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BackgroundRabies, caused by the rhabdovirus, is a fatal zoonotic disease with over 59,000 annual deaths globally. Asia and Africa account for 95%, with India leading, followed by China. In Pakistan, where it's endemic, over 50,000 cases are reported yearly. Controlling rabid dog populations through vaccination is crucial in curbing mortality. This research aimed to evaluate healthcare professionals' knowledge, attitudes, and practices concerning rabies in Peshawar, Pakistan.MethodsThe study was conducted at different tertiary care hospitals in Peshawar, Pakistan from 16 August 2021 to 15 February 2022. Cross-sectional research was conducted to gather data from a total of 100 healthcare workers representing different sections within the healthcare field, including Medical Officers, House Officers, Faculty Staff, Nurses, and Paramedics. Data on knowledge, attitudes, and practices about rabies were collected using a standardized questionnaire. The data analysis included using descriptive statistics and chi-square testing to ascertain potential correlations.ResultsAmong the healthcare professionals, 68 (68%) were males, and 32 (32%) were females. Profession-wise, the included professionals were Nurses 31 (31%), Medical Officers 27 (27%), House officers 26 (26%), paramedical staff 13 (13%), and faculty staff 3 (3%). 91 (91%) and 9 (9%) healthcare professionals responded that dogs and cats are responsible for rabies transmission, respectively. Moreover, 82 (82%) individuals responded that animal bite plays a vital role in the transmission of rabies, whilst 76 (76%) individuals responded that rabies transferred from human to human. 82 (82%) individuals replied that the anti-rabies vaccine (ARV) is the treatment of choice for rabies. Furthermore, 78 (78%) individuals responded that ARV is safe in pregnancy and lactation. Moreover, after being asked about the perception of the health care professionals about the failure in controlling rabies, their responses were unavailability of ARV/RIG 41 (41%), lack of control of stray dogs 34 (34%), lack of awareness 20 (20%). The study revealed statistically significant correlations between healthcare occupations and variables: knowledge of animals responsible for transmitting rabies (p = 0.024) and awareness of human-to-human transmission (p = 0.007). Significant disparities were noted in understanding rabies transmission through contaminated water (p = 0.002). There were variations in attitudes and practices seen across different positions, particularly about views about home treatments (p = 0.033) and the perceived effectiveness of cleansing bite wounds (p = 0.010). Disparities in perceptions of rabies treatment and the accessibility of anti-rabies vaccines and immunoglobulin were observed, with variations based on individual roles.ConclusionThe present research elucidates variations in rabies knowledge, attitudes, and practices among healthcare workers, specifically concerning their respective roles. Tailored training programs and standardized practices play a crucial role in mitigating these discrepancies, fostering a greater understanding of rabies, and enhancing the quality of patient treatment. It is recommended that future studies undertake an assessment of the efficacy of therapies and advocate for the adoption of collaborative One Health strategies in the realm of rabies management.

The design of cheap, noble-metal-free, and efficient electrocatalysts for an enhanced hydrogen evolution reaction (HER) to produce hydrogen gas as an energy source from water splitting is an ideal approach. Herein, we report the synthesis of Fe2O3 nanorods–NiFe2O4 nanoparticles on cotton fiber cloth (Fe2O3-NiFe2O4/CF) at a low temperature as an efficient electrocatalyst for HERs. Among the as-prepared samples, the optimal Fe2O3-NiFe2O4/CF-3 electrocatalyst exhibits good HER performance with an overpotential of 127 mV at a current density of 10 mA cm−2, small Tafel slope of 44.9 mV dec−1, and good stability in 1 M KOH alkaline solution. The synergistic effect between Fe2O3 nanorods and NiFe2O4 nanoparticles of the heterojunction composite at the heterointerface is mainly responsible for improved HER performance. The CF is an effective substrate for the growth of the Fe2O3-NiFe2O4 nanocomposite and provides conductive channels for the active materials’ HER process.

The expansion of E-wallet service providers in Indonesia is quite encouraging. In its report, Bank of Indonesia indicated that 48 E-wallet services are lawful. This is consistent with the number of E-wallet transactions, where USD 1.5 billion were recorded in 2018 and this number is expected to increase in 2023. This statistic increases the researcher's motivation to investigate E-wallet acceptability in Indonesia. The intention to use e-wallets among Indonesian adults must be studied in order to comprehend adoption factors, identify user preferences, inform marketing strategies, promote financial inclusion, and inform policy and regulatory decisions. This cross-sectional quantitative study conducted in Indonesia aimed to examine the factors influencing the formation of an intention to use electronic wallets (E-Wallets). It focused on perceived ease of use, perceived trust, perceived risk, perceived usefulness, social influence, compatibility, facilitating conditions, and perception of new technology. While previous studies have explored factors influencing users' intention to adopt electronic wallets, few have explicitly focused on mediating factors in the Indonesian context. This study fills this gap by investigating the mediating factors that affect Indonesian users' intention to adopt electronic wallets. It enhances the understanding of the direct factors influencing users' intention and sheds light on the complex relationships of other factors (mediators) that explain the underlying dynamics of this phenomenon. The study analyzed data from 384 valid participants using partial least squares and structural equation modeling with Smart PLS 4.0. The findings revealed that e-wallet facilitating conditions, perceived usefulness, perceived trust, compatibility, perception of risk, and perception of new technology positively and significantly influenced users' intention to use e-wallets in Indonesia. However, social influence and ease of use did not have a positive impact on e-wallet adoption intention among the Indonesian sample. The implications of this study suggest that e-wallet providers should prioritize balancing ease of use and security in their systems. If an e-wallet system is perceived as too easy to use, it may raise concerns about safety and unauthorized access, negatively affecting users' intention to adopt electronic wallets. Therefore, e-wallet providers should ensure user-friendly systems that address security concerns. Future research should explore other factors related to e-wallet adoption and assess their long-term effects on users' intention to use and adopt e-wallets. Despite its limitations, this study provides valuable insights for e-wallet providers, policymakers, and researchers in understanding electronic wallet adoption in Indonesia. It offers guidance for developing effective strategies and interventions to promote widespread adoption and use of electronic wallets.

Abstract Background The incidence of inguinal hernia in the pediatric population is 0.8–4.4% with a male to female ratio of 5:1.The reported incidence of sliding hernia containing an ovary in female infants and children is 15–20%.The complete androgen insensitivity syndrome occurs in 1–2% of girls with an inguinal hernia. Thus, the incidence of CAIS in females with hernias and palpable gonads is 4/1,000,000. Results This is a retrospective analysis of 694 children that had undergone inguinal hernia repair in last 11 years. Out of these, 123 were females, 36 cases had palpable gonads at the time of presentation. FISH analysis was done in 29 cases (80%). None of the cases showed the presence of the Y chromosome. An abnormal chromosomal pattern was seen in one case on complete karyotyping. Conclusion The reported incidence of CAIS in girls with inguinal hernia is low, thus subjecting every girl child with inguinal hernia to undergo karyotyping is distressing for the parents. FISH analysis is an effective screening modality to rule out CAIS in girls with an inguinal hernia. Thus, it is recommended to screen only high-risk cases with palpable gonads at presentation.

This paper reflects on the lived experiences of young refugees located in Pakistan and Rwanda when interacting with education technology (EdTech) during and following displacement. We offer a broad decolonial commentary on issues related to the design and development of EdTech initiatives for refugees, noting some of the historical trends prevalent in the education and emergencies sector. We are guided by questions such as: Why EdTech to start with? Who designs the products? Where are they designed? How are they designed? And, which power dynamics are at play during the design process? From this, we draw on qualitative data generated through three focus groups, where we explore young refugees’ experiences of EdTech. The focus group included a creative element inviting participants to imagine what a liberatory EdTech practice would look like. We aim to illustrate the practical implications of design choices taken by EdTech developers and, from this, recommend a set of justice-centred design principles for developers of EdTech in refugee contexts. These insights relate specifically to the experiences of refugees in Rwanda and Pakistan, though we also discuss the implications of these learnings for other contexts.

