSTRACT FROM AUTHOR]

Introduction: Echinococcosis is a neglected tropical zoonotic infection that affects both the human and livestock populations. In Pakistan, the infection is long-standing, but data on its molecular epidemiology and genotypic characterization in the southern Punjab region are limited. The aim of the current study was the molecular characterization of human echinococcosis in southern Punjab, Pakistan. Methods: Echinococcal cysts were obtained from a total of 28 surgically treated patients. Patients’ demographic characteristics were also recorded. The cyst samples were subjected to further processing to isolate DNA in order to probe the Nad1 and Cyt-b genes, followed by DNA sequencing and phylogenetic analysis for genotypic identification. Results: The majority of the echinococcal cysts were from male patients (60.7%). The liver was the most commonly infected organ (60.71%), followed by the lungs (25%), spleen (7.14%), and the mesentery (7.14%). Molecular and genotypic identification through sequencing and phylogenetic tree analysis showed that most of the cysts (24/28, 85.7%) were caused by the species Echinococcus granulosus sensu stricto (E. granulosus s.s.) (G1 and G3), followed by Echinococcus multilocularis (E. multilocularis) and Echinococcus canadensis (E. canadensis) (G6/G7) (3/28, 10.8%, and 1/28, 3.5%, respectively). Conclusion: The current study concluded that the majority of human infections were caused by E. granulosus s.s., followed by the E. multilocularis and E. canadensis species (G6/G7). Genotypic characterization among both human and livestock populations is needed to explore the genetic diversity of echinococcosis. [ABSTRACT FROM AUTHOR]

The present study was intended to examine the effect of psychosocial factors on the stigma of mental illness among people addicted to drugs who have relapsed in Punjab, Pakistan. A sample composed of 116 people addicted to drugs and who have relapsed was collected through the purposive sampling technique. Certain self-report measures were used to assess the pertinent study variables. The results elucidated that self-efficacy, social support, and conscientiousness were found to be negative predictors and neuroticism a positive predictor of stigma. The results also confirmed social support as being a significant moderator in the relationship between self-efficacy and stigma, and self-efficacy as being a significant moderator in the relationship between social support and stigma. It was safe to conclude that psychosocial factors such as self-efficacy, social support, personality traits and stigma have a significant role in causing addiction relapse. The conclusions made have been discussed thoroughly. [ABSTRACT FROM AUTHOR]

Climate change is the momentous and persisting change in the world's temperature, precipitation, humidity, and other climatic variables. This study, therefore estimated the impact of climatic variations on tomato productivity across agro ecological zones of Khyber Pakhtunkhwa, Pakistan. Panel data for 28 years (1991-2018) across the six districts of the agro ecological was used due to availability of data on tomato productivity and climatic variables. Yield of tomato, area, maximum temperature and rainfall were included in the final estimated model. The results indicate that the average maximum temperature and average maximum temperature square have a significant impact on tomato yield. Average maximum temperature has positive coefficient while the average maximum temperature square has a negative coefficient. This demonstrates that, at first, the tomato yield increases as the temperature rises. It reaches the maximum at the critical temperature (34.95°C) but shows a decline once the temperature rises from the critical value. [ABSTRACT FROM AUTHOR]

Over the last five decades, Pakistan experienced its worst drought from 1998 to 2002 and its worst flood in 2010. This study determined the record-breaking impacts of the droughts (1998–2002) and the flood (2010) and analyzed the given 12-year period, especially the follow-on period when the winter wheat crop was grown. We identified the drought, flood, and warm and cold edges over the plain of Punjab Pakistan based on a 12-year time series (2003–2014), using the vegetation temperature condition index (VTCI) approach based on Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) data products. During the year 2010, the Global Flood Monitoring System (GFMS) model applied to the real-time Tropical Rainfall Measuring Mission (TRMM) rainfall incorporated data products into the TRMM Multi-Satellite Precipitation Analysis (TMPA) for the flood detection/intensity, stream flow, and daily accumulative precipitation, and presented the plain provisions to wetlands. This study exhibits drought severity, warm and cold edges, and flood levels using the VTCI drought-monitoring approach, which utilizes a combination of the normalized difference vegetation index (NDVI) with land surface temperature (LST) data products. It was found that during the years 2003–2014, the VTCI had a positive correlation coefficient (r) with the cumulative precipitation (r = 0.60) on the day of the year (D-073) in the winter. In the year 2010, at D-201, there was no proportionality (nonlinear), and at D-217, a negative correlation was established. This revealed the time, duration, and intensity of the flood at D-201 and D-217, and described the heavy rainfall, stream flow, and flood events. At D-233 and D-281 during 2010, a significant positive correlation was noticed in normal conditions (r = 0.95 in D-233 and r= 0.97 in D-281 during the fall of 2010), which showed the flood events and normality. Notably, our results suggest that VTCI can be used for drought and wet conditions in both rain-fed and irrigated regions. The results are consistent with anomalies in the GFMS model using the spatial and temporal observations of the MODIS, TRMM, and TMPA satellites, which describe the dry and wet conditions, as well as flood runoff stream flow and flood detection/intensity, in the region of Punjab during 2010. It should be noted that the flood (2010) affected the area, and the production of the winter wheat crop has consistently declined from 19.041 to 17.7389 million tons. [ABSTRACT FROM AUTHOR]

The Punjab region of Pakistan faced significant losses from flash flooding in 2010 and experienced a multiyear drought during 1998–2002. The current study illustrates the drought and flood conditions using the multi-satellite data products derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) and Tropical Rainfall Measuring Mission (TRMM) as well as the TRMM Multi-satellite Precipitation Analysis (TMPA) satellites with high-quality resolution in the region of Punjab during 2010–2014. To determine the drought and flood events, we used the Vegetation Temperature Condition Index (VTCI) drought monitoring approach combined with the Normalized Difference Vegetation Index (NDVI) and Land Surface Temperature (LST) to identify the warm and cold edges (WACE) in the provision of soil moisture as well as the VTCI imagery using the MODIS-Aqua data products. We assessed the 2010 flood effect on the four years (2011–2014) of drought conditions during winter wheat crop seasons. The obtained VTCI imagery and precipitation data were utilized to validate the drought and flood conditions in the year 2010 and the drought conditions in the years 2011–2014 during the winter-wheat-crop season. It is worth mentioning that over the four years (2011–2014) of the Julian day~D-041 year, the VTCI shows a stronger link with the accumulative precipitation anomaly (r = 0.77). It was found that for D-201 during the 2010 flood was the relationship was nonlinear, and in D-217, there was a negative relationship which revealed the flood timing, duration, and intensity. For D-281, a correlation (r = 0.97) was noted during fall 2010, which showed the drought and flood extreme conditions for the winter-wheat-crop season in the year 2010–2014. In regard to 2010, the Global Flood Monitoring System (GFMS) model employs the TRMM and TMPA data products to display the study region during the 2010 flood events and validate the VTCI results. This study's spatial and temporal observations based on the observed results of the MODIS, TRMM, and TMPA satellites are in good agreement with dry and wet conditions as well as the flood runoff stream flow and flood intensity. It demonstrates the flood events with high intensity compared with the normality of flood with the complete establishment of flood events and weather extremes during the year of 2011–2014, thereby highlighting the natural hazards impacts. Our findings show that the winter wheat harvest was affected by the 2010 monsoon's summer high rain and floods in the plain of Punjab (Pakistan). [ABSTRACT FROM AUTHOR]

Global Navigation Satellite System (GNSS)-based ionospheric anomalies are nowadays used to identify a possible earthquake (EQ) precursor and hence a new research topic in seismic studies. The current study also aims to provide an investigation of ionospheric anomalies associated to EQs. In order to study possible pre-and post-seismic perturbations during the preparation phase of large-magnitude EQs, statistical and machine learning algorithms are applied to Total Electron Content (TEC) from the Global Positioning System (GPS) and Global Ionosphere Maps (GIMs). We observed TEC perturbation from the Sukkur (27.8° N, 68.9° E) GNSS station near the epicenter of Mw 5.4 Mirpur EQ within 5–10 days before the main shock day by implementing machine learning and statistical analysis. However, no TEC anomaly occurred in GIM-TEC over the Mirpur EQ epicenter. Furthermore, machine learning and statistical techniques are also implemented on GIM TEC data before and after the Mw 7.7 Awaran, where TEC anomalies can be clearly seen within 5–10 days before the seismic day and the subsequent rise in TEC during the 2 days after the main shock. These variations are also evident in GIM maps over the Awaran EQ epicenter. The findings point towards a large emission of EQ energy before and after the main shock during quiet storm days, which aid in the development of lithosphere ionosphere coupling. However, the entire analysis can be expanded to more satellite and ground-based measurements in Pakistan and other countries to reveal the pattern of air ionization from the epicenter through the atmosphere to the ionosphere. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis (CE), or hydatid cyst disease (HCD), is a zoonosis of significant importance caused by the cestode of Echinococcus granulosus sensu lato (s. l.) that affects mainly nomadic populations and has substantial economic consequences. Due to the 76% rural and nomadic population, Baluchistan is a highly endemic region in Pakistan for CE; however, it has not yet been investigated for CE. For this purpose, this study was carried out to investigate the molecular epidemiology of CE in this region. In total, 23 human hydatid cyst samples were collected from tertiary health care units in Baluchistan and processed for DNA extraction, which was then followed by sequencing of the cox1 mitochondrial gene of all 23 collected samples, genotyping, and phylogenetic and haplotype analysis. Most subjects were livestock owners (39.13%) in rural settings (73.91%). Most patients (73.19%) were pet owners (dogs) and used water from open sources for drinking. The liver was the most affected organ (52.17%), followed by the lungs (17.39%). Sequence analysis based on the cox1 gene revealed that EG genotype 1 (G1) was the most prevalent (56.52%), followed by G3 (34.78%), while some samples (8.7%) were identified as the Echinococcus canadensis (G6/7) genotype. A total of five haplotypes were detected with high haplotype diversity (0.80) and low nucleotide diversity (0.033). Phylogenetic analysis revealed two diverse sub-clades, each of G1 and G3 isolates from Baluchistan, that were evolutionarily related to previously reported G1 and G3 isolates from Pakistan and China. On the other hand, the G6/7 isolates of this study were evolutionarily identical to the already reported G6/7 isolates from Pakistan, Turkey, and Kazakhstan. This study concludes that diverse G1 and G3 EG isolates are present in this part of Pakistan, while the G6/G7 genotype was reported for the first time from Baluchistan. [ABSTRACT FROM AUTHOR]

