English Background as the Predictors for Students’ Speaking Skills in Pakistan

This paper is based on the English background of the students as the predictors for students English speaking skills at the secondary level at province of Sindh, Pakistan. A questionnaire was designed for students of grade-11, which was used to collect data from 60 male students of the public institutes in district Hyderabad, Pakistan. There were three independent variables used in this study: (X1) either students attended English language institute, (X2) number of years students were educated in English medium schools, and (X3) last class’s English score. The dependent variable was English speaking score (Y). Students’ speaking skills were assessed by a standardized rubric designed by language experts. There were four research questions formulated. Data was analyzed using linear and multiple regression, and t-test in SAS 9.2 (Statistical Analysis System). With ?=0.05, the result indicates that there is a significant relationship between student last class’s English score (N=60, M=50.45, SD=9.00) and their speaking scores (N=60, M=11.77, SD=3.21), r = 0.73, p<0.001. The number of years educated in English medium school (b = 0.22, t =2.05) and last class’s English score (b = 0.26, t = 8.26, p <.0001) were found significant predictors at R2 =0.57, F(2,57) =37.20, p<0.001. No statistical significance was indicated in students speaking score between those who attended English language institute (N=48, M= 12.04, SD= 3.43) and those who did not attend an English language institute (N=12, M= 10.67, SD= 1.83), t(58)= –1.34, p = 0.19. Interaction with students showed that most of the students do not speak English with fellow students because of shyness and lack of confidence. Keywords: English speaking, language, speaking skills, secondary school

English Background as the Predictors for Students’ Speaking Skills in Pakistan

This paper is based on the English background of the students as the predictors for students English speaking skills at the secondary level at province of Sindh, Pakistan. A questionnaire was designed for students of grade-11, which was used to collect data from 60 male students of the public institutes in district Hyderabad, Pakistan. There were three independent variables used in this study: (X1) either students attended English language institute, (X2) number of years students were educated in English medium schools, and (X3) last class’s English score. The dependent variable was English speaking score (Y). Students’ speaking skills were assessed by a standardized rubric designed by language experts. There were four research questions formulated. Data was analyzed using linear and multiple regression, and t-test in SAS 9.2 (Statistical Analysis System). With ?=0.05, the result indicates that there is a significant relationship between student last class’s English score (N=60, M=50.45, SD=9.00) and their speaking scores (N=60, M=11.77, SD=3.21), r = 0.73, p<0.001. The number of years educated in English medium school (b = 0.22, t =2.05) and last class’s English score (b = 0.26, t = 8.26, p <.0001) were found significant predictors at R2 =0.57, F(2,57) =37.20, p<0.001. No statistical significance was indicated in students speaking score between those who attended English language institute (N=48, M= 12.04, SD= 3.43) and those who did not attend an English language institute (N=12, M= 10.67, SD= 1.83), t(58)= –1.34, p = 0.19. Interaction with students showed that most of the students do not speak English with fellow students because of shyness and lack of confidence. Keywords: English speaking, language, speaking skills, secondary schoo

Education as gender equalizer: overcoming youth unemployment in Pakistan

Resistance to a positive change brings no change in a society unless its members do not work for it. In many parts of Pakistan female employment is a sensitive cultural issue. In this country the female population is more than 90 million, and quarter of it is youth, but majority of female youth are not master of their own soul because of the low female literacy rate in the country.  This study presents an in-depth outlook of female education, unemployment and its consequences for female gender. A detailed description of the factors and forces which are resisting a positive change in the society has also been presented. This paper presents practicable solutions to make female youth economically active, productive and more independent in male dominant society. Keywords: Education, Female youth, unemploymen

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

TEACHING WRITING SKILLS IN UNIVERSITY LARGE CLASSES IN PAKISTAN: ISSUES, CHALLENGES AND SOLUTIONS

This study aims to investigate the concept of a large class, challenges and issues faced by the teachers while teaching writing skills courses in large classes along with the strategies they use in order to cater to the problems. Therefore, in-depth interviews with nine private and public sector university teachers were conducted. The thematic analysis of the data revealed that a large class, in the Pakistani context, consists of 30 to 35 students and teachers particularly face the problems in assessment, giving feedback, ensuring individual attention, maintaining discipline, and controlling noise factor, etc. The assessment and feedback issues can be catered to by using peer assessment and peer feedback as they are viable strategies to deal with the large writing classes. In order to reduce the noise factor, some related activities can be practised to ensure maximum involvement of learners and ultimately, it reduces the disruptive noise. Identification of students in terms of their behaviour and seriousness towards learning paves the way for choosing appropriate teaching techniques which in turn helps to manage large writing classes having mixed ability students to achieve objectives of the course

Heat Inactivation of Avian Influenza (H7N3) Virus In Experimentally Infected Chicken Meat

Introduction Avian influenza virus (H7N3) cause severe systemic disease in chickens and can be persisted in infected chicken meat that cause public health concern. Influenza viruses are heat liable but parameters for heat inactivation have not been known. Methodology The study investigated the quantitative heat inactivation of H7N3 virus from experimentally infected chicken meat. Twenty (20) sero-negative broiler chickens of 04 weeks age were divided into two group viz A (control) and B artificially infected by giving 0.1ml of 106 embryo infectious dose 50 (EID50) (H7N3) virus through intranasal route. Birds were slaughtered on day 9 post infection and tissues (trachea, kidney, lungs and liver) were collected. Inactivation curves were determined at temperature 60, 61, 62, 63 and 64°C. Results Based on D values, time to inactivate H7N3 virus depends on viral titers and inversely related to temperature. This study investigated confirmed that H7N3 virus was effectively inactivated in chicken meat at 60°C in 4 minutes while at 64°C in 1 minutes. Moreover, protocols per log EID50/g reduction in terms of D values at 60 and 64°C were noted 120 and 30 sec, the coefficient of regression ranged as 0.941 to 0.889

The performance prediction and techno-economic analyses of a stand-alone parabolic solar dish/stirling system, for Jamshoro, Pakistan

This study aims to propose a simulation as well as mathematical model to carry out the performance assessment and efficiency improvement of a stand-alone Parabolic Solar Dish Stirling (PSDS) system. The simulation for a 25 ​kW PSDS system is performed in the System Advisor Model (SAM) under the environmental conditions of Jamshoro, Sindh, Pakistan. The results show that the city has a good potential of direct solar irradiance with yearly average value of 1719.15 ​kWh/m2/y. The system can generate yearly 38.6 ​MWh with overall system net efficiency of 23.39%. Whereas, the maximum energy of 3.38 ​MWh is produced in month of January, due to high solar irradiance. However, the lowest energy of 2.15 ​MWh is produced in July, due to the monsoon spell in selected city. Furthermore, from the techno-economic analyses of the proposed system, the levelized cost of energy is found to be 0.13 $/kWh, which is quite low. As the Stirling Engine (SE) works at higher temperature, so, increasing the diameter of concentrator results more thermal energy at the cavity. The solar radiations are high around the solar noon, therefore, the operating temperature can damage the hot-side of SE due to thermal overloading. In future, to protect the hot-side of SE, it is recommended to use thermo electric generator

Mo-based MXenes: synthesis, properties, and applications

Ti-MXene allows a range of possibilities to tune their compositional stoichiometry due to their electronic and electrochemical properties. Other than conventionally explored Ti-MXene, there have been ample opportunities for the non-Ti-based MXenes, especially the emerging Mo-based MXenes. Mo-MXenes are established to be remarkable with optoelectronic and electrochemical properties, tuned energy, catalysis, and sensing applications. In this timely review, we systematically discuss the various organized synthesis procedures, associated experimental tunning parameters, physiochemical properties, structural evaluation, stability challenges, key findings, and a wide range of applications of emerging Mo-MXene over Ti-MXenes. We also critically examined the precise control of Mo-MXenes to cater to advanced applications by comprehensively evaluating the summary of recent studies using artificial intelligence and machine learning tools. The critical future perspectives, significant challenges, and possible outlooks for successfully developing and using Mo-MXenes for various practical applications are highlighted