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This research analyzed and compared administrators' supervisory and teachers' pedagogical skills concerning quality education in Public and Punjab Education Foundation Funded Schools at the secondary level, in line with the Vision of Sustainable Development Goal 4 (SDG-4) by 2025 (Minimum Standards for Quality Education in Pakistan, 2016). The research employed a descriptive method and adopted a quantitative approach. For this study, 248 head teachers were selected from public schools and 126 from Punjab Education Foundation Funded Schools via simple random sampling, making a total sample of 374 respondents. Data were collected using a five-response Likert scale and analyzed with SPSS, including mean, standard deviation, t-test, and f-test to assess the difference between administrators' supervisory and teachers' pedagogical skills towards quality education in both school types. The study concluded that administrators in public secondary schools exhibited better academic and professional qualifications and that both administrators' supervision and teachers' pedagogical skills were superior in public schools. Additionally, public schools were more aligned with the Minimum Quality Standards for Schooling to meet the vision of Sustainable Development Goal 4 (SDG-4) by 2025 for quality education compared to Punjab Education Foundation Funded Schools. It is recommended that the heads of Punjab Education Foundation-funded schools enhance their supervisory skills, while teachers should improve their pedagogical skills to align with the vision of Sustainable Development Goal 4 (SDG-4) by 2025.

This study investigated in Math and Classroom Learning Environment (CLE) through quantitative approach Public Schools of Punjab were the population of the study. Using random sampling, 997 respondents (Boys = 489, Girls = 508) from two districts (conveniently) were selected. The scale (Fraser, 2007). Self measured students' self scale developed by the researchers was used. CLE and Retention in Math, similar perception regarding these variables with respect to their male counterparts. Findings revealed no significant relationship between CLE and SR of students for the whole sample as well; further, relationship between it was significant for females as compared to males. This study should be conducted at large scale and in varied setting for further implications. Abstract This study investigated relationship of self-regulation (SR) with retention in Math and Classroom Learning Environment (CLE) through quantitative approach based on survey method. 10 th grade students from Public Schools of Punjab were the population of the study. Using random sampling, 997 respondents (Boys = 489, Girls = 508) from two districts (conveniently) were selected. The CLE was explored by using (Fraser, 2007). Self-Regulation scale (Zimmerman, 2008) measured students' self-regulation while for retention in mathematics, a scale developed by the researchers was used. For the whole sample, SR, CLE and Retention in Math, were positive and female students had similar perception regarding these variables with respect to their male Findings revealed no significant relationship between CLE and SR of students for the whole sample as well; further, no significant relationship between CLE and students' retention in Math was found but it was significant for females as compared to males. This study should be conducted at large scale and in varied setting for further implications.

In recent research on information systems (IS), the advantages of social networking sites (SNS) in the education field have received widespread attention. However, excessive use of SNSs will negatively impact students academic performance, leading to the discontinuation intentions of social media. Therefore, this study aims to investigate an extended research model drawing on the stress-strain-outcome (SSO) theory and transactional model of stress to examine the adverse effect of SNS stressors on academic performance. The required data from the target population was collected through a structured questionnaire. The valid sample size of this study was n = 505 respondents. The data were analyzed using structural equation modeling (SEM) in AMOS (version 23.0) to examine the study hypotheses. The results confirmed that the SNS stressors, namely, social overload, information overload, and system feature overload, induce strain in terms of poor academic performance by generating feelings of guilt. It also unravels the effect of guilt feelings on discontinuance intention indirectly. This study offers imperative theoretical and practical implications.

The current research was designed in order to investigate the differences in hope, gratitude and psychological well-being in mothers of children with and without hearing impairment. This is hypothesised that there is likely to be significant differences in hope, gratitude and psychological well-being in mothers of children with and without hearing impairment. The sample for the current research comprised of n = 300 (n = 150 mothers of children with hearing impairment who were compared with mothers of hearing children (n = 150, after matching them on core subject variables); children within age ranges of 12-18 years were selected through non-probability purposive sampling. The scales included Hope Trait Scale, Psychological Well-Being Scale and Gratitude Questionnaire. Independent Sample "t"-test revealed significant differences in hope, gratitude and psychological well-being in mothers of children with and without hearing impairment. Pearson Product Moment correlation revealed significant positive relationship among hope, gratitude and psychological well-being in mothers of children. Regression analyses revealed that hope and gratitude are significant predictors of psychological well-being. The findings are promising for counsellors, teachers and mothers to change the perception and views regarding disability to seek better results in their children's functioning.

Evaluating athletes' knowledge of and attitudes toward sports-related concussions is important. However, there is limited research involving South Asian athletes, partly due to the lack of a valid and reliable tool. This study, therefore, aimed to translate and validate the Rosenbaum Concussion Knowledge and Attitude Survey—Student Version, an established tool used to measure knowledge and attitude toward concussion, into Urdu. Rosenbaum Concussion Knowledge and Attitude Survey—Student Version was translated into Urdu using the standard guidelines and then completed by 369 athletes participating in contact sports at different universities in Pakistan. Confirmatory factor analysis was performed on the Concussion Attitude Index items to examine the underlying factorial structure. Construct validity of Concussion Attitude Index factors was also investigated using convergent and discriminant validity. The results showed that the Urdu version of the Rosenbaum Concussion Knowledge and Attitude Survey—Student Version has good psychometric properties and is a valid and reliable tool for evaluating Urdu-speaking athletes' knowledge of and attitudes toward concussions. [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement and engagement (PPIE) in clinical trials is increasingly recognized as vital for ensuring research relevance and accessibility. Despite its proven benefits, PPIE remains limited, particularly in low- and middle-income countries, and more examples of effective strategies for involvement are needed. This commentary outlines the establishment of a PPIE group for clinical trials in a lower-middle-income country setting with limited research infrastructure. Main Body: We established Pakistan's first ever PPIE group for clinical trials within a new clinical trials unit at Ziauddin University in Karachi. The objectives of our project were focused on group formation, redesign of informed consent documents for trials, and dissemination of trial results to the public. Recruitment strategies involved referrals from clinicians and existing collaborators as well as engagement at public events, distribution of advertising leaflets and social media posts. Ten potential members were selected based on motivation, commitment and ability to contribute critically, with six members continuing their involvement long-term. An existing tool designed to establish the access needs of public partners was adapted to our project to help us document and account for members' expectations and support requirements. The process of using the tool enabled deep engagement, clarified roles, and fostered trust between coordinators and group members. Patient and public members gained confidence about the legitimacy of the project and felt more comfortable participating in the first group meeting. Lessons learned emphasize the importance of wide-ranging engagement efforts and transparent discussions about expectations to build effective collaborative relationships. Conclusion: Our experience demonstrates the feasibility of establishing a PPIE group for clinical trials in Pakistan and highlights strong public interest for research involvement. The use of a formal tool to document needs, prior experiences and expectations encouraged relationship-building and helped coordinators make relevant accommodations for members. This account contributes to the growing body of literature on effective PPIE practices, emphasizing the value of tailored support and transparent communication in facilitating meaningful public involvement in clinical trials. Plain English summary: Working together with patients and members of the public has the potential of making clinical trials better, more person-centered and relevant. Unfortunately, partnerships between trial researchers and the public are still uncommon. It is not known what the best ways are to involve the public in clinical trials, especially when it comes to non-Western populations. We set up the first-ever patient and public involvement and engagement group to support clinical trials in Pakistan. In this commentary, we share our initial experiences of successfully establishing the group and the two main lessons we learned. Ten group members were identified by widely advertising our project to doctors, community organizations, patients and their carers at our hospital. Before the first group meeting, two coordinators met with each potential member to discuss and document their interests, expectations and needs. Both researchers and group members felt that these discussions were a good use of their time and helped make the project a success. The first main lesson learned from our experience was that enough time, funding, staff and resources are needed to identify members and build meaningful collaborative partnerships. The second main lesson learned was that honest discussions are needed at the very beginning of a collaboration about expectations. Our experience shows that involving patients and members of the public in clinical trials in Pakistan is possible and we hope it inspires and helps other researchers in their patient and public engagement efforts. [ABSTRACT FROM AUTHOR]

Objective: To explore impact of flood on breastfeeding practices and identify barriers in continuation of breastfeeding among mothers residing in flood relief camps. Methods: This exploratory observational study was conducted during visit of medical team of The University of Child Health Sciences, Children’s Hospital at flood relief camps of Sindh (7th September to 12th September, 2022) and southwest of Punjab province (18th November to 20th November, 2022). The data was collected on structured questionnaire from 40 lactating mothers residing in flood relief camps. Purposive sampling technique was used in this regard. Results: The mean age of breastfed children was 16.1±7.811 months. There was negative impact on breastfeeding practices (n=21, 52.5%) as frequency decreased in 18(45%) mothers and 3(7.5%) totally stopped breastfeeding. There was significant relation between pre-flood breastfeeding status and impact of flood on breastfeeding practices (p=0.001). The major barriers to appropriate breastfeeding were mother’s perception of insufficient breast milk due to inadequate diet (n=6, 15%) or depression and anxiety (n=4, 10%), mother’s illness (n=3, 7.5%), constant displacement (n=2, 5%) and provision of breast milk substitutes (n=2, 5%). Conclusion: There has been significant negative impact of flood on breastfeeding practices among lactating mothers residing in flood relief camps. Perception of decreased milk production due to inadequate diet and stress are major barriers in continuation of breastfeeding. Breastfeeding supportive services need to be integral component of flood crisis management. [ABSTRACT FROM AUTHOR]

Students' conceptions of how they initiate, plan, implement and monitor self-regulated learning (SRL) strategies have practical implications for teaching and learning. This study explores the nature and use of SRL strategies employed by university students as it occurs in naturalistic settings, for example, studying in non-classroom environments. Framed within the social cognitive perspective, it focuses on a group of students from an under-researched population. Focus group interviews were used to elicit information about the nature of SRL strategies and contexts for their use. The findings reveal that students employ a range of SRL strategies, from shallow to cognitively rich and deep processing. Furthermore, the use of SRL strategies alters under different contextual influences such as personal goals, SRL phase specific conditions, semester and academic capabilities.

Background: Covid 19 was declared as a public health emergency by the World Health Organisation (WHO) due to its rapid spread and catastrophic effects on health. It affected around 119 M people with mortality rate of 0.27% worldwide, including South-Asians. This review aims to understand the risk perceptions, cultural religious beliefs and the coping mechanisms of South Asians during the Covid 19 pandemic. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following search engines were used: Medline, Cochrane Library, PsycINFO, CINAHL, and Web of Science. Included studies investigated perceptions and opinions of individuals on knowledge, risk and protective factors, native faith based practices, and attitudes towards the COVID-19 pandemic. Results: The database search produced 282 articles to screen. The final narrative synthesis included five studies comprising of 13,476 participants from Pakistan, India, Nepal, and Bangladesh. Ten studies, comprising 7,893 participants, were eligible and included for meta-analysis. The overall pooled prevalence with maximum heterogeneity for correct knowledge of symptoms, hand washing or use of sanitizers, face masking use of herbal or traditional remedies and physical distancing or avoidance of contact was reported through meta-analysis. Conclusion: The review brings forth a useful comparison of individual and cultural differences in KAP, risk perceptions and coping strategies. This review highlights the need for and importance of tailored information dissemination, culturally sensitive risk communication, targeted educational interventions, community engagement and empowerment, policy, and infrastructure improvements, as well as continued research and data collection. By addressing these implications, efforts to mitigate the impact of COVID-19 can be more effective and equitable across diverse populations. Prospero registration: CRD42021246475. [ABSTRACT FROM AUTHOR]

Background: The study aimed to compare the self-perceived oral health status measured through a self-administered questionnaire with clinically determined oral health status measured by decayed-missing-filled teeth (DMFT) and community periodontal index of treatment need (CPITN) indices in university going females. In addition, access barriers to treatment related to oral healthcare were also determined. Methods: A 3-month analytical cross-sectional study was designed for consenting university going females (aged 18–22 years) in Islamabad, Pakistan. The self-perceived oral health was recorded through a questionnaire requesting information regarding socio-demographics, self-perception of oral health, frequency of dental visits and barriers to seeking oral health. Seven independent examiners performed intraoral clinical examination and assessed the oral health status using globally standardized oral health assessment indices (DMFT and CPITN). Results: A total of 400 students were included in the final sample. The study revealed a significant disparity between self-perceived oral health and clinical assessment. Although perceived oral health was considered "good" by 80.0% of the respondents, clinical examination revealed moderate DMFT scores (mean 2.95 ± 1.41) and periodontal disease requiring treatment in 89.5% of the individuals. The most common barriers in seeking dental care were lack of knowledge, dental phobia, affordability issue and false self-perception. Conclusion: The present study demonstrated a notable discrepancy between self-perception of oral health and clinically assessed oral health. These results emphasize the importance of focused educational programs and community outreach programs, especially directed towards this demographic. Prioritizing such initiatives will help individuals to recognize their actual oral health condition thus encouraging positive oral health behaviors and outcomes. [ABSTRACT FROM AUTHOR]

Tocopherol and sterol are non-dietary functional molecules in sunflower oil, which act as antioxidants, reduce cholesterol and improve immunity against diseases. The present study was designed to determine tocopherol and sterol contents in 13 high and two low oleic acid sunflower hybrids across two seasons (spring and autumn) and four locations under subtropical conditions of Pakistan with contrasting reproductive phase temperatures. The results showed that tocopherol and sterol contents varied across the seasons and locations. Autumn planting produced high tocopherol content. Moreover, locations under high temperature during reproductive phase negatively affected the sterol and tocopherol contents. High oleic acid hybrids yielded 38% higher tocopherol content than low oleic acid hybrids. High oleic acid hybrids produced higher sterol contents at all locations and seasons. Hybrids such as H4 and H5 are considered stable due to comparatively close values of tocopherol and sterol contents across the four locations when compared with standard checks and other hybrids during spring season as indicated from various stability parameters. Hybrids H8, H4 and H5 also manifested higher magnitude of heterosis for tocopherol and sterol contents that may be due to overdominance gene action. Breeding lines such as B.116.P, B.112.P and RH.365 were positive combiners for the investigated traits, thus likely carrying positive alleles for both tocopherol and sterol traits. [ABSTRACT FROM AUTHOR]

The herpetofauna diversity of Pakistan is underestimated due to the country's lack of molecularbased identification. Field surveys were conducted from August 2018 through July 2022 to collect as many as possible specimens from Punjab, Pakistan. A total of 21 species were collected and initially identified by morphological characteristics. The three gene fragments in four amphibian species and seven reptile species were successfully amplified and sequenced. A total of 18 DNA sequences of 11 species representing nine genera and five families were deposited in GenBank, and accession numbers were obtained. Furthermore, phylogenetic analysis was performed through the Neighbor-joining method using 100 bootstrap pseudo-replicates in MEGA X. Closely related toad species, namely Duttaphrynus melanostictus and Duttaphrynus stomatitis, were clearly separated in the tree inferred from Cytb gene sequences. Similarly, conspecific sequences were analyzed for multiple individuals of Platyceps rhodorachis clustered together in the tree inferred from COI gene sequences. In our findings, 16S rRNA appears to be more reliable in identifying amphibian species, while COI has a better success rate in reptile species identification. In our recommendations, molecular-based identification of herpetofauna is necessary nationwide to document any new subspecies. [ABSTRACT FROM AUTHOR]

Cotton, a key source of income for Pakistan, has suffered significantly by cotton leaf curl disease (CLCuD) since 1990. This disease is caused by a complex of phylogenetically-related begomovirus (genus Begomovirus, family Geminiviridae) species and a specific betasatellite (genus Betasatellite, family Tolecusatellitidae), cotton leaf curl Multan betasatellite. Additionally, another DNA satellite called alphasatellite (family Alphasatellitidae), is also frequently associated. All these virus components are vectored by a single species of whitefly (Bemisia tabaci). While many factors affect cotton productivity, including cotton variety, sowing time, and environmental cues such as temperature, humidity, and rainfall, CLCuD is a major biotic constraint. Although the understanding of begomoviruses transmission by whiteflies has advanced significantly over the past three decades, however, the in-field seasonal dynamics of the viruses in the insect vector remained an enigma. This study aimed to assess the levels of virus and betasatellite in whiteflies collected from cotton plants throughout the cotton growing season from 2014 to 2016. Notably, begomovirus levels showed no consistent pattern, with minimal variations, ranging from 0.0017 to 0.0074 ng.μg-1 of the genomic DNA in 2014, 0.0356 to 0.113 ng.μg-1 of the genomic DNA in 2015, and 0.0517 to 0.0791 ng.μg-1 of the genomic DNA in 2016. However, betasatellite levels exhibited a distinct pattern. During 2014 and 2015, it steadily increased throughout the sampling period (May to September). While 2016 showed a similar trend from the start of sampling (July) to September but a decline in October (end of sampling). Such a study has not been conducted previously, and could potentially provide valuable insights about the epidemiology of the virus complex causing CLCuD and possible means of controlling losses due to it. [ABSTRACT FROM AUTHOR]