Abstract Background Congenital perineal hernia is an extremely rare entity with only 10 cases having been reported in literature. We report a newborn with exposed bowel loops coming out through a defect in the perineum to the right of the median raphe and propose the term perineoschisis for this abnormality. The exposed bowel loops were a sequestered segment of colon. The baby also had extreme perineal hypospadias and left undescended testis. Case presentation A term neonate, born of caesarean section, was noted at birth to have exposed bowel loops visible in the perineum. The bowel loops were not covered by any membrane. To avoid injury to the exposed bowel loops and setting in of infection, the baby was taken up for emergency surgery. At laparotomy, the bowel loops were traced from duodeno–jejunal junction to ileocecal junction and sigmoid colon and rectum. No loops were seen herniating outside from the abdomen through the perineum opening. The extruded bowel loops were sequestered and ending blindly close to the rectum. The sequestered bowel loops were excised completely and perineum reconstruction was done. Conclusion The extruded bowel loops would appear to be a form of colonic duplication with the duplicated colonic loops herniating outside through an opening in the perineum. Since the bowel loops were lying to the right of median raphe and were not covered by hernia sac or any other membrane we propose the term perineoschisis for this abnormality. The baby also had extreme hypospadias with a perineal meatus, bifid scrotum and penoscrotal transposition. This association of herniated duplicated colon with extreme hypospadias is hitherto unreported to the best of our knowledge.

RhoGTPase regulators play a key role in the development of the nervous system, and their dysfunction can result in brain malformation and associated disorders. Several guanine nucleotide exchange factors (GEF) have been linked to neurodevelopmental disorders. In line with this, ARHGEF17 has been recently linked as a risk gene to intracranial aneurysms. Here we report siblings of a consanguineous Pakistani family with biallelic variants in the ARHGEF17 gene associated with a neurodevelopmental disorder with intellectual disability, speech delay and motor dysfunction but not aneurysms. Cranial MRI performed in one patient revealed generalized brain atrophy with an enlarged ventricular system, thin corpus callosum and microcephaly. Whole exome sequencing followed by Sanger sequencing in two of the affected individuals revealed a homozygous missense variant (g.11:73021307, c.1624C>T (NM_014786.4), p.R542W) in the ARHGEF17 gene. This variant is in a highly conserved DCLK1 phosphorylation consensus site (I/L/V/F/M]RRXX[pS/pT][I/L/M/V/F) of the protein. Our report expands the phenotypic spectrum of ARHGEF17 variants from increased intracranial aneurysm risk to neurodevelopmental disease and thereby add ARHGEF17 to the list of GEF genes involved in neurodevelopmental disorders.

Geological structures such as faults play a critical role in the flow of fluids in a reservoir by affecting its permeability. This study explores the role of the Chaman Fault in the distribution of hydrological division, groundwater separation of the aquifer systems of Khojak and Chaman basins. The Chaman Fault is a left-lateral strike-slip transform plate boundary located at the border city of Chaman, District Killa Abdullah, Balochistan. The Chaman fault plays an important role in the division of groundwater in the subsurface, accommodating the structural compartment of the aquifer system. The studies showed that the strike-slip movement of the fault made the aquifer impervious along the fault line. This assertion may also be confirmed by the drastic change in the water table across the fault. Sharp changes in the groundwater table and Total Dissolved Solids (TDS) were observed during the study. The Karazes which are an indigenous method of irrigation is present in the eastern foothills of Khojak mountains called Khojak basin. Here the water table is as shallow as ≈ 6 meters in comparison to the western side of the fault, where the water table drops to ≈274 meters towards the valley of Chaman basin. The average TDS level on the eastern side of the fault line is 773 mg/L and 1361 mg/L on the western side. Therefore, the Chaman fault is acting as a groundwater barrier which is feeding the Karezes for centuries.

Organizations are increasingly adopting green human resource management policies to encourage environmentally friendly behaviors. Research shows that adopting green policies and procedures is beneficial for the hospitality industry. However, limited empirical evidence exists on the association between environmental-specific ethical leadership, psychological green climate, and employees’ green behavior. Therefore, this study intends to examine psychological green climate (PGC) as a mediator between the relationship of environmental-specific ethical leadership (ESEL) and employees’ green behavior (EGB), specifically in the hotel industry of Pakistan. Data from 224 non-managerial position employees in the understudy sector was collected using a convenient sampling technique. Structural equation modeling (SEM) was utilized to examine the direct and indirect effects among the variables using the Smart PLS 3.3.3 version. This study showed that ESEL is positively related to PGC and EGB. Moreover, PGC is positively associated with EGB, and PGC mediated in the relationship between ESEL and EGB. Thus, current research highlights the significance of environmental-specific ethical leadership behavior, which assists in establishing a green psychological climate, thereby fostering employees’ green behavior in the hotel industry of Pakistan.

In Pakistan, women face economic and social vulnerability, which keeps them underpaid even without social barriers. Government micro and macroeconomic policies are aimed at income generation rather than making women part of the economic mainstream. The cash transfer program is an essential component of social protection policy in the developing world, with one of its key objectives of raising women's financial autonomy. This research investigates the impact of Pakistan's first and largest cash transfer program, named Benazir Income Support Program (BISP), on women's vulnerable employment. BISP was initiated by identifying poor households based on poverty score cutoff, thereby exploiting Regression Discontinuity Design. The findings revealed that this program reduced vulnerable employment in the initial years of its inception. However, it does not impact the later follow-up years. Policymakers should take necessary measures so that women's non-vulnerable employment may improve.

This study examined the effect of high-performance work systems on developing incremental and radical innovation capabilities. Drawing on resource-based and knowledge-based theories, the mediating effects of human capital, social capital, and organizational capital were tested. Data were collected from 233 middle-to-senior level managers working in the banking sector of Pakistan, and hypotheses were tested through partial least squares structural equation modeling using Smart PLS 4.0. The findings showed that all components of intellectual capital mediated the relationship to develop both types of innovation capabilities. In terms of the strength of the relationship, social capital was found to be a more effective mediator, and next to this were human capital and organizational capital, respectively. Our findings contribute to the existing literature by explaining the relationship between HPWS and innovation capabilities, which is also referred to as the black box through the mediation of intellectual capital. Decision makers should recognize the importance of this relationship because it develops innovation capabilities that enhance organizational performance by giving them a competitive advantage.

Globally, the COVID-19 pandemic has brought significant implications to the workplace and highly impacted employee performance in every organization. In contemporary research, the scholars agree that leadership is one of the critical antecedents to predict employee performance in organizations. However, research is needed to investigate the mediating role of integral factors such as benevolence values (BV) and self-efficacy (SE) in predicting employee performance in the workplace. This study aimed to investigate the impact of key antecedents on employee performance in the banking industry. The findings reveal that the key antecedents, e.g., servant leadership (SL), self-efficacy (SE), and benevolence values (BV), have a direct positive relationship with employee performance (EP). Moreover, multiple indirect paths were tested, including serial mediation. This study used a quantitative methodology based on the positivist paradigm. A sample of 560 employees was randomly chosen. A survey questionnaire was distributed among them, and 400 were returned with a response rate of 70%, and the clean data of 400 employees was used for data analysis. The structural equation modeling (SEM) technique was employed using Smart PLS 3.3.3 software. The results confirmed that both SE and BV mediate the relationship between SL and EP. Likewise, BV mediates the relationship between SE and EP, and SE mediates the relationship between SL and BV. Finally, in serial mediation, the relationship between SL and EP is also established via SE and BV together as mediators.

