SMEs Exports are Influenced by Different Risk Factors: Empirical Study of Emerging Economy

Study intent to identify the direct (indirect) risk factors that can influence the export of medical instruments from SMEs sector of Pakistan by using the time series monthly data sample for a period of fifteen years that is from FY 2003 to FY 2017. Empirically a strong long term relation between the export of medical instruments with operational risk, market risk, export refinance schemes and steel prices are proven by Johansen co-integration. Study also establishes a direct positive relation of operational risk and market risk with the export of medical instruments as a result of Vector Error Correction Model

The impact of COVID-19 shocks on the volatility of stock markets in technologically advanced countries

This study examines the volatility of China and the most advanced countries of the world stock markets due to the pandemic of COVID-19 using the TGARCH model. This research study presents empirical support for the TGARCH specification for explaining the daily time dependence in the rate of information arrival to the market for stocks traded on China stock market. Using the sample containing closing stock market returns from 05 January 2015 to 04 April 2020 of sample countries, we found that through the COVID-19, there is no significant impact of returns volatility coming from advanced countries towards the China stock market. Further, results state that China has a significant impact on explaining the volatility of the most advanced countries of the world (Switzerland, Sweden, Netherlands, and the UK) except the U.S.A. during COVID-19. We found no significant impact of China stock market returns on the U.S.A.’s volatility, but there is a presence of leverage effect during COVID 19

Risk factors for mortality of patients with ceftriaxone resistant E. coli bacteremia receiving carbapenem versus beta lactam/beta lactamase inhibitor therapy

Objective: Extended spectrum β-lactamases (ESBL) producing Enterobacteriaceae predominantly E. coli and K. pneumoniae bacteremia have limited treatment options and high mortality. The objective was to determine the risk factors for in-hospital mortality particularly treatment with carbapenem versus beta lactam/beta lactamase combination (BL/BLI) in patients with ceftriaxone resistant E. coli bacteremia. A retrospective cohort study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with sepsis and monomicrobial ceftriaxone resistant E. coli bacteremia were enrolled. Factors associated with mortality in patients were determined using logistic regression analysis. Results: Mortality rate was 37% in those empirically treated with carbapenem compared to 20% treated with BL/BLI combination therapy (p-value: 0.012) and was 21% in those treated with a carbapenem compared to 13% in patients definitively treated with BL/BLI combination therapy (p-value: 0.152). In multivariable logistic regression analysis, only Pitt bacteremia score of ≥ four was significantly associated with mortality (OR: 7.7 CI 2.6-22.8) while a urinary source of bacteremia was protective (OR: 0.26 CI 0.11-0.58). In-hospital mortality in patients with Ceftriaxone resistant E. coli bacteremia did not differ in patients treated with either a carbapenem or BL/BLI combination. However, Pitt bacteremia score of ≥ 4 was strongly associated with mortality

Role of awake prone positioning in patients with moderate-to-severe COVID-19: An experience from a developing country

There is limited evidence on the efficacy of awake prone positioning (PP) in non-ventilated patients with COVID-19 who have hypoxemia. We, therefore, aim to describe our experience with the use of early proning in awake, non-intubated patients with confirmed COVID-19. In our retrospective observational study, 23 patients with confirmed positive PCR test results for Severe Acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and hypoxemia that required oxygen therapy with or without non-invasive ventilation were treated with PP. Patients were classified into mild, moderate and severe COVID-19 disease. There were no targeted number of hours for proning per day and patients were kept in prone position according to their tolerance. The primary outcome measure was the avoidance of intubation and secondary outcomes were in-hospital mortality, length of hospital stays and complications related to PP. The mean (standard deviation) age of our cohort was 54.5 (11.7) years, and the majority were males (21/23, 91.3%). Sixty-one per cent (14/23) of the patients were suffering from severe disease and 82.6% (19/23) had bilateral lung involvement with interstitial infiltrates. Majority of the patients were prone positioned for a median of 6 days (IQR 4 - 8). Only one patient required transfer to ICU for mechanical ventilation and subsequently died due to severe ARDS. All 22 patients showed progressive improvement in oxygen requirement and PF ratio, mostly after 3-5 days of proning. The mean length of hospital stay was 12 days. All patients, except one, were discharged in stable conditions, on room air or on a minimal oxygen requirement of 1-2 liters. No major complication of PP was recorded. Awake prone positioning is a valuable and safe therapeutic adjunct that can be applied in patients with moderate-to-severe COVID-19. It can also be included in the home-based management protocols of COVID-19 to improve patient outcomes and mitigate the burden on health care facilities

Portfolio Optimization Using Mean-Semi Variance approach with Artificial Neural Networks: Empirical Evidence from Pakistan

Purpose: The challenge of managing a portfolio effectively is allocating capital among numerous stock holdings to achieve maximum profit. Therefore, the purpose of this study is to guide investors in developing optimal portfolios in the stock market of Pakistan. Design/Methodology/Approach: To pick and optimize a portfolio in the most effective way possible, we used the daily closing stock prices of a sample of listed firms at the Pakistan stock exchange. The study applied the mean semi-variance approach and compared the performance of portfolios with equally weighted portfolios under artificial neural networks and historical-based return estimation in Pakistan. Findings: The result shows that artificial neural network-based estimation of the expected return vector has outperformed the historical return estimation under mean semi-variance portfolio optimization and constrained mean semi-variance portfolios based on the Sharp ratio in Pakistan. Implications/Originality/Value: The study suggests that investors, fund managers, and portfolio analysts should focus on the more sophisticated neural network-based choice for the development of portfolios in the equity market of Pakistan.&nbsp

ADVERTISING SPEND: ADOPTION OF ISLAMIC BANKING IN THE BOTTOM OF THE PYRAMID MARKET OF PAKISTAN: Muhammad Taimoor Hassan, Safia Nosheen

The study investigated to remedy the research gap of measuring the moderating effect of advertising spend on consumer adoption behavior of Islamic banking at the bottom of the pyramid (BOP) market of Pakistan. Cross-sectional research data collected from a total of 300 respondents of which 267 (89%) were useful to analyze the test on the framework of the research. SEM approach was used to test the hypothesized relationship of the framework in two sequential steps wherein the 1st step the reliability and validity analysis was performed and in the 2nd step sequential structural analysis among the variables were conducted with and without moderation. The empirical analysis confirmed a positive direct relationship of Perceived Usefulness (PU), Perceived Ease of Use (PEOU), and Advertising Spend (AS) on the adoption of Islamic banking (AIB) in the Bottom of the Pyramid Market. AS further confirmed the hypothesized relationships of the variables through increased individual predicting power of the PU and PEOU on the AIB with an overall effect size of f 2 value of 0.565. The overall adoption value of the r2 increased from simple moderation of 0.482 to moderating r2 value of 0.669 thus depicting 18.7 percent interaction effect of the AS. The study suggests that the advertising spends on marketing communication practices should be well-focused by the managers to penetrate in the BOP market of Pakistan. Moreover, future research can eliminate the limitation of the cross-sectional analysis and generalizability of the results as a functional probability in the other regional settings and industrial sectors by adding more variables to predict the adoption behavior with different roles. The consumer adoption behavior of the low-income markets has not yet been examined for Islamic banking in Pakistan. The research is useful for the industry to keep pace with the competition by focusing on the advertising and communication practices in this industr

Moderating effect of vertical integration on the relationship between sustainability and performance: evidence from oil and gas energy sector

Abstract This research study aims to examine the impact of sustainability on firm performance and analyze how vertical integration moderates the connection between performance and sustainability in the oil and gas sector. We analyzed a sample dataset of oil and gas companies from the top ten oil-producing countries spanned over ten years (2011–2020). The pool-fixed regression technique confirms that sustainability and its three components, i.e., social, environmental, and governance, are negatively related to performance. However, vertical integration moderated the connection between sustainability and performance in the case of the oil and gas sector. We have identified firm size, age, and return share price positively related to firm performance in the oil and gas industry. At the same time, the debt ratio negatively impacts the firm’s performance. The findings are significant for the management of oil and gas firms and the policymakers and regulatory authorities of oil-producing and exporting countries

C. auris and non-C. auris candidemia in hospitalized adult and pediatric COVID-19 patients; single center data from Pakistan

We compared candidemia due to Candida auris and other non-C.auris cases in hospitalized COVID-19 patients over a period of nine months at our institution. Candidemia cases in all admitted patients (with or without COVID-19) from April-December 2020 were identified. Electronic records were accessed to record clinical data of COVID-19 patients with candidemia. For statistical analysis, independent samples Mann-Whitney U test was used for continuous and Fisher\u27s exact test was used for categorical variables.A total of 26 candidemia cases (four C.auris, 22 non-C.auris) in 2438 admitted COVID-19 (10.7 per 1000 admissions) and 59 candidemia cases (six C.auris, 53 non-C.auris) in admitted non-COVID patients (8.2 per 1000 admission) were identified. The proportion of C.auris candidemia in COVID-19 and non-COVID-19 patients was 15.4% and 10% respectively. 4/26 of COVID-19 candidemia patients were aged ≤ 15 years (10 months-15 years). Comparison of C.auris and non-C.auris candidemia cases reveal significant difference in prior antifungal exposure, present in 100% C.auris candidemia versus 27% non-C.auris candidemia patients (p-value 0.014). Although not statistically significant, C.auris candidemia patients had a longer stay in hospital before candidemia (20 vs 9 days), higher isolation rate of multidrug resistant bacteria (100% vs 50%), increased rate of prior colonization of Candida species (50% vs 14%) and lower mean beta-d-glucan levels (48.73 pg/mL vs. 138.146 pg/mL). Both C.auris and non-C.auris COVID-19 patients had similar mortality rate (67% vs 65%). A significant number of critically ill COVID-19 patients developed candidemia in our study highlighting the need for prompt diagnosis and management.Lay summary: 26 candidemia cases (4 Candida auris;22 non-C.auris) in COVID-19 patients (April-December 2020) are reported from Pakistan. Compared to non-C.auris, C.auris candidemia patients had higher prior antifungal exposure, longer hospital stay, higher MDR bacteria and increased rate of Candida colonization