Background: Crimean-Congo hemorrhagic fever (CCHF) continues to pose a serious threat to the fragile healthcare system of Pakistan with a continuous increase of morbidity and mortality. The present study aimed to assess the knowledge, attitudes, and practices regarding CCHF among general people who resided in Pakistan. Methods: An online cross-sectional survey design was applied, and a convenience sampling technique was used to recruit 1039 adult people from Pakistan. Data were collected from September 08 to October 12, 2021. The questionnaire consisted of a total of 32 questions in four parts assessing socio-demographics, as well as knowledge, attitudes, and practices regarding CCHF. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS), and logistic regression analyses were performed to determine the factors associated with good knowledge, positive attitudes, and good practices. Results: Alarmingly, 51.5% of participants heard about CCHF infection before administering the survey. Among these, 20.2%, 33.3%, and 48.2% of the study participants had demonstrated good knowledge, positive attitudes, and good practices, respectively. Binary logistic regression analysis revealed that education and income status had a significant impact on knowledge and attitudes (p<0.05). Similarly, the mean attitude scores differed significantly by age, education, and income status (p<0.05). Conclusions: The findings reflected inadequate levels of knowledge, attitudes, and practices regarding CCHF among general people in Pakistan which may regard as lower than expected. As CCHF is a highly contagious disease, it's urgent to initiate a comprehensive approach to handle the situation before it spreads further in Pakistan. Author summary: Crimean-Congo hemorrhagic fever (CCHF) is usually transmitted by ticks or contact with viremic animal tissues (animal tissue where the virus has entered the bloodstream) during and immediately after post-slaughter of animals and can lead to epidemics, has a high case fatality ratio (10–40%), potentially results in hospital and health facility outbreaks, and is difficult to prevent and treat. The number of CCHF infections increases around Eid-ul-Adha as more livestock is moved from rural areas to cities during Eid-ul-Adha. In Pakistan, the current national control program has been unable to eliminate CCHF on its own. Therefore, sociocultural and behavioral research can inform and improve the impact of future control programs. To this end, we investigated knowledge, attitudes, and practices related to CCHF in general population of Pakistan. We alarmingly found low levels of disease knowledge and attitudes and practices. Preventive interventions are uncommon due to poor infrastructure, a lack of education, and restricted access to health care and livestock-related facilities. It is high time that Pakistan's health, agriculture, and media sectors collaborate with international organizations to establish and implement a strategic framework for CCHF awareness and prevention. This kind of social context is vital to future public health campaigns, and highlights the importance of cross-disciplinary work to achieve successful disease control. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) could potentially elevate the risk of postoperative complications and, consequently, mortality following colorectal cancer (CRC) surgery. This topic holds significant clinical importance, yet no prior studies have been undertaken in our specific study area. Therefore, we are planning to conduct a study to address this knowledge gap. Objective: The present study was conducted to investigate the impact of COPD on final outcome of colorectal cancer and its surgery. Methodology: A cross-sectional observational investigation was conducted at a subset of Rawalpindi, Pakistan's tertiary care hospitals. IBD patients with colorectal cancer, and divided the study cases on the basis of COPD presence or absence. All study cases were interviewed and their medical records reviewed in order to compile data. Results: A total of 240 patients included in this study. The average age of the cohort was 42.13+11.9 years. The average age of CRC patients was 45.08 years, compared to 40.20 years for non-CRC patients (p<0.05). Dietary patterns substantially affected the risk of CRC, with Western diet consumers having 3.2-fold greater risk than vegetarians (p<0.05). Immunosuppressant use was associated with twofold increase in incidence of CRC (p<0.05). 30-day mortality was 13% (95% CI 11.4% to 14.9%) among patients with COPD and 5.3% (95% CI 5.0% to 5.7%) among patients without COPD, corresponding to an adjusted HR of 1.7 (95% CI 1.5 to 2.0). Conclusion: This study has emphasized the significance of several key factors, including age, respiratory variables like smoking, a history of respiratory conditions, exposure to air pollutants, dietary habits, and specific medications. These factors significantly impact the progression from Inflammatory Bowel Disease (IBD) to Colorectal Cancer (CRC). This underscores the necessity for tailored prevention strategies and interventions for individuals with IBD who are at risk. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to identify the key patronage factors that encouraged the public for investment in the Modaraba scam – a Ponzi scheme perpetrated in Pakistan with a whim of Sharīʿah-compliant business and intermediation of religious clerics. Design/methodology/approach: In a qualitative research, semi-structured interviews were conducted with the investors of the scam followed by thematic analysis to conclude on the subject matter. Findings: The results reveal numerous stimuli, thematically categorized as the monetary stimulus, religiosity stimulus and lubricants, which mobilized investment towards the scam. In general, a lucrative rate of return on investment and personality of the agents, being religious clerics, were the two prominent reasons, which convinced unanimously all investors. In particular, the religiosity stimulus (agents' personality and Sharīʿah-compliant business) was a novel and eye-catching slogan of the scheme. Originality/value: Keeping in view the amount of scam and number of victims, this research is a robust attempt to conclude on the determinants of investment decision in the Modaraba scam. [ABSTRACT FROM AUTHOR]