Background: This study conducted to determine the prevalence and severity of musculoskeletal discomfort among two-wheeler riders; however, musculoskeletal discomfort refers to pain, discomfort, or impairment in the muscles, bones, joints, tendons, ligaments, or other structures that support the body's movement. It is a common problem experienced by individuals involved in various physical activities, including motorcycle riding. Methods: This investigation was longitudinal research in which the Nordic muscular questionnaire (NMQ) was used to rule out the possibility of musculoskeletal disorders in motorcyclists. In Karachi, Pakistan, data were collected beginning in September of 2021 and continuing through February of 2022 using the convenience sampling method. Sixty-four individuals made up the sample. Participants were males ranging between the ages of 19 and 50 who rode standard motorcycles for their commute for about 6 to 8 h daily. Participants who had a tumor, an infection, or other comorbid are excluded. Results: Sixty-four participants were included in this study, out of which 40 (62.5%) reported difficulty and discomfort in their neck, followed by their lower back (48.5%), shoulders (34.4%), and hips (26.6%). Sixteen motorcyclists (25%) complained wrist pain. When asked out their level of discomfort. However, 51.6% of individuals experienced lower back pain at the 12th month, while 46.9% had neck pain. 28.1%, 17.2%, and 14.1% reported shoulder, hip, and upper back discomfort. 51.6% of individuals had not seen a specialist for lower back symptoms. Lower back, neck, shoulders, and hip have been affected the longest, according to participants. Conclusion: In conclusion, motorcyclists had a substantially greater rate of musculoskeletal problems than other drivers. Regulating musculoskeletal disorders in motorcyclists helps reduce symptoms and clinical indications of disease. [ABSTRACT FROM AUTHOR]

Background: Diabetes control is poor globally and leads to burdensome microvascular and macrovascular complications. We aimed to assess post hoc between-group differences in sustained risk factor control and macrovascular and microvascular endpoints at 6.5 years in the Center for cArdiovascular Risk Reduction in South Asia (CARRS) randomized trial. Methods and findings: This parallel group individual randomized clinical trial was performed at 10 outpatient diabetes clinics in India and Pakistan from January 2011 through September 2019. A total of 1,146 patients with poorly controlled type 2 diabetes (HbA1c ≥8% and systolic BP ≥140 mm Hg and/or LDL-cholesterol ≥130 mg/dl) were randomized to a multicomponent quality improvement (QI) strategy (trained nonphysician care coordinator to facilitate care for patients and clinical decision support system for physicians) or usual care. At 2.5 years, compared to usual care, those receiving the QI strategy were significantly more likely to achieve multiple risk factor control. Six clinics continued, while 4 clinics discontinued implementing the QI strategy for an additional 4-year follow-up (overall median 6.5 years follow-up). In this post hoc analysis, using intention-to-treat, we examined between-group differences in multiple risk factor control (HbA1c <7% plus systolic BP <130 mm Hg and/or LDL-cholesterol <100 mg/dl) and first macrovascular endpoints (nonfatal myocardial infarction, nonfatal stroke, death, revascularization [angioplasty or coronary artery bypass graft]), which were coprimary outcomes. We also examined secondary outcomes, namely, single risk factor control, first microvascular endpoints (retinopathy, nephropathy, neuropathy), and composite first macrovascular plus microvascular events (which also included amputation and all-cause mortality) by treatment group and whether QI strategy implementation was continued over 6.5 years. At 6.5 years, assessment data were available for 854 participants (74.5%; n = 417 [intervention]; n = 437 [usual care]). In terms of sociodemographic and clinical characteristics, participants in the intervention and usual care groups were similar and participants at sites that continued were no different to participants at sites that discontinued intervention implementation. Patients in the intervention arm were more likely to exhibit sustained multiple risk factor control than usual care (relative risk: 1.79; 95% confidence interval [CI], 1.45, 2.20), p < 0.001. Cumulatively, there were 233 (40.5%) first microvascular and macrovascular events in intervention and 274 (48.0%) in usual care patients (absolute risk reduction: 7.5% [95% CI: −13.2, −1.7], p = 0.01; hazard ratio [HR] = 0.72 [95% CI: 0.61, 0.86]), p < 0.001. Patients in the intervention arm experienced lower incidence of first microvascular endpoints (HR = 0.68 [95% CI: 0.56, 0.83), p < 0.001, but there was no evidence of between-group differences in first macrovascular events. Beneficial effects on microvascular and composite vascular outcomes were observed in sites that continued, but not sites that discontinued the intervention. Conclusions: In urban South Asian clinics, a multicomponent QI strategy led to sustained multiple risk factor control and between-group differences in microvascular, but not macrovascular, endpoints. Between-group reductions in vascular outcomes at 6.5 years were observed only at sites that continued the QI intervention, suggesting that practice change needs to be maintained for better population health of people with diabetes. Trial registration: ClinicalTrials.govNCT01212328. Nikhil Tandon and colleagues explore the impact of a quality improvement strategy for patients with type 2 diabetes 6.5 years after its implementation for the CARRS randomised trial. Author summary: Why was this study done?: Data on whether improvements in diabetes care goal achievement can be sustained (>5 years) with quality improvement (QI) strategies are lacking from low- and middle-income countries (LMICs). Prior studies of QI strategies to improve care goal achievement among people with diabetes from high-income countries reported modest benefits in blood glucose, blood pressure, and lipids, but the effects of these improvements on reducing vascular complications and deaths related to diabetes are unknown. What did the researchers do and find?: In the Center for cArdiovascular Risk Reduction in South Asia (CARRS) randomised trial of 1,146 patients with type 2 diabetes attending 10 diverse diabetes clinics in India and Pakistan, the QI strategy was associated with benefits on diabetes care goals (HbA1c <7% plus systolic BP <130 mm Hg and/or LDL-cholesterol <100 mg/dl) at 2.5 years after randomization. Four clinics discontinued implementation, while 6 clinics continued to implement the QI strategy for an additional 4 years. This report assesses whether benefits were sustained and reduced vascular complications and deaths associated with diabetes at 6.5 years. Patients receiving the QI strategy, compared to those receiving usual care, experienced sustained benefits on diabetes care goals and less microvascular endpoints (eye, kidney, and nerve diseases) at 6.5 years after randomization. Total macrovascular and microvascular events were also lower in those receiving the QI strategy, and this was only observed at sites that continued implementation of the QI strategy for 6.5 years. What do these findings mean?: These findings add to our knowledge of the long-term effects of multicomponent QI strategies in sustaining multiple risk factor control and reducing combined vascular events compared to usual care in resource-limited settings. In view of these findings, clinical decision support and trained nonphysician health workers may be important QI strategies to consider integrating into India's healthcare system to improve diabetes care quality and reduce morbidity and mortality. One limitation of the study is that the tertiary care facilities included in the CARRS trial may not be generalizable across LMICs. [ABSTRACT FROM AUTHOR]

Machine learning for hydrologic modeling has seen significant recent development and has been suggested as a valuable augmentation to physical hydrological modeling, especially in data-scarce catchments. In Pakistan, surface water flows predominantly originate from the transboundary Upper Indus sub-catchments of Chenab, Jhelum, Indus, and Kabul rivers. These catchments have large drainage areas, climate-driven streamflows, high variations in elevation, and limited streamflow gauge coverage. Hence, using machine learning models for data-driven river flow modeling may be well-suited for these catchments. However, hydrologic interpretability of machine learning models is important for the practical use of such models for these catchments. Thus, the current study besides evaluating the potential of three machine learning models (XGBOOST, Classification and Regression Trees(CART), and RandomForest) for streamflow simulation also focused on the hydrologic interpretation of machine learning models using SHapley Additive exPlananations (SHAP). All of these models performed well and the range of R 2 and Nasche-Efficiency for all three models lies between 0.61 to 0.90. Moreover, SHAP correctly identified minimum temperature as the most critical feature in glacier-fed Indus and Chenab catchments. It also provides logical insights into interactions between minimum temperature and precipitation for the indus and Chenab catchment. The findings of this study strongly illustrate the usefulness of SHAP analysis in interpreting the behavior of data-scarce high-elevation climate-sensitive catchments using tree-based machine learning models. [ABSTRACT FROM AUTHOR]

