Determinants of competitiveness in textile industry of Pakistan

This study investigated the determinants of competitiveness in textile industry of Pakistan. Both financial (leverage, liquidity, investment, productive asset and firm size) and nonfinancial factors (exporting and market share) were collectively studied from 2002 to 2012 for 84 textile firms. Balanced panel data used for analysis. Hausman test confirmed fixed effect panel data regression model as appropriate research technique. Results proven that leverage, productive asset and firm size had negative significant relationship with competitiveness of firm while market share had positive significant relationship. Extraordinary use of debt financing, inefficient asset management and improper usage of productive asset were the point of main concern for further improvement of firm competitiveness. For capturing large market share firm desired to achieve economies of scale and economies of scope. Exporting and liquidity had positive but insignificant relationship while investment had negative insignificant relationship with competitiveness

Assessment of a novel computer aided learning tool in neuroanatomy education

Impaired understanding of intricate neuroanatomical concepts and structural inter-relationships has been associated with a fear of managing neurology patients, called neurophobia, among medical trainees. As technology advances, the role of e-learning pedagogies becomes more important to supplement the traditional dissection / prosection and lecture-based pedagogies for teaching neuroanatomy to undergraduate students. However, despite the availability of a myriad of e-learning resources, the neuro (-anatomy-) phobia – neurophobia nexus prevails. The focus of the PhD was to investigate the difficulties associated with learning neuroanatomy and to develop and assess the efficacy of a novel e-learning tool for teaching neuroanatomy, in the context of the strengths and pitfalls of the currently available e-learning resources. Firstly, we sought to provide direct evidence of the medical and health science students’ perception regarding specific challenges associated with learning neuroanatomy. The initial results showed that neuroanatomy is perceived as a more difficult subject compared to other anatomy topics, with spinal pathways being the most challenging to learn. Participants believed that computer assisted learning and online resources could enhance neuroanatomy understanding and decrease their neurophobia. Next, in the context of the significance of e-learning for supplementing traditional pedagogies, we identified features of neuroanatomy web-resources that were valued by students and educators with regards to learning neuroanatomy of the spinal pathways. Participants identified strengths and weaknesses of existing neuroanatomy web-resources and ranked one resource above the others in terms of information delivery and integration of clinical, physiological and medical imaging correlates. This provides a novel user perspective on the influence of specific elements of neuroanatomy web-resources to improve instructional design and enhance learner performance. Finally, considering the data acquired from students and educators, a novel, interactive, neuroanatomy learning e-resource was developed to support teaching of the neuroanatomy of the spinal pathways. The instructional design included a discussion of the clinical interpretation of basic neuroanatomical facts to aid in neurological localization. The e-learning tool was assessed and evaluated by undergraduate medical and neuroscience students using neuroanatomy knowledge quizzes and Likert-scale perception questionnaires and compared to the previously identified best-ranked neuroanatomy e-resource. Participants’ opinion regarding the usefulness of various components of the tools was also gauged. The results showed that usage of the UCC e-resource led to a significant increase in participants’ knowledge of the neuroanatomy of the spinal pathways compared to students’ who did not use e-resources. Moreover, the participants reported a greater interest in learning neuroanatomy with the novel tool, showing a greater appreciation for it while learning clinical neurological correlates compared to those using the best available e-resource identified earlier. In summary, the prevailing problem of neurophobia could be addressed by enhancing student-interest. Technological e-learning pedagogies, with intelligently designed interactive user-interface and clinical correlation of basic neuroanatomical facts can play a pivotal role in helping students learn neuroanatomy and breaking the nexus between neuro (-anatomy-) phobia and neurophobia

Quasi experimental analysis to evaluate the effects of educational sessions in improvement of Knowledge Practice regarding Food hygiene among women in rural community.