Vegetables are perishable in nature, and it requires a well-established market to facilitate the farmers for selling their produce at a reasonable price and make it accessible for ultimate consumers in preferred shape and location in the required duration. This research is carried out to analyze the existing marketing channels, marketing costs and margins of different market functionaries of potato crop in the selected villages of district Peshawar, Khyber Pakhtunkhwa Pakistan in 2019. For this purpose, a total of seventy producers, twenty wholesalers and twenty retailers are randomly selected and interviewed for data collection. From the current research it can be revealed that majority of potato growers followed the same marketing channel i.e. Producer Wholesaler Retailer Consumer. The analysis shows that marketing-margins of potato growers, wholesalers and retailers is estimated as 31.8 percent, 24.1 percent, and 42 percent respectively. Similarly, the share of producer in consumer rupee is obtained as 31.3 percent, respectively. Marketing margin and cost indicated that by reducing the huge margin of retailers the share of growers and wholesalers can be raised in the prevailing marketing channels. The research findings recommended that government must focus on establishing markets at village level, by minimizing the role of intermediaries which will help farmers to generate more profit. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is a chronic inflammatory disorder in the intestinal tract as a response to the use of gluten in genetically predisposed individuals. It is a worldwide problem, with a high prevalence rate in North America. This is a descriptive cross-sectional study involving 1090 samples collected from different hospitals of Rawalpindi and Islamabad, Pakistan, from January 2019 to December 2019. In this study, 1090 blood samples screened for seroprevalence of anti-tTG antibodies in CD symptomatic patients via ELISA (enzyme-linked immunosorbent assay). 1090 fecal samples from the same CD patients were collected and tested for the presence of rotavirus (RV) via ELISA and RT-PCR. Of the 1090 patients tested for seroprevalence of anti-tTG antibodies, 112/1090 (10.3%) were found to be positive. Of the 112 anti-tTG-positive patients, 78/112 (70%) were positive for RV via ELISA and 74/112 (66.1%) were RV positive via RT-PCR. A statistically significant association was reported between rotavirus infection and celiac disease (p ˂ 0.05). Anti-tTG antibodies were higher in age group 6 (12-18 years) patients (18.4%) and at minimum in age group 3 (1-3 years) patients (4.8%). However, there was a statistically insignificant relationship between group age and CD prevalence (p > 0.05). The highest CD prevalence was noted during winter season (19.6%) and the lowest (3.0%) during fall/autumn. Our study findings demonstrate that Pakistan has a high prevalence of CD compared to other studies. Further studies in the fields of environmental risk factors and treatment with more advanced serological and histopathological studies are needed in the future. [ABSTRACT FROM AUTHOR]

Groundwater depletion has become a major concern all over the world. Recently, the rapid population growth and need for water and food have placed a massive strain on land and water resources. In this study, groundwater depletion resulting from land-use and climate change was investigated in the Faisalabad district, Pakistan, from 2000 to 2015. A Pearson correlation analysis between climatic parameters and land-use indices with groundwater was conducted to explore the major influencing factors. Interpolation maps of groundwater were generated using the inverse distance weighting interpolation (IDW) method. The Normalized Difference Built-up Index (NDBI) of five-year intervals demonstrated a strong increasing trend, whereas the Normalized Difference Vegetation Index (NDVI) presented a declining trend. The results also indicated a significant declining trend in groundwater levels in the region, with the annual average groundwater level decreasing at a rate of approximately 0.11 m/year. Climatic parameters (i.e., precipitation and temperature) further reveal an insignificant increasing trend estimated using the Mann–Kendall test and Sens's slope. Overall, spatial analysis results showed a statistically significant positive trend in the groundwater level of the Faisalabad district, where the NDBI ratio is high and the NDVI is low, owing to the extensive extraction of groundwater for domestic and industrial use. These findings may be useful for a better understanding of groundwater depletion in densely populated areas and could also aid in devising safety procedures for sustainable groundwater management. [ABSTRACT FROM AUTHOR]

Background: Constipation is a prevalent adverse effect associated with various treatments administered to patients across a wide range of medical conditions, and it plays a particularly significant role in management of chronic obstructive pulmonary disease (COPD) patients. Objective: To assess the relationship between nutritional status, constipation symptoms and disease-related variables such as spirometry test results, quality of life, and disease duration in patients with COPD. Methodology: Between January and August of 2019, 500 COPD patients from three tertiary care centers in Rawalpindi, Pakistan participated in the study. The Constipation Severity Instrument (CSI) was utilized to assess the severity of constipation symptoms, while the St. George Respiratory Questionnaire (SGRQ) was implemented to evaluate quality of life. The patients' nutritional status was ascertained through the utilization of a dietary frequency questionnaire. The fat-free mass index (FFMI) and body mass index (BMI) were determined through the implementation of bioelectrical impedance analysis (BIA). Results: The sample consisted primarily of males (60.4%), aged 45 years and above and with BMI greater than 25 kg/m², which signified propensity for overweight or obesity. At 18.5 kg/m² on average, FFMI indicated reduction in muscle mass. Constipation was noted to be moderate, as indicated by mean CSI score of 35 out of 73. A correlation existed between the fact that majority of participants were former smokers and fact that smoking is COPD risk factor. The mean duration of COPD was 62 months and spirometry findings indicated moderate decline in lung function. Significant impacts on symptoms and activity levels were indicated by SGRQ scores. An evident correlation was identified between elevated BMI and deteriorating outcomes associated with COPD. Increased overall CSI scores were associated with more severe symptoms of COPD and decline in lung function. A higher fiber intake was associated with improved lung function and reduced SGRQ scores, according to dietary analysis, whereas a high fat and cholesterol intake was linked to worse outcomes. Conclusion: The research underscored substantial influence that nutritional status and constipation have on outcomes of COPD. Enhanced pulmonary function, prolonged disease duration and more severe disease symptoms were all associated with elevated BMI, especially in obese patients. Dietary components, particularly fiber consumption, are pivotal in the management of COPD severity and enhancement of patients' quality of life. [ABSTRACT FROM AUTHOR]