The district Toba Tek Singh is located in the center of Punjab province. It occupies 2nd important position in national citrus production after Sargodha, with citrus orchard area of 11412 hectares and annual production of 160758 tons. Citrus productivity in Pakistan, in general, and Toba Tek Singh, in particular, is far below its its potential which could be attributed to several factors but poor soil health and inadequate soil fertility may be considered an important reason. A comprehensive nutrient indexing survey of thirty citrus orchards grown in different parts of district Toba Tek Singh was conducted to evaluate the soil characteristics and plant nutrient status. GPS coordinates of selected sites were recorded prior to sampling. Soil samples were coll ected at 0-20 cm, 21-40 cm and 41-60 cm depth using standard procedure. Five soil samples were collected from each site to get a composite sample for each depth. The leaf samples were collected from the 7-month-old non-fruiting branches of plants around the tree canopy during the month of September, 2022. Five healthy and uniform citrus trees were sampled from each site to get a composite leaf sample. The soil samples were analyzed for pH, electrical conductivity (EC), soil organic matter (SOM) and calcium carbonate (CaCO3). The soil and leaf samples were analyzed for macro and micronutrients. It was found that most of orchard soils of district Toba Tek Singh were moderately alkaline (pH 7.52-8.90), slight to strong calcareous (2-15% CaCO3), non-saline (0.77-3.0 dS m-1 EC) and low in SOM (0.23-1.49%) with low to medium nitrogen (0.01-0.06%) and phosphorus (0.58-10.52 mg kg-1) while medium to high potassium (56.47-315.34 mg kg-1). The sampled soils were low to marginal in boron (0.09-0.72 mg kg-1), copper (0.05-0.59 mg kg-1), iron (0.23-10.75 mg kg-1) and zinc (0.03-1.83 mg kg-1) while adequate in manganese (1.35-26.20 mg kg-1). Leaf analysis revealed that almost 50% orchards were deficient in phosphorus (0.05-0.23%) and potassium (0.40-1.76%), while having low to marginal values of copper (1.96-20.99 mg kg-1), zinc (4.13-31.96 mg kg-1), boron (3.12-95.40 mg kg-1), manganese (42.62- 96.46 mg kg-1) but adequate iron (171-552 mg kg-1). The surveyed orchard soils were mostly alkaline calcareous, deficient in organic matter and having low to moderate macro and micronutrients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate response of neoadjuvant chemotherapy in Stage I-II triple-negative breast cancer and impact of pathologic complete response on survival. Study Design: Retrospective longitudinal study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan, from Jan 2006 to Jul 2014. Methodology: Al patients with triple-negative breast cancer who received neoadjuvant chemotherapy were included and data was retrieved from cancer registry of hospital. The patients received neoadjuvant chemotherapy folowed by surgery. Radiotherapy was given wherever clinicaly indicated. Kaplan-Meier and log-rank test was used to calculate survival. Results: Out of 1113 triple negative breast cancer patients, 150 received neoadjuvant chemotherapy. Mean age was 43±7 years. Fifty-two patients (34.7%) achieved pathological complete response (complete eradication of invasive or in situ carcinoma in breast and axila (ypT0/is/ypN0) in surgical specimen). Over a median folow up of 61 months, 52 patients (34.7%) had disease progression. Patients with pathological complete response had significantly beter 5-years disease-free survival (pvalue 0.001) and 5-years overal survival (p-value 0.002) in comparison to non-pathological complete response group. The 5-years disease-free survival was 90% in pathological complete response group compared to 55% in non-pathological complete response group. Similarly, 5-years overal survival was 94% in pathological complete response group compared to 70% nonpathological complete response group. Conclusions: Neoadjuvant chemotherapy is an effective treatment modality in management of triple-negative breast cancer. Achievement of pathological complete response is a potential surrogate endpoint as it is associated with significantly beter disease-free survival and overal survival. [ABSTRACT FROM AUTHOR]

This article aims to explore the access of patient assistance program (PAPs) and the role of pharmacists in improving access to oncology care in Pakistan. PAPs aim to reduce the financial burden of cancer in Pakistan, with pharmaceutical companies providing medication at reduced costs, ranging from 33% to 90%. Pharmacists play a pivotal role in managing these programs, facilitating PAP, pharmacist, oncology care setting, cancer therapy more accessible to those who faced financial barriers to accessing them. [ABSTRACT FROM AUTHOR]

Inclusion of echocardiography as diagnostic tool and polyarthralgia and monoarthritis as major criteria for high-risk populations in the Revised Jones Criteria 2015 is likely to surface substantial variability in clinical manifestations among various populations. This study aimed to compare clinical profile of patients presenting with first and recurrent episodes of acute rheumatic fever (ARF) using most recent criteria. 130 consecutive patients with ARF were included in the study from August 2019 to March 2022. World Heart Federation standardized echocardiographic criteria were used for cardiac evaluation. The socio-demographic variables, clinical details and relevant investigations were recorded. Median age was 13(6–26) years. Male to female ratio was 1.6:1. Majority was of low socioeconomic status (90%) and with > 5 family members in a house (83.8%). 27 patients (20.8%) were with ARF while 103 (79.2%) with recurrent ARF. Carditis was the most common presenting feature (n = 122, 93.8%), followed by polyarthralgia (n = 46, 35.4%), polyarthritis (n = 32, 24.6%), subcutaneous nodules (n = 10, 7.7%), monoarthritis (n = 10, 7.7%), and chorea (n = 5, 3.8%). Monoarthralgia was more common in ARF than recurrence (29.4% vs. 3.2%, p = 0.004). Carditis (97.1% vs. 81.5%, p = 0.01) and congestive cardiac failure (18.5% vs. 5.9%, p = 0.001) were more common in recurrent ARF than ARF. Diagnostic categorization of Jones criteria for different populations has highlighted important variability in clinical presentation of ARF. Monoarthralgia is common in first episode of ARF. Carditis is the most common feature in recurrent ARF. Polyarthralgia is seen with higher frequency that polyarthritis. Subcutaneous nodules seem to be more common in our population. [ABSTRACT FROM AUTHOR]

The population pressure and rapid urbanization in the Southern Punjab of Pakistan have led to massive landuse transformations in the recent years, especially in the Multan and Bahawalpur district. These frequent landuse alterations disrupt the crop yield and indirectly affect the livelihoods and economy at the national level. With an aim to assess the agricultural shifts in cotton landscapes of Multan and Bahawalpur districts over two decades, the advanced classification techniques of Machine Learning Algorithms (MLA), Random Forest (RF) was used. One year composite of monthly time series images were taken along with Normalized Difference Vegetation Index in Google Earth Engine (GEE) for the selected years (2000, 2005, 2010, 2015, and 2020). The Landuse/Landcover classes extracted through satellite imagery included cropland, orchards, settlement, water, and other land for both districts, while forest class was extracted for Bahawalpur district only. The results indicated that the use of MLA, RF classifier highlights the variations in cotton landscapes with an accuracy greater than 85%. It was observed that the cropland and other lands in Multan reduced by 3.03% and 20.33%, respectively, while the classes such as orchard, wetland, and settlement significantly increased by 66.1%, 40.3%, and 75.5%, respectively. Similarly, in Bahawalpur an overall increase was observed in croplands, forests, water bodies, and settlements over the two decades. It can be confidently concluded that GEE has become a viable alternative to conventional methodologies for remote sensing applications while providing a comparatively higher degree of confidence in results. [ABSTRACT FROM AUTHOR]

The main purpose of the study was to examine the job satisfaction level of the teachers of Bahawalpur, in order to achieve the desire end, 340 teachers were taken as sample out of these gender wise distribution was male (195) and female (145). A 32 items questionnaire (Likert scale) was constructed and divided into 9 dimensions namely (nature of work, administrative support, salary, atmosphere, promotion, decision making, and relation with colleagues, job security and over all job satisfaction). Questionnaire was pilot tested and the reliability of the questionnaire was found 0.789 (Cronbach's Alpha). After getting the data, the data was tabulated by using statistical package for social sciences (SPSS XII). Independent sample t-test and ANOVA were run in order to compare the different variables (gender, nature of job, designation, age and experience). The study reveals that female teachers are more satisfied than their male counter parts, permanent teachers are more satisfied than contractual teachers on different dimensions of the job satisfaction scale as well as on over all job satisfaction, designation wise secondary school teachers (SSTs) are more positive than elementary school teachers (ESTs) on atmosphere of the institutions. Age wise the group having the age group of 41-50 years is significantly positive than the age group of 20-30 years on relation with colleagues. Experience wise the group having experience of 16-20 years is more positive than group having experience of 1-5 years on relation with colleagues. The findings of the study lead to several recommendations.

