Inefficiencies in Public Electricity Provision and Impacts on Firms in Karachi’s Manufacturing Sector

The private costs of electricity supply failures are substantial and inimical to industrial productivity. Using results from a small sample survey of manufacturing firms in Karachi, the study documented the causes, extent and incidence of the failures, identified and classified the firms’ private responses, and estimated the capital share of internally produced power and the associated costs. The results are reported here to engender discussion for developing a policy model of infrastructure provision suited to a developing country like Pakistan. The most encouraging options are those that allow for cooperative provision amongst firms with concurrent reforms in the regulatory and institutional environments. An optimal policy will allow inter-firm trading of electricity making the power market competitive. Those firms that already have extensive private generating capacity due to weak public supply will realise scale economies by selling electric power to lower the costs of private provision. Competition in electricity supply implies that industrial users will find attractive substitutes in the private sector. This will lead to a reduction in the demand on public service, already limited in quantity and quality in key urban-industrial locations like Karachi.

Land, governance & the gendered politics of displacement in urban Pakistan

Urdu version available in IDRC Digital Library: Land, governance & the gendered politics of displacement in urban Pakistan [Urdu language]Pakistan is home to diverse geographies of land displacement, which are accelerating in an era of rapid urban development. This paper summarises the findings and recommendation from a 28-month research project which charts - for the first time - the contemporary context of land displacement in urban Pakistan, through the lens of its largest city, Karachi

Heat Governance in Urban South Asia: The Case of Karachi

This scoping study draws on a review of key policy documents, plans, grey, academic, and scientific literature to outline the role of state and non-state actors in Karachi’s heat governance. It emphasizes the need to understand heat, microclimates, urban planning, infrastructural inequities, and vulnerability in a relational context. It also presents original climate data analysis for the last 60 years in Karachi, to quantify the rapid temperature change in the city: findings that underscore why it is important now, more than ever, to talk about heat in the context of an unequal city

Recipes for Life with Heat during Ramzan

The holy month of Ramzan (also spelled Ramadan) is a medium for Muslims around the world to rejuvenate their piety to the Creator. Each year, somewhere in the world, the month of Ramzan coincides with a period of seasonal or unseasonal heat. Against the backdrop of rising global temperatures, this collection asks: how do people and institutions manage the heat of Ramzan while fasting? This multilingual collection examines the gendered relationship between consumption, mobility and piety during Ramzan. The collection brings together participant observation and social analysis, with an archive of found materials from print and online media

Impact of natural killer cells on outcomes after allogeneic hematopoietic stem cell transplantation: A systematic review and meta-analysis.

Background: Natural killer (NK) cells play a vital role in early immune reconstitution following allogeneic hematopoietic stem cell transplantation (HSCT). Methods: A literature search was performed on PubMed, Cochrane, and Clinical trials.gov through April 20, 2022. We included 21 studies reporting data on the impact of NK cells on outcomes after HSCT. Data was extracted following the PRISMA guidelines. Pooled analysis was done using the meta-package (Schwarzer et al.). Proportions with 95% confidence intervals (CI) were computed. Results: We included 1785 patients from 21 studies investigating the impact of NK cell reconstitution post-HSCT (8 studies/1455 patients), stem cell graft NK cell content (4 studies/185 patients), therapeutic NK cell infusions post-HSCT (5 studies/74 patients), and pre-emptive/prophylactic NK cell infusions post-HSCT (4 studies/77 patients). Higher NK cell reconstitution was associated with a better 2-year overall survival (OS) (high: 77%, 95%CI 0.73-0.82 vs low: 55%, 95%CI 0.37-0.72; n=899), however, pooled analysis for relapse rate (RR) or graft versus host disease (GVHD) could not be performed due to insufficient data. Higher graft NK cell content demonstrated a trend towards a better pooled OS (high: 65.2%, 95%CI 0.47-0.81 vs low: 46.5%, 95%CI 0.24-0.70; n=157), lower RR (high: 16.9%, 95%CI 0.10-0.25 vs low: 33%, 95%CI 0.04-0.72; n=157), and lower acute GVHD incidence (high: 27.6%, 95%CI 0.20-0.36 vs low: 49.7%, 95%CI 0.26-0.74; n=157). Therapeutic NK or cytokine-induced killer (CIK) cell infusions for hematologic relapse post-HSCT reported an overall response rate (ORR) and complete response (CR) of 48.9% and 11% with CIK cell infusions and 82.8% and 44.8% with NK cell infusions, respectively. RR, acute GVHD, and chronic GVHD were observed in 55.6% and 51.7%, 34.5% and 20%, and 20.7% and 11.1% of patients with CIK and NK cell infusions, respectively. Pre-emptive donor-derived NK cell infusions to prevent relapse post-HSCT had promising outcomes with 1-year OS of 69%, CR rate of 42%, ORR of 77%, RR of 28%, and acute and chronic GVHD rates of 24.9% and 3.7%, respectively. Conclusion: NK cells have a favorable impact on outcomes after HSCT. The optimal use of NK cell infusions post-HSCT may be in a pre-emptive fashion to prevent disease relapse

Extreme Heat and COVID-19: The Impact on the Urban Poor in Asia and Africa

The research on which this report was based was funded by the UK Research and Innovation and the Global Challenges Research Fund through the Economic and Social Research Council (Award ES/T008091/1) and by the Scottish Funding Council as part of Cool Infrastructures, a multi-disciplinary project into life with heat in global cities. We also thank the Norwegian Red Cross and Norwegian Ministry of Foreign Affairs for publication support.The study provides substantial new data on the direct as well as indirect impacts of the COVID-19 pandemic, thermal comfort and heat-related illness, in Jakarta (Indonesia), Hyderabad (India), Karachi and Hyderabad (Pakistan) and Douala (Cameroon). These cities are home to very large or rapidly growing low-income populations dealing with extreme heat. Alongside data on heat exposure and symptoms associated with heat-related illness, the report supplies supplementary data points on access to electricity, water, food, health services, as well as income and food intake during the COVID-19 pandemic, that will be of use to policy makers and researchers. The report is intended for use by governmental and non-governmental organisations in these cities and countries as they work to fine-tune policy and programme responses to the COVID-19 pandemic and avoid heat-related health impacts. Its broader findings are intended to be of use to inform interventions in urban areas facing similar challenges across Sub-Saharan Africa, South Asia and South East Asia

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication