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The critiques on modernism have challenged the current set of rules of free market societies where demands are fulfilled without considering the adverse consequences of the environment. The business environment has yet to transform to explore modern innovative entrepreneurial solutions to create harmony in the natural ecosystem. Recent studies have separately investigated the role of business growth in economic development and its negative influence on the global environment. This study analyzes global data by analyzing global data to develop a nonlinear relationship between climate change and entrepreneurship. Based on the disruptive innovation theory, we argue that economic activities cause a rise in CO2 emissions and create opportunities for entrepreneurship. Data has been taken from 45 countries to analyze the impact of climate change on entrepreneurship. The results show a nonlinear relationship exists between climate change and entrepreneurship at the global level. Policy developments are required for a sustainable environment through entrepreneurship.

Sickle cell disease is a group of health disorders that affect hemoglobin in red blood cells. Sickle cell disease causes multiple manifestations and complications, including infections, delayed growth, pain crisis, and multi-organs damage. These complications can disturb the patients' vital signs, including body temperature, heart rate, and oxygen saturation. The decline in hemoglobin level is another indication of sickle cell disease due to abnormal hemoglobin that distorts red blood cells resulting in sickle cell anemia. RBCs, also called erythrocytes, are found in the blood and responsible for carrying oxygen to the body tissues attached to the hemoglobin. Optical microscopy can detect and monitor sickle cell disease, but it requires a blood sample and offline analysis, which is a time-consuming process. There is currently no known technology available to provide non-invasive monitoring solutions for sickle cell disease patients' health. Therefore, a need arises for a non-invasive and continuous monitoring solution to continuously check on sickle cell disease patients, which can be transformed into a wearable monitoring device. The proposed optical wristband consists of optical sensors that provide non-invasive and continuous health status monitoring of sickle cell disease patients using key vital signs and hemoglobin levels. A comparative study was performed among 21 participants and equally divided into three groups (non-anemic, anemic, and sickle cell disease patients). The data was collected from optical sensors, Arduino used as a processor, and continuously monitors the patient's vital signs and hemoglobin levels. Abnormal reading of any parameter alerts the user of any unhealthy status, and the parameter's trend assists the clinician in patient assessment. The body temperature and oxygen saturation levels of the anemic patients were found in the normal ranges, but the heart rate of three patients and hemoglobin of all the participants were found in aberrant ranges. The vital signs and hemoglobin levels of all sickle cell disease patients were beyond the normal ranges and significantly different (p>0.001) than non-anemic and anemic groups. Therefore, these physiological parameters monitoring has clinical importance for sickle cell disease management and early treatment.

While the concept of entrepreneurial ecosystems has famously been capturing the holistic view of entrepreneurial development, the question of how entrepreneurial ecosystems can specifically foster inclusiveness and advance toward sustainable development goals (SDGs) set by the United Nations is still an underexplored area of research. Despite the fact that scholars have shown a growing interest in defining and measuring entrepreneurial ecosystems, this is still a neglected area of research in the context of marginalized communities. Previously the effectiveness of entrepreneurial ecosystems has largely been focused on aligning skills with opportunities, providing equal accessibility to available geographical resources, and supporting social networks with favourable policies. However, few studies explain social, economic and geographical issues faced by marginalized communities within the debate of entrepreneurial ecosystem. By critically analyzing the literature on entrepreneurial ecosystems, this paper conceptualizes the new construct of inclusive entrepreneurial ecosystems and their related dimensions. At the interface research, scholars will create unique positioning by using theoretical advancement. Moreover, policy-makers could align their strategic goals with the purposed inclusive dimensions that transform the socio-economic conditions of marginalized communities.

