Long-term quantification of springtime aerosols over Saudi Arabia using multi-satellite remotely sensed data.

A comprehensive analysis of aerosol characteristics over Saudi Arabia from 2005 to 2022, utilizing high-resolution satellite-based observations and reanalysis datasets, examining the distribution of aerosols and their subtypes across the three dimensions (temporal, spatial, and altitude based) for March, April, and May. This study focuses on the analysis of parameters such as aerosol optical depth (AOD), angstrom exponent (AE), absorption aerosol optical depth (AAOD), and Ultraviolet Aerosol Index (UVAI), revealing significant spatial disparities, with elevated aerosol concentrations in the central and eastern regions and comparatively lower concentrations along the western coastal areas. In this study, the spatial patterns and temporal trends are analyzed through trajectory modeling. The study also investigates the composition of aerosols in various Saudi cities. Aerosols prevailing in a dozen Saudi Arabian cities were systematically categorized into six sub-types, considering their particle size and UV-absorbing properties. Notably, two major aerosol sub-types, absorbing coarse (AC) aerosols (UVAI > 0.25, AE < 0.70) treated as mineral dust and absorbing mixed (AM) aerosols (0.70 < AE < 1.25) along with neutral fine (NF) particles (- 0.5 < UVAI < 0.25, AE > 1.25) treated as urban, predominate across the Kingdom of Saudi Arabia.

Microbiome miracles and their pioneering advances and future frontiers in cardiovascular disease.

Cardiovascular diseases (CVDs) represent a significant global health challenge, underscoring the need for innovative approaches to prevention and treatment. Recent years have seen a surge in interest in unraveling the complex relationship between the gut microbiome and cardiovascular health. This article delves into current research on the composition, diversity, and impact of the gut microbiome on CVD development. Recent advancements have elucidated the profound influence of the gut microbiome on disease progression, particularly through key mediators like Trimethylamine-N-oxide (TMAO) and other microbial metabolites. Understanding these mechanisms reveals promising therapeutic targets, including interventions aimed at modulating the gut microbiome's interaction with the immune system and its contribution to endothelial dysfunction. Harnessing this understanding, personalized medicine strategies tailored to individuals' gut microbiome profiles offer innovative avenues for reducing cardiovascular risk. As research in this field continues to evolve, there is vast potential for transformative advancements in cardiovascular medicine, paving the way for precision prevention and treatment strategies to address this global health challenge.

Utilization of organic-residues as potting media: Physico-chemical characteristics and their influence on vegetable production.

Soilless agriculture is acknowledged worldwide because it uses organic leftovers as a means of supporting intensive and efficient plant production. However, the quality of potting media deteriorates because of lower nutrient content and excessive shrinkage of most organic materials. A current study was undertaken to identify the optimal blend of locally available organic materials with desirable qualities for use as potting media. Therefore, different ingredients, viz., Pinus roxburghii needles, sugarcane bagasse, and farmyard manure were used alone or in combination as potting media to test their suitability by growing spinach as a test crop. Results showed that an increase in Pinus roxburghii needles and sugarcane bagasse decreased medium pH and electrical conductivity. Higher pH and electrical conductivity were recorded for the treatments having a higher farmyard manure ratio (≥50%) in combination. Except for pine needles 100%, pH and electrical conductivity were in the recommended range. The growth attributes include, leaves plant-1, shoot length, fresh- and dry shoot weight along with plant macronutrients (nitrogen, phosphorous, and potassium) and micronutrients (iron, copper, manganese, and zinc) content were higher in treatment pine needles 50%+farmyard manure 50% followed by pine needles 25%+farmyard manure 50%+sugarcane bagasse 25%. Moreover, the particular treatment of pine needles 50%+farmyard manure 50% exhibited the highest concentrations of macro- (nitrogen, phosphorus, and potassium) as well as micronutrients (iron, copper, manganese, and zinc) in the potting media following the harvest. This study highlights the potential of utilizing agro-industrial litter/waste as a soilless growing medium for spinach production under greenhouse conditions. When employed in appropriate proportions, this approach not only addresses disposal concerns but also proves effective for sustainable cultivation. Further research is needed to investigate the use of these wastes as potting media by mixing various particle-size ingredients.

Assessment of the impact of integrated disease surveillance and response system on surveillance management at healthcare facilities in Pakistan.

Background: Disease surveillance is very crucial especially in high vulnerability settings like Pakistan. However, surveillance and outbreak response management are still evolving in the country and research studies are needed to assess the existing system. Aim: To assess the impact of integrated disease surveillance and response system (IDSRS) implemented by the provincial government to strengthen infectious disease surveillance and reporting in 6 districts of Pakistan in 2016. Methods: A baseline cross-sectional assessment of health facilities and the healthcare workforce was conducted in 2016 to identify needs and gaps in public sector health facilities and the health system of 6 selected districts of Khyber Pakhtunkhwa Province, Pakistan. This was followed by a 2018 endline survey of the same facilities using the same variables. Results: Overall, there was improvement in district management and facility level performance (χ2 (1, 314) = 21.19, P < 0.001, V = 0.26). District level management improved significantly in areas with relatively lower Gross Domestic Product (GDP)? χ2(1, 154) = 30.41, P <0.001, V = 0.44). Facilitation domain variables improved in the lower GDP districts (χ2 (1, 74) = 5.76, P = 0.016, V = 0.28) and showed counterintuitive deterioration (χ2 (1, 74) = 4.80, P = 0.028, V = 0.25) in relatively higher GDP areas. Conclusion: IDSRS is effective in improving surveillance and response systems, however, its effectiveness appears to depend on locale-specific economies and can be enhanced by modifying the implementation approach. Better empowerment of the local workforce can contribute to such improvement.

Effectiveness of locally produced ready-to-use supplementary foods on the prevention of stunting in children aged 6-23 months: a community-based trial from Pakistan.

Undernutrition is a major public health problem in developing countries. Around 40·2 % of children are stunted in Pakistan. This longitudinal study aimed to assess the effectiveness of locally produced ready-to-use supplementary foods in the prevention of stunting by detecting change in of children in intervention v. control arm against the 2006 WHO growth reference. A community-based non-randomised cluster-controlled trial was conducted from January 2018 to December 2020 in the district of Kurram, Khyber Pakhtunkhwa, Pakistan. A total of 80 clusters (each cluster comprising ≈ 250-300 households) were defined in the catchment population of twelve health facilities. Children aged 6-18 months were recruited n 1680. The intervention included a daily ration of 50 g - locally produced ready-to-use-supplementary food (Wawa-Mum). The main outcome of this study was a change in length for age z-score (LAZ) v. WHO growth standards. Comparison between the interventions was by t test and ANOVA. Cox proportional hazard models were used to assess the association between stunting occurrence and the utilisation of locally produced supplement. Out of the total 1680, fifty-one out of the total 1680, 51·1 out of the total 1680 and 51·1 % (n 859) were male. Mean age 13·9 months (sd + 859) were male. Mean age 13·9 months (sd + -4·4). At baseline, 36·9 % (n 618) were stunted. In the intervention group, mean LAZ score significantly increased from -1·13(2·2 sd) at baseline to -0·93(1·8 sd) at 6-month follow-up (P value 0·01) compared with the control group. The incidence rate of stunting in the intervention arm was 1·3 v. 3·4 per person year in the control arm. The control group had a significantly increased likelihood of stunting (Hazard Ratio (HR) 1·7, 95 % CI 1·46, 2·05, P value < 0·001) v. the intervention group. Locally produced ready-to-use supplementary food is an effective intervention for reducing stunting in children below 2 years of age. This can be provided as part of a malnutrition prevention package to overcome the alarming rates of stunting in Pakistan.

Oral health behind the bars: oral health seeking behavior among jail prisoners at central jail of Peshawar, Pakistan: a cross-sectional study.

