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Paper mulberry pollen, declared a pest in several countries including Pakistan, can trigger severe allergies and cause asthma attacks. We aimed to develop an algorithm that could accurately predict high pollen days to underpin an alert system that would allow patients to take timely precautionary measures. We developed and validated two prediction models that take historical pollen and weather data as their input to predict the start date and peak date of the pollen season in Islamabad, the capital city of Pakistan. The first model is based on linear regression and the second one is based on phenological modelling. We tested our models on an original and comprehensive dataset from Islamabad. The mean absolute errors (MAEs) for the start day are 2.3 and 3.7 days for the linear and phenological models, respectively, while for the peak day, the MAEs are 3.3 and 4.0 days, respectively. These encouraging results could be used in a website or app to notify patients and healthcare providers to start preparing for the paper mulberry pollen season. Timely action could reduce the burden of symptoms, mitigate the risk of acute attacks and potentially prevent deaths due to acute pollen-induced allergy. [ABSTRACT FROM AUTHOR]

The banking sector serves as a nudge between increased financial investments and reduced environmental impacts in the modern era of sustainability thus, integrating the social, environmental, and economic dimensions. This paper aims to explore the practices and ongoing activities on account of sustainable banking which is being practised in the Pakistani Banking Sector. A mixed methods approach using a survey with a sample size of (n = 250) and in-depth interviews of (n = 25) provides significant evidence for the research. SmartPLS4.0 was used for hypotheses testing and to ascertain the path coefficient association within the constructs. This research fills the gap in existing literature by testing and implying the mediating role of Stakeholders' Influence on the relationship between Green Banking Practices and the Bank's Performance. The results of the quantitative analysis show a positive association between variables, highlighting the role of stakeholders and their need to partake efficiently, in the countrywide execution of green banking. The qualitative analysis portrays that; green banking is currently the partial focus of the banking sector in the developing economy of Pakistan whereas, approaches like financing green projects, investments in renewable energy, in-house greening of the banking sector, and provision of easy lending facilities to encourage and support environmental initiatives are some commonly practised accomplishments of the banking sector. [ABSTRACT FROM AUTHOR]

This paper investigates the long-run and short-run relationship between money supply and inflation in Pakistan, utilizing annual data spanning from 1981 to 2021. The key objective is to assess the impact of monetary policy, specifically money supply, on inflation dynamics in the country. To achieve this, the Autoregressive Distributed Lag (ARDL) bounds testing approach is employed, which is suitable for analyzing cointegration among variables with mixed integration orders. The results reveal both short and long-run cointegration between inflation, money supply, unemployment, and interest rates. Notably, unemployment demonstrates a negative correlation with inflation, while money supply and interest rates exhibit a positive relationship. These findings underscore the importance of dedicated policy measures to manage inflation effectively. The paper concludes by recommending the establishment of a policy implementation body and collaboration between the government and the central bank to ensure financial stability and control inflation through well-calibrated monetary and fiscal policies. [ABSTRACT FROM AUTHOR]

The Internet has become the fastest-growing way to sell luxury products. Purchase intention for luxury products in online stores has taken attention in the last few years since the sector has proliferated. The primary objective of this study is to examine the impact of various factors such as Product knowledge, Price consciousness, Perceived enjoyment, Perceived ease of usage, and usefulness on online luxury purchase intention in developing countries like Pakistan. Data was collected from 267 luxury fashion customers in Pakistan through an online questionnaire, and the results were analyzed using Smart PLS-SEM. In addition, the paper investigates the moderating effect of Perceived risk, Brand awareness and Web Atmospheric on the link between the Attitude and Online Luxury Purchase Intentions of the consumer to buy luxury fashion products online. The framework of this study is validated by structural equation modelling (SEM). The findings of this study show that perceived enjoyment, price consciousness, and Perceived ease of use significantly and positively impact online luxury purchase intention. Additionally, the findings indicated that brand awareness, perceived risk, and web atmospherics each intervened as moderators in the relationship between attitudes toward purchasing luxury products and online luxury purchase intentions. Product knowledge is not directly related to online purchase intention, but Attitude plays a mediating role in the relationship between product knowledge and online luxury buying purpose. In the context of luxury product intention, this study is one of the first to investigate the moderating effect that brand awareness, perceived risk, and web atmospherics play. It will help luxury brands develop the right tactics for selling luxury goods online in developing countries like Pakistan. [ABSTRACT FROM AUTHOR]

Background: Low-and-middle-income countries (LMICs) bear a disproportionate burden of communicable diseases. Social interaction data inform infectious disease models and disease prevention strategies. The variations in demographics and contact patterns across ages, cultures, and locations significantly impact infectious disease dynamics and pathogen transmission. LMICs lack sufficient social interaction data for infectious disease modeling. Methods: To address this gap, we will collect qualitative and quantitative data from eight study sites (encompassing both rural and urban settings) across Guatemala, India, Pakistan, and Mozambique. We will conduct focus group discussions and cognitive interviews to assess the feasibility and acceptability of our data collection tools at each site. Thematic and rapid analyses will help to identify key themes and categories through coding, guiding the design of quantitative data collection tools (enrollment survey, contact diaries, exit survey, and wearable proximity sensors) and the implementation of study procedures. We will create three age-specific contact matrices (physical, nonphysical, and both) at each study site using data from standardized contact diaries to characterize the patterns of social mixing. Regression analysis will be conducted to identify key drivers of contacts. We will comprehensively profile the frequency, duration, and intensity of infants' interactions with household members using high resolution data from the proximity sensors and calculating infants' proximity score (fraction of time spent by each household member in proximity with the infant, over the total infant contact time) for each household member. Discussion: Our qualitative data yielded insights into the perceptions and acceptability of contact diaries and wearable proximity sensors for collecting social mixing data in LMICs. The quantitative data will allow a more accurate representation of human interactions that lead to the transmission of pathogens through close contact in LMICs. Our findings will provide more appropriate social mixing data for parameterizing mathematical models of LMIC populations. Our study tools could be adapted for other studies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has emerged as a significant event of the current century, introducing substantial transformations in economic and social activities worldwide. The primary objective of this study is to investigate the relationship between daily COVID-19 cases and Pakistan stock market (PSX) return volatility. To assess the relationship between daily COVID-19 cases and the PSX return volatility, we collected secondary data from the World Health Organization (WHO) and the PSX website, specifically focusing on the PSX 100 index, spanning from March 15, 2020, to March 31, 2021. We used the GARCH family models for measuring the volatility and the COVID-19 impact on the stock market performance. Our E-GARCH findings show that there is long-term persistence in the return volatility of the stock market of Pakistan in the period of the COVID-19 timeline because ARCH alpha (ω1) and GARCH beta (ω2) are significant. Moreover, is asymmetrical effect is found in the stock market of Pakistan during the COVID-19 period due to Gamma (ѱ) being significant for PSX. Our DCC-GARCH results show that the COVID-19 active cases have a long-term spillover impact on the Pakistan stock market. Therefore, the need of strong planning and alternative platform should be needed in the distress period to promote the stock market and investor should advised to make diversified international portfolio by investing in high and low volatility stock market to save their income. This study advocated the implications for investors to invest in low volatility stock especially during the period of pandemics to protect their return on investment. Moreover, policy makers and the regulators can make effective policies to maintain financial stability during pandemics that is very important for the country's economic development. [ABSTRACT FROM AUTHOR]

Background: The pharmaceutical sector in Pakistan has grown over a period with export potential, however, there are certain barriers in the framework that regulate the growth and export of domestically manufactured pharmaceuticals. The purpose of this study was to highlight the current challenges that hinder the export of pharmaceuticals, especially to the countries with stringent regulatory authorities (SRA), as perceived by the domestic pharmaceutical industry experts, and to highlight the facilitators that may help to resolve the identified challenges. Methods: In a qualitative study, the data were collected from the consented experts from the pharmaceutical industries in Lahore, Karachi, Peshawar, and Quetta. Industrial experts with a minimum of 10 years of experience and who were serving at managerial levels or above were recruited through purposive sampling. The semi-structured interviews were conducted for the collection of data from industrial experts. Thematic content analysis was applied to conclude the data. Results: Data analysis generated 4 themes and 16 codes. The export of pharmaceuticals, despite having greater potential was regarded as poor, which was attributed to the following: (a) inadequate industrial research and development, particularly on new molecules (b) non-compliance with the cGMP standards, (c) absence of high-tech equipment, (d) unwillingness of the pharmaceutical companies for bioequivalence studies on their generics, (e) unavailability of locally manufactured active pharmaceutical ingredients, (f) disruption in the supply of imported raw material, (g) poor international market perception about local pharmaceutical products and (h) lack of support from regulatory in process expedition. The respondents also suggested the measures for overcoming the above challenges to boost the export of domestic pharmaceuticals and expand their international market share in countries with SRA. Conclusion: Export from Pakistan to the SRA countries can be enhanced with mandatory bioequivalence studies during generic registration. The pharmaceuticals export could effectively contribute to the national economy. [ABSTRACT FROM AUTHOR]

