Are the Better Educated Less Likely to Support Militancy and Terrorism? Women Are

I use 2009 public opinion survey data from Pakistan to show that the relationship between education and support for terrorism varies by gender. Specifically: 1) as women become more educated, they are less likely to support militancy relative to similarly educated men, whereas uneducated women are more likely to support militancy relative to uneducated men, controlling for religiosity, demographics, region, and terrorist events in the district; 2) the effect of women’s education is driven by the years of schooling immediately preceding and following high school; 3) educated women have more negative views of the United States and are more likely to support terror attacks against the U.S. relative to educated men, and uneducated women have more positive views of the United States relative to uneducated men. I discuss possible omitted factors which could explain the results, and use the Altonji Elder Taber test to show that a causal explanation is plausible

Diagnostic Performance of Breast MRI in the Evaluation of Contralateral Breast in Patients with Diagnosed Breast Cancer

AIMS: The purpose of our study was to evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in the evaluation of contralateral breast in patients with diagnosed breast cancer. A secondary objective was to determine accuracy of breast MRI in diagnosing multi-focal and multicentric lesions in the ipsilateral breast.MATERIALS AND Methods: Using a non-probability convenience sampling technique, patients with histopathologically diagnosed breast cancer with MRI of breast performed to exclude additional lesions were included. MRI findings were correlated with histopathology. In addition, follow-up imaging with mammography and ultrasound was also assessed for establishing stability of negative findings and for the detected of benign lesions.Results: Out of 157 MRI breast conducted during the period of 2008 to 2013, 49 were performed for patients with diagnosed breast cancer. The sample comprised of all females with mean age 50.7 ± 11.0 years. The patient follow-up imaging was available for a period of 2-5 years. The sensitivity, specificity, and positive and negative predictive values of MRI in the detection of multifocal/multicenteric lesions was 85.7%, 88.8%, 60% and 96.6% respectively and for the detection of lesions in the contralateral breast were 100%, 97%, 83.3% and 100% respectively.CONCLUSIONS: Our study highlights the diagnostic performance and the added value of MRI in the detection of multifocal /multicenteric and contralateral malignant lesions. In patients with diagnosed breast cancer having dense breast parenchyma and with infiltrating lobular carcinoma as the index lesion MRI is particularly useful with excellent negative predictive value in the exclusion of additional malignant foci in the ipsilateral and contralateral breasts

Knowledge, attitudes, practices and perceived barriers of emergency health care providers regarding sepsis and septic shock in a tertiary care centre: A cross-sectional study

This study aimed to assess knowledge, attitudes, practices, and perceived barriers of emergency healthcare providers regarding the management of sepsis and septic shock. This cross-sectional study was conducted in the Emergency Department of Aga Khan University Hospital, Karachi, Pakistan from August to October 2017. A total of 53 healthcare providers participated in the study. Overall, 42(79%) of the participants demonstrated correct knowledge of the sepsis bundle. The most common barrier reported in the compliance of the sepsis bundle was a shortage of staff (62%), followed by delayed presentation of patients (58%) and overcrowding (42%). Furthermore, better staffing was perceived by the participants (60%) to improve the care of septic patients, followed by sepsis awareness sessions (23%) and reduction in ED crowding (11%). Staff shortage, delayed presentation of patients, and ED overcrowding were considered the most common barriers in the management of sepsis in this setting

ENHANCING CLIMATE RESILIENCE IN AGRICULTURAL PRACTICES: THE ROLE OF AGRICULTURAL EXTENSION WORKERS IN DISTRICT RAHIM YAR KHAN, PUNJAB, PAKISTAN

Abstract In recent years, the intricate relationship between climate change and its profound impact on agricultural productivity has garnered increasing attention, particularly concerning the pivotal role played by agricultural extension workers. This study delves into climate change mitigation strategies within the realm of agriculture, with a specific focus on the instrumental contributions of agricultural extension workers. Climate change presents a multifaceted challenge to global agricultural systems, exerting significant influences on productivity, crop yields, and food production. Amid these challenges, agricultural extension workers emerge as central figures bridging the chasm between technical knowledge and practical adaptation methods for farmers. This qualitative investigation draws upon a synthesis of existing research and incorporates insights from key informant interviews. By shedding light on the intricate interplay between climate change, agricultural productivity, and the pivotal function of agricultural extension workers, this research aspires to provide a comprehensive understanding of the dynamic relationships between these variables. By facilitating the adoption of climate-resilient techniques, such as cultivating drought-resistant crop varieties, implementing water-efficient irrigation methods, and promoting agroforestry, extension workers empower farmers to mitigate the severe impacts of climate change. Furthermore, extension workers play a pivotal role in bolstering farmers' adaptive capabilities and equipping them with essential skills to navigate increasingly volatile climatic conditions. Studies underscore that farmers who receive training from extension workers report heightened confidence in successfully implementing climate-adaptive strategies

Characterization of Hepatitis C Virus genotype 3a Hypervariable region 1 in patients achieved rapid virological response to alpha interferon and Ribavirin Combination therapy

<p>Abstract</p> <p>Background</p> <p>Hepatitis C virus roots a chronic liver disease. Currently approved treatment strategy includes administration of alpha interferon and ribavirin combined therapy for 24-48 weeks. One of the predictor of sustained virological response is an early virological response to treatment characterized as rapid response. Hyper variable region 1 (HVR1) of E2 protein is responsible for viral entry and acts as a target for neutralizing antibodies. Any mutation in this region would effect virus interaction with target cell and viral persistence.</p> <p>Methods</p> <p>Thirty one clones of six pre-treatment samples subjected to combination therapy were investigated. Three of the patients were rapid responders (R1, R2 and R3) and two were breakthrough responders (BT1 and BT2). Envelope 2 gene was amplified, cloned and sequenced. Amino acid substitution, frequency, composition and antigenic properties of HVR 1 of E2 protein were studied.</p> <p>Results</p> <p>In both rapid responders (R.R) (14 amino acid sites) and breakthrough responders (BT.R) (13 amino acid sites) half of the amino acid sites were either conserved or resistant to any physiochemical change due to amino acid substitution. It also indicated that average composition of hydrophilic and basic amino acids were comparatively lower in rapid responders than other samples affecting probable interaction of virus with target cells. A central non antigenic region was constant among the breakthrough responders but differed in length significantly among rapid responders reflecting the adaptive nature of HVR1 to the immune response.</p> <p>Conclusions</p> <p>We observed that although HVR1is quite variable region in HCV 3a patients responding differently to treatment it still maintains its physiochemical properties for its proper functioning and viability.</p

Mutations in the E2-PePHD region of hepatitis C virus genotype-3a and correlation with response to interferon and ribavirin combination therapy in Pakistani patients

Hepatitis C is a major health problem affecting more than 200 million individuals in the world. Current treatment regimen consisting of interferon alpha and ribavirin does not always succeed in eliminating the virus completely from patient's body. One of the mechanisms by which virus evades the antiviral effect of interferon alpha involves protein kinase (PKR) eukaryotic initiation factor 2 alpha (eIF2a) phosphorylation homology domain (PePHD). This domain in genotype 1 strains is reportedly homologous to PKR and its target eIF2a. By binding to PKR, PePHD inhibits its activity and therefore cause virus to evade antiviral activity of interferon (IFN). Many studies have correlated substitutions in this domain to the treatment response and lead to inconclusive results. Some studies suggested that substitutions favor response while others emphasized that no correlation exists. In the present study we therefore compared sequences of PePHD domain of thirty one variants of six hepatitis C virus patients of genotype 3. Three of our HCV 3a infected patients showed rapid virological response to interferon alpha and ribavirin combination therapy whereas the remaining three had breakthrough to the same combination therapy. It is found that PePHD domain is not entirely conserved and has substitutions in some isolates irrespective of the treatment response. However substitution of glutamine (Q) with Leucine (L) in one of the breakthrough responders made it more identical to HCV genotype 1a. These substitutions in the breakthrough responders also tended to increase average hydrophilic activity thus making binding of PePHD to PKR and inhibition of PKR more favorable

Factors Affecting Bank-specific and Macroeconomic profitability Determinants of Islamic and Conventional Banks in Pakistan

This empirical research aims to look at the factors that mark the financial performance of Islamic and traditional banking sector in Pakistan. Theresults of the data signify that gross domestic product and inflation is connectedtothefinancialperformanceofIslamicbanks in all aspectsof profitability ratios and grossdomesticproducthasinsignificantrelation with the return on equity and assets ofconventionalbanks.Inflation has a weighty effect on return of assets of conventional banks.Further results indicate a negative impact of bank size on return of assets Islamic and positive impact on conventional banks. Anegativeimpact of banksizeonreturnonequityofIslamicandpositiveimpactonconventional banks. There is no performance impact of bank size on price earnings ratio. Results alsoindicatethatanegativeperformanceimpactofageofbankonreturn on assets of Islamic and traditional banks

Effects of Host and virus related factors on Interferon-α+ribavirin and Pegylated-interferon+ribavirin treatment outcomes in Chronic Hepatitis C patients

<p>Abstract</p> <p>Background</p> <p>Current standard therapy commonly followed for chronic Hepatitis C Virus (HCV) in Pakistan is interferon alpha plus ribavirin combination therapy (IFN α/ribavirin) and pegylated interferon plus ribavirin (PegIFN/ribavirin). PegIFN/ribavirin has increased rate of sustained virological response than standard IFN α/ribavirin therapy. Objective of current study was to analyze rate of early and delayed response to antiviral treatment as well as rate of relapse response in patients following standard treatment IFN α/ribavirin and in patients following pegylated interferon treatment.</p> <p>Methods</p> <p>Baseline serum samples of 153 patients enrolled for IFN α/ribavirin and 50 patients for PegIFN/ribavirin were collected. After total RNA extraction, genotyping was and HCV RNA viral load was done. Subsequently HCV RNA viral load was estimated at 4 weeks of treatment, at 12 weeks, at 24 or 48 weeks and finally after 6 months follow up period. All the data was statistically analyzed using fisher's exact test.</p> <p>Results</p> <p>Total 86 patients out of 153 patients following conventional IFN α/ribavirin therapy completed treatment and 69% of them showed Rapid Virological Response (RVR). Whereas 50 patients following PegIFN/ribavirin treatment completed treatment and 80% of them achieved RVR. Total 64 out of 86 patients following IFN α/ribavirin therapy completed follow up period and 53.5% of them achieved Sustainded Virologcal Response (SVR). Forty-five out of total 50 patients who received PegIFN/ribavirin treatment completed 6 months follow up period and among these 70% achieved SVR. SVR rates were significantly associated with RVR (p < 0.001), age (p < 0.001) and gender (p < 0.01)</p> <p>Conclusions</p> <p>Rate of sustained virological response can be determined by factors like rapid virological response and age since they share significant association with one another. More over rate of SVR was more prominent in males than in females.</p