BACKGROUND: The oral health care-seeking behavior among prison inmates is an overlooked area, often leading to deteriorating general health due to the prisoners' limited awareness of oral hygiene practices. It is crucial to address this issue and understand the factors associated with oral healthcare-seeking behavior in prisons. OBJECTIVE: To assess the oral healthcare-seeking behavior of prison inmates at Central Prisoner Jail, Peshawar Pakistan and to look the factors associated with their dental care utilization. MATERIAL AND METHODS: This cross-sectional study was conducted at Central Prisoner Jail, Peshawar Khyber Pakhtunkhwa, Pakistan from November 2021 to April 2022. A consecutive sampling technique was used to collect data from both convicted and under-trial prisoners by using a pre-tested WHO Basic Oral Health Survey 2013 tool. Our outcome variable was "Visit to a dentist in the last 12 months (Never/Once or more than one visit). Chi-square test was used to determine univariate association with other explanatory variables while multivariable logistic regression was performed to adjust for potential confounders. RESULT: A total of 225 participants were recruited to the study with a mean (SD) age of 32.9(11.4). More than two-thirds of 200(88.9%) of the participants were males. One-third of the sample never visited the dentist75(33.3). Participants who completed college/university education and never visited the dentist in the last 12 months constituted a smaller proportion (17.6%) compared to those who visited the dentist once or more than once n = 28(82.4%, p-value = 0.003). Individuals who were using toothbrushes were most frequently visiting the dentist n = 130(72.6%=p value = 0.001) as compared to never visitors. Multivariate logistic regression analysis revealed that Participants who experienced teeth pain or discomfort had 0.42 times lower odds of visiting the dentist compared to those who did not experience any pain or discomfort [AOR 0.42 (95% CI 0.17-0.80), p = 0.04]. Similarly, Participants who do not use any denture have 4.06 times higher odds[AOR 4.06(95% CI 1.76-9.36), p = 0.001] of visiting the dentist compared to those who use a denture. CONCLUSION: Our result demonstrates that those prisoners who were experiencing tooth pain or discomfort and not using dentures were the strong predictors with lower dental visit frequency to seek oral health care.

Assessment of medical students' knowledge regarding radiation associated risk and its protection: finding from a cross-sectional study.

OBJECTIVE: The current study assessed the knowledge of the medical students regarding the nature of radiation, associated risks, and protective measures. METHOD: A cross-sectional study was conducted among international students enrolled in different medical colleges/universities in Xian, PR China. A self-developed and self-reported questionnaire was used for the current study. The descriptive statistics was carried out to summarize the finding of the study. Chi-square and Fisher exact tests were conducted to assess the association of the demographics with knowledge level. RESULTS: A total of 796 students responded among 980. Most of the participants fell in the age range of 20-25 years (42.6%), being male (67.1%) and having bachelor's education (56.7%). Participants with previous experience was 58.7%. The age group of 20-25 years (p < 0.001), being male (p < 0.001), having bachelor education (p < 0.001), and previous experience (p = 0.009) was significantly associated with moderate to good knowledge. The overall knowledge about the nature of radiation (96%) and associated risk (82%) was good, but regarding protection, 59% of the participants showed good knowledge. CONCLUSION: Most of the participants showed satisfactory result. However, the knowledge regarding protection measures was poor in almost half of the population.

Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan.

BACKGROUND: The COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives. METHODS: A cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22. RESULTS: A total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn't receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn't receive training, labeled as "high risk" compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10-0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25-0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23-12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don't have skills to wear them. CONCLUSION: Our findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.

Methodological analysis of a community-based training initiative using the EPIS framework: an ongoing initiative to empower 10 million bystanders in CPR and bleeding control.

Background: Out-of-hospital cardiac arrest (OHCA) and life-threatening bleeding from trauma are leading causes of preventable mortality globally. Early intervention from bystanders can play a pivotal role in increasing the survival rate of victims. While great efforts for bystander training have yielded positive results in high-income countries, the same has not been replicated in low and middle-income countries (LMICs) due to resources constraints. This article describes a replicable implementation model of a nationwide program, aimed at empowering 10 million bystanders with basic knowledge and skills of hands-only cardiopulmonary resuscitation (CPR) and bleeding control in a resource-limited setting. Methods: Using the EPIS (Exploration, Preparation, Implementation and Sustainment) framework, we describe the application of a national bystander training program, named 'Pakistan Life Savers Programme (PLSP)', in an LMIC. We discuss the opportunities and challenges faced during each phase of the program's implementation and identify feasible and sustainable actions to make them reproducible in similar low-resource settings. Results: A high mortality rate owing to OHCA and traumatic life-threatening bleeding was identified as a national issue in Pakistan. After intensive discussions during the exploration phase, PLSP was chosen as a potential solution. The preparation phase oversaw the logistical administration of the program and highlighted avenues using minimal resources to attain maximum outreach. National implementation of bystander training started as a pilot in suburban schools and expanded to other institutions, with 127 833 bystanders trained to date. Sustainability of the program was targeted through its addition in a single national curriculum taught in schools and the development of a cohesive collaborative network with entities sharing similar goals. Conclusion: This article provides a methodological framework of implementing a national intervention based on bystander response. Such programs can increase bystander willingness and confidence in performing CPR and bleeding control, decreasing preventable deaths in countries having a high mortality burden. Level of evidence: Level VI.