The current correlational study aimed to examine the relationship between father involvement, co-parenting relationship quality, and social-emotional behaviors of children and adolescents ages 4–17 in the collectivistic, patriarchal societal context of Pakistan. A purposive sampling strategy was used to collect data from 160 fathers, who gave information about their involvement in child-rearing activities, co-parenting relationship quality with their wives, and the social-emotional behaviors of their children. The results indicated that father involvement has a negative correlation (r =.11; p =.07) with child problem behaviors; moreover, there was a significant positive correlation with child pro-social behaviors (r =.15; p =.04). Whereas co-parenting relationship quality had a significant negative correlation (r =.30; p <.001) with child problem behaviors and a significant positive correlation of (r =.29; p <.001) with child pro-social behaviors. Results of the moderation analysis showed that the working hours of the father moderate the relationship between father involvement and the pro-social behaviors of children (B = −.014, p =.02). In conclusion, it can be stated that flexibility in the work hours of fathers and helping them be involved with their families can aid the healthy development of children and families in Pakistan. [ABSTRACT FROM AUTHOR]

The Upper Indus Basin (UIB) is a major water resource for Pakistan, and recent years have seen it profoundly affected by climate change, resulting in catastrophic events. Analyzing climatic patterns in UIB and its sub-basins is vital for sustainable water resource management. This research delves into the precipitation and temperature trends within the Gilgit and Hunza River basins (sub-basins of UIB) from 1980 to 2019, utilizing an extensive dataset comprising ground station records and global climate datasets such as CRU and ERA 5. Our findings indicate a notable increase in temperatures, particularly pronounced in the Hunza basin compared to Gilgit. Conversely, precipitation trends reveal a predominant decrease. Employing validation techniques, we confirmed that ERA 5 surpassed CRU in providing accurate temperature and precipitation data. Employing methods including the Mann–Kendall, Sen's slope, and Abrupt Change Point Tests, we identified temperature increases of 0.21 °C and 0.25 °C per decade. Additionally, CRU assessments unveiled a decline in diurnal temperature. Seasonal analysis showcased significant temperature rises during summer, autumn, and spring, while winter conditions remained consistently stable. Our analysis also pointed to slight increases in summer precipitation, with winters exhibiting heightened wetness according to the CRU datasets. Continual monitoring of the Upper Indus Basin (UIB) is imperative for enhancing precision and reliability. This proactive approach, complemented by meticulous spatiotemporal analysis, will establish a robust foundation for comprehending and addressing climate changes in the region. [ABSTRACT FROM AUTHOR]

Background: Tracheostomy is considered the oldest and the most effective operative procedure for patients admitted to intensive care units and in emergencies. The study's objective was to evaluate healthcare providers' knowledge regarding tracheostomy care. Results: All healthcare professionals directly involved in the provision of care to patients with tracheostomy were included and asked to fill out the questionnaire. The response rate was 87.63%. Out of 50, the mean comfort score was 37.69. 70.6% of participants reported having a comfort score equal to or more than 70%. Out of 10, the mean score was 5.29. Only 20.9% of participants were able to score equal to or more than 70%. The results demonstrate that healthcare professionals' knowledge of tracheostomy care was below par. Only those who were experienced in this field were able to score above average. Conclusion: The assessment of knowledge in tracheostomy care highlights the significance of ongoing education and training in the healthcare field. As medical practices evolve, it is imperative for healthcare providers to stay updated with the latest guidelines and techniques to provide the highest standard of care. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is a global public health problem. The objectives of this study were to analyze the prevalence and correlates of IPV perpetrated by men against women from the recent nationally representative Pakistan Demographic and Health Survey (PDHS) 2017–18, and to analyze levels and trends of IPV perpetrated by current/former husbands from PDHS conducted in 2012–13, in the four provinces and the capital city. Methods: Association of having ever experienced IPV, defined as either emotional, physical and/or sexual violence, by ever married women aged 15–49, with 12 explanatory socio-demographic, attitudinal, and experiences were analyzed using simple and multiple logistic regression models. Results: The prevalence of having ever experienced IPV was 33.48% (95% CI: 30.76–36.32). In the final multivariable model, number of living children, having knowledge of parental physical IPV, husband's use of alcohol, and marital control were statistically significantly associated with IPV. Proportions and trend analysis of emotional and physical IPV between the PDHS 2017–18 and PDHS 2012–13, showed that in general, rural areas of provinces reported higher prevalence of emotional and physical IPV, compared with urban areas, and in general, emotional, and physical IPV prevalence declined from PDHS2012-13 to PDHS2017-18. Conclusions: The prevalence of having experienced physical and/or sexual intimate partner violence in Pakistan was lower than the prevalence for the WHO Eastern Mediterranean region. However, IPV burden at the provincial urban-rural residency status underscore the need for location specific strategies to effectively address IPV in Pakistan. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of hyperthyroidism in Pakistan is 2.9%, which is two times higher than in the United States. Most high-quality hyperthyroidism clinical practice guidelines (CPGs) used internationally originate from high-income countries in the West. Local CPGs in Pakistan are not backed by transparent methodologies. We aimed to produce comprehensive, high-quality CPGs for the management of hyperthyroidism in Pakistan. Methods: We employed the GRADE-ADOLOPMENT approach utilizing the 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis as the source CPG. Recommendations from the source guideline were either adopted as is, excluded, or adapted according to our local context. Results: The source guideline included a total of 124 recommendations, out of which 71 were adopted and 49 were excluded. 4 recommendations were carried forward for adaptation via the ETD process, with modifications being made to 2 of these. The first addressed the need for liver function tests (LFTs) amongst patients experiencing symptoms of hepatotoxicity while being treated with anti-thyroid drugs (ATDs). The second pertained to thyroid status testing post-treatment by radioactive iodine (RAI) therapy for Graves' Disease (GD). Both adaptations centered around the judicious use of laboratory investigations to reduce costs of hyperthyroidism management. Conclusion: Our newly developed hyperthyroidism CPGs for Pakistan contain two context-specific modifications that prioritize patients' finances during the course of hyperthyroidism management and to limit the overuse of laboratory testing in a resource-constrained setting. Future research must investigate the cost-effectiveness and risk-benefit ratio of these modified recommendations. [ABSTRACT FROM AUTHOR]

Emergence of new variants of infectious bronchitis virus is a continuous threat to poultry industry in Pakistan which is causing unusual outbreaks resulting in high mortality in chickens. The present study was designed to investigate the presence of newly emerging variants of IBV through molecular characterization, S1 gene amplification and phylogenetic analysis. A total of 412 outbreaks were investigated which affected flocks in Multan, Lahore, Rawalpindi and Abbottabad regions of Pakistan. At least five (05) suspected samples from each outbreak were collected and then pooled into a single sample. Out of these 412 samples, 138 were found positive showing an overall positivity of 33.49%. The phylogenetic analysis revealed that our six isolates (OL763341, OL763342, OL763343, OL763344, OL763345, OL763346) had a homology of 92-93% and 93-95% with three nephro-pathogenic strains (i.e., KX832222, KX832223 & KF809795) isolated in India and China while 97-98% with the Pakistani isolate (MK689242). Among other Pakistani isolates, 83% and 95% nucleotide similarity was found with two isolates (MH703660 and MH703657) on the basis of 390bp S1 gene sequences. These Pakistani reference strains were also of variant/untyped genotype. Further, when these isolates were subjected for in-ovo propagation in 10-days old embryonated chicken eggs, they induced IBV typical teratogenic effects in chicken embryos. It was concluded that despite regular vaccination, variant strains including nephro-pathogenic strains are involved in IB outbreaks in field in Pakistan. It is recommended that a country wise surveillance and vaccine cross protection study may be conducted to investigate and control the problem. [ABSTRACT FROM AUTHOR]

Objectives: Keeping in view the economic and veterinary public health importance of brucellosis, this research was conducted to determine its seroprevalence and associated risk determinants in small ruminants in district Khanewal, Southern Punjab, Pakistan. Materials and Methods: Two-stage cluster sampling technique was used for sampling, and the sample size was calculated using C-survey 2.0. Accordingly, sera samples (n = 392) were collected from small ruminants in the study area from October 2022 to July 2023. All the samples were tested for the presence of anti-Brucella antibodies by Rose Bengal Plate Test (RBPT), followed by confirmation of all the samples using an enzyme linked immunosorbent assay (ELISA) kit (ID.vet®, France; sensitivity and specificity=100%, each). Results: The seropositivity rate of brucellosis was 7.14% [n = 28/392; 95% confidence interval (CI) = 4.87%-10.12%] by RBPT, whereas the results of ELISA showed an overall seroprevalence rate of 7.40% (n = 29/392; 95% CI = 5.11%-10.37%) in the study population. Univariate analysis of risk factors revealed that abortion history (AH), retained fetal membranes (RFMs), repeat breeding, flock size (FS), educational status of farmers (ESFs), awareness about brucellosis (AB), and farm hygiene had a significant association with the seroprevalence of brucellosis (p < 0.05). The multivariate analysis using a binary logistic regression model revealed that variables including tehsil, FS, AH, RFM, ESF, AB, and farming system were significant factors (p < 0.05) associated with brucellosis in the target population. Conclusion: Brucellosis is prevalent in small ruminants in Khanewal, Pakistan. The disease burden can be reduced by improving the reproductive health of animals, farm hygiene, and farmers' awareness about the diseases. Further studies are needed on a larger scale to devise stringent disease control strategies to avoid losses associated with brucellosis at regional, national, and global levels. [ABSTRACT FROM AUTHOR]

Violent extremism is a phenomenon of great global concern, being responsible for displacements, deaths, and insecurity across the world. This paper investigates the relationship of childhood exposure to domestic violence with violent extremism, through the mediating role of moral disengagement, in the light of general strain theory coupled with social cognitive theory of moral disengagement. The sample (N = 562; men; n = 273; women; n = 289) is comprised of young adults (age range between 16 to 25 years), a segment of the population that is highly impacted and susceptible yet understudied. The instruments used in this study include Urdu versions of childhood exposure to domestic violence scale, moral disengagement scale, and violent extremism scale. The results show that the relationship between childhood exposure to domestic violence and violent extremism is mediated by moral disengagement. These findings shed light on the underlying mechanism of the pathway leading to violent extremism in the cultural context of Pakistan. Limitations and implications of the study, as well as suggestions for future research directions are discussed. [ABSTRACT FROM AUTHOR]

Brucellosis is a widespread zoonotic disease of veterinary and public health importance with considerably higher prevalence in developing/underdeveloped countries. This study reports the prevalence and risk determinants of brucellosis in small ruminants of peri-urban and rural areas of district Multan, Southern Punjab, Pakistan. For this purpose, sera samples (n = 392) of small ruminants were collected and subjected to preliminary screening using commercially available RBPT reagents followed by serodetection of brucellosis using multispecies i-ELISA kit (ID.vet, France). All the ELISA positive samples were confirmed by PCR using genus-specific primers, and frequencies of Brucella species in positive samples were enumerated using species-specific primers. Results indicated seropositivity rates of 9.69, 9.95, and 10.20% in study population using RBPT reagents of IDEXX-USA, ID.Vet-France, and VRI-Pakistan, respectively, with a statistically nonsignificant difference p > 0.05 . Results of ELISA showed an overall seroprevalence rate of 7.14% in target population with a slightly higher rate in sheep (7.65%) as compared to goat (6.63%) population (p = 0.695 ; OR = 1.16, 95% CI = 0.53, 2.57). Results revealed that out of total positive samples, B. abortus was detected in 60.71% of seropositive samples and B. melitensis was detected in 14.28% of positive samples. It was revealed that risk factors including body condition scores, hygienic conditions of the housing facility, farming system, reproductive disorders, educational status of farmers, and awareness of farmers about brucellosis had significant association with brucellosis in small ruminants of study area p < 0.05 . Conversely, farm/herd size, locality, gender, age, weight, and parity showed a nonsignificant association p > 0.05 with brucellosis. In conclusion, brucellosis is prevalent in small ruminants of Multan, Pakistan. It is recommended to devise and implement effective control strategies with a major focus on raising awareness about brucellosis in farmers for the containment of infection in the region. [ABSTRACT FROM AUTHOR]

The current industrial and economic activities in Sindh Province, Pakistan, polluted the region's water, air, soil, and marine resources. However, there is a rising demand for eco-friendly production, and it is important to develop new policies and tools to combat environmental degradation and enhance economic development. Cleaner Production (CP) provides opportunities to address many of these issues. Employed method for this study was based on three approaches: a literature review and stakeholder mapping; a collection of data and information from key stakeholders through focal group discussions, consultative workshops, and one-on-one meetings; and analysis and synthesis of data that were gathered from different sources. The analysis of collected information provides an overview of CP strategies moving forward. Participant workshops gave in-depth information on policy implementation, technological impediments to methods that have been employed elsewhere, and needed capacity building as well as financial consequences of policy implementation. Through increasing financial resources and institutional resources, the expansion of CP will help to replace the conventional methods of waste treatment with an eco-efficiency approach to preventing pollution at the source, thus reducing the need for expensive pollution control and management costs for environmental compliance. Experiences, achievements, and implementation pitfalls from this study can provide a lesson to other developing countries to improve their economic and environmental sustainability. [ABSTRACT FROM AUTHOR]

In line with the contact hypothesis, several studies show that digitally mediated interfaith contact on social networking sites also improves relationships between members of different faiths. Yet most theoretical and empirical scholarships are mainly conducted in societies generally free of religiously driven violent incidents, lacking insights from contexts with more serious interfaith challenges. Additionally, factors that predict digitally mediated interfaith contact and condition its effect have not gained enough attention. Relying on survey data of Facebook users in Pakistan (n = 645), this study shows that Muslims' favorable attitude toward potential Facebook interfaith contact is positively associated with their number of Facebook interfaith contacts, which is, in turn, negatively associated with social distance toward non-Muslim religious minorities. Moreover, status legitimacy plays a moderating role, suggesting that the mediating relationship above is only significant for those who perceive a low level of status legitimacy – a perception that the social status difference between ingroup and outgroups is legitimate. It exhibits the inhibiting role of status legitimacy in hindering the effects of Facebook interfaith contact on social distance. This study discusses the potentially positive role of digitally mediated interfaith contact and concludes with limitations and recommendations. [ABSTRACT FROM AUTHOR]

Snow and glaciers are very sensitive to changing climate. Glaciers in the central Karakoram, western Himalaya and eastern Hindukush mountain ranges are not responding to global warming in the same manner as their counterparts around the world. Glaciers in this region are behaving differently. Some are retreating, while others are stable or surging. It is important to monitor these changes to protect downstream communities from the negative consequences. This study is conducted to monitor the state of the selected glaciers of Hunza River Basin, such as Batura, Passu, Ghulkin, Gulmit, Baulter, Barpu, Samaiyar Bar, Muchuhar, and Shishper glaciers were analysed using Digital Elevation Model and satellite images for 1972, 1979, 1990, 1998, 2008 and 2018. A semi-automatic approach was adopted to delineate the glacier boundary supplemented by manual editing. These glaciers show different fluctuations over the last fifty years. The Batura glacier showed surge in the 1970s and then retreated followed by quiescence. There is no prominent change in Ghulkin, Barpu, and Samaiyar Bar glaciers while almost 40 m per year retreat was observed in Passu and Gulmit glaciers but Muchuhar retreated at a faster rate. The surge of Shishper results in the formation of glacier-dammed lake which has so far triggered four Glacial Lake Outburst Floods (GLOFs). Overall, area of nine glaciers decreased from 596.54 ± 31.02 km2 in 1972 to 568.52 ± 8.51 km2 in 2018, which accounts for 4.8% decrease in area. This decrease will affect landscape development, regional hydrology and people living downstream. [ABSTRACT FROM AUTHOR]

Background: Brucellosis is a zoonotic disease caused by a bacterial pathogen belonging to the genus Brucella. It is one of the most frequent bacterial zoonoses globally but unfortunately, it is still considered as a neglected disease in the developing world. Keeping in view, this study was conducted to determine the prevalence and risk determinants of brucellosis in large ruminants of peri-urban and rural areas of district Multan-Pakistan. For this purpose, blood samples (n = 490) were collected from the cattle (n = 245) and buffalo (n = 245) population of the study area and subjected to preliminary screening of brucellosis using local and imported RBPT reagents. All the samples were further analyzed using commercially available multi-specie indirect ELISA kit followed by their confirmation by PCR using genus and species-specific primers. Data obtained from lab analysis and questionnaires were subjected to statistical analysis for Pearson Chi-square, Odds Ratio and Confidence intervals (95%). Results: The results showed that the maximum seropositivity was recorded with local RBPT reagent (VRI, Pakistan; 12.45%; 95%CI = 9.72–15.65%) followed by RBPT-IDEXX (12.24%; 95%CI = 9.52–15.45%) and RBPT-ID.vet (11.84%; 95%CI = 9.18–14.95%) however statistical difference was non-significant (P = 0.956). The ELISA results showed an overall seroprevalence rate of 11.22% (95%CI = 8.59–14.33%) with comparatively higher rate in cattle (12.65%; 95%CI = 8.82–17.44%) as compared to buffaloes (9.80%; 95%CI = 6.49–14.15%). The PCR analysis confirmed the presence of genus Brucella in all seropositive samples whereas frequency of B. abortus and B. melitensis in seropositive samples was 80% and 20%, respectively. The co-existence of both species was also observed in 5.45% samples. The statistical analysis showed a significant association of bovine brucellosis with herd size, breed, reproductive disorders, mode of insemination, educational status and farmers' awareness about brucellosis (P < 0.05). Conversely, locality, age, weight, gender, pregnancy status, parity and puberty status had no associations with brucellosis (P > 0.05). Conclusion: In conclusion, brucellosis is prevalent in large ruminants of district Multan, Pakistan. It is suggested to devise and implement stringent policies for the effective control and prevention of brucellosis in the region. Further, the current situation also warrants the need to strengthen interdisciplinary coordination among veterinarians and physicians in one health perspective to ensure and strengthen the human and animal health care systems in the region. [ABSTRACT FROM AUTHOR]