Purpose: The vulnerability and prevalence of common psychiatric illnesses, that is, anxiety and depression are very high at the time of pregnancy in the socio‐cultural context of Southeast Asian low‐ middle‐income countries' pregnant women. However, the issue remains poorly understood despite the fact that pregnancy can be stressful for women, their families and is strongly connected with marital quality and perceived social support. The present study examines the impact of anxiety proneness, marital satisfaction, and perceived social support on fear of childbirth and development of depression among pregnant women. Design and Methods: Participants were purposively selected 136 pregnant women who were in the third trimester with ages ranging between 19 and 35 years and were selected through a purposive sampling technique from six hospitals in Pakistan. The STICSA, RAS, MSPSS, CAQ, and PADQ scales and questionnaires were used as study tools. Findings: Anxiety proneness positively predicted childbirth fear and depression; marital satisfaction and perceived presence of social support were negative predictors among pregnant women. Practice Implications: Obstetricians, nurses, midwives, and mental health professionals can imply these findings towards developing targeted antenatal programs that focus on the pregnant woman's mental health. [ABSTRACT FROM AUTHOR]

Introduction: During the pandemic, sedentary behaviors, anxiety, and boredom caused by confinement at home could affect lifestyle patterns, degrade diet quality, and promote overconsumption. This cross-sectional study aimed to identify the impact of lockdowns on lifestyle behaviors among Pakistan's population and changes in the nutritional and eating patterns. Materials and Methods: This is an online, questionnaire-based, cross-sectional study. The study collected demographic information, dietary habits, and lifestyle patterns. Descriptive and summary statistics were used to describe data, and Chi-square or Fisher's exact tests were used for associations. Results: Most respondents were females (82.1%) aged 18–29 years (98.1%). 90.3% of them were students. 16.0% were overweight pre-pandemic, which increased to 20.0% during the pandemic. The majority ate more during the pandemic (P < 0.001). 47.9% reported a physical activity duration of 0.5–2 h pre-pandemic, and 50.6% reported decreased physical activity during the pandemic, with increased food intake (P = 0.007). Screen time was <4 h for most (48.8%) participants pre-pandemic, and the majority (89.7%) of respondents reported an increased screen time during the pandemic, associated with a higher food intake (47.9%, P = 0.029). Conclusion: The pandemic has negatively impacted lifestyles and diets, including a significant decrease in physical activity, increased food intake, and increased screen time. [ABSTRACT FROM AUTHOR]

Long‐term drought monitoring and its assessment are of great importance for meteorological disaster risk management. The recurrent spells of heat waves and droughts have severely affected the environmental conditions worldwide, including Pakistan. The present work sought to investigate the spatiotemporal changes in drought characteristics over Pakistan during Rabi and Kharif cropping seasons. The role of large‐scale circulation and interannual mode of climate variability is further explored to identify the physical mechanisms associated with droughts in the region. Monthly precipitation and temperature data (1983–2019) from 53 meteorological stations were used to study drought characteristics, using the standardized precipitation evapotranspiration index (SPEI). The nonparametric Mann–Kendall, Sen's Slope, and Sequential Mann–Kendall tests were applied on the drought index to determine the statistical significance and magnitude of the historical trend. The state‐of‐the‐art Bayesian Dynamic Linear model was further used to analyse large‐scale climate drivers of droughts, revealed an increase in drought severity, mostly over arid to semiarid regions for both cropping seasons. While temperature played a significant role in defining droughts over dry and hot seasons, rainfall is influential over the western disturbances influenced region. The analysis of atmospheric circulation patterns revealed that large‐scale changes in wind speed, air temperature, relative humidity, and geopotential height anomalies are the likely drivers of droughts in the region. We found that Niño4, sea surface temperature, and multivariate El Niño‐Southern Oscillation (ENSO4.0) Index are the most influential factors for seasonal droughts across Pakistan. Overall, the findings provide a better understanding of drought‐prone areas in the region, and this information is of potential use for mitigating and managing drought risks. [ABSTRACT FROM AUTHOR]

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The risk of heatwave events and their persistence has intensified in recent past and is expected to increase faster in future. However, the anticipated changes in socioeconomic exposure to heatwaves are still unexplored. Here, we investigate the projected heat stress and associated socioeconomic exposure across South Asia (SA) and its subregions using the newly released ensemble mean of 23 global climate models from the Coupled Model Intercomparison Project Phase 6 (CMIP6), population, and Gross Domestic Product (GDP) projections. We used two Shared Socioeconomic Pathways (SSPs), namely SSP2‐4.5 and SSP5‐8.5, and three‐time periods, that is, near‐term, midterm, and long‐term relative to the base period (1985–2005). We found that SA region has the potential for widespread changes to Wet bulb globe temperature (WBGT) of 6.5°C, which can exceed the theoretical limits of human tolerance by the mid of 21st century. The SA population's exposure significantly increases during midterm and long‐term periods by ∼750×106 $750\times {10}^{6}$ person‐hours under the SSP5‐8.5 scenario. The GDP exposure is the greatest for the same period's up to 200×109 $200\times {10}^{9}$ dollar‐hours under the SSP2‐4.5. Moreover, the foothills Himalayans and northern parts of Pakistan are presently unaffected by WBGT during midterm and long‐term periods under both scenarios. Among subregions (hereafter R1, R2, R3, and R4), the frequency of subdaily WBGT is projected to increase in the region R2 and R4 by ∼70% and ∼90% under the SSP2‐4.5 and SSP5‐8.5 scenarios relative to the base period. The highest upsurge in exposure is anticipated for R2, including southern Pakistan and southwestern India, followed by R1 and R3. Notably, the climate effect is more dominant than the population, whereas changes in GDP effect contribute to the total change in GDP exposure. Plain Language Summary: SA is one of the hotspot regions to the climatic extremes where the earliest exposure to heat waves is expected in future warmer climates. We show that the SA population is highly exposed to subdaily WBGT for midterm and long‐term periods. In contrast, the robust change in GDP exposure appeared for the same periods under SSP2‐4.5 and SSP5‐8.5. In contrast, relatively less frequent WBGT exhibited over foothills Himalayans and northern parts of Pakistan. Still, the spatial magnitude of WBGT is more likely to be intensified by the end of the 21st century. Regarding regional aggregate changes, R2 and R4 are anticipated to upsurge in subdaily WBGT relative to the base period under SSP2‐4.5 and SSP5‐8.5 scenarios. We also found that southern Pakistan and south‐northern India are projected to increase exposure to heat stress, followed by R1 and R3. Overall, the projected changes in exposure are mainly due to the interaction effect accounted for ∼650 (800) × 106 person‐hours under SSP2‐4.5/SSP2 and SSP5‐8.5/SSP5 scenarios. It can be inferred that the climate influence is more dominant than the population, particularly for southwestern Pakistan and most parts of India. Key Points: The region of South Asia experiences widespread changes to Wet bulb globe temperature of 6.5°CThe spatial magnitude of Wet bulb globe temperature is likely to be intensified by the end of the 21st centuryProjected changes in socioeconomic exposure are mainly due to the interaction effect under Shared Socioeconomic Pathways [ABSTRACT FROM AUTHOR]

