Mapping Digital Media: Pakistan

The Mapping Digital Media project examines the global opportunities and risks created by the transition from traditional to digital media. Covering 60 countries, the project examines how these changes affect the core democratic service that any media system should provide: news about political, economic, and social affairs.Pakistan has long suffered from high inflation, led by soaring food prices, which has increased poverty levels. According to the United Nations' 2011 Human Development Report, half the population suffers deprivations of all types. Only half is literate. Even then there are only 12 million television sets (surely a desirable medium for those who cannot read)—one for every 14 people.This means a lot of communal watching of mostly state-owned channels of the Pakistan Television Corporation (PTV). At present, the only other terrestrial television channel is the privately owned ATV, in which PTV and the Pakistan Broadcasting Corporation are majority (80 percent) shareholders. The sameness is deafening.However, urban Pakistanis are getting richer and spending money on alternatives. Thus PTV has ceded ground to more than 20 privately owned broadcasters with 89 domestic and 26 foreign channels, with national television viewing split evenly between terrestrial on the one hand, and cable and satellite on the other.This proliferation of channels has enabled Pakistani media to wield more influence over politics and public discourse than ever before. With this growing influence comes, however, a corresponding increase in attempts by the government to control media outlets. Indeed, state coercion and increasing censorship are among the greatest pressures on the media industry

Tactical cities : negotiating violence in Karachi, Pakistan

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Comparative Media Studies, 2008."June 2008."Includes bibliographical references (p. 150-155).This thesis examines the relationship between violence and urbanity. Using Karachi, Pakistan, as a case study, it asks how violent cities are imagined and experienced by their residents. The thesis draws on a variety of theoretical and epistemological frameworks from urban studies to analyze the social and historical processes of urbanization that have led to the perception of Karachi as a city of violence. It then uses the distinction that Michel de Certeau draws between strategy and tactic in his seminal work The Practice of Everyday Life to analyze how Karachiites inhabit, imagine, and invent their city in the midst of - and in spite of - ongoing urban violence. Using de Certeau's argument to contextualize ethnographic research, media analysis, and personal narrative, this thesis argues that the everyday practices of Karachiites such as remembering, driving, and blogging are 'tactics' aimed at creating representational spaces that are symbolically free of violence. Through such tactics, this thesis concludes, cities with an urban imaginary of violence nonetheless boast a vibrant city culture.by Huma Yusuf.S.M

Exploring ionic liquids for formaldehyde separation via computational COSMO-RS screening

Formaldehyde is an emerging human carcinogen from gaseous spark ignition engines and in aqueous stream. In addition to causing leukaemia and nasal cancer, the emissions harm the environment. The present study examined ionic liquids (ILs) as greener alternatives for removing formaldehyde from different sources. Because of its reliability and excellent predicting ability a conductor-like screening model for real solvents (COSMO-RS) were employed as a simulation means to evaluate potential ILs for formaldehyde. Screened IL can be used as an extracting agent, an adsorbent, a carrier, or an absorbent in formaldehyde separation. 392 different cation-anion combinations were screened. To measure the efficacy of IL, the activity coefficient at infinite dilution, capacity, selectivity, and interaction energies were predicted for all 1600 ILs combinations. Short-chain quaternary ammonium cations were found to be potentially effective compared to long-chain and aromatic cations. Moreover, halogenated and food-grade anions such as fluoride, acetate, and lysinate showed higher capacity and selectivity. Whereas than weakly coordinating anions such as [AsF6] and [BCl4] were observed to be least effective for formaldehyde separation. ILs tetramethylammonium hydroxide [TMAmm][OH], tetramethylammonium fluoride [TMAmm][F], tetramethylammonium acetate [TMAmm] [Ac], and [TMAmm][Lys] were found to be the most effective separating agents for formaldehyde. This study will facilitate the selection and design of biobased ILs for the separation of formaldehyd

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe

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

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

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

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Pakistan grants India Most Favored Nation trading status?

For more about the East-West Center, see http://www.eastwestcenter.org/The clumsy manner in which Pakistan announced that it would grant the trade status of Most Favored Nation (MFN) to India indicates the political significance of this decision. Two days after the official announcement, other government spokespeople tempered this message, explaining that the cabinet had simply approved the process of "normalization" of India-Pakistan trade relations, which included granting MFN status. Huma Yusuf, Columnist for Pakistan's Dawn newspaper, discusses why this cautious approach is a reminder that Pakistan's dealings with India remain fraught in spite of recent confidence-building measures