Care Introduction: Food is a vital need for a human being it's a source of energy that provides important ingredients for body growth. According to the European Food Safety Authority food composition affecting 69553 individuals, with the domestic kitchen as a second-most typically reported setting for food contamination. Food handlers (women) play an important role in the incidences of food spoilage. By health education knowledge of food, hygiene can be improved. Methods: Quasi-experimental study design was used in this study by using pre and post-test phase, conducted among women in rural community Ali Raza Abad Lahore, to determine the effectiveness of health education on knowledge and practice of food hygiene in women. The sample size was 60 that calculated by using convenient sampling technique in which those participants selected who were conveniently available to participate in the study. SPSS version 21 statistical software was used for data analysis at 95% of confidence interval and P-value was 0.05 Results: Results showed that the total mean of knowledge before intervention was 15.75 but after intervention, the total mean of knowledge was 27.93 similarly the total mean of practice before the intervention was 16.23 but after interventions mean of practice was 34.95 that showed the significant increase in knowledge and practice of women regarding food hygiene. Conclusions: This study described the effectiveness of health education for knowledge and practice of food hygiene among women in the rural community. The mean knowledge and practice score on food hygiene increased significantly after health education. Keywords- Effectiveness. Health education. Food hygiene. Knowledge. Practice.

An Efficient and Intelligent Recommender System for Mobile Platform

Recommender Systems are valuable tools to deal with the problem of overloaded information faced by most of the users in case of making purchase decision to buy any item. Recommender systems are used to provide recommendations in many domains such as movies, books, digital equipment’s, etc. The massive collection of available books online presents a great challenge for users to select the relevant books that meet their preferences. Users usually read few pages or contents to decide whether to buy a certain book or not. Recommender systems provide different value addition factors such as similar user ratings, users past history, user profiles, etc. to facilitate the users in terms of providing relevant recommendations according to their preferences. Recommender systems are broadly categorized into content based approach and collaborative filtering approach. Content based or collaborative filtering approaches alone are not sufficient to provide most accurate and relevant recommendations under diverse scenarios. Therefore, hybrid approaches are also designed by combining the features of both the content based and collaborative filtering approaches to provide more relevant recommendations. This paper proposes an efficient hybrid recommendation scheme for mobile platform that includes the traits of content based and collaborative filtering approaches in addition of the context based approach that is included to provide the latest books recommendations to user.Objective and subjective evaluation measures are used to compute the performance of the proposed system. Experimental results are promising and signify the effectiveness of our proposed hybrid scheme in terms of most relevant and latest books recommendations

Neuroanatomy of the spinal pathways: evaluation of an interactive multimedia e-learning resource

Introduction: A diminished number of young doctors opt for specialty neurology training and show reduced confidence in managing neurology patients and interlink difficulties in managing neurology patients with impaired understanding of neuroanatomy and associated clinical correlates. Aim: To evaluate an interactive e-resource for the neuroanatomy of the spinal pathways based on cognitive theories of multimedia learning in aiding medical students learn neuroanatomy. Methods: Using a single-blinded controlled experimental design, knowledge of the spinal pathways was assessed prior and after usage of the novel e-resource compared to control web resource. The perceived usefulness of the tool used was gauged using Likert-scale questionnaires. Results: Performance in the second assessment improved for all users but the learning gain of participants in the experimental groups was higher compared to participants who did not use e-resources. Likert-scale ratings revealed a significantly higher appreciation for the novel tool compared to the control tool when learning clinical correlates. Conclusions: Stronger correlations between the studentsâ perception of the tool used and their second assessment scores suggest that students favored the instructional design of the novel e-tool which shows promising results in bridging the gap between neuroanatomy knowledge and its clinical application

Graphene oxide incorporated polyether sulfone nanocomposite antifouling ultrafiltration membranes with enhanced hydrophilicity