This research aims to assess the household and individual-level factors, specifically education, that affect the probability of women being engaged in decent work activities in the labor market. The study utilized the most recent labor force survey data from Pakistan with a sample size of 64,009 women. The research exploits the multinomial logit model (MNL) for data analysis. Several studies exist on the causes of female labor force participation nationally—in Pakistan—and internationally. However, there is a lack of research exploring the link between women’s access to decent work and various household and individual-level characteristics. This study intends to fill this literature gap by exploiting the largest nationwide labor force survey and exploring how household and individual-level factors, specifically focusing on women’s education level, relate to women’s employment status categories. The study’s findings reveal that education plays an essential role in uplifting women for better employment opportunities, i.e., educated women are more likely to be engaged in decent labor market activities such as paid employees and employers. The findings of the study propose some significant policy implications. E.g., (i) since education is the key to open better and decent work opportunities, it is crucial for women and their household heads to invest in education and vocational training; (ii) there is a dire need to have a policy shift in providing women access to at least a higher secondary (HS) level of education in Pakistan. The rationale is that less educated and illiterate women are concentrated in vulnerable employment; and (iii) at a micro level, there is a need to bring awareness among male household heads, specifically in rural areas, to realize that working women should not be considered a social stigma for the household.

This study investigated the relationship between entrepreneurial education and big-five personality traits with entrepreneurial intention. Besides, it assessed how the attitude toward entrepreneurship mediates these relationships. Employing a quantitative approach to address the research objectives, data of 165 respondents were collected through questionnaires. Structural equation modeling (SEM) and path analysis were conducted using AMOS 24 software. Study findings revealed that attitude toward entrepreneurship mediates the relationship of entrepreneurial education and big-five personality traits with entrepreneurial intention. Entrepreneurial education and big-five personality traits cause attitude which in turn affects entrepreneurial intention. These findings suggest that if the appropriate educational supports applied, it could help to develop students’ entrepreneurial attitudes and improve matching their skill expectations with their skill achievement. Universities can play a considerable role to promote entrepreneurship view by more focus on increasing entrepreneurial thinking and offering different types of vocational training workshops.

The purpose of this study is to examine the relationship among multiple organizational climates and micro level performance (MLP) in public sector organization of Pakistan. The research study has examined that five types of organizational climates (participative, innovative, leadership, service and ethical) effect MLP outcomes. The primary data was collected via standard questionnaire randomly from sample size of 250 employees working at regional head office and various branches of National Database & Registration Authority (NADRA) Peshawar, KPK, Pakistan. In addition standard multiple regressions model was used to test several hypotheses statistically about multiple climate, ‘MLP’ outcomes including, group level organizational citizenship behavior (GOCB), exit, and job satisfaction. The research findings have revealed that multiple climates were positively related with MLP outcomes i.e. employees’ job satisfaction and GOCB and exit.

This paper examines the extent to which refugee girls and young women were able to access learning during COVID-19 education closures in Pakistan, and the role that EdTech played in their learning access. It is based on findings from a survey with 403 Afghan refugee students, along with in-depth interviews with six young female refugees. The research shows that, while the majority of female refugee students were able to continue accessing education in some form during school closures, learning access was nevertheless limited, and a sizable minority were not engaged in any learning during this time. Teacher and institutional support was either absent or inadequate for many students, and infrastructure and devices that serve to support remote learning were not always reliable or accessible. Although male respondents were less likely than females to engage in independent study during the closures, refugee girls and young women were significantly less likely than their male counterparts to own the devices they needed for learning. The findings demonstrate how targeted investment in specific types of EdTech and teacher professional development, as well as supporting educational institutions in the establishment of remote learning opportunities, could help sustain learning during future periods of educational restriction.

