Evolution and Trends of Progressive Historiography in Pakistan

The paper evolves the thematic assumption that historical consciousness reflected in progressive historiography in last four decades or so is primarily a reaction against the feudal fabric and outlook of the society and tends to understand the historical process and trends which paved way for the emergence of this school of historiography in the country. Progressive School of Historiography links itself with the progressive movement of mid-thirties which inspired a considerable number of scholars i.e. the leftist lot of the country. They adopted a self-motivated rather missionary approach to proliferate a historiographical ideal what is typically termed as the “other side” of History Writing.  In the wake of revolutionary outburst of 1969 in the country- which claimed the first Martial Law regime, public hoped for the end of the country’s oppressive fabric forever. Although the endeavor remained fruitless yet it gave way to the realization of “social democracy” and “populism” in the country with an aim to create dialectic against the feudal as well as industrial classes of the country. The progressive historiographers were viewed as subversive to the indigenous history writing pursuits rather they were termed as hardliners both content and methodology they adopted for the promotion of their ideologies. Another phenomenon which emerges as the by-product of this dialectic was the influence of politics over the history writing which resulted into the leftist-rightist milieu. The progressive movement in spite of failing to produce the desired results yet the influence of the historical school of thought it produced cannot be marginalized or undermined. Hence the Progressive historiography is the logical outcome of the subaltern, alternate, anti-colonial, and post modern concepts of history and historiography destined to reshape the socio-cultural fabric of the society

Prospects for Regional Integration through Gawadar Seaport

Since 1960s, Pakistan has been emerging as a convergence point for numerous corridors between the three regions with the involvement of collaboration in energy sector, shipment trade, transport and tourism. Gawadar is a place of excessive geostrategic worth, providing enormous promotion to Pakistan's prominence in the entire region and is an imperious economic and strategic chokepoint that provides unobstructed access to the Indian Ocean that has been passageway of 100,000 shipping vessels annually estimating about 70% of world’s total oil trade. Gawadar being the world’s third largest and deep water Seaport may have been the sole port having the potential of receiving 200,000 tons of supertankers in the region. The proximity of Gawadar Seaport to CARs, Eurasia, Persian Gulf, and chief trading and energy chokepoints of the world all contributes for demonstration of its exclusive prominence. The entire Central Asia is landlocked and it has been in the need of proper trade routes of pipelines for the export of its resources to the world market economies. The Central Asian Republics (CARs) have been exporting their supplies via Russia towards Europe that is considered to be a lengthiest trade route. The transit route towards Mediterranean Sea passing through the territory of Russia has remained to be a cause of apprehensions for Europeans, Kazakhs, Uzbeks and Turkmenistan’s. Gawadar seaport route would be a viable option for the (CARs) to save time and money in the transportation of their productions. Gawadar is an inter-link between the East and the West on account which it can change the strategic atmosphere and economy of the regional political community and will increase trading volumes, growth rating, employments, foreign direct investment (FDI), and revenues in Pakistan and the region leading towards en route to affluence and prosperity. The seaport will substantiate to be a strategic nucleus for the commercial activities of the entire region. The reduction of oil resources and increasing energy requirements in the world has intensified the importance of Pakistan to manifolds, as the energy and trading routes of (CARs) Central Asian Republics, Afghanistan and China may have to be passing through the territory of Pakistan. This paper makes an analysis of the prospects for regional integration through Gawadar in terms of geographic and commercial collaboration

Chinese Quest for Strategic Maritime Security of Energy Supplies Trough Gawadar Seaport

China has been having serious concerns with reference to likelihood of interruptions for smooth transportation of the oil & gas shipment vessels towards China approaching from Africa and the region of Gulf via Strait of Malacca in relations for prone to be attacks by terrorists and pirates, as 80% of Chinese oil supplies has been coming through strategic energy chokepoint of the Strait of Malacca. China desires for reduction of its dependency on the Strait of Malacca and has been looking for alternate prospects to safeguard its energy supplies. The position of Gawadar Seaport in close proximity to Central & South Asia and more so to Middle Eastern States has transformed it to be western-most interlink under Chinese ‘String of Pearls’ strategy on accounts of which it has considered getting hold to key-strategic seaports at Gawadar, Sri Lanka, Bangladesh, Thailand, Cambodia, Burma, and the South China Sea. Gawadar Seaport may help China with regard for extending its presence in the Persian Gulf region and the Arabian Sea from where it has been importing 60% supplies of energy requirements. The presence of China at Gawadar may provide not only admittance to Indian Ocean and facilities of basing but also chances for taking control of Strait of Hormuz for ensuring smooth supplies of energy demands coming through West Asia. Pakistan may be capable of playing the role of a transit facility by providing China admittance towards the markets of Central Asian and its energy resources. This paper makes an analytical study of the need for maritime energy security, geostrategic potential of Gawadar Seaport in the Chinese and regional perspective and the Chinese quest for maritime energy security through Gawadar Seaport

An Intelligent Hybrid Scheme for Customer Churn Prediction Integrating Clustering and Classification Algorithms

Nowadays, customer churn has been reflected as one of the main concerns in the processes of the telecom sector, as it affects the revenue directly. Telecom companies are looking to design novel methods to identify the potential customer to churn. Hence, it requires suitable systems to overcome the growing churn challenge. Recently, integrating different clustering and classification models to develop hybrid learners (ensembles) has gained wide acceptance. Ensembles are getting better approval in the domain of big data since they have supposedly achieved excellent predictions as compared to single classifiers. Therefore, in this study, we propose a customer churn prediction (CCP) based on ensemble system fully incorporating clustering and classification learning techniques. The proposed churn prediction model uses an ensemble of clustering and classification algorithms to improve CCP model performance. Initially, few clustering algorithms such as k-means, k-medoids, and Random are employed to test churn prediction datasets. Next, to enhance the results hybridization technique is applied using different ensemble algorithms to evaluate the performance of the proposed system. Above mentioned clustering algorithms integrated with different classifiers including Gradient Boosted Tree (GBT), Decision Tree (DT), Random Forest (RF), Deep Learning (DL), and Naive Bayes (NB) are evaluated on two standard telecom datasets which were acquired from Orange and Cell2Cell. The experimental result reveals that compared to the bagging ensemble technique, the stacking-based hybrid model (k-medoids-GBT-DT-DL) achieve the top accuracies of 96%, and 93.6% on the Orange and Cell2Cell dataset, respectively. The proposed method outperforms conventional state-of-the-art churn prediction algorithms

Therapeutic outcomes following isolated transcatheter tricuspid valve repair: A systematic review and meta-analysis

Tricuspid regurgitation (TR) is traditionally treated surgically, but isolated transcatheter tricuspid valve repair (ITTVR) offers a less invasive option. This study conducts a meta-analysis and systematic review to evaluate ITTVR outcomes in patients with TR. Database searches until March 2023 identified studies assessing ITTVR safety and efficacy in moderate/severe TR patients. Primary outcomes analyzed were severe TR, NYHA functional class improvement, and 6-minute walking distance. Meta-analyses used Risk ratio (RR) or mean difference with a random effects model. The review included 25 studies with 2421 patients. ITTVR improved NYHA functional class (RR: 3.262), reduced TR severity (RR: 0.303), and enhanced 6-minute walking distance (MD: +47.077 m). Echocardiographic parameters improved, including reductions in TR vena contracta, TR EROA, septolateral tricuspid annular diameter, RVEDD, RV FAC, and TAPSE. LVEF and PASP showed no significant changes. ITTVR improves functional outcomes and echocardiographic parameters in TR patient

Echocardiography‐ versus intracardiac electrocardiogram‐based optimization of cardiac resynchronization therapy: A systematic review

Abstract Objective This systematic review aimed to evaluate the performance of echocardiography‐based programming in comparison with the intracardiac electrocardiogram (IEGM)‐based method for the optimization of cardiac resynchronization therapy (CRT). Methods A literature review was conducted using digital databases to systematically identify the studies reporting CRT optimization through echocardiography compared with IEGM. Detailed patient‐level study characteristics including the type of study, sample size, therapy, the New York Heart Classification (NYHA) status, lead placement, and other parameters were abstracted. Finally, postprogramming outcomes were extracted for each article. Results In a total of 11 studies, 919 patients were recruited for the final analysis. Overall, 692 (75.29%) were males. The mean duration of the QRS complex in our study population ranged from 145.2 ± 21.8 ms to 183 ± 19.9 ms. There was an equal improvement in the NYHA class between the two methods while the left ventricular ejection fraction (LVEF) demonstrated an improvement by IEGM. Many studies supported IEGM to increase the 6‐minute walk test and left ventricular outflow tract velocity time interval (LVOT VTI) when compared to echocardiography. The mean time for echocardiography‐based optimization was 60.15 min while that of IEGM‐based optimization was 6.65 min. Conclusion IEGM is an alternative method for CRT optimization in improving the NYHA class, LVEF, and LVOT VTI, and is less time‐consuming when compared to the echocardiography‐based methods

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies