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This paper intended to analyze the practices of digital citizenship among university student in Pakistan. The quantitative descriptive survey research design was adopted for this study. The population of the study was 800 students of BS (Education) program in ten public sector universities in Punjab, Pakistan. Simple random sampling technique was used for the selection of sample. The sample of the study was 280 students (120 males and 160 females). The research instrument used for the data collection was a five-point Likert scale having nine aspects of digital citizenship identified by Ribble and Baily (2007). The validity of the research instrument was ensured through experts' opinion. Cronbach's Alpha value was used for the reliability of this instrument and its value was .89. The data were analyzed by applying both descriptive and inferential statistics. The research concluded that the majority of the students were involved in the digital citizenship practices in all the ten public sector universities. It was suggested that universities may manage digital citizenship education, formulate the laws for using digital citizenship for positive and healthy activities, conduct co-curricular activities to promote the knowledge of students and integrate digital citizenship education into the curriculum at all stages of education.

Introduction Upper crossed syndrome (UCS) is a common musculoskeletal issue that includes the dysfunctional tone of the muscles in the shoulder girdle or cervicothoracic region. The objective of the current study is to compare the effects of muscle energy techniques with the National Academy of Sports Medicine-based exercise protocol on pain, range of motion, and disability in patients with UCS. Methods It was a single-blinded randomised clinical trial carried out in the Physiotherapy Department of the University of Lahore Teaching Hospital, Pakistan. Fifty patients with upper cross syndrome aged between 20 to 35 years were randomly allocated into two groups: group A (routine physical therapy combined with muscle energy techniques) and group B (routine physical therapy combined with the National Academy of Sports Medicine-based exercise protocol) for three sessions per week for total 8 weeks. Data were collected at baseline, 4 th , 8 th , and 12 th week for assessing the long-term effects of the treatment protocol as well. The Visual Analogue Scale, Neck Disability Index, and an inclinometer were used to measure the pain, disability, and range of motion of the cervical region, respectively. The data was analysed using SPSS version 23.0 (IBM, New York, USA). Results Out of 50 participants, 30 were male and 20 were female. The mean age of all the participants in experimental group A was 29.76 ± 2.89 and that in experimental group B was 30.56 ± 2.48. At the 4 th , 8 th , and 12 th week, pain and disability were significantly ( p -value < 0.05) reduced and cervical range of motion was significantly ( p -value < 0.05) improved within both groups. After 8 weeks of treatment, a significant between-group difference was seen in favour of group A in terms of cervical range of motions (flexion, extension, rotation, and side bending) with p -values of less than 0.05 and in favour of group B in terms of pain ( p -value 0.03) and disability ( p -value 0.04) was seen. These differences were maintained at the 12 th week follow-up as well. Conclusions This study concluded that both NASM (National Academy of Sports Medicine-based exercise protocol) and METs (muscle energy techniques) are effective treatment options for people with upper cross syndrome. It was also concluded that METs are more effective in improving Range of motion (ROM), while the NASM-based exercise protocol is more effective in improving symptoms of pain and neck-related disability.

Background: Peritonitis is a grievous surgical emergency, characterized by the inflammation of the peritoneum and a major cause of morbidity and mortality in surgical situations. This study investigated the delayed presentation impact on 30-day mortality in emergency laparotomies for peritonitis patients in Karachi. Methods: This longitudinal study was employed on 148 peritonitis patients at Jinnah Postgraduate Medical Centre, selected through non-probability convenient sampling. The study included secondary peritonitis-diagnosed patients of all ages and genders admitted from December 2022 to August 2023. Data encompassed pre-hospital experiences, care received at our center, and previous medical consultations. National Exploratory Laparotomy Audit (NELA) score estimated the 30-day mortality rate. SPSS version 26.0 was used, with qualitative variables presented as percentages and frequencies, considering p

Aim: The study aimed to explore the incidence of cancer as an adverse event to SGLT2 inhibitors (SGLT2i) use in Type 2 diabetes.Materials & methods: The study followed PRISMA guidelines to pool RCTs conforming the inclusion criteria. Random effects model was used to pool risk ratios.Results & conclusion: After reviewing 19 studies, the analysis suggested a possible increased risk of reproductive, breast, thyroid, hematologic/lymphatic, urinary, skin and skeletal cancers with SGLT2i use. Conversely, lower incidences of respiratory and cardiovascular cancers were noted. However, these associations lacked statistical significance. Caution is advised in using SGLT2i due to potential cancer risks, especially in diabetic patients prone to cancer. More RCTs are essential due to limited research in this area.