Telemedicine is utilized to deliver health care services remotely. TM gained popularity as a result of pandemics, it can help the patients to get required medical care while sitting in the comfortable environment of their homes. In the future, it will continue to be used as a convenient, cost-effective patient care modality. This cross-sectional study was conducted in a tertiary care hospital, the objectives were to identify challenges faced by physicians during teleconsultations, recognize the opportunities and strengths of this modality during pandemic in a lower-income country. The self-made questionnaire was filled through an online medium and responses were recorded on a five-point Likert scale. A total of 83 participants were enrolled in this study. Most of them were Associate professors (29.8%), Assistant professors (26.2%), the ratio of the females was (52.4%) greater than males (47.6%). 46 (54.8%) lie between the age group 30–40 years. Pediatricians and senior instructors faced more difficulty in using telemedicine. The ones having clinical experience of less than 15 years or categorized in the age of 50–60 years faced challenges while using this modality. During the current pandemic, situation telemedicine is the only glimmer of light to provide better quality health care. Telemedicine is an innovative strategy and it is important to understand the perception of physicians about it. Incomplete and inadequate infrastructure and attitude of the physicians are the main obstacles toward successful implementation of telemedicine. Successful installation and deployment of this technology require a complete grasp of the process among physicians. [ABSTRACT FROM AUTHOR]

Background: Anal cancers are uncommon neoplasms that make up to <1% of all tumours globally. Concurrent chemoradiation remains the standard of care treatment for patients who present with non-metastatic anal squamous cell carcinomas (ASCCs). Methods: We aimed to evaluate the response rate and 2-year survival outcome of the definitive chemoradiation approach in patients with non-metastatic ASCCs of our population. We conducted a cross-sectional review of these patient populations who were treated and then followed after completion of treatment at our institute during the last 10 years. Results: A total of 17 patients were enrolled after fulfillment of the eligibility criteria. The responses were documented in 16 patients through magnetic resonance imaging or computed tomography of the pelvis, done at 3 months of treatment completion. More than 80% of the patients had complete radiological responses. Among the surviving participants, the 2-year disease-free survival rate was found to be more than two-thirds. Approximately 20% of the study participants had disease recurrence during the subsequent clinic visits following treatment completion. Conclusion: This review emphasises the impact of definitive chemo-radiation in achieving radiological and clinical responses in patients with non-metastatic ASCCs. Moreover, to our knowledge, this is the first review to highlight anal cancer's incidence and characteristics in Pakistan. [ABSTRACT FROM AUTHOR]

Using the investor-herding index (IHRB) and manager-herding index (MHRB), the emergence of investors' and managers' herding behavior at the corporate-level and its potential impact on firm financial performance (FFP) is analyzed in the entire study. The study utilizes the micro-level data of 296 listed firms of Pakistan stock exchange (PSX) from 2013 to 2017. Empirical findings show that the investors' and managers' herding significantly affect FFP. The results are robust under alternative measurements of FFP. This study has a unique contribution to the literature on behavioral finance by addressing the astonishingly overlooked phenomena of firm-level biases and their potential impact on FFP. For prospective investor's decision, the findings are significant in such way that the market index is irrelevant than the firm-level financial evidence. Explicitly, the study concludes that positive herding behavior is elucidated by the bullish trend and inverse herding behavior of investors with respective to firm value leads toward bearish trend of stock market index. The likelihood of market crash may become more stringent in circumstances once managers and investors interactively exhibit negative herding behavior. Thus, the study offers useful policy and strategy implications for the associated stakeholders to the device the policies accordingly. [ABSTRACT FROM AUTHOR]

Maize is a dynamic cereal of world’s agriculture community. It is grown in spring and autumn seasons in Pakistan and both pistillate and staminate flowers experience severe temperature stress during spring sowing (February sowing) at reproductive phase, which ultimately results in poor seed setting because of increased silk dryness and pollen desiccation. In-vivo haploid induction was performed by using 2nd generation tropically adapted maize haploid inducer allocated from CIMMYT. Indigenously developed maize double haploid (DH) lines using local segregating population as source were screened out against high temperature stress. DH lines were evaluated and selected by using various indicators cell membrane thermostability (CMT), leaf temperature (LT), pollen production potential (PPP), pollen germination %age (PG%), pollen tube length (PTL), grain yield per plant (GY/P), plant height (PH), ear height (EH), days to tasseling (DT), days to silking (DS), number of grains per row (NGPR) and number of rows per cob (NRPC). Significant differences were noted at allelic level among the DH lines for high temperature tolerance related indicators, which provided wide range of option for selection, opportunity to improve tolerance level against high temperature stress and usage of these DH lines in different future maize breeding programs. Correlation coefficient analysis depicted PH, NGPR, HGW, PPP, PTL, and PG as suitable selection criteria for GY/P. The most effective physiological benchmarks for evaluating germplasm resistance to high temperature stress are CMT, PG%, and PTL. According to principal component analysis (PCA) DH lines viz. 5 (PBG-5), 11 (PBG-11), 15 (PBG-15), 19 (PBG-19), 24(PBG-24), 30(PBG-30), 33(PBG-33), 39 (PBG-39), 46 (PBG-46) and 52 (PBG-52) showed high level of diversity and performed well under the normal and high temperature stress conditions and DH lines viz. 10 (PBG-10), 13 (PBG-13), 26 (PBG-26), 37 (PBG-37) and 51 (PBG-51) performed poor under the normal and high temperature stress conditions. To develop maize varieties that can thrive in high-temperature conditions, it is necessary to cultivate DH lines that exhibit strong adaptability when exposed to induced stress. These lines could serve as a valuable genetic resource, as they likely contain a diverse array of genes that contribute to high temperature tolerance. [ABSTRACT FROM AUTHOR]

Medicinal plants are being used for the treatment of various livestock ailments by the local peoples since earliest times. It is a recognized fact that plants are an important source of ethnoveterinary medicines. From the last decade, ethnoveterinary practices have gained tremendous importance due to the discovery of some effective ethnoveterinary products. Ethnoveterinary practices are more common in developing countries including Pakistan due to different socioeconomic factors. The studies showed that many medicinal plants used for the treatment of Lumpy skin disease (LSD). Ethno-pharmacological content was obtained from 200 people with knowledge and experience of using plants as medicines for this disease in different areas of Sargodha and Khushab, Punjab, Pakistan. The field study was carried out from January-2023 to June-2023. All the data was collected by evaluation and interviews by calculating Use value (UV). The result from this study shows that 20 medicinal plants that belong to fifteen families greatly represented by Family Meliaceae were significant in treating LSD. This study indicated that the ethno-medicinal practices and knowledge are still used in District Sargodha and Khushab plants that support health care and help in the improvement of alternative system of medicines. These results gave commencing information on the significance use of medicinal plants. It can be tested for use in the future that leading to new discoveries of medicines in the treatment of LSD and other diseases of cattle. [ABSTRACT FROM AUTHOR]

The Coccinellidae is a highly diversified family of order Coleoptera. Coccinellid ladybirds are well known for their role as biological control agent against varied range of agricultural pests. The samples of coccinellid ladybird collected from Pakistan were identified and characterized as Micraspis allardi (Mulsant, 1866). This is one of the least-studied ladybird species with limited work on its ecological distribution as a biological control agent. The genus Micraspis has vast genetic diversity with a possible presence of unknown number of cryptic species. Sequence information of some species of the genus Micraspis are present in NCBI database. However, least molecular data or sequences describing M. allardi could be available from database. Therefore, morphological and molecular characterization was imperative for this species. Here, the samples collected from sugarcane field of Faisalabad District of Pakistan and were identified by using morphological and molecular protocols. For molecular identification, two different regions of mitochondrial cytochrome c oxidase I (COI) gene (COI-5′ and COI- 3′) were used as molecular markers for the identification of the species. Morphological appearance, DNA sequence similarity searches and phylogenetic analysis collectively indicated it as M. allardi. To the best of our knowledge, this is the first report providing molecular evidence of M. allardi using mitochondrial DNA barcode region (658bp) as well as mtCOI-3ʹ sequences (817bp). The study will help in understanding population genetics through diversity analysis, ecological role, and phenotypic structures associated with the geographic range of this species. [ABSTRACT FROM AUTHOR]

The El Nino Southern Oscillation (ENSO) phenomenon is devastating as it negatively impacts global climatic conditions, which can cause extreme events, including floods and droughts, which are harmful to the region's economy. Pakistan is also considered one of the climate change hotspot regions in the world. Therefore, the present study investigates the effect of the ENSO on extreme precipitation events across the Upper Indus Basin. We examined the connections between 11 extreme precipitation indices (EPIs) and two ENSO indicators, the Southern Oscillation Index (SOI) and the Oceanic Niño Index (ONI). This analysis covers both annual and seasonal scales and spans the period from 1971 to 2019. Statistical tests (i.e., Mann–Kendall (MK) and Innovative Trend Analysis (ITA)) were used to observe the variations in the EPIs. The results revealed that the number of Consecutive Dry Days (CDDs) is increasing more than Consecutive Wet Days (CWDs); overall, the EPIs exhibited increasing trends, except for the Rx1 (max. 1-day precipitation) and Rx5 (max. 5-day precipitation) indices. The ENSO indicator ONI is a temperature-related ENSO index. The results further showed that the CDD value has a significant positive correlation with the SOI for most of the UIB (Upper Indus Basin) region, whereas for the CWD value, high elevated stations gave a positive relationship. A significant negative relationship was observed for the lower portion of the UIB. The Rx1 and Rx5 indices were observed to have a negative relationship with the SOI, indicating that El Nino causes heavy rainfall. The R95p (very wet days) and R99p (extreme wet days) indices were observed to have significant negative trends in most of the UIB. In contrast, high elevated stations depicted a significant positive relationship that indicates they are affected by La Nina conditions. The PRCPTOT index exhibited a negative relationship with the SOI, revealing that the El Nino phase causes wet conditions in the UIB. The ONI gave a significant positive relationship for the UIB region, reinforcing the idea that both indices exhibit more precipitation during El Nino. The above observations imply that while policies are being developed to cope with climate change impacts, the effects of the ENSO should also be considered. [ABSTRACT FROM AUTHOR]

