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This qualitative case study examines the Education Faculty Perspectives (EFPs) of the Karakoram Public International University in Gilgit-Baltistan, Pakistan, on teachers' experiences of a recently introduced education reform (an Honor's Bachelor of Education program [B. Ed Hons] mandated by Pakistan's Higher Education Commission (HEC) in 2010. The B. Ed Hons has replaced the existing pre-service programs nationwide. Our analysis identified several paradoxical themes about borrowing of the B. Ed Hons: at the "talk"/rhetoric level, the program was welcomed as a transformative shift in teacher education; at the "walk"/implementation level, its practicality and sustainability became complicated; at the decolonisation level, the discourses on the colonial nature of knowledge and North-South dependency were muted. Implications for moving from borrowing external "best practices" to producing local solutions are highlighted. The analysis suggests the contextual realities and challenges should be addressed, individual and structural capacities developed, and an incremental, critical-constructive approach to both external and local ideas be pursued, and decolonization discourse included.

Abstract Cardiac embolism plays a very significant role in acute ischemic strokes (AIS), constituting approximately one-third of cases. The origin of these emboli often stems from intracardiac thrombi in the left atrium or left ventricle. Utilizing the National Readmission Database from 2016 to 2019, we investigate the prevalence of cardiac thrombi in AIS patients and explore their potential correlation with endovascular thrombectomy (EVT) utilization, and mortality rates. Among 1,272,456 AIS patients, 0.6% had concurrent cardiac thrombus, with an increasing trend observed over the study period (P value

Key Clinical Message The presented primary thyroid leiomyosarcoma (TL) case report underscores the importance of recognizing and addressing the diagnostic challenges and management complexities associated with this exceedingly rare malignancy. Given the limited effective therapeutic strategies available, timely intervention, thorough diagnostics, and vigilant follow‐up are paramount in managing such intricate tumors. Further research focusing on molecular‐based treatment modalities is imperative to improve patient outcomes in cases of primary TL.

Given the expanding number of First-Generation Students (FGS) and the social, economic, and civil ramifications of their inequitable struggles with higher education, investigating the influence of support systems on FGS in higher education is vital, especially in Africa. This phenomenological study examined FGS's available and accessible support in Ghanaian higher education using social and cultural capital and ecological theories. There were two focus group discussions with eighteen FGS and in-person interviews with two institutional heads. According to the findings, FGS's only form of accessible support is intermittent support from parents, siblings, teachers, and neighbours. The higher education institutions and government have ineffective, limited, and competitive available support for FGS, which exacerbates the challenges in their higher education journey. The research proposes that FGS, their families, ministry personnel, and other charity organisations may work together to build a supporting network for FGS throughout their academic careers. Instead of providing general support programs for all students, we advocate that governments and organizational systems in higher education institutions should make structural changes and provide targeted support for FGS.

The rapid growth of the elderly population is a major global demographic and social issue. Unfortunately, there is a shortage of pension plans and social security programmes for this population in developing countries, which has severe consequences for their quality of life and well-being. In this article, we aim to better understand the pension systems in developing country contexts such as Ghana, Pakistan, and Myanmar by reviewing official government materials (for example, pension reports) and the published literature to suggest relevant policy recommendations. We observed several policy implementation gaps and inequities in pension schemes for older people, specifically for informal and private sector workers. Considering the size of formal versus informal economies and the level of development index of each country, we suggest a wide variety of options for pension policies, financing, designing cash benefits, and pension payments to cover all older citizens. This article addresses the unmet needs of the elderly and their wider economic sustainability to ensure social justice and resource utilisation. Governments in developing countries should embrace and establish unique, inclusive, and friendly policies encompassing the informal sector to warrant older adults’ functional and social well-being with dignity and honour.