Smart Technologies used as Smart Tools in the Management of Cardiovascular Disease and their Future Perspective.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality worldwide. The advent of smart technologies has significantly impacted the management of CVD, offering innovative tools and solutions to improve patient outcomes. Smart technologies have revolutionized and transformed the management of CVD, providing innovative tools to improve patient care, enhance diagnostics, and enable more personalized treatment approaches. These smart tools encompass a wide range of technologies, including wearable devices, mobile applications,3D printing technologies, artificial intelligence (AI), remote monitoring systems, and electronic health records (EHR). They offer numerous advantages, such as real-time monitoring, early detection of abnormalities, remote patient management, and data-driven decision-making. However, they also come with certain limitations and challenges, including data privacy concerns, technical issues, and the need for regulatory frameworks. In this review, despite these challenges, the future of smart technologies in CVD management looks promising, with advancements in AI algorithms, telemedicine platforms, and bio fabrication techniques opening new possibilities for personalized and efficient care. In this article, we also explore the role of smart technologies in CVD management, their advantages and disadvantages, limitations, current applications, and their smart future.

Patient Satisfaction and Utilization of Ambulance Services in Prehospital Services at a Tertiary Care Hospital: A Cross-Sectional Study in Peshawar, Khyber Pakhtunkhwa, Pakistan.

OBJECTIVE: Patients reporting to emergency departments frequently use different ambulance services; therefore, the measurement of patient satisfaction is relevant to encouraging those services to meet patient expectations. The aim of this study was to determine the patients' satisfaction and utilization of different ambulance services at a tertiary health care hospital in Peshawar relating to prehospital services. METHODS: This cross-sectional study was conducted at Lady Reading Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan, from July 2019 to January 2020 using a consecutive sampling technique with a total sample size of 378. The patients reporting to the emergency department using any ambulance service were included in this study. Different types of ambulance services were used as an outcome variable. Proportions were compared for the categoric variables using the chi-square test, whereas the 1-way analysis of variance test was used to determine the mean response time and age. Results were considered significant at a P value ≤ .050. All analyses were completed using SPSS version 20 (IBM Corp, Armonk, NY). RESULTS: Of the total 378 study participants, approximately 166 (43.9%) used Rescue 1122 services, 99 (26.2%) used private ambulance services, and 44 (11.6%) used public ambulance services. Road traffic accidents were the most common complaint by 98 (25.9%, P < .003) participants. The mean response time for Rescue 1122 was 13.2 ± 18 minutes followed by the Chippa Foundation (private) at 17.8 ± 20 minutes (P < .005). Males (n = 254) were the predominant users of all services. Participants from the urban region (n = 112) used Rescue 1122, whereas the public ambulance service was used only by 31 patients (P < .005). Among all the ambulance services, 19 (61.3%) participants were not satisfied with the Chippa service regarding vehicle cleanliness, whereas participants were highly satisfied with Rescue 1122. CONCLUSION: Overall, the patients were more satisfied with the services provided by the Rescue 1122 ambulances compared with all other ambulance services.

Estimating environmental efficiency of the selected Asian countries: does convergence exist?

Environmental degradation has attained much attention from researchers and policymakers at national and global levels. The ever-increasing energy use in production methods is considered one of the fundamental reasons for environmental degradation. The concept of environmental efficiency in the wake of sustainable growth evolved in the last three decades. The present study has been designed to estimate environmental efficiency using the Malmquist-Luenberger productivity index (MLI) using annual data from 43 Asian countries from 1990 to 2019. The MLI is an established econometric approach to estimate cases where input variables are used to get output variables in desirable and undesirable forms. Labor, capital, and energy consumption are input variables, while carbon dioxide (CO2) emissions (undesirable variable) and gross domestic product (undesirable variable) are taken as output variables. The results suggested that, on average, environmental efficiency has decreased by 0.3% over the period in selected Asian countries. Cambodia, Turkey, and Nepal have the highest total factor productivity (TFP) output growth rate on average among 43 Asian countries. These countries are excellent examples of sustainable development that balances environmental protection and efficiency. On the other hand, Kuwait, Mongolia, and Yemen showed the least TFP growth. The study also employed unconditional and convergence tests where the countries' conditional convergence is based on foreign direct investment, population density, inflation, industrialization, and globalization. Some policy implications for Asian countries are also discussed at the end of the study.

Linkages between poverty and food insecurity in Pakistan: Evidence from urban and rural households in Peshawar.

Objective: To assess household poverty, sanitation and hygiene practices, and food security in both urban and rural settlements of district Peshawar. Methods: We conducted this cross-sectional study from March 2019 to October 2019 in the urban and rural households of Peshawar, KPK. Using stratified random sampling, 554 households (HH) having children and young adolescents of age 5-19 years, adult men > 19 - 62 years, and adult women >19 - 62 years were included in this study. Data was collected using comprehensive tool comprised of all validated questionnaires and was analyzed using SPSS Version 24.0. Result: Within the urban clusters, the maximum number of households (n=29) were from Gari Baloch and the minimum number of households (n=7) were from Gulberg. In the rural clusters, the maximum number of households surveyed (n=41) were from Lamara, minimum(n=21) was from Chargula. The average age of household heads was 44.5 ±12.5 with mean age slightly higher in urban areas (45.1 ±11.8) compared to 44.0 ±13.2 in rural areas. The mean poverty score was 56.8 (±11.6) with 72.1% non-poor households, and 94.2% households being food secure. Handwashing practices were highly prevalent among all the HH, however, handwashing practices before eating were comparatively lower in all HH (45.2%), lowest (37.8%) among rural households. Conclusion: The findings of the study revealed both non-poor and food secure households with satisfactory water, hygiene and sanitation practices.

Electrochemical analysis of glyphosate using porous biochar surface corrosive nZVI nanoparticles.

Glyphosate [N-(phosphonomethyl)glycine] is a widely used phosphonate herbicide for different agricultural purposes. Due to its widespread use, suspected toxicity, and ubiquitous bioaccumulation, it is one of the most harmful contaminants found in drinking water. This demands efficient sensing and removal of glyphosate from contaminated water. Here, we report the decoration of novel and highly porous biochar with nanozero-valent iron (nZVI) nanoparticles to develop an efficient electrochemical sensor for the trace detection of glyphosate. The as-synthesized composite was thoroughly characterized by various state-of-the-art instrumental techniques. The electron micrographs of the composite materials revealed the cavity-like structure and the abundant loading of nZVI nanoparticles. FTIR and XPS analyses confirmed the presence of oxygen-rich functionalities and Fe(0) in the composite nanostructure. Electrochemical analysis through CV, LSV, and DPV techniques suggested efficient sensing activity with a limit of detection as low as 0.13 ppm. Furthermore, the chronopotentiometric response suggested excellent and superior stability for long-term applications. To gain more insight into the interaction between glyphosate and the composite material, DFT calculations were carried out. The Frontier Molecular Orbital study (FMO), Molecular Electrostatic Potentials (MEPs), and Density of States (DOS) suggest an increase in the electron density, an increase in the DOS, and a decrease in the HOMO-LUMO band gap by combining nZVI nanoparticles and biochar. The results suggest more facile electron transfer from the composite for trace detection of glyphosate. As a proof of concept, we have demonstrated that real-time analysis of milk, apple juice, and the as-synthesized composite shows promising results for glyphosate detection with an excellent recovery rate.

Variations in the aerosol index and its relationship with meteorological parameters over Pakistan using remote sensing.