(2) >=95% vaccination coverage with the second MCV dose in every district of each country either through the implementation of a routine two-dose vaccination schedule or through supplementary immunization activities (SIAs). A study conducted in Karachi, the largest metropolitan city in Pakistan showed that even after 1 year of mass measles vaccination campaign, only 55% of children in Karachi had detectable measles serologic immunity. This shows that a large proportion (45%) of the under 5-year population in Karachi is still susceptible even after successful vaccination against it.7 Pakistan is facing various challenges in achieving herd immunity against measles. [Extracted from the article]

The study attempted to analyze the role of right to information in ensuring good governance in Pakistan. The study objectives were to investigate the experiences of public information officers and civil society actors regarding the right to information contribution to good governance and to analyze the challenges in the implementation of right to information law. For the selection of sampling size, purposive sampling was used and data were collected from 11 ministries public information officers and 3 civil society actors through in depth interviews in Islamabad, Pakistan. Being qualitative study, data were analyzed by using thematic analyses. Jurgen Habermas theory of 'Public Sphere" was used to throw light on main theme of the study. [ABSTRACT FROM AUTHOR]

Introduction: Aside from personal beliefs, young adults' intention to uptake the COVID‐19 vaccine can be influenced by their fear of COVID‐19 and perceived infectability of COVID‐19. The present study incorporated fear of COVID‐19 and perceived infectability with the theory of planned behavior (TPB) to form an expanded TPB to analyze factors affecting Pakistani young adults' intentions to uptake the COVID‐vaccine in Pakistan. Methods: A cross‐sectional study was conducted and recruited participants from Pakistani social media users. The proposed extended TPB model was examined by using structural equation modeling. Results: A total of 1034 individuals replied to the survey. The three factors of the original theory of planned behavior and the fear of COVID‐19 were positively related to their intention to uptake COVID‐19 vaccination (r = 0.25‐0.66). Moreover, the perceived infectability positively influenced the three theories of planned behavioral factors and the fear of COVID‐19 (r = 0.27‐0.60), also affecting the participants' intentions to uptake COVID‐19 vaccination. Conclusions: Perceived infectability was positively related to the participants' intentions to uptake COVID‐19 vaccination, and perceived behavioral control was the strongest mediator. More evidence‐based information concerning treatments and COVID‐19 vaccination are needed to encourage individuals to uptake the vaccine. [ABSTRACT FROM AUTHOR]

This document is a corrigendum for an article titled "Recent and projected changes in water scarcity and unprecedented drought events over Southern Pakistan." The correction addresses an error in the funding statement of the article, providing the correct funding information. The authors express their gratitude for the financial support and state that the correction does not affect the scientific conclusions of the article. The document also includes a note from the publisher, stating that the claims expressed in the article are solely those of the authors and do not necessarily represent the views of their affiliated organizations or the publisher. The authors and their affiliations are listed at the end of the document. [Extracted from the article]

Background: While vaccine development is itself a challenge; ensuring optimal vaccine uptake at population level can present an even more significant challenge. Therefore, this study aimed to assess the Pakistani population's attitude and preferences towards the Coronavirus disease 2019 (COVID-19) vaccine.Method: A cross-sectional study was carried out through an online self-administered questionnaire from 27 September 2020 to 11 October 2020. A total of 883 people responded to the survey. The questionnaire included the participants' socio-demographic variables, attitudes, beliefs towards the COVID-19 vaccine and acceptance and rejection of vaccination, and reasons for them. Logistic regression analysis was used to analyze the predictors for vaccine acceptance and willingness to pay for the vaccine.Results: A majority (70.8%) of respondents will accept the COVID-19vaccine if available, and 66.8% showed a positive attitude towards vaccination. Monthly family income, education level, self-diagnosis of COVID-19 or a friend, family member, or colleague are significant factors influencing the acceptance of COVID-19 vaccination. The dogma of being naturally immune to COVID-19 was a key reason for the refusal of the vaccine. Less than half (48%) of those who refuse will vaccinate themselves if government officials have made it compulsory. A third (33.9%) of participants were willing to pay up to (7 USD) 1000 Pkr (Pakistani Rupees) for the vaccine.Conclusion: The population's positive attitude should be improved by increasing awareness and eradicating false myths about vaccines through large-scale campaigns. [ABSTRACT FROM AUTHOR]