Pakistan is known for the problems of its religious minorities. Moreover, official Pakistani nationalism is religio-ethnic – a state created for the Muslims of British India. One would expect that Pakistan's religious minorities don't feel a sense of belonging to it. Drawing on more than 50 interviews and four months of extensive fieldwork among working class Hindu residents of a mixed Hindu-Muslim neighbourhood in Karachi, Pakistan, this article evidences that they felt belonging to the Pakistani nation based on an embodied connection they had with the land of Pakistan through birth, nourishment from the land and similarly embodied connections of their ancestors. By presenting the idea of terric nationalism, this article critiques the ethnic/civic nationalism binary. Further it makes a case for nationalism studies to focus on the subjectivity of the subaltern to build theory. [ABSTRACT FROM AUTHOR]

Background: Protection against SARS-CoV-2 is mediated by humoral and T cell responses. Pakistan faced relatively low morbidity and mortality from COVID-19 through the pandemic. To examine the role of prior immunity in the population, we studied IgG antibody response levels, virus neutralizing activity and T cell reactivity to Spike protein in a healthy control group (HG) as compared with COVID-19 cases and individuals from the pre-pandemic period (PP). Methods: HG and COVID-19 participants were recruited between October 2020 and May 2021. Pre-pandemic sera was collected before 2018. IgG antibodies against Spike and its Receptor Binding Domain (RBD) were determined by ELISA. Virus neutralization activity was determined using a PCR-based micro-neutralization assay. T cell – IFN-γ activation was assessed by ELISpot. Results: Overall, the magnitude of anti-Spike IgG antibody levels as well as seropositivity was greatest in COVID-19 cases (90%) as compared with HG (39.8%) and PP (12.2%). During the study period, Pakistan experienced three COVID-19 waves. We observed that IgG seropositivity to Spike in HG increased from 10.3 to 83.5% during the study, whilst seropositivity to RBD increased from 7.5 to 33.3%. IgG antibodies to Spike and RBD were correlated positively in all three study groups. Virus neutralizing activity was identified in sera of COVID-19, HG and PP. Spike reactive T cells were present in COVID-19, HG and PP groups. Individuals with reactive T cells included those with and without IgG antibodies to Spike. Conclusions: Antibody and T cell responses to Spike protein in individuals from the pre-pandemic period suggest prior immunity against SARS-CoV-2, most likely from cross-reactive responses. The rising seroprevalence observed in healthy individuals through the pandemic without known COVID-19 may be due to the activation of adaptive immunity from cross-reactive memory B and T cells. This may explain the more favourable COVID-19 outcomes observed in this population. [ABSTRACT FROM AUTHOR]

This research aims to identify and analyse the challenges faced by the energy–power supply chain (LNG Power) in Pakistan a developing economy from combined perspectives of supply chain sustainability and resilience in the context of the Triple Bottom Line framework, UN SDGs 7, 13 and energy security. The significance of this research increases many folds as energy-power supply chains have been severely disrupted by events such as COVID-19, the Russia–Ukraine war and massive devastation caused by floods in Pakistan. Pakistan meets more than 60% of its energy-power needs from natural gas (including LNG), being less harmful than coal and oil power generation. The industry is in a state of deep crisis as it faces a complex set of challenges. Exploratory research design using a mixed method case study approach was used for the identification and shortlisting of challenges. Later these were ranked using group BWM. Major challenges were lack of strategy, top management commitment, weak compliance to UN SDGs, stalled structural reforms, disasters, lack of supply chain orientation, risk management culture, financial instability, LNG non-availability, demand uncertainty, infrastructure inadequacies and lack of awareness of Industry 4.0. The research enables policy-making besides providing energy practitioners a roadmap to overcome these challenges. [ABSTRACT FROM AUTHOR]

Evidence from previous research indicates that lack of self-control and resilience play a significant role in extremist attitudes and unethical conduct. However, little is known about the protective role of self-control and resilience in relation to violent extremist attitudes. This study investigated whether self-control and resilience have an impact on violent extremist attitudes. This study utilized purposive convenient sampling. The sample consisted of N = 562 (men; n = 273; women; n = 289) with age range between 16 and 25 years (M = 19.27; SD = 2.50). The sample of young adults was collected from seminaries [madaaris], college, and university students from different provinces of Pakistan. The measures used in this study included the Urdu versions of Connor and Davidson Resilience scale, Violent Extremism Scale, and Brief Self-Control Scale. Findings indicated that self-control significantly negatively predicted violent extremist attitudes, while resilience significantly moderated the association among self-control and violent extremist attitudes. Efforts to detect and intervene in such context should be made for the improvement of the emotion-regulation strategies of young adults which in turn will reduce violent extremist attitudes. [ABSTRACT FROM AUTHOR]

This research analyzed and compared administrators’ supervisory and teachers’ pedagogical skills concerning quality education in Public and Punjab Education Foundation Funded Schools at the secondary level, in line with the Vision of Sustainable Development Goal 4 (SDG-4) by 2025 (Minimum Standards for Quality Education in Pakistan, 2016). The research employed a descriptive method and adopted a quantitative approach. For this study, 248 head teachers were selected from public schools and 126 from Punjab Education Foundation Funded Schools via simple random sampling, making a total sample of 374 respondents. Data were collected using a five-response Likert scale and analyzed with SPSS, including mean, standard deviation, t-test, and f-test to assess the difference between administrators’ supervisory and teachers’ pedagogical skills towards quality education in both school types. The study concluded that administrators in public secondary schools exhibited better academic and professional qualifications and that both administrators’ supervision and teachers’ pedagogical skills were superior in public schools. Additionally, public schools were more aligned with the Minimum Quality Standards for Schooling to meet the vision of Sustainable Development Goal 4 (SDG-4) by 2025 for quality education compared to Punjab Education Foundation Funded Schools. It is recommended that the heads of Punjab Education Foundation-funded schools enhance their supervisory skills, while teachers should improve their pedagogical skills to align with the vision of Sustainable Development Goal 4 (SDG-4) by 2025. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of estimates regarding the at-risk population associated with long COVID in Pakistan due to the absence of prospective longitudinal studies. This study aimed to determine the prevalence of long COVID and its association with disease severity and vaccination status of the patient. Design and data sources: This prospective cohort study was conducted at the Aga Khan University Hospital and recruited patients aged > 18 years who were admitted between February 1 and June 7, 2021. During this time, 901 individuals were admitted, after excluding patients with missing data, a total of 481 confirmed cases were enrolled. Results: The mean age of the study population was 56.9±14.3 years. Among patients with known vaccination status (n = 474), 19%(n = 90) and 19.2%(n = 91) were fully and partially vaccinated, respectively. Severe/critical disease was present in 64%(n = 312). The mortality rate following discharge was 4.58%(n = 22). Around 18.9%(n = 91) of the population required readmission to the hospital, with respiratory failure (31.8%, n = 29) as the leading cause. Long COVID symptoms were present in 29.9%(n = 144), and these symptoms were more prevalent in the severe/critical (35.5%, n = 111) and unvaccinated (37.9%, n = 105) cohort. The most prominent symptoms were fatigue (26.2%, n = 126) and shortness of breath (24.1%, n = 116), followed by cough (15.2%, n = 73). Vaccinated as compared to unvaccinated patients had lower readmissions (13.8% vs. 21.51%) and post-COVID pulmonary complications (15.4% vs. 24.2%). On multivariable analysis, after adjusting for age, gender, co-morbidity, and disease severity, lack of vaccination was found to be an independent predictor of long COVID with an Odds ratio of 2.42(95% CI 1.52–3.84). Fully and partially vaccinated patients had 62% and 56% reduced risk of developing long COVID respectively. Conclusions: This study reports that the patients continued to have debilitating symptoms related to long COVID, one year after discharge, and most of its effects were observed in patients with severe/critical disease and unvaccinated patients. [ABSTRACT FROM AUTHOR]