Cross-Site Scripting (XSS) remains a significant threat to web application security, exploiting vulnerabilities to hijack user sessions and steal sensitive data. Traditional detection methods often fail to keep pace with the evolving sophistication of cyber threats. This paper introduces a novel hybrid ensemble learning framework that leverages a combination of advanced machine learning algorithms—Logistic Regression (LR), Support Vector Machines (SVM), eXtreme Gradient Boosting (XGBoost), Categorical Boosting (CatBoost), and Deep Neural Networks (DNN). Utilizing the XSS-Attacks-2021 dataset, which comprises 460 instances across various real-world traffic-related scenarios, this framework significantly enhances XSS attack detection. Our approach, which includes rigorous feature engineering and model tuning, not only optimizes accuracy but also effectively minimizes false positives (FP) (0.13%) and false negatives (FN) (0.19%). This comprehensive methodology has been rigorously validated, achieving an unprecedented accuracy of 99.87%. The proposed system is scalable and efficient, capable of adapting to the increasing number of web applications and user demands without a decline in performance. It demonstrates exceptional real-time capabilities, with the ability to detect XSS attacks dynamically, maintaining high accuracy and low latency even under significant loads. Furthermore, despite the computational complexity introduced by the hybrid ensemble approach, strategic use of parallel processing and algorithm tuning ensures that the system remains scalable and performs robustly in real-time applications. Designed for easy integration with existing web security systems, our framework supports adaptable Application Programming Interfaces (APIs) and a modular design, facilitating seamless augmentation of current defenses. This innovation represents a significant advancement in cybersecurity, offering a scalable and effective solution for securing modern web applications against evolving threats. [ABSTRACT FROM AUTHOR]

Background: Water, sanitation, and hygiene (WASH) are essential for a healthy and productive life. High-quality access to these services reduces disease occurrence and spread in communities. Developing countries, including Pakistan, face significant challenges in providing these facilities. This study aims to highlight WASH-related service disparities in Pakistani households based on socioeconomic strata. Methodology: A stratified random sampling strategy was used, with a sample size of 1200 households based on the PDHS 2019 special survey. Descriptive analysis and chi-square tests were conducted to assess the association between wealth quintiles and WASH access. Results: The study found that 82.4% of households had access to improved sources of drinking water. Only 4.8% of households in the lowest quintile had access to improved drinking water sources. Water unavailability for at least one day per week was 13% higher among the lower quintiles. Forty-four percent of households using improved sanitation facilities belonged to the two highest strata, while poorer households predominantly used unimproved sanitation facilities. Conclusion: Lower-quality WASH access is more prevalent among lower wealth quintiles, increasing the risk of disease and infection. Further research is needed to inform policymakers and develop plans to reduce inequalities in access to WASH services. Keywords: Water and sanitation, hygiene, Pakistan Demographic and Health Survey, inequalities, wealth quintiles [ABSTRACT FROM AUTHOR]

Objective: To explore the concept of spiritual healing and compare its effects with allopathic medicine in terms of disease conceptualization, treatment approach and patient perception and use in community setting. Methods: A qualitative research design with a grounded theory approach was utilized for this study. Semi-structured interviews and focus group discussions were conducted, and data were analyzed using thematic content analysis technique. Results: The explorative of spiritual healing revealed motivation challenges and treatment frameworks. Healers emphasized skills mastery and adherence to values, employing methods like Ijazas and wazaiif. Patients reported mixed experiences, with some finding benefit while others expressed their doubt. Comparison with allopathic medicine highlighted drawbacks leading to discussion on preference or potential co-existence. Conclusion: In conclusion, spiritual healing offers a unique perspective on healthcare, while challenges exist, including skepticism and the need for integration with allopathic medicine. The field continues to play a pivotal role in addressing social well being. [ABSTRACT FROM AUTHOR]