Objectives: Our objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through “extended contact screening” (ECS) with those of patients identified through routine passive case finding (PCF). Methods: Active TB case finding by ECS was tested from 2013–2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared. Results: Of the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8–57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6–50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1–88.9) in the ECS group and 50.3% (95% CI 49.2–51.4) in the PCF group. By regression analysis we found that compared with patients aged 15–44 years, children aged

Generally, cardiac masses are initially suspected on routine echocardiography. Cardiac magnetic resonance (CMR) imaging is further performed to differentiate tumors from pseudo-tumors and to characterize the cardiac masses based on their appearance on T1/T2-weighted images, detection of perfusion and demonstration of gadolinium-based contrast agent uptake on early and late gadolinium enhancement images. Further evaluation of cardiac masses by CMR is critical because unnecessary surgery can be avoided by better tissue characterization. Different cardiac tissues have different T1 and T2 relaxation times, principally owing to different internal biochemical environments surrounding the protons. In CMR, the signal intensity from a particular tissue depends on its T1 and T2 relaxation times and its proton density. CMR uses this principle to differentiate between various tissue types by weighting images based on their T1 or T2 relaxation times. Generally, tumor cells are larger, edematous, and have associated inflammatory reactions. Higher free water content of the neoplastic cells and other changes in tissue composition lead to prolonged T1/T2 relaxation times and thus an inherent contrast between tumors and normal tissue exists. Overall, these biochemical changes create an environment where different cardiac masses produce different signal intensity on their T1- weighted and T2- weighted images that help to discriminate between them. In this review article, we have provided a detailed description of the core CMR imaging protocol for evaluation of cardiac masses. We have also discussed the basic features of benign cardiac tumors as well as the role of CMR in evaluation and further tissue characterization of these tumors.

Background Tuberculosis (TB) in children is difficult to detect and often needs specialists to diagnose; the health system is supposed to refer to higher level of health care when diagnosis is not settled in a sick child. In Pakistan, the primary health care level can usually not diagnose childhood TB and will refer to a paediatricians working at a secondary or tertiary care hospital. We aimed to determine the health services access to child TB services in Pakistan. Objective We aimed to determine the geographical access to child TB services in Pakistan. Method We used geospatial analysis to calculate the distance from the nearest public health facility to settlements, using qGIS, as well as population living within the World Health Organization’s (WHO) recommended 5-km distance. Result At primary health care level, 14.1% of facilities report child TB cases to national tuberculosis program and 74% of the population had geographical access to general primary health care within 5-km radius. To secondary- and tertiary-level health care, 33.5% of the population had geographical access within 5-km radius. The average distance from a facility for diagnosis of childhood TB was 26.3 km from all settlement to the nearest child TB sites. The population of one province (Balochistan) had longer distances to health care services. Conclusion With fairly good coverage of primary health care but lower coverage of specialist care for childhood TB, the health system depends heavily on a good referral system from the communities.

Objective: To compare the effectiveness of second line injectables containing shorter (duration 9–12 months) and longer treatment regimens (LTR, duration ≥ 20 months) among multidrug-resistant tuberculosis (MDR-TB) patients with no documented resistance and history of treatment with any second-line anti-TB drug (SLD) for ≥ 1 month.Methods: This was an observational cohort study of MDR-TB patients treated at eight PMDT units in Pakistan. Patients’ data from baseline until treatment outcomes were collected from Electronic Nominal Recording and Reporting System. The treatment outcomes of “cured” and “treatment completed” were grouped together as successful, whereas “death,” “treatment failure,” and “lost to follow-up” were collectively grouped as unsuccessful outcomes. Time to sputum culture conversion (SCC) was analyzed using the Kaplan–Meier method and the differences between groups were compared through the log-rank test. Multivariate Cox proportional hazards and binary logistic regression analyses were used to find predictors of time to SCC and unsuccessful treatment outcomes. A p-value < 0.05 was considered statistically significant.Results: A total 701 eligible MDR-TB patients [313 treated with shorter treatment regimen (STR) and 388 treated with LTR at eight centres in Pakistan were evaluated]. Time to achieve SCC was significantly shorter in STR group [mean: 2.03 months, 95% confidence interval (CI):1.79–2.26] than in LTR group (mean: 2.69 months, 95% CI: 2.35–3.03) (p-value60 years (OR = 5.84, p-value60 kg (OR = 0.23, p-value

This faculty-student collaborative article is a result of a graduate seminar on ‘Environmental Education’ taught at the Aga Khan University’s Institute for Educational Development in Karachi, and it illuminates new perspectives and pedagogies of nature from the global South, specifically South Asia. Drawing inspiration from feminist and indigenous thought, the narratives of ecology shared here center the place of emotions, experience, memory and spiritual intimacy, offering one means of decolonizing environmental studies and expanding our understanding of ‘environmental consciousness’. These narratives defy ontologies of nature-human separation, capturing not just the co-existence of animals, spirits and humans but their co-constitution. Such indigenous ecologies of knowledge and wisdom, we argue, offer a timely corrective to fragmented and exploitative constructions of the natural environment as mere resource, pleasure, or commodity, while providing a profound, alternative basis for a richly layered, spirited, environmental education. How to cite this article: ALI, Nosheen; SAMNANI, Binish; WALI KHAN, Abdul; KHATOON, Najmi; ALI, Barkat; ASFUNDYAR, Sadia; ASLAM, Muhammad; AMIRALI, Sumaira. Decolonizing nature/knowledge: indigenous environmental thought and feminist praxis. Scholarship of Teaching and Learning in the South. v. 3, n. 1, p. 77-91, Apr. 2019. Available at: https://sotl-south-journal.net/?journal=sotls&page=article&op=view&path%5B%5D=80&path%5B%5D=36 This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

It has been suggested that pulmonary arterial hypertension (PAH) could be a potential sequela of coronavirus disease 2019 (COVID-19) in particular in those with hypertension; however, development of PAH after the course of COVID-19 in normotensive individuals are rarely reported. Here, we report a patient who developed PAH two months post-COVID-19. The patient was a 55-year-old female and normotensive, tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), developed mild respiratory distress syndrome and necessitated continuous positive airway pressure during the treatment in the hospital. After two months discharged from the hospital with RT-PCR negative for SARS-CoV-2, the patient presented with exertional dyspnea, dry cough, fatigue and episodes of syncope during exertion. Based on clinical presentation, electrocardiography, computed tomography, and transthoracic echocardiography assessment, PAH diagnosis was made. To our knowledge, this is a rare PAH case and this highlights the possible of PAH as sequala that might present in post COVID-19 patients.

The COVID-19 has caused the deadliest pandemic around the globe, emerged from the city of Wuhan, China by the end of 2019 and affected all continents of the world, with severe health implications and as well as financial-damage. Pakistan is also amongst the top badly effected countries in terms of casualties and financial loss due to COVID-19. By 20th March, 2021, Pakistan reported 623,135 total confirmed cases and 13,799 deaths. A state space model called 'Bayesian Dynamic Linear Model' (BDLM) was used for the forecast of daily new infections, deaths and recover cases regarding COVID-19. For the estimation of states of the models and forecasting new observations, the recursive Kalman filter was used. Twenty days ahead forecast show that the maximum number of new infections are 4,031 per day with 95% prediction interval (3,319-4,743). Death forecast shows that the maximum number of the deaths with 95% prediction interval are 81 and (67-93), respectively. Maximum daily recoveries are 3,464 with 95% prediction interval (2,887-5,423) in the next 20 days. The average number of new infections, deaths and recover cases are 3,282, 52 and 1,840, respectively, in the upcoming 20 days. As the data generation processes based on the latest data has been identified, therefore it can be updated with the availability of new data to provide latest forecast.