Background: Depression and mild cognitive impairment (MCI) are often comorbid mental health issues in older adults. The current study explored the prospective mediating role of loneliness in the relationship between depression and the quality of life in elderly with MCI. A second aim was to examine differences in depression, loneliness, and the quality of life in the elderly with MCI among gender groups, and type of residence groups. Methods: A cross‐sectional survey with purposive sampling was used. Older adults with MCI (N = 170) from old age homes in Lahore and Rawalpindi (n = 82) and family residences in Sargodha (n = 88) in Pakistan completed UCLA Loneliness Scale, Depression Anxiety Stress Scale, and Mild Cognitive Impairment Scale. Results: Most of the participants had severe to extreme depression (98.2%), and moderate to moderately high levels of loneliness (85.3%). Depression was significantly associated with loneliness (b = 0.29, P < 0.05) and poor quality of life in MCI (b = 0.49, P < 0.001). The indirect effect of depression on the quality of life in MCI through loneliness was significant (95% confidence interval (CI) [0.002, 0.156]). However, the indirect effect of quality of life in MCI on depression through loneliness was not significant (95% CI [−0.001, 0.043]). The elderly with MCI living in old age homes had higher depression, loneliness, and poor quality of life. Elderly women had higher levels of depression and poor quality of life, whereas older men were lonelier. Conclusion: The relationship between depression and quality of life in the elderly with MCI may be bidirectional, and loneliness partially mediates only one of these relationships. [ABSTRACT FROM AUTHOR]

Banking industries are blamed to be among the major factors that affect global climate change both directly and indirectly. The green banking concept has emerged in the last decade to trigger the adverse impact the banks put on a healthy environment. However, research regarding the adoption of green banking practices in developing economies, especially in Pakistan, is scarce. While environment friendly businesses are promoted by the government including in the banking industry. Green banking practices not only adopted by the business operations but also to practice it at policy-making level. It also encourages green project financing to ascertain environmental efficiency. Based on SRI theory, this study investigates the relationship between green banking practices and their direct and indirect impact on environmental performance. Structural equation modelling approach has been adopted to test the relationships of variables of the study. The impact of the green practices has been recognized much greater and influential in promoting green environment regarding policy-making and investments in green projects. Results reveal that there is a significant influence of policy, daily operations, and investments on the adoption of green banking practices. Interested parties can adopt the study proposed framework to access and identify the factors which can promote justified level of green banking practices in the country. Moreover, this study may help in providing rich updated literature in green banking to speed up future research in the same area. [ABSTRACT FROM AUTHOR]

This research aimed to identify red flags of the Modaraba scam and offers some suggestions on the prevention of Ponzi schemes. A thematic analysis of the data, collected through semi-structured interviews with eighteen sample respondents, enabled the researchers to conclude on the substance of the scam. Results revealed that critical red flags of the scam are exorbitant profits, void investment agreements, multifaceted, complex and unregistered operations, exponential and participative rate of agents' commission, and deferred periodic profits. Findings further suggest that investors and state-run regulatory authorities can help in the prevention of Ponzi schemes with the due exercise of their roles. [ABSTRACT FROM AUTHOR]

Iron deficiency anemia (IDA) is a common public health occurrence of pregnancy which is particularly prevalent in developing countries like Pakistan. During this critical period, the deficiency of iron is very common as the iron requirements are greatly enhanced. IDA during pregnancy is associated with intrauterine growth retardation, premature birth, low birthweight, increased labor time, higher risk of infection, elevated maternal and prenatal mortality, muscle dysfunction, and low physical capacity. The present study was aimed to check the prevalence, effect of diet on IDA and its association with the pregnancy outcome, that is, birthweight. Five different public sector hospitals of Rawalpindi and Islamabad were analyzed. A sample size of 500 pregnant females of third trimester was observed which were then followed after delivery from September 2020 to January 2021. A well‐designed questionnaire was developed where different demographic factors, dietary recalls, biomarkers, and other determinants were obtained. The data from the questionnaires were later coded for the purpose of analysis in the statistical package (SPSS) using chi‐square test. Our study indicated that IDA is a moderate public health problem among pregnant women in twin cities and more than half of study subjects have depleted iron stores. Approximately 63% of the subjects were having iron deficiency and 24.8% were facing severe iron deficiency anemia. Only 12% of the subjects were considered as normal. The high prevalence of anemia in our subjects was probably due to low iron intake and poor dietary habits. The results of the study may not be generalizable due to time constraints and other factors. Maternal anemia still remains a major public health concern that requires more attention especially in developing and underdeveloping countries. [ABSTRACT FROM AUTHOR]

Drought is one of the most frequent natural disasters occurring in Pakistan and has a great influence on livelihood, agriculture, and economy. The availability of long‐term high‐quality reanalysis products over Pakistan has been of great concern in recent decades. Here, we conduct drought assessment in Pakistan based on the standardized precipitation index (SPI) and the standardized precipitation evapotranspiration index (SPEI) at 3, 6, and 12 months timescales during 1983–2018. We use long‐term in situ observations to evaluate the accuracy of reanalysis products, including Climatic Research Unit (CRU TS), National Centers for Environmental Prediction version II (NCEP‐2), European Centre for Medium‐Range Weather Forecasts Version‐5 (ERA‐5), and Modern‐Era Retrospective analysis for Research and Applications version II (MERRA‐2). The main results are summarized as follows: (a) drought indices and drought areas assessed from reanalysis products are relatively more representative of historical droughts that had occurred in southern Pakistan and overestimation is evident for drought severity in western than eastern Pakistan; (b) statistically significant increasing trends (1984–1998 and 2000–2010) in monthly drought areas and occurrence are evident by CRU TS and MERRA‐2 in dominant arid and semiarid regions; (c) climate variables and drought features of southern Pakistan are best represented by CRU TS and MERRA‐2, while that of southwestern and western parts are best represented by ERA‐5; (d) the Nash–Sutcliffe efficiency (NSE) results range from −2 to 1, where the NSE of SPEI values (−1.0) show relatively weaker than SPI values (0.5) in most parts of the regions, specifically in the southern Pakistan; (e) a strong positive linear relationship on a monthly scale is evident in CRU TS, MERRA‐2, and ERA‐5 exhibiting relatively high correlation coefficient (0.84), except for NCEP‐2. Furthermore, the SPEI results are found to be better than SPI; thus, this study suggests SPEI may be more suitable than SPI in monitoring droughts under climate change. [ABSTRACT FROM AUTHOR]