Fruit flies of genus Bactrocera are important insect pests of commercially cultivated mangos in Pakistan limiting its successful production in the country. Despite the economic risk, the genetic diversity and population dynamics of this pest have remained unexplored. This study aimed to morphologically identify Bactrocera species infesting Mango in major production areas of the country and to confirm the results with insect DNA barcode techniques. Infested mango fruits from the crop of 2022, were collected from 46 locations of 11major production districts of Punjab and Sindh provinces, and first-generation flies were obtained in the laboratory. All 10,653 first generation flies were morphologically identified as two species of Bactrocera; dorsalis and zonata showing geography-based relative abundance in the two provinces; Punjab and Sindh. Morphological identification was confirmed by mitochondrial cytochrome oxidase gene subunit I (mt-COI) based DNA barcoding. Genetic analysis of mtCOI gene region of 61 selected specimens by the presence of two definite clusters and reliable intraspecific distances validated the results of morphological identification. This study by morphological identification of a large number of fruit fly specimens from the fields across Pakistan validated by insect DNA barcode reports two species of Bactrocera infesting mango in the country. [ABSTRACT FROM AUTHOR]

Contaminated air quality, in lieu of massive industrial pollution, is severely attributing to health anomalies in the proximity of industrial units. Cardiovascular Disease (CAD) is rising around industrial units in the planned capital city of Pakistan, Pakistan. To study self-reported CAD in the proximity of Industrial Estate Islamabad (IEI) by equating two distinct study groups as 'Band-I': the residence 0–650 meters and 'Band-II' 650–1300 meters radius around the perimeter of IEI. The perimeters were digitized using Google Earth and GIS. Field survey was conducted on deploying 388 (194 in each Band) close-ended (self-administered) questionnaires at the household level, after adjusting the potential confounding variables. The research calculated odds ratios (ORs) of the CAD at 95% CI. The study's findings of the multiple logistic regression for ORs confirmed a significant increase in CAD problems due to industrial affluents in Band-I than in Band-II which were less severe and less life-threatening. Study confirmed high incidences of high blood pressure and breathing issues (up to 67%), due to accumulation of unhealthy affluents thus leading to heart stroke (Band I = 56.20% and Band II = 60.30%). It is aided by smoking that has increased CAD in Band-I. Societal attributes of knowledge, beliefs, attitudes, and preferences fail to safeguard the local residents amid high concentration of harmful pollutants. As a counter measure the affected respondents engaged in highlighting the issue to the concerned public offices, yet there is a high need on part of the capital government to take mitigative measures to immediately halt the disastrous industrial air emissions to save precious lives. [ABSTRACT FROM AUTHOR]

The genus Agaricus includes more than 500 species mostly containing the edible and cultivated species worldwide. As part of the ongoing studies on the biodiversity of genus Agaricus in Pakistan, our objective was to focus on A. sect. Minores which is the largest section of the genus. In the first phylogenetic analyses based on the ITS region of the nuclear ribosomal DNA, our sample included specimens of 97 named species, 27 unnamed species, and 31 specimens (29 newly generated sequences in this study) from subtropical climate zones of Pakistan that likely belong to this section based on their morphology. The 31 specimens grouped into five distinct, well-supported clades corresponding to five species: A. glabriusculus already known from Pakistan and India, A. robustulus first recorded from Pakistan and briefly described here but already known from Bénin, Malaysia, China, and Thailand, and three possibly endemic new species described in detail A. badiosquamulosus sp. nov., A. dunensis sp. nov., and A. violaceopunctatus sp. nov. The sixth species currently known in Pakistan, including A. latiumbonatus also found in Thailand, were included in a multigene tree based on ITS, LSU, and Tef-1α sequence data. They all belong to a large pantropical paraphyletic group while most temperate species belong to a distinct clade, which includes about half of the species of the section. The current study aims to propose three novel species of genus Agaricus based on comprehensive morphological as well as molecular phylogenetic evidences from Pakistan. [ABSTRACT FROM AUTHOR]

Background: Zinc deficiency poses significant health risks, particularly in low-income settings. This study aims to evaluate the impact of agronomically zinc biofortified (fermented and non-fermented) and post-harvest wheat flour flatbread on zinc status and metabolic health in adolescents and adult women in rural Pakistan. Methods: A four-arm triple-blind randomized controlled trial will be conducted in a rural district of Pakistan. Participants (adolescents aged 10–19 and adult women aged 20–40) will be assigned to receive fermented or unfermented high zinc agronomically biofortified wheat flour flatbread, post-harvest zinc-fortified wheat flour flatbread, or low zinc conventional whole wheat flour flatbread. The meal would be served once a day, six days a week for six months. The study aims to enroll 1000 participants and will be analyzed based on the intention-to-treat principle. The trial is registered with number NCT06092515. Outcomes: Primary outcomes will include serum zinc concentration and metabolic markers, while secondary outcomes include anthropometric measurements, blood pressure, and dietary intake. Conclusion: This trial will provide valuable insights into the efficacy of agronomically zinc biofortified wheat flour in improving zinc status and metabolic health. Findings may inform public health strategies to combat zinc deficiency in resource-limited settings. [ABSTRACT FROM AUTHOR]

This research investigates the complex interaction between liquidity and volatility while considering Economic Policy Uncertainty (EPU) as a moderating factor. Using a comprehensive dataset that incorporates various liquidity measures such as market resilience, depth, and breadth, the study examines how changes in liquidity impact volatility in four Asian incipient economies: China, Pakistan, India, and South Korea. By utilizing sophisticated econometric techniques, particularly the System Generalized Method of Moment (GMM), the findings demonstrate a statistically significant inverse relationship between liquidity and volatility. These findings imply that, within the Asian context, lower levels of volatility are correlated with higher market liquidity. By incorporating EPU into the model, the research acknowledges the significant role of economic factors in shaping market dynamics. Stakeholders, decision-makers, and investors can gain valuable insights from this analysis of variables influencing market stability in Asian emerging economies. The study's outcomes can guide policymakers in formulating strategies that promote market stability and improve market microstructure. [ABSTRACT FROM AUTHOR]

The main objective of this research is to examine whether the implementation of new human resource management practices (NHRM) can enhance innovative performance (IP) by fostering innovation capability (NC). Additionally, it examines the moderating influence of an innovative climate (IC) and its associated attributes on the association with new human resource management and innovation capability, a factor that has been relatively overlooked in prior research. The study's data was obtained from 398 employees in the pharmaceutical sector of Pakistan, and hierarchical regression analysis was utilized to analyze the data. The results from the mediating and moderating analyses underscore the significance of NHRM practices, innovation capability, and an innovative climate, along with its specific attributes, in promoting innovative performance through factors such as operational efficiency, suitable practices, and employees' willingness to participate in organizational endeavors. Furthermore, the moderated mediation analysis findings reveal that the influence of innovation capability as a mediator is strengthened when the workplace climate is more conducive to innovation. These findings have implications for both theoretical understanding and practical application, particularly in similar developing countries. The study offers insights that can be generalized to developing nations with comparable economic and social structures. [ABSTRACT FROM AUTHOR]

Background: Pakistan is endemic to a diverse set of parasitic, mycobacterial and viral diseases. The recognition of BCG Trained Immunity (TI) led us to postulate that the continued presence of BCG-TI may play a protective role, previously reported for both infectious and noninfectious conditions. Most of the previous studies have addressed the issue of BCG-TI in the paediatric populations. This study addressed the key issue of maintenance of BCG-TI in a wider age range (adolescent and adults) to identify the strength and quality of the immune responses. Objective: To assess the BCG-induced recall responses in healthy individuals by cytokines secreted from the TI network and its potential role in providing cross-protection against COVID-19 and other viral infections. Study design: In this cross-sectional study, healthy young adults and adolescents (n = 20) were recruited from 16–40 years of age, with no prior history of TB treatment, autoimmune, or chronic inflammatory condition. Methods: BCG-induced cytokine responses were assessed using prototypic markers for cells of the TI network [macrophages [M1 (TNFα, IFNγ), M2 (IL10)], NK (IL2), Gamma delta (γδ) T (IL17, IL4)] and SARS CoV2 IgG antibodies against RBD using short-term (12 hrs.) cultures assay. Results: Significant differences were observed in the magnitude of recall responses to BCG with macrophage cytokines showing the highest mean levels of TNFα (9148 pg/ml) followed by IL10 (488 pg/ml) and IFNγ (355 pg/ml). The ratio of unstimulated vs.BCG-stimulated cytokines was 132 fold higher for TNFα, 40 fold fo r IL10, and 27 fold for IFNγ. Furthermore, SARS-CoV-2 antibodies were also detected in unstimulated plasma which showed cross reactivity with BCG. Conclusion: The presence of cross reactive antibodies to SARS-CoV-2 and the relative ratio of pro- and anti-inflammatory cytokines secreted by activated TI cellular network may play a pivotal role in protection in the early stages of infection as observed during the COVID-19 pandemic in the younger age groups resulting in lower morbidity and mortality. [ABSTRACT FROM AUTHOR]

Retinopathy of Prematurity (ROP) significantly contributes to childhood blindness globally, with a disproportionately high burden in low- and middle-income countries (LMICs) due to improved neonatal care alongside inadequate ROP screening and treatment facilities. This study aims to validate the performance of Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria in a cohort of premature infants presenting at a tertiary care setting in Pakistan. This cross-sectional study utilized retrospective chart review of neonates admitted to the neonatal intensive care unit (NICU) at The Aga Khan University Hospital, Pakistan from January 2018 to February 2022. The complete G-ROP criteria were applied as prediction tool for infants with type 1 ROP, type 2 ROP, and no ROP outcomes. Out of the 166 cases, 125 cases were included in the final analysis, and remaining cases were excluded due to incomplete data. ROP of any stage developed in 83 infants (66.4%), of whom 55 (44%) developed type 1 ROP, 28 (22.4%) developed type 2 ROP, and 19 (15.2%) were treated for ROP. The median BW was 1060 gm (IQR = 910 to 1240 gm) and the median gestational age was 29 wk (IQR = 27 to 30 wk). The G-ROP criteria demonstrated a sensitivity of 98.18% (95% CI: 90.28–99.95%) for triggering an alarm for type 1 ROP. The G-ROP criteria achieved 100% sensitivity (95% CI: 87.66 to 100%) for type 2 ROP. The overall sensitivity of G-ROP criteria to trigger an alarm for any type of ROP was 98.8% (95% CI: 93.47 to 99.97%). Thus, the G-ROP screening model is highly sensitive in detecting at-risk infants for ROP in a Pakistani tertiary care setting, supporting its use in LMICs where standard screening criteria may not suffice. [ABSTRACT FROM AUTHOR]

To encourage technological and industrial innovation, nations worldwide implement "re-industrialization" and "manufacturing return." This study investigates the relationship between GDP growth, expenditure on research and development, and medium- to high-tech as a percentage of manufactured exports on technological innovation in Pakistan. We evaluated long-run and short-run causal relationships using the ARDL, bound-F test, and ECM regression. The study found a positive relationship between GDP growth and technological innovation in the short and long run. In the short run, with a one-year lag, the analysis reveals a positive and statistically significant relationship between technological innovation, medium-high-tech exports, and GDP growth. In the long run, R&D is positive and significant, while economic growth and technological innovation are positive but not statistically significant. There is a 0.38 percent chance that exogenous shocks will eventually lead to equilibrium in the long run. Based on the findings of this study, it is recommended to allocate resources to research and development, promoting collaborative initiatives, ensuring intellectual property rights, and developing a skilled workforce. [ABSTRACT FROM AUTHOR]

Road crashes are a major public safety concern in Pakistan. Prior studies in Pakistan investigated the impact of different factors on road crashes but did not consider the temporal stability of crash data. This means that the recommendations based on these studies are not fully effective, as the impact of certain factors may change over time. To address this gap in the literature, this study aims to identify the factors contributing to crash severity in road crashes and examine how their impact varies over time. In this comprehensive study, we utilized Generalised Linear Model (GLM) on the crash data between the years 2013 to 2017, encompassing a total sample of 802 road crashes occurred on the N-5 road section in Pakistan, a 429-kilometer stretch connecting two big cities of Pakistan, i.e., Peshawar and Lahore. The purpose of the GLM was to quantify the temporal stability of the factors contributing crash severity in each year from 2013 to 2017. Within this dataset, 60% (n = 471) were fatal crashes, while the remaining 40% (n = 321) were non-fatal. The results revealed that the factors including the day of the week, the location of the crashes, weather conditions, causes of the crashes, and the types of vehicles involved, exhibited the temporal instability over time. In summary, our study provides in-depth insights aimed at reducing crash severity and potentially aiding in the development of effective crash mitigation policies in Pakistan and other nations having similar road safety problems. This research holds great promise in exploring the dynamic safety implications of emerging transportation technologies, particularly in the context of the widespread adoption of connected and autonomous vehicles. [ABSTRACT FROM AUTHOR]

The objective of the study is to explore the relationship between country governance practices along with political stability and Economic policy uncertainty, and stock market performance of two different economies, Pakistan and Kurdistan region of Iraq. To meet our objectives, we used the 25 years past data from 1996 to 2021. Data is collected from the DataStream database. The regression analysis is used as the method of estimation for linear and moderation effect. Our results show that regulatory quality, rules of law and political stability has significant positive relationship with stock market performance of Pakistan, but all the governance indicators have significant positive relationship with stock market performance of the Kurdistan Region of Iraq. Moreover, political stability has significant moderating impact between the governance practices and the performance of the stock markets of both economies indicating that the governance practices perform well with the political stability that leads to rise in the stock market indices of selected countries. Economic policy uncertainty has significant negative moderation impact due to creating the risk in both economies that decrease the performance of the stock markets of the selected economies. Finally, our study advocated some implications for the investors to increase their confidence on the stock of high political stability and low economic policy uncertainty economies. Government can take significant measures to control the uncertainty of the policy and portfolio managers can adjust their risk on the ground of the political stability and efficient governance practices countries. [ABSTRACT FROM AUTHOR]

The order Hymenoptera holds great significance for humans, particularly in tropical and subtropical regions, due to its role as a pollinator of wild and cultivated flowering plants, parasites of destructive insects and honey producers. Despite this importance, limited attention has been given to the genetic diversity and molecular identification of Hymenopteran insects in most protected areas. This study provides insights into the first DNA barcode of Hymenopteran insects collected from Hazarganji Chiltan National Park (HCNP) and contributes to the global reference library of DNA barcodes. A total of 784 insect specimens were collected using Malaise traps, out of which 538 (68.62%) specimens were morphologically identified as Hymenopteran insects. The highest abundance of species of Hymenoptera (133/538, 24.72%) was observed during August and least in November (16/538, 2.97%). Genomic DNA extraction was performed individually from 90/538 (16.73%) morphologically identified specimens using the standard phenol-chloroform method, which were subjected separately to the PCR for their molecular confirmation via the amplification of cytochrome c oxidase subunit 1 (cox1) gene. The BLAST analyses of obtained sequences showed 91.64% to 100% identities with related sequences and clustered phylogenetically with their corresponding sequences that were reported from Australia, Bulgaria, Canada, Finland, Germany, India, Israel, and Pakistan. Additionally, total of 13 barcode index numbers (BINs) were assigned by Barcode of Life Data Systems (BOLD), out of which 12 were un-unique and one was unique (BOLD: AEU1239) which was assigned for Anthidium punctatum. This indicates the potential geographical variation of Hymenopteran population in HCNP. Further comprehensive studies are needed to molecularly confirm the existing insect species in HCNP and evaluate their impacts on the environment, both as beneficial (for example, pollination, honey producers and natural enemies) and detrimental (for example, venomous stings, crop damage, and pathogens transmission). [ABSTRACT FROM AUTHOR]

Background: Precision medicine (PM) is in great progressive stages in the West and allows healthcare practitioners (HCPs) to give treatment according to the patient's genetic findings, physiological and environmental characteristics. PM is a relatively new treatment approach in Pakistan Therefore, it is important to investigate the level of awareness, attitude, and challenges faced by oncology physicians while practicing PM for various therapies, especially cancer treatment. Objectives: The present study aims to explore the level of awareness, attitude, and practice of PM in Pakistan along with the challenges faced by the oncologists for the treatment of cancer using the PM approach. Methods: Phenomenology-based qualitative approach was used. Face-to-face in-depth interviews were conducted using the purposive sampling approach among oncologists in Lahore, Pakistan. The data were analyzed using thematic content analysis to identify themes and sub-themes. Results: Out of 14 physicians interviewed 11 were aware of PM. They were keen on training to hone their skills and agreed on providing PM. Oncologists believed PM was expensive and given to affluent patients only. Other impeding factors include cost, lack of knowledge, and drug unavailability. Conclusions: Despite basic knowledge and will to practice, resource and cost constraints were marked as significant barriers. Additional training programs and inclusion into the curriculum may help to pave the way to PM implementation in the future. In addition, health authorities and policymakers need to ensure a cheaper PM treatment can be made available for all cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal deaths and stillbirths are significant public health concerns in Pakistan, with an estimated stillbirth rate of 43 per 1,000 births and a neonatal mortality rate of 46 deaths per 1,000 live births. Limited access to obstetric care, poor health seeking behaviors and lack of quality healthcare are the leading root causes for stillbirths and neonatal deaths. Rehri Goth, a coastal slum in Karachi, faces even greater challenges due to extreme poverty, and inadequate infrastructure. This study aims to investigate the causes and pathways leading to stillbirths and neonatal deaths in Rehri Goth to develop effective maternal and child health interventions. Methods: A mixed-method cohort study was nested with the implementation of large maternal, neonatal and child health program, captured all stillbirths and neonatal death during the period of May 2014 till June 2018. The Verbal and Social Autopsy (VASA) tool (WHO 2016) was used to collect primary data from all death events to determine the causes as well as the pathways. Interviews were conducted both retrospectively and prospectively with mothers and caregivers. Two trained physicians reviewed the VASA form and the medical records (if available) and coded the cause of death blinded to each other. Descriptive analysis was used to categorize stillbirth and neonatal mortality data into high- and low-mortality clusters, followed by chi-square tests to explore associations between categories, and concluded with a qualitative analysis. Results: Out of 421 events captured, complete VASA interviews were conducted for 317 cases. The leading causes of antepartum stillbirths were pregnancy-induced hypertension (22.4%) and maternal infections (13.4%), while obstructed labor was the primary cause of intrapartum stillbirths (38.3%). Neonatal deaths were primarily caused by perinatal asphyxia (36.1%) and preterm birth complications (27.8%). The qualitative analysis on a subset of 40 death events showed that health system (62.5%) and community factors (37.5%) contributing to adverse outcomes, such as delayed referrals, poor triage systems, suboptimal quality of care, and delayed care-seeking behaviors. Conclusion: The study provides an opportunity to understand the causes of stillbirths and neonatal deaths in one of the impoverished slums of Karachi. The data segregation by clusters as well as triangulation with qualitative analysis highlight the needs of evidence-based strategies for maternal and child health interventions in disadvantaged communities. [ABSTRACT FROM AUTHOR]

