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The revolution in technology has led to new approaches toward open and distance learning, particularly in the form of e-learning. E-learning governs the system of modern education by using Information and Communication Technology (ICT). There are different design approaches and interpretations of e-learning, primarily involving variations in instructional strategies and pedagogical models employed with the technology. These innovations offer compelling opportunities to educational institutions, students and faculty alike, yet they have also posed formidable challenges for e-learning. This is especially the case in the developing countries. This paper engages the concept and aims of e-learning with regard to the issues in the developing countries. The next part of the paper presents the need of e-learning in Pakistan and describes the major institutes offering e-learning and distance education as an alternate mode of education. The paper also elaborates major challenges of e-learning and explores the influencing factors for the adoption of e-learning in Pakistan. The important factors are investigated in terms of available ICT infrastructure and other country specific parameters. The paper also presents results of a survey that was conducted to evaluate students' preferences regarding e-learning. The survey result demonstrates a strong preference for e-learning by the students. The paper concludes by presenting a generalized model of e-learning that can fulfill the needs of learners under available technology infrastructure.

E-learning is becoming mainstream and novel driving force for the learning and training. Industry and educational institutions are investing heavily in this electronic mode of training and education because of its accessibility, ease of training, up-to-the-minute learning, effectiveness of cost and flexibility. Besides its advantages, low level of uptake in this mode of learning is perceived due to lower quality of these systems. Therefore, this work intends to gather the proposed Critical Success Factors (CSFs) from state-of-the-art literature regardless of the dimension and/or perspective in which these CSFs have been proposed. Moreover, this study scrutinizes the coverage and effect of CSFs on the quality of e-learning systems according to their severity and importance for higher education institutions. Intensive literature review has been done for identification and collection of CSFs regardless of their perspective. Empirical investigations were conducted to extract the CSFs influencing quality of e-learning systems. Cronbach's Alpha and factor analysis method has been utilized to ensure the reliability and ranking the identified factors.

Proper training on the preventive measures against COVID-19 among health-care workers is crucial for mitigating the spread of viral infection. The present study evaluated the efficacy of a brief web-based module on the practice of hand hygiene and respiratory etiquette among respective health-care workers. A comparative study was conducted with a total of 500 participants. A self-reported questionnaire was used for both pre- and post-intervention evaluation. The post-intervention assessment was conducted 1-2 weeks following the intervention. The difference in the practice of hand hygiene and respiratory etiquettes during work hours was recorded. We found that the intervention resulted in an evident difference in the use of alcohol-based hand sanitizer by the participating doctors before examining the patient. Interns showed a much higher propensity to wash their hands for at least 20 s, relative to other health-care workers. The difference between pre- and post-intervention handwashing for >5 times/day was 6.5% in females and 4.5% in males. In short, the study was able to demonstrate that a web-based health education module is an effective tool for the education and promotion of preventative measures in hospital setups, which may ultimately aid in halting the spread of COVID-19 among health-care workers.

Background: Myocardial infarction management relies on pharmaceuticals and interventions like percutaneous coronary intervention (PCI). While complete PCI has shown noninferiority to culprit-only PCI, its impact on major adverse cardiovascular events (MACE) outcomes in multiple subpopulations has been unknown. Methods: A systematic literature search (from January 2000 to May 2024) identified four relevant randomized controlled trials involving ST-segment elevation myocardial infarction patients. Data analysis employed a random-effects model with inverse variance weighting. Results: MACE risk was significantly lower in males than females undergoing complete PCI compared with culprit-only PCI (hazard ratio: 0.52; 95% CI: 0.39–0.68; p < 0.01; I2 = 53%). Furthermore, complete PCI significantly lowered the risk of MACE outcomes in patients without diabetes and in patients under the 65-year age limit in comparison to culprit-only PCI. Conclusion: Complete PCI reduces MACE risk in male, nondiabetic ST-segment elevation myocardial infarction patients under 65 with multivessel coronary artery disease, necessitating further investigation into outcome differences among different subpopulations. Article highlights Complete percutaneous coronary intervention (PCI) in male patients with ST-segment elevation myocardial infarction significantly reduces major adverse cardiovascular events (MACE) risk compared with culprit-only PCI procedures. Gender disparities in MACE outcomes following PCI warrant further investigation. Male patients with ST-segment elevation myocardial infarction undergoing complete PCI are at a reduced risk of developing MACE adverse events as compared with females undergoing complete PCI. Complete PCI reduced the risk of MACE compared with culprit-only PCI in all ages and diabetic status groups. However, the results for reduced risk were only significant in those <64 years of age and nondiabetic group. Limited data availability from limited randomized controlled trials underscores the need for more extensive research. Additional randomized controlled trials and post hoc analyses are required to validate findings and refine treatment guidelines. [ABSTRACT FROM AUTHOR]

Injector configuration and spray characteristics are important parameters that define diesel combustion and emissions performance. One of the critical spray inputs is the Rate-of-Injection (ROI) profile. The ROI profile depends on the spray's operating conditions, including nozzle geometry (e.g., nozzle diameter), injection pressure, and injection duration. Besides, the internal nozzle flow phenomenon and external ambient conditions can further impact fuel introduction characteristics. This study measured the ROI profile of a heavy-duty (multi-hole) diesel injector using the Bosch tube technique. Injection pressure and injection duration were varied from 600 to 2600 bar and 0.5–3.0 ms, respectively. After post-processing, measurement data were then used to train numerical models, including a developed machine learning (ML) model that can create very similar ROI profiles with experimental data. Next, a Computational Fluid Dynamics (CFD) simulation used the ROI profile generated by ML model. For comparison, there are other simplified ROI profiles used in similar CFD simulation configuration. Results showed that the any difference in ROI profiles could affect the combustion and emissions significantly. This further emphasizes the need to provide high-fidelity spray input in terms of ROI profile for CFD simulation. The current ML model can deliver a realistic ROI profile for any given rail pressure and injection duration.

Background: Autoimmune thyroid diseases (AITDs) are characterized by unique immune responses against thyroid antigens and persist over time. The most common types of AITDs are Graves' disease (GD) and Hashimoto's thyroiditis (HT). There is mounting evidence that changes in the microbiota may play a role in the onset and development of AITDs. Objective: The purpose of this comprehensive literature study was to answer the following query: Is there a difference in microbiota in those who have AITDs? Methods: According to the standards set out by the PRISMA statement, 16 studies met the requirements for inclusion after being screened for eligibility. Results: The Simpson index was the only diversity measure shown to be considerably lower in patients with GD compared to healthy participants, whereas all other indices were found to be significantly greater in patients with HT. The latter group, however, showed a greater relative abundance of Bacteroidetes and Actinobacteria at the phylum level, and consequently of Prevotella and Bifidobacterium at the genus level. The strongest positive and negative relationships were seen for thyroid peroxidase antibodies and bacterial load. Conclusion: Overall, both GD and HT patients showed significant changes in the gut microbiota's diversity and composition. [ABSTRACT FROM AUTHOR]

Objective: Toevaluate the distribution of risk factors and determined their association with hypertension in Pakistani population. Study Design: Prospective longitudinal study. Place and Duration of the Study: The study was conducted in different hospitals in Punjab and Sindh, Pakistan from Dec 2018 to Jun 2019. Methodology: Data of subjects between the ages of 18-75 were included in the study using non-probability convenience sampling technique. A questionnaire was used to record socio demographic information and risk assessment was done. Weight and blood pressure measurements were also recorded. Bivariate analysis was used for analysis to identify risk factors associated with hypertension. Result: A data of 350 subjects was recorded with a mean age±SD of 43.7±10.5 years. The prevalence of hypertension was recorded to be 26%. Prevalence of current smoking, and passive smoking was 57(16%) and 11(3%) respectively. Gender, smoking, level of education, physical inactivity, were each significantly associated with increased risk for hypertension. Conclusion: Our study demonstrates that in Pakistan, increasing age, marital status, level of education, poor dietary habits, smoking, obesity, and other modifiable factors are contributing to the increased risk and prevalence of hypertension. [ABSTRACT FROM AUTHOR]

Objectives: To find the association of breastfeeding and the risk of breast cancer in our population. Study Design: Case-control study. Place and Duration of Study: Oncology Ward-4 at Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jun 2018 to Jun 2019. Methodology: All patients with diagnosed Breast Cancer visiting the outpatient department were enrolled in this study. Controls were randomly selected from the community. Demographic characteristics, reproductive history, breastfeeding pattern, and hormonal status of cancer were collected from all participants. Results: Among patients who had a positive history of breastfeeding were three times more likely to develop breast cancer than those with no history of breastfeeding [Odds Ratio 3.315 (95% Confidence Interval: 2.094-5.249)]. 69.7% of participants in our study breastfed for more than 2 years. There was also a weak inverse association between lactation amenorrhea and breast cancer risk. Women who experienced lactation amenorrhea had only half the risk of women who did not experience lactation amenorrhea [Odds Ratio 0.685 (95% of Confidence Interval: 0.397-1.182)]. Conclusion: There was a negative relationship between breast cancer and breastfeeding. Further research should explore the genetic and cultural differences and the risk of breast cancer. [ABSTRACT FROM AUTHOR]

During the Covid-19 pandemic, the education institutions remained closed for a long time and physical activities were also limited. People were maintaining social distance alongwith strictly following other Covid-19 SOP's. Meanwhile, children were also bound to their home boundaries, which ultimately increased their screen time. The purpose of this study was to find out the impact of YouTube Kids Channel on social learning and socialization of children during the period of Covid-19. For the purpose, researchers used purposive sampling technique and designed a questionnaire, which was distributed among 301 parents whose children were between 2 to 8 years of age. Researchers applied Social Learning Theory and Uses and Gratification Theory to seek the answers to the research question and meet the objectives. Data were analyzed using SPSS version 21, and appropriate statistical tests were applied. Findings of the study suggested that YouTube kids had both type of impacts on children, positive and negative. Results also indicate that more than half of the children used YouTube kids for 2 to 4 hours per day. The usage of YouTube kids was same in both genders, although different age groups of children learnt different attitudes and behaviors from watching videos on YouTube kids. Children learnt different type of vocabulary from YouTube kids' content. At the same time YouTube kids decreased the physical activities of children and had been damaging their health in different ways. Results of the study also showed that some children also learnt violence and aggressiveness from some of the videos on YouTube kids. [ABSTRACT FROM AUTHOR]