In this study, the polyether sulfone (PES) based membranes containing various concentrations of graphene oxide (GO), polyvinylpyrrolidone (PVP), and polyethylene glycol (PEG) were synthesized via the phase immersion method. This study aims to evaluate the effect of GO addition on the structural properties and performance of the membranes. The membranes were analyzed by x-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier transforms infrared spectroscopy (FTIR). The FTIR-ATR spectra indicated the presence of hydroxyl and carboxylic acid groups on the surface of GO-incorporated membranes, which improved their dispersion in the polymeric matrix and hydrophilicity. The SEM analysis of the GO-containing PES membranes confirmed the formation of a well-defined finger-like porous structure presenting adequate water flux (95 l.m(-2).h(-1)) and salt rejection (72%) compared to the pristine PES membranes (46 l.m(-2).h(-1) and similar to 35%, respectively). In addition, the significantly large wettability and considerably improved antibacterial characteristic (against S. aureus and E. coli strains) of the GO-PES membranes are considered impressive features.National University of Sciences and Technology (NUST) Research Directorate; HEC; NRPU [6020]6020; Higher Education Commission, Pakistan, HEC; National University of Sciences and Technology, NUS

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Comparison of Catheter Related Blood Stream Infections in Hemodialysis Patients Treated With Trisodium Citrate as Catheter Locking Solution vs Heparin as Conventional Locking Method

Objective: To compare the frequency of temporary catheter related blood stream infections using sodium citrate as catheter locking solution with heparin as standard in hemodialysis patients. Methods: A comparative randomized control trial was conducted at hemodialysis unit of nephrology department, Pakistan Institute of Medical Sciences (PIMS) Islamabad between August 2022 and February 2023. Total 110 patients included consecutively with end stage renal disease, aged above 18 years undergone hemodialysis using temporary central venous catheter as vascular access irrespective of etiology of renal failure. Patients were divided into two groups: Group-I (Trisodium citrate) was administrated with lock solution of trisodium citrate 46.7%, whereas Group-II (Heparin) was administrated with lock solution of heparin 2000 U/ml (as control). The primary endpoint of this study is catheter-related bloodstream infection (CRBSI), measured as the number of observed episodes per 1000 catheter days between the two groups. Secondary endpoints were the number of catheters with thrombosis, catheter infection, and bleeding episodes. Results: The average age of patients in both groups was 51.98±13.57 years. The average duration of dialysis in both groups was 4.01±3.1 months and mean catheter time in group-I was 13.65±8.29 days and in group-II was 13.40±8.33 days with statistically insignificant (p ≥ 0.05). The rate of CRBSI per 1000 catheter days was 3.12 days for group I and 5.14 days for group II (p = 0.001). The cumulative mean infection-free catheter survival in the trisodium citrate group was lower than the heparin group (log rank = 2.31, p = 0.128). Cox regression survival analysis between two groups; the difference in group I & II was insignificant (HR = 1.6, CI = 0.49–1.17, p = 0.201). Practical implication: is that the determination of catheter related blood stream infections and comparing two methods i.e., trisodium citrate and heparin in hemodialysis patients. Conclusion: There is insignificant difference between trisodium citrate 46.7% and heparin as a catheter lock solution in the survival rate of tunneled hemodialysis catheters in end-stage renal disease

The Synergistic Effect of Polystyrene/Modified Boron Nitride Composites for Enhanced Mechanical, Thermal and Conductive Properties

Thermal conductivity (TC) and thermal stability are the basic requirements and highly desirable properties in thermal management, heat storage and heat transfer applications. This work is regarding the fabrication of polystyrene/boron nitride composites and melt extruded to produce good thermal stability, increased thermal conductivity and enhanced mechanical properties. Our strategy is potentially applicable to produce thermally conductive composites of low cost over large scale. Boron nitride powder is bath sonicated in 10% NH3 solution to avoid its agglomeration and tendency toward entanglement in a polymer matrix. An approximately 67.43% increase in thermal conductivity and 69.37% increase in tensile strength as well as 56 multiple increases in thermal stability of the optimum samples were achieved. The developed polymeric composites are potentially applicable in the electronic industry, especially in electronic devices used for 5G, heat sink and several other aviation applications