Particulate pollution has become a major issue in developing countries including Pakistan. Aerosols are causing severe impacts on climate and human health. To understand the effects of aerosols on the environment and human health, we must first understand their optical and physical properties. In this paper, we used ozone monitoring instrument (OMI) retrieved ultraviolet aerosol index (UVAI) to analyze spatial and temporal distribution, annual and seasonal trends of absorbing aerosols, and their relationship with meteorological parameters (e.g., temperature, relative humidity, and wind speed) over Pakistan from October 2004 to December 2021. Significant spatiotemporal changes in UVAI values were found with high values in southern and central regions and low values in northern regions of Pakistan. The mean UVAI over Pakistan showed an increasing trend of 2.89% year-1. Seasonally, UVAI increases at the rate of 3.97% winter-1, 3.24% autumn-1, 0.81% summer-1, and 0.71% spring-1. A strong positive correlation of UVAI with precipitation and temperature (~ 0.6) is observed in the central and southern regions of Pakistan. A negative and positive correlation of -0.3223 and 0.4284 of UVAI with CO2 emissions and primary industry is observed in Pakistan, respectively. We also found potential sources of aerosols over major cities of Pakistan using the Hybrid Single Particle Langrangian Integrated Trajectory (HYSPLIT) model. It determines that the dominant aerosols over Karachi are natural aerosols like sea salt and dust particles and anthropogenic aerosols are dominant over Lahore. Moreover, the natural and anthropogenic factors influencing absorbing aerosols are also discussed herein. Considering the outcomes of this study different methods would be used to reduce the concentration of particulate pollution like afforestation, efficient fuel energy consumption, promotion of public transport networks, etc.

Evaluating the role of renewable energy and technology innovations in lowering CO2 emission: a wavelet coherence approach.

Environmental sustainability is one of the most critical issues that require efficient environmental and economic policies in modern times. Advancements in renewables and green technologies contribute significantly to sustained long-term development without affecting environmental quality. Several studies focus on the association of carbon dioxide emissions (CO2e) with economic variables. However, they ignored the impact of technological innovations and renewable energy consumption on CO2e in developed countries. Therefore, this study examines the relationship between CO2e, energy consumption, gross domestic product (GDP), renewable energy consumption, and technology innovations in G-7 countries by employing cross-sectionally augmented autoregressive distributed (CS-ARDL) lag and wavelet coherence techniques during 1990-2020. The results depict that GDP and renewable energy consumption are inversely related to CO2e. A 1% increase in CO2e will decrease GDP and renewable energy consumption by 0.459 and 0.172% in the long run and by 0.471 and 0.183% in the short run in G7 countries. Technology innovations negatively impact CO2e in the short run while positively influencing it in the long run. Considering the advancements in green technologies in different energy-dependent and manufacturing sectors is crucial for a sustainable environment in the long run. Such initiatives ensure the effective use of energy sources by limiting CO2e in the atmosphere. Moreover, the dynamic common correlated effects mean group model confirms the reliability and effectiveness of the CS-ARDL. The wavelet coherence approach revealed a causality relation between CO2e and technology innovation in Italy, Japan, the UK, and the USA during the study period.

Financial Institutional and Market Deepening, and Environmental Quality Nexus: A Case Study in G-11 Economies Using CS-ARDL.

This study presents a new insight into the dynamic relationship between financial institutional deepening (FID), financial deepening, financial market deepening (FMD), foreign direct investment (FDI), economic growth (GDP), population, and carbon dioxide emissions (CO2e) in the G-11 economies by employing a cross-sectionally augmented autoregressive distributed lag (CS-ARDL) approach during 1990-2019. The outcomes from the CS-ARDL and dynamic common correlated effects mean group (DCCEMG) models shows that financial deepening, GDP, FDI, and population degraded environmental quality both in the short run and the long run. Contrary to this, FID and FMD improves environmental quality in these countries. The government should work to maximize financial institutions (access, depth, efficiency) and financial markets (access, depth, efficiency) to reduce the CO2e. A strong positive and in-phase correlation of CO2e with economic growth and population is observed for G-11 countries. These results suggest policy makers should further improve financial institutions by creating opportunities for their populations. Moreover, the governments of G-11 countries should revise their foreign direct investment policies and attention should be given to import efficient means of energy production.

Patients' and healthcare professionals' perspectives on a community-based intervention for schizophrenia in Pakistan: A focus group study.