The study explores the impact of employee perceptions of corporate social responsibility (CSR) in improving employee loyalty by examining the direct and indirect role of person-organization fit and employee trust. A convenient sampling technique was employed to collect the data sample. A total of 338 questionnaires were collected at three different China-Pakistan Economic Corridor (CPEC) projects in Pakistan. The SmartPLS-3 was used to test the study hypotheses. The results revealed that CSR positively and significantly influenced employee loyalty. The findings indicated a partial mediating impact of P-O fit and employee trust in the relationship between CSR and employee loyalty. Discussions, implications, limitations, and future research direction are also given. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BCa) is the most common cause of cancer death in Pakistan. In 2019, Pakistan saw the highest global BCa-associated death rate. But do Pakistani women know about the various aspects of BCa? And how prevalent are BCa screening methods amongst Pakistani females? These questions formed the basis for our study. Methods: We conducted this review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. On September 1, 2023, we searched PubMed, Embase, Scopus, and Google Scholar, and performed a citation search to search for eligible studies published in 2010 or after, using the following terms: "breast cancer" and "Pakistan". Observational studies that evaluated BCa awareness and/or practice amongst Pakistani females who were not associated with medicine were eligible. We used the National Institutes of Health quality assessment tool to assess the risk of bias. We conducted a proportion meta-analysis to calculate pooled prevalences for variables. Results: Responses from 9766 Pakistani women across 18 included studies showed alarmingly low levels of BCa knowledge: risk factors, 42.7% (95% CI: 34.1%-51.4%); symptoms, 41.8% (95% CI: 26.2%-57.5%); diagnostic modalities, 36.3% (95% CI: 23.1%-49.4%); treatments, 46.6% (95% CI: 13.5%-79.8%). Prevalence of breast self-examination (BSE) and ever having undergone a clinical breast exam (CBE) was 28.7% (95% CI: 17.9%-39.6%) and 15.3% (95 CI: 11.2%-19.4%), respectively. BCa knowledge was significantly associated with better educational status, age, and socioeconomic status. Conclusion: On average, only two in five Pakistani women are aware of one or more risk factors, symptoms, or diagnostic modalities. Approximately one in two women know about possible BCa treatment. Less than one in three women practice regular BSE, and less than one in five women have ever undergone a CBE. [ABSTRACT FROM AUTHOR]

This specific research initiative aims to intricately examine the intricate dynamics connecting terrorism, corruption, and capital flight within the context of South Asian economies, encompassing countries including Bangladesh, India, Pakistan, and Sri Lanka. The principal objectives of this study entail a comprehensive investigation into the synergistic impacts of terrorism and corruption on the prevalence of capital flight. To realize these objectives, the study employs longitudinal data from 1990 to 2019, adopting the portfolio choice framework as its theoretical underpinning. In terms of methodology, the empirical inquiry uses the Generalized Method of Moments (GMM) estimation technique. The empirical findings derived from this analysis distinctly establish a statistically noteworthy and positive correlation between terrorism, corruption, and the occurrence of capital flight across multiple South Asian nations. In light of these discerning outcomes, it is strongly recommended that the governments of South Asian countries prioritize and actively pursue the fortification of their institutional governance mechanisms. This strategic approach is deemed crucial in efficaciously counteracting the escalation of capital flight. Specifically, a targeted focus on augmenting institutional governance practices, fostering transparency, fortifying anti-corruption measures, and intensifying counterterrorism efforts could collectively contribute to reducing capital flight tendencies. By undertaking these recommendations, South Asian governments can foster an environment of enhanced economic stability, attractiveness for investment, and sustainable growth, thereby deterring the adverse impact of capital flight while concurrently combatting the underlying challenges posed by terrorism and corruption. [ABSTRACT FROM AUTHOR]

Post-stratification is applied when the subpopulation membership is observed only for sampled values and the goal is to estimate stratum-specific parameters which leads the survey statisticians towards primary goals i.e., classification of non-sampled units into different strata and prediction of the values of the study variables. Regression models, on one side, optimize the prediction of the study variable's non-sampled values while the classification algorithms, on the other side, look for the classification of non-sampled cases into different strata. Hence, it is crucial to deal with these two goals simultaneously for the estimation of stratum-specific parameters. This study introduces the idea of a double-objective classification and regression trees (CARTs) approach for estimating stratum-specific parameters. Theoretical properties of the total estimator are derived. An application on the estimation of health outcomes in different domains is given to delineate the practical significance as well as the efficiency of the proposed CART-based method. The proposed estimator of population total performs better than the existing stratum-specific estimator in terms of relative efficiency for all choices of parameters. As an ensemble model, the random forest CART outperforms the other competing tree-based models and homogenous population model without using any auxiliary variable. [ABSTRACT FROM AUTHOR]

Equine embryo transfer (EET) is a prominent technology in the equine breeding industry, and its efficacy is affected by a number of factors. The current study aimed to determine the effects of the breed of donor/recipient mares, estrus/ovulation induction treatment, cooled transportation of embryos, and synchrony between donor and recipient mares on the efficiency of the EET under subtropical conditions of Pakistan. A total of eighty-four (n = 84) Polo-playing donor mares (Argentino-polo = 41 and Anglo-Arab = 43) and seventy (n = 70) recipient mares (light breed = 26 and heavy breed = 44) were used for EET. The donor mares exhibiting natural estrus (n = 28) were detected by teaser a stallion, and corpus luteum (CL) having mares (n = 56) were treated with prostaglandin (150 μg of Cloprostenol) for estrus induction. The mares' follicular growth was monitored through ultrasonography until the dominant follicle's size reached 35 mm or more with a moderate to obvious uterine edema score. Afterward, the mares were treated either with GnRH, i.e., 50 μg of Lecirelin acetate (n = 41) or Ovusyn, i.e., 1500 IU hCG (n = 43). Insemination with chilled semen was performed 24 hours later. The embryos were collected non-surgically, 7 or 8 days after ovulation, from the donor mares. The collected embryos were transferred into the well-synchronized recipient mares as fresh (n = 44) or chilled (n = 26) embryos. The pregnancy after ET was checked through ultrasonography. Statistical analysis revealed that the embryo recovery rate (ERR) remained significantly higher (P<0.05) for the Prostaglandin (PG) treated group of donors as compared to the natural heat group of donors. The breed of donor mares, type of ovulatory treatment given, and day of embryo collection did not significantly (P>0.05) affect the ERR. There was no significant effect of the type (fresh vs chilled), classification, and stage of development of embryo on pregnancy outcomes (P>0.05). ET pregnancy rate was significantly affected by the breed of recipient mares and ovulation synchrony between donor and recipient mares (P<0.05). In conclusion, under the subtropical conditions of Pakistan, PG-based estrus induction of donor mares, breed of recipient mares, and ovulation synchrony between the donor and recipient mares had a substantial effect on the efficiency of EET. [ABSTRACT FROM AUTHOR]

This study investigates the impact of board governance mechanism on investment efficiency (IE) in PSX-listed firms. The study also examines the role of institutional ownership (IO) in board-IE relationships. In addition, we extend our analysis to re-examine this relationship by splitting the sample into two groups, i.e., the introductory phase of corporate governance (CG) i.e., 2004 to 2013, and revised codes of CG (2014 to 2018) to examine the impact of these separately on IE. The sample data comprises 155 non-financial PSX-listed firms from 2004 to 2018. IE is measured using firms' growth opportunities. The random effect model is used to test the study's hypotheses. A robustness test is also performed to validate the study's findings. The paired-sample t-test results show a significant improvement in IE after revising the CG codes in 2012. According to the regression results, board size has a significant direct, whereas board diversity has a significant inverse effect on IE. Regarding moderating effect, IO was found to moderate the relationship between board independence and IE significantly. Furthermore, it was discovered that following the issuance of revised CG codes-2012, the level of board independence and diversity increased in PSX-listed firms; however, only diversity positively impacted IE, and board independence had no impact on IE from 2014 to 2018. Despite the issuance of revised CG codes-2012, the level of CG among PSX-listed firms is low, which is a source of concern for regulators such as the Securities and Exchange Commission of Pakistan. [ABSTRACT FROM AUTHOR]