Recent developments which were coined to the opening up of borders have attracted interest of many researchers from many disciplines. A lot of work can be observed regarding the role of globalization / internationalization on economic growth and social development, this study specifically explores the implications of globalization on the ultimate goal that is life longevity. Adapting from the Kuznets curve, this study proposed a quadratic function of economic globalization and life longevity. The results using panel the ARDL model for the SAARC region, it can be seen that expansion of trade globalization de jure and management of financial globalization de facto and de jure may help them to increase longevity in the long run.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in an increase in the number of patients necessitating prolonged mechanical ventilation. Data on patients with COVID-19 undergoing tracheostomy indicating timing and outcomes are very limited. Our study illustrates--- outcomes for surgical tracheotomies performed on COVID-19 patients in Tanzania. This was a retrospective observational study conducted at the Aga Khan Hospital in Dar es Salaam, Tanzania. Nineteen patients with COVID-19 underwent surgical tracheotomy between 16 This is the first and largest study describing tracheotomy outcomes in COVID-19 patients in Tanzania. Our results revealed a high mortality rate. Multicenter studies in the private and public sectors are needed in Tanzania to determine optimal timing, identification of patients, and risk factors predictive of improved outcomes.

Spontaneous splenic rupture is a rare and life-threatening complication of severe malaria. It demands particular attention since delayed or missed diagnosis can be potentially fatal. The exact incidence is unknown largely due to underreporting. Acute malarial infection accounts for most of the spontaneous splenic rupture. Plasmodium vivax has been associated with the majority of them; however, on rare occasion, other Plasmodium infections have also resulted in splenic rupture. We report the case of a 74-year-old male who was diagnosed with severe malaria caused by Plasmodium falciparum (P. falciparum) infection and developed an acute abdomen while on treatment due to spontaneous splenic rupture which necessitated emergency splenectomy.

A large number of studies evidenced the role of energy on growth and renewable energy as a cleaner input, which is the need of the hour as because of population and growth, the energy demand is on the rise in South Asia region. This study scrutinizes the quadratic effect of the non-renewable and renewable energy consumption mix and its impact on sustainable development while controlling for trade openness, development expenditures and industrialization. This study resorts to feasible generalized least squared model for the estimation of quadratic function for five SAARC countries between 1990 and 2017. The results show that the non-renewable-to-renewable energy mix ratio follows an inverted U-shaped relationship with HDI. Further renewable energy must be significantly higher than non-renewable energy in order to ensure that it is development promoting.

The postmodernism stance critiques the current discourse of modern consumption-based societies. These societies legitimize their embedded beliefs and actions based on their lifestyle reflected through their consumption patterns. Their consumption patterns relate to carbon footprints that are yet to be explored in the current body of knowledge at the macro level. The legitimacy of their lifestyle and consumption patterns rely on their conscious efforts in reducing carbon footprints. This study uses the environmental Kuznets curve model and explores the impact of household lifestyle and household consumption patterns on CO

venous thromboembolism is a complication among admitted medical and surgical patients. International guidelines recommend patients are assessed upon admission and appropriate thromboprophylaxis should be initiated. However, studies have shown that thromboprophylaxis for patients at risk of venous thromboembolism is underutilized.this was a retrospective study conducted on hospitalized medical and surgical patients at Aga Khan Hospital Dar es salaam from January to June 2019. Patient's medical records were reviewed and data was collected for analysis of venous thromboembolism assessment and compliance with Caprini risk assessment model. The data was entered into statistical package for the social sciences (SPSS) 25 and categorized into risk groups, frequency of patients' demographic and clinical characteristics data was calculated and the main study outcomes were analyzed with Fisher´s exact test or Pearson chi-square test for categorical variables and student t-test for continuous variables. Regression analyses were done to identify significant risk factors where by P ≤ 0.05 was considered statistically significant.compliance of venous thromboembolism assessment among medical and surgical patients was similar at 78% and 80%, respectively, with a baseline 22% of all admitted patients considered at risk of venous thromboembolism, hence needing thromboprophylaxis following the Caprini risk assessment modelscore. Thromboprophylaxis practices was identified at just 25% of at-risk individuals received pharmacological prophylaxis with enoxaparin; the most commonly used agent (92%). Identified risk factors for venous thromboembolism were advancing age (60 years), history of prior major surgery, Major surgery lasting60 minutes, obesity, and immobilization.risk assessment for venous thromboembolism should be emphasized upon admission of both surgical and medical patients. Adequate thromboprophylaxis should be prescribed upon identification of patients at risk.