OBJECTIVE: To explore the perceptions and experiences of schizophrenia from patients, their care givers, health care providers, spiritual and traditional healers to develop a community-based intervention for improving treatment adherence for people with schizophrenia in Pakistan. METHODS: This qualitative study involved four focus group discussions (FGD) with a total of 26 participants: patients and carers (n = 5), primary care staff (n = 7), medical technicians (n = 8) and traditional and spiritual healers (n = 6). The participants were selected using purposive sampling method. FGDs were audio-recorded and transcribed. A thematic analysis was applied to the data set. RESULTS: The themes identified were (i) Schizophrenia is not merely a biomedical problem: participants believed that poverty and an inferiority complex resulting from social disparity caused schizophrenia and contributed to non-adherence to medications; (ii) Spiritual healing goes hand in hand with the medical treatment: participants regarded spiritual and traditional treatment methods as an inherent part of schizophrenia patients' well-being and rehabilitation; (iii) Services for mental illness: mental health is not covered under primary health in a basic health unit: participants believed that the lack of services, training and necessary medication in primary care are major issues for treating schizophrenia in community; (iv) Barriers to community-based interventions: primary care staff believed that multiple pressures on staff, lack of incentives, non-availability of medication and lack of formal referral pathways resulted in disintegration of dealing with schizophrenia patients in primary care facilities. CONCLUSION: The study has identified a number of barriers and facilitators to developing and delivering a psychosocial intervention to support people living with schizophrenia in Pakistan. In particular, the importance of involving spiritual and traditional healers was highlighted by our diverse group of stakeholders.

Detection of Novel Biallelic Causative Variants in COL7A1 Gene by Whole-Exome Sequencing, Resulting in Congenital Recessive Dystrophic Epidermolysis Bullosa in Three Unrelated Families.

Background: Dystrophic Epidermolysis bullosa (DEB) is a rare, severe subtype of epidermolysis bullosa (EB), characterized by blisters and miliary rashes of the skin. Dystrophic EB (DEB) includes variants inherited both in an autosomal-dominant or autosomal-recessive manner. Recessive dystrophic EB (RDEB) is divided into many subtypes and prevails as a result of biallelic genetic mutations in COL7A1 gene encoding type VII collagen, a major stabilizing molecule of the dermo-epidermal junction. The blister formation is mainly due to the variable structural and functional impairment of anchoring fibrils in VII collagen (COLVII), responsible for the adhesion of the epidermis to the dermis. Method: Three Pakistani families (A, B and C) affected with congenital dystrophic epidermolysis bullosa were recruited in the present study. The whole-exome sequencing (WES) approach was utilized for the detection of the pathogenic sequence variants in probands. The segregation of these variants in other participants was confirmed by Sanger sequencing. Results: This study identified a novel missense variant c.7034G>A, p. Gly2345Asp in exon 91, a novel Frameshift mutation c.385del (p. His129MetfsTer18) in a homozygous form in exon no 3, and a previously known nonsense variation (c.1573 C>T; p. Arg525Ter) in exon 12 of COL7A1 gene in families A, B, and C, respectively, as causative mutations responsible for dystrophic epidermolysis bullosa in these families. Conclusion: Our study validates the involvement of the COL7A1 gene in the etiology of dystrophic epidermolysis bullosa. It further expands the COL7A1 gene mutation database and provides an additional scientific basis for diagnosis, genetic counseling, and prognosis purposes for EB patients.

Urease and α-Chymotrypsin Inhibitory Activities and Molecular Docking Studies of Alkaloids Isolated from Medicinal Plant Isatis minima Bunge.

Phytochemical studies on the alkaloids fraction of the entire plant of Isatis minima Bunge resulted in the alkaloids 1-4 isolation, which were first time isolated from this species. The 1D and 2D NMR spectroscopic data were used to identify their structures, and there was satisfactory compatibility of the data compared to those which were previously published. In the examined compounds 1-4, Isaindigotidione (3) and Isaindigotone (4) were shown as an effective urease inhibitor in such a concentration-dependent way against Jack bean and Bacillus pasteurii urease, with IC50 values 29.03 ± 0.04, 20.04 ± 0.09 and 34.03 ± 0.07, 26.13 ± 0.08 µM, respectively. Compounds 3 and 4 were likewise shown to be an effective inhibitor against α-chymotrypsin, exhibiting IC50 values 16.09 ± 0.07 and 22.01 ± 0.06 µM, correspondingly. The program MOE-Dock was used to perform a molecular docking analysis to confirm probable binding modes of the active complexes of the isolated compounds 1-4 and the crystal structure of urease and α-chymotrypsin enzymes. Compound 3 was the most active, having the highest docking scores against Bacillus pasteurii urease, α-chymotrypsin, and Jack bean (-8.6876), (-7.6647), and (-13.1927) µM, respectively. All four alkaloids (1-4) showed significant urease and protease inhibitory potential and further these activities were confirmed with the help of molecular docking study.