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Introduction: It could be challenging for healthcare workers to diagnose patients with factitious disorder who present with rare ophthalmologic manifestations such as haemolacria, because of the unavailability of adequate literature and associated guidelines. The present case report aims to fulfill this knowledge gap. Case Presentation: A 20‐year‐old tribal illiterate married female patient with symptoms of bleeding episodes from her left eye was admitted to the hospital. An extensive workup was done for diagnosing possible bleeding disorders but all the parameters were normal. Later on, she was diagnosed with factitious disorder presenting haemolacria after sufficient evidence at the psychiatric unit observations. The patient was treated accordingly, counseled and discharged, but lost‐out to follow‐ups. Practical Implications: The present case is reported from a developing country, Pakistan, for the first‐time may help in diagnosing patients suffering from factitious disorder with unusual ophthalmologic problems. [ABSTRACT FROM AUTHOR]

Background: Malaria, disproportionately affects poor people more than any other disease of public health concern in developing countries. In resource-constrained environments, monitoring the occurrence of malaria is essential for the success of national malaria control programs. Militancy and military conflicts have been a major challenge in monitoring the incidence and controlling malaria and other emerging infectious diseases. The conflicts and instability in Afghanistan have resulted in the migration of refugees into the war-torn tribal districts of Pakistan's Khyber Pakhtunkhwa (KPK) province and the possible introduction of many contagious epidemics. Although malaria is very common in all tribal districts, molecular, clinical and epidemiological data are scarce in these high-burden districts. Therefore, for the proper surveillance, detection, and control of malaria, obtaining and analyzing reliable data in these districts is essential. Methodology/Principal findings: All 1,127 malaria-suspected patients were sampled within the transmission season in the tribal districts of KPK province between March 2016 to December 2018. After a detailed demographic and clinical investigation of malaria-suspected patients, the data were recorded. The data of the control group was collected simultaneously at the same site. They were considered as uncomplicated cases for statistical analyses. Blood samples were collected from malaria-suspected patients for the detection of Plasmodium species using microscopy and nested PCR (nPCR). Microscopy and nPCR examination detected 78% (n = 882) and 38% (n = 429) Plasmodium-positive patients, respectively. Among1,127 of 429nPCR detected cases with both species of malaria, the frequency of complications was as follows: anemia (n = 71; 16.5%), decompensated shock (n = 40; 9%), hyperpyrexia (n = 117; 27%), hyperparasitaemia (n = 49; 11%) hypoglycemia (n = 45; 10.5%), jaundice (n = 54; 13%), multiple convulsions (n = 37; 9%), and petechia (n = 16; 4%). We observed that 37% (n = 157 out of 429) of those patients infected by both Plasmodium species were children between the ages of 1 and 15 years old. The results revealed that Bajaur (24%), Kurram (20%), and Khyber (18%) districtshada higher proportion of P. vivax than P. falciparum cases. Most of the malaria cases were males (74%). Patients infected by both Plasmodium species tended to less commonly have received formal education and ownership of wealth indicators (e.g., fridge, TV set) was lower. Conclusions/Significance: Malaria in tribal districts of the KPK province largely affects young males. P. vivax is a major contributor to the spread of malaria in the area, including severe malaria. We observed a high prevalence of P. vivax in the Bajaur district. Children were the susceptible population to malaria infections whereas they were the least expected to use satisfactory prevention strategies. A higher level of education, a possession of TV sets, the use of bed nets, the use of repellent fluids, and fridges were all associated with protection from malaria. An increased investment in socio-economic development, a strong health infrastructure, and malaria education are key interventions to reduce malaria in the tribal districts. Author summary: The malaria epidemic and endemic in tribal areas of KPK, Pakistan is a present and constant threat to public health. It has been a great challenge in monitoring the incidence of malaria in tribal districts of KPK because of the military conflict. We report an epidemiological, clinical, and household assessment of malaria endemicity in the six tribal districts of KPK, Pakistan, which is the most neglected area due to militancy and war in Afghanistan. The study sample comprised of1,127malaria-suspectedpatients. Their blood samples were collected for microscopy, nPCR and biochemical analysis. Of the samples collected, 78% were identified as Plasmodium-positive by microscopic analysis, whereas, 38% were determined as Plasmodium-positive by nPCR. Then PCR analysis detected 87% (n = 373 out of 429) and 13% (n = 56 out of 429) P. vivax and P. falciparum cases, respectively. Cases were noticeably higher in males (74%). We found poor hygiene conditions in all the districts we examined, probably caused by low socioeconomics settings. Hyperpyrexia (27%) was the prominent clinical feature among all the cases infected by both P. vivax and P. falciparum. Our findings have substantial implications for both malaria control and public health in the tribal districts of Pakistan. [ABSTRACT FROM AUTHOR]