Globalization boosts the process of market predictions in the pursuit of economic growth. When economic, political, and social forces gain traction by promoting policies and the climate favoring globalization, entrepreneurial results reach out. Policymakers are still searching for a context within which regional policies can be structured to foster long-term entrepreneurship opportunities. The literature on entrepreneurial phenomena is incomplete and uncertain as to how globalization forces establish a nonlinear mechanism to promote the entrepreneurial process. This study provides the basic context for identifying globalization forces to create a nonlinear effect on the entrepreneurial process in order to address this problem. The results propose that policymakers strengthen the social and political dimension of globalization to increase opportunities-based entrepreneurship.

Nadeem Kassam,1 Eric Aghan,2 Omar Aziz,1 Hanifa Mbithe,1 Kamran Hameed,1 Reena Shah,3 Salim Surani,4 James Orwa,5 Samina Somji1 1Internal Medicine, The Aga Khan Hospital, Dar es Salaam, Tanzania & Aga Khan University, Medical College, Dar-es- Salaam, Tanzania; 2Family Medicine, The Aga Khan Hospital, Dar es Salaam, Tanzania & Aga Khan University, Medical College, East Africa, Dar-es-Salaam, Tanzania; 3Infectious Disease & Internal Medicine, The Aga Khan University, Medical College, Nairobi, Kenya; 4Pulmonology & Internal Medicine, Texas a&m University, Texas A&M College Station, TX, USA; 5Population Health, Aga Khan University, Medical College, East Africa, Nairobi, KenyaCorrespondence: Nadeem Kassam Email nadeem.kassam@aku.eduBackground: The emergence of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There has been paucity of data for hospitalized African patients suffering from COVID-19. This study aimed to identify factors associated with in-hospital mortality in patients suffering from COVID-19 in Tanzania.Methods: This was a single center, retrospective, observational cohort study in adult patients hospitalized with confirmed COVID-19 infection. Demographics, clinical pattern, laboratory and radiological investigations associated with increased odds of mortality were analyzed.Results: Of the 157 patients, 107 (68.1%) patients survived and 50 (31.8%) died. Mortality was highest in patients suffering with severe (26%) and critical (68%) forms of the disease. The median age of the cohort was 52 years (IQR 42– 61), majority of patients were male (86%) and of African origin (46%), who presented with fever (69%), cough (62%) and difficulty in breathing (43%). Factors that were associated with mortality among our cohort were advanced age (OR 1.07, 95% CI 1.03– 1.11), being overweight and obese (OR 9.44, 95% CI 2.71– 41.0), suffering with severe form of the disease (OR 4.77, 95% CI 1.18– 25.0) and being admitted to the HDU and ICU (OR 6.68, 95% CI 2.06– 24.6).Conclusion: The overall in-hospital mortality was 31.8%. Older age, obesity, the severe form of the disease and admission to the ICU and HDU were major risk factors associated with in-hospital mortality.Keywords: COVID-19, factors, hospital, mortality, Tanzania

The pursuit of happiness is the major goal of humanity. Multidisciplinary research efforts had tried to find its determinants. This study investigates the role of different dimensions of institutional quality of happiness for 33 Asian countries. Quality of institutes helps people feel a sense of control and achievement, which may lead to perceived wellbeing. This study has used a panel FGLS model. The results confirmed that good governance, money, openness, and employment have a significant effect on happiness. It is urged that improvement in indicators like regulatory quality and rule of law to promote employment and trade openness which may help in national happiness.

In the current era robots play vital role in several industries, hospitals, and research organizations etc. In hospitals robots support and nursing staff currently may also use in this era during COVID19 Pandemic to transport such patient sample or dispose of their usage belonging to avoid spreading of this pandemic to clinical staff. From making deliveries, dispensing medication, visiting patients to aiding surgeries, robots are improving the way hospitals function. Central Sterilization Supply Department (CSSD) offers sterilization amenities to Outpatient Department (OPDs), wards and operation theatre (OT) of hospitals. It provides facilities to receive, clean, pack, disinfects, sterilizes, store and distribute instruments, in accordance with well-delineated protocols and standardizes procedures. An alarming boost in Hospital Acquired Infections (HAI) demonstrates the necessity of a well-organized CSSD to prevent surge in HAI. Although quality assurance procedures are followed to ensure safety and efficiency at all levels: appropriate handling of contaminated items, decontamination, proper cleansing, and instrument care, but the necessity of human presence to implement these procedure in-creases the threat of HAI. Thus, an intelligent autonomous multi-sensor wireless controlled NXT robot using MATLAB is proposed to handle contaminated items and sterilize equipments in the centralized sterilization sup-ply department. The proposed system is entirely automated and eliminates the need of human presence to implement quality assurance procedures, thus decreasing the threat of HAI. An archetype using Lego NXT robotic kit is developed to implement tasks performed in CSSD. MATLAB is used to control NXT robot instead of Lego Mindstorms software, due to its versatility, capability to perform computationally intensive tasks and wide usage by researchers. A powerful control system is designed that allows user to interrupt, control and monitor autonomous NXT robots.

Purpose- Knowledge creation refers to the ability of firms to create new knowledge that starts from individuals to integrating the firms and then the overall economy. This study suggests that knowledge acquisition in a country has a significant relationship with innovative performance. Design/Methodology- Data from 48 highly HDI countries is taken from World Bank and World Economic Forum. Based on 480 country-year observations in a panel mediator model, it is revealed that the national efforts of boosting knowledge acquisition influence the firms’ innovative performance. Findings- Further, it is found that absorptive capacity in the employability of knowledgeable workers works as a mediator between knowledge acquisition and innovation. Whereby higher knowledge acquisition leads to higher absorptive capacity and higher innovation. Practical Implications- This study builds a quantitative model for the macroeconomic context of knowledge-based view.

Industrial competitiveness could be achieved through policies reforms favoring globalization process. The reality, however, is two-folded. Initially, government policies restrict globalization and impose barriers to trade, restrict social and political activities. Structural reforms become inevitable to remain in the competition. Local resources, human capital, infrastructure, education and health facilities should be transformed. It is done through deploying a flexible structure that is adapting social, political and economic changes coming from the globalization process in order to make the local industry competitive. This paper argues that beneficiaries of globalization earn this status through strategizing and processing their resources into a competitive position. This gap is covered by empirically investigating the U-shaped relationship between globalization and competitiveness. Furthermore, categorizing the selected countries into under or over globalized nations.

Mind Synchronization is an attempt to make a voiceless communication, without using tongue, indications, or gestures. It is to entertain the medical field in making devices which can help deaf and dumb people to express and deliver their thoughts with their counterparts and an attempt to make a system in which a subject just has to think of a word in his conscious mind and it can be conveyed to the desired destination securely, silently and accurately. When a person initializes his brain to say something, an image of the word or alphabets are portrayed at the back of his mind. This process has been done less than a second that’s why no one can notice this through a naked eye, scientifically, it is proved that anything a man thinks or tries to convey is stored in subconscious mind in the form of an image. Every alphabet thought in mind results with the slight change in the Electroencephalogram of the person. This slight change distinguished and used to make this project working. The suggested method investigates the usefulness of Time – Frequency Analysis as a methodology for classifying various alphabets using electroencephalogram (EEG). For signal acquisition the Electrodes are placed on a subject scalp followed by Instrumentation amplifier which consisting of two stage amplifier i.e., (OPAMP INA118 and TL082), optocoupler subject projection circuit has also been designed for the safety of circuit and the subject too, along with these circuitry Right Driven Leg circuit has also designed to reduce Common-mode interference during acquiring the brain EEG signal from a subject. Narrow band multi feedback filter were also designed to just detect the Alpha wave activity of the subject brain because of aim of this project just to detect these waves for this purpose (8 to 13 HZ) narrow band filleter designed at these ranges. TMS320C6713 digital signal processing kit was also used to perform periodogram on the acquired EEG and extracting the local maxima of the input acquired for the further analysis. The results suggest this approach can retrieve alphabets in half a second. Up to the full number of methods can be used for EEG signal detection to differentiate alphabets. Ranges of data for some alphabets are also collected.

Breast carcinoma is the most common malignancy in women with high mortality rates if diagnosed in advanced stages. Breast carcinoma is not uncommon in pregnant and lactating women but is usually diagnosed late due to physiological hormonal changes. Invasive micropapillary breat carcinoma is a rare variant. Here we describe a case of this rare entity in a young lactating woman.

Among the Health care associated infection (HCAI) Surgical Site Infection(SSI) is one of the most common complications occur after surgery and increases mortalityand morbidity rate. The objective of this study is to identify the common causative organisminvolved in postoperative wound infections along with their sensitivity and resistivity patterns.Study Design: Prospective cross sectional study. Setting: Tertiary Health Care setup inKarachi, Pakistan. Period: Six month from April 2016 till September 2016. Method: A total of100 patients are included in this study that underwent various surgical procedure. Result: Inthis study E. coli isolated from 32% of cases followed next in frequency by S.aureus in 16%,Coagulase negative Staphylococci in 14 %.the other less common pathogen involved Klebsiella,P. aeuroginosa, Enterococcus & Acinetobacter, Enterobacter, Streptococcus group D. AmikacinIimipenem and Meropenem is found to be of more Sensitive against E. Coli while Ampicillin andco trimaxazole showed higher resistivity against E. coli or other various organism. Teicoplannand vancomycin and linzolid have shown absolute sensitivity to various pathogens. Penicillinis found to be highly resistant against Coagulase negative Staphylococci. Conclusion: E.coli is the most common pathogens involved in Post-surgical Infection Amikacin, imipenem,Meropenem, Teicoplann, vancomycin. linzolid is found to be more Sensitive against variousorganism isolated in our study. Acinetobacter are highly resistant to various drugs while P.aeuroginosa have also shown optimal sensitivity pattern against various groups of antibiotics.Present study signifies the adaptation of antibiotic combination in rational way for prophylacticuse and the exploitation of a synchronized system of surgical wound management and cure.

The hepatoprotective effects of Boerhaavia diffusa was studied against the hepatotoxicity induced by oxaliplatin. Male Wistar rats were divided in three groups.Group N* control group (0.9% normal saline), Group NP0 oxaliplatin treated group and Group NP2 were prophylactically treated with Boerhaavia diffusa and then with oxaliplatin in order to assess the protective effects of Boerhaavia diffusa against the toxicity of oxaliplatin. The levels of liver enzymes ALT, AST and γ-GT were significantly reduced in the group prophylactically treated with Boerhaavia diffusa (NP2) compared with the group treated with oxaliplatin (NP0). Boerhaavia diffusa was effective in reducing risk of hypercholestremia associated with oxaliplatin. Histopathological examination of rat liver revealed that prophylactically treated group with Boerhaavia diffusa was effective in reducing oxidative stress induced steatohepatitis by oxaliplatin.

Background: Ultrasonography is a useful modality to diagnose stones and to confirm the occurrence of complications of other renal pathology, so it is important to understand these characteristic findings and other diseases that mimic them. In addition, other imaging modalities such as computed tomography (CT) can be recommended if the clinical or radiological diagnosis is ambiguous.Methods: A group of 325 patients with clinical suspicion of renal calculi were included in this study. Out of these 325 patients 179 (55.0%) were male and 146 (44.9%) were female. All these patients underwent ultrasonography (USG) examination. Final diagnosis was based on CT findings which was done subsequently.Results: The total number of patients comprising the study were 325 who underwent ultrasound examination. After USG and CT scan was done to confirm the diagnosis. Out of 325 patients, 201 patients were confirmed having renal calculi on USG analysis and remaining 103 patients were true negative.Conclusions: The study proves that USG is highly accurate in diagnosing and characterizing renal calculi. USG also guides in defining exact location as well as aids in deciding the medical or surgical approach to be used.

National strategic dynamic capabilities refer to the nations' ability to acquire, develop, and transfer national resources into innovation. This would help provoke firms and individuals’ capabilities to sense and seize to expedite innovative performance transformation. This study suggests that through the dynamic capabilities (DC) framework, the government can increase Innovation by channelizing the economic innovation system indicators. Macroeconomic indicators from 62 countries were taken to assess the significance of indicator-based dynamic capabilities model. The results confirm that sensing and seizing indices motivate Innovation, while the cost of business negatively moderates sensing. This model suggests that governments can motivate Innovation by exploring the indicators which are determining the sensing and seizing environment of decision-makers in businesses.