'Background:' Influenza is a common respiratory disease in Pakistan. However, the absence of a robust surveillance system makes it difficult to estimate the burden of disease. 'Purpose:' We conducted this study to identify key strengths and weaknesses of the laboratory-based influenza surveillance system in Pakistan and to make recommendations for improvement. 'Methods:' We conducted an evaluative descriptive study of the national laboratory-based influenza surveillance system from April to July 2017. We conducted this assessment using the updated guidelines for evaluating public health surveillance systems issued by CDC in 2011. 'Findings: 'The system was found to be simple and easy to operate, but with little flexibility to integrate with other pathogens and diseases. Data quality was good, given that 80% of observed forms were completed. Timeliness was good, as it takes only 24-48 hours from sample collection to report a submission to the central level. Acceptability was good, since both private and public sector hospitals and labs are involved. Sensitivity was 62% and positive predictive value (PPV) was 37.2%. The representativeness of lab based influenza surveillance system was poor, since it is a sentinel surveillance system with specific, strategically placed reporting sites. 'Conclusions:' The system meets its objectives. Sustainability and stability of the system needs to be improved by allocation of public funds. Coverage of the system should be expanded to improve representativeness. Regular capacity building with staff at reporting sites will ensure continued quality of reporting.

Online discussion forums are repositories of valuable information where users interact and articulate their ideas and opinions, and share experiences about numerous topics. These online discussion forums are internet-based online communities where users can ask for help and find the solution to a problem. A new user of online discussion forums becomes exhausted from reading the significant number of irrelevant replies in a discussion. An automated discussion thread summarizing system (DTS) is necessary to create a candid view of the entire discussion of a query. Most of the previous approaches for automated DTS use the continuous bag of words (CBOW) model as a sentence embedding tool, which is poor at capturing the overall meaning of the sentence and is unable to grasp word dependency. To overcome these limitations, we introduce the LSTM Auto-encoder as a sentence embedding technique to improve the performance of DTS. The empirical result in the context of the proposed approach's average precision, recall, and F-measure with respect to ROGUE-1 and ROUGE-2 of two standard experimental datasets demonstrates the effectiveness and efficiency of the proposed approach and outperforms the state-of-the-art CBOWmodel in sentence embedding tasks and boost the performance of the automated DTS model. [ABSTRACT FROM AUTHOR]

Climate change has a significant impact on the intensity and spread of dengue outbreaks. The objective of this study is to assess the number of dengue transmission suitable days (DTSD) in Pakistan for the baseline (1976–2005) and future (2006–2035, 2041–2070, and 2071–2099) periods under Representative Concentration Pathway (RCP4.5 and RCP8.5) scenarios. Moreover, potential spatiotemporal shift and future hotspots of DTSD due to climate change were also identified. The analysis is based on fourteen CMIP5 models that have been downscaled and bias-corrected with quantile delta mapping technique, which addresses data stationarity constraints while preserving future climate signal. The results show a higher DTSD during the monsoon season in the baseline in the study area except for Sindh (SN) and South Punjab (SP). In future periods, there is a temporal shift (extension) towards pre- and post-monsoon. During the baseline period, the top ten hotspot cities with a higher frequency of DTSD are Karachi, Hyderabad, Sialkot, Jhelum, Lahore, Islamabad, Balakot, Peshawar, Kohat, and Faisalabad. However, as a result of climate change, there is an elevation-dependent shift in DTSD to high-altitude cities, e.g. in the 2020s, Kotli, Muzaffarabad, and Drosh; in the 2050s, Garhi Dopatta, Quetta, and Zhob; and in the 2080s, Chitral and Bunji. Karachi, Islamabad, and Balakot will remain highly vulnerable to dengue outbreaks for all the future periods of the twenty-first century. Our findings also indicate that DTSD would spread across Pakistan, particularly in areas where we have never seen dengue infections previously. The good news is that the DTSD in current hotspot cities is projected to decrease in the future due to climate change. There is also a temporal shift in the region during the post- and pre-monsoon season, which provides suitable breeding conditions for dengue mosquitos due to freshwater; therefore, local authorities need to take adaption and mitigation actions. [ABSTRACT FROM AUTHOR]