This research paper focuses on the fatigue analysis of load-carrying cruciform joints made up of thick plates, which are crucial components in ship structures. The study investigates the fatigue life of fillet welded cruciform joints using both 2D and 3D geometries. Various loading conditions and boundary conditions are considered, and an elastic-plastic finite element analysis is conducted using ABAQUS 2021. The number of cycles to failure is estimated using Fe-Safe and the strain-based Brown Miller Morrow model. The results, presented through contour plots, Log Life repeats, and Load Range vs. Number of Cycles graphs, reveal the fatigue behavior and failure locations. Additionally, the methodology is validated against experimental data from literature, demonstrating its applicability. The findings provide insights into the fatigue characteristics of load-carrying cruciform joints in thick plates, contributing to enhanced design and reliability in the shipbuilding industry.

Summary: Background: Children in low and middle-income countries remain vulnerable following hospital-discharge. We estimated the incidence and correlates of hospital readmission among young children admitted to nine hospitals in sub-Saharan Africa and South Asia. Methods: This was a secondary analysis of the CHAIN Network prospective cohort enrolled between 20th November 2016 and 31st January 2019. Children aged 2–23 months were eligible for enrolment, if admitted for an acute illness to one of the study hospitals. Exclusions were requiring immediate resuscitation, inability to tolerate oral feeds in their normal state of health, had suspected terminal illness, suspected chromosomal abnormality, trauma, admission for surgery, or their parent/caregiver was unwilling to participate and attend follow-up visits. Data from children discharged alive from the index admission were analysed for hospital readmission within 180-days from discharge. We examined ratios of readmission to post-discharge mortality rates. Using models with death as the competing event, we evaluated demographic, nutritional, clinical, and socioeconomic associations with readmission. Findings: Of 2874 children (1239 (43%) girls, median (IQR) age 10.8 (6.8–15.6) months), 655 readmission episodes occurred among 506 (18%) children (198 (39%) girls): 391 (14%) with one, and 115 (4%) with multiple readmissions, with a rate of: 41.0 (95% CI 38.0–44.3) readmissions/1000 child-months. Median time to readmission was 42 (IQR 15–93) days. 460/655 (70%) and 195/655 (30%) readmissions occurred at index study hospital and non-study hospitals respectively. One-third (N = 213/655, 33%) of readmissions occurred within 30 days of index discharge. Sites with fewest readmissions had the highest post-discharge mortality. Most readmissions to study hospitals (371/450, 81%) were for the same illness as the index admission. Age, prior hospitalisation, chronic conditions, illness severity, and maternal mental health score, but not sex, nutritional status, or physical access to healthcare, were associated with readmission. Interpretation: Readmissions may be appropriate and necessary to reduce post-discharge mortality in high mortality settings. Social and financial support, training on recognition of serious illness for caregivers, and improving discharge procedures, continuity of care and facilitation of readmission need to be tested in intervention studies. We propose the ratio of readmission to post-discharge mortality rates as a marker of overall post-discharge access and care. Funding: The Bill & Melinda Gates Foundation (OPP1131320).

Summary: Environmental enteric dysfunction (EED) is a subclinical enteropathy challenging to diagnose due to an overlap of tissue features with other inflammatory enteropathies. EED subjects (n = 52) from Pakistan, controls (n = 25), and a validation EED cohort (n = 30) from Zambia were used to develop a machine-learning-based image analysis classification model. We extracted histologic feature representations from the Pakistan EED model and correlated them to transcriptomics and clinical biomarkers. In-silico metabolic network modeling was used to characterize alterations in metabolic flux between EED and controls and validated using untargeted lipidomics. Genes encoding beta-ureidopropionase, CYP4F3, and epoxide hydrolase 1 correlated to numerous tissue feature representations. Fatty acid and glycerophospholipid metabolism-related reactions showed altered flux. Increased phosphatidylcholine, lysophosphatidylcholine (LPC), and ether-linked LPCs, and decreased ester-linked LPCs were observed in the duodenal lipidome of Pakistan EED subjects, while plasma levels of glycine-conjugated bile acids were significantly increased. Together, these findings elucidate a multi-omic signature of EED.

This research study was designed to explore the teaching-learning approaches to distance education and measuring students' learning perceptions. Using the multi-stage sampling technique, eight hundred and two (802) students of the Master of Arts in a distance education university were taken using the universal sampling. Data were collected through a self-developed questionnaire. The validity and reliability were properly ensured. Descriptive statistics such as mean gained score and standard deviation were applied to analyze the data. The study found that the time for solving home assignments was enough but the students were confused about the procedure to upload it on the learning management system (LMS).Online workshops were conducted by using the learning management system (LMS) but communication flaws were found in using (LMS) Aaghai portal. The students were quite satisfied with teaching-learning techniques, TV and radio programs, and the study material. It was also concluded that the students were not satisfied with the conduction of the online workshop through LMS due to unstable internet, no familiarization with LMS and the slow process of the Aaghai portal. It is recommended that the AIOU may provide proper guidelines through the conduction of training about the use of technology for assignments and workshops purposes.