Personal Remittance, A Reagent of Macroeconomic Stability in the Perspective of Pakistan (2005-2017)

Pakistan is a semi-industrialized economy, which mainly comprehends fabrics, chemicals, food dispensation, cultivation and other activities. Economy of Pakistan is at very stirring phase in structural and financial point of view such as unfavorable balance of payments and high debt profile. To disrupt these unfavorable economic balances many peripheral economic factors act as a source of income or core factor of advantageous balances such as FDI, Remittances, Exports, Foreign aids etc. So this study is aimed to detect pros and cons of personal remittances along with correlation with macroeconomic volatilities. Data is collected from secondary sources during time span of 2005-2017. The period is chosen for study is 2002 to 2017 and numerical data is used for validity. Data is evaluated through statistical software EVIEWS. Standardized criteria is assumed to accept or reject the hypothesis. On the basis of inferences, policies and implication are given in the shape of recommendation for curative measures. Keywords: Personal Remittances, Current account balance, Unemployment, Inflation DOI: 10.7176/JESD/10-6-10 Publication date:March 31st 201

Community engagement and integrated health and polio immunisation campaigns in conflict-affected areas of Pakistan: a cluster randomised controlled trial.

BACKGROUND: Pakistan faces huge challenges in eradicating polio due to widespread poliovirus transmission and security challenges. Innovative interventions are urgently needed to strengthen community buy-in, to increase the coverage of oral polio vaccine (OPV) and other routine immunisations, and to enhance immunity through the introduction of inactivated polio vaccine (IPV) in combination with OPV. We aimed to evaluate the acceptability and effect on immunisation coverage of an integrated strategy for community engagement and maternal and child health immunisation campaigns in insecure and conflict-affected polio-endemic districts of Pakistan. METHODS: We did a community-based three-arm cluster randomised trial in healthy children aged 1 month to 5 years that resided within the study sites in three districts of Pakistan at high risk of polio. Clusters were randomly assigned by a computer algorithm using restricted randomisation in blocks of 20 by an external statistician (1:1:1) to receive routine polio programme activities (control, arm A), additional interventions with community outreach and mobilisation using an enhanced communication package and provision of short-term preventive maternal and child health services and routine immunisation (health camps), including OPV (arm B), or all interventions of arm B with additional provision of IPV delivered at the maternal and child health camps (arm C). An independent team conducted surveys at baseline, endline, and after each round of supplementary immunisation activity for acceptability and effect. The primary outcome measures for the study were coverage of OPV, IPV, and routine extended programme on immunisation vaccines and changes in the proportion of unvaccinated and fully vaccinated children. This trial is registered with ClinicalTrials.gov, number NCT01908114. FINDINGS: Between June 4, 2013, and May 31, 2014, 387 clusters were randomised (131 to arm A, 127 to arm B, and 129 to arm C). At baseline, 28 760 children younger than 5 years were recorded in arm A, 30 098 in arm B, and 29 126 in arm C. 359 clusters remained in the trial until the end (116 in arm A, 120 in arm B, and 123 in arm C; with 23 334 children younger than 5 years in arm A, 26 110 in arm B, and 25 745 in arm C). The estimated OPV coverage was 75% in arm A compared with 82% in arm B (difference vs arm A 6·6%; 95% CI 4·8-8·3) and 84% in arm C (8·5%, 6·8-10·1; overall p<0·0001). The mean proportion of routine vaccine doses received by children younger than 24 months of age was 43% in arm A, 52% in arm B (9%, 7-11) and 54% in arm C (11%, 9-13; overall p<0·0001). No serious adverse events requiring hospitalisation were reported after immunisation. INTERPRETATION: Despite the challenges associated with the polio end-game in high-risk, conflict-affected areas of Pakistan, a strategy of community mobilisation and targeted community-based health and immunisation camps during polio immunisation campaigns was successful in increasing vaccine coverage, including polio vaccine coverage. FUNDING: Bill & Melinda Gates Foundation

Quality of service optimization in IoT driven intelligent transportation system

High mobility in ITS, especially V2V communication networks, allows increasing coverage and quick assistance to users and neighboring networks, but also degrades the performance of the entire system due to fluctuation in the wireless channel. How to obtain better QoS during multimedia transmission in V2V over future generation networks (i.e., edge computing platforms) is very challenging due to the high mobility of vehicles and heterogeneity of future IoT-based edge computing networks. In this context, this article contributes in three distinct ways: to develop a QoS-aware, green, sustainable, reliable, and available (QGSRA) algorithm to support multimedia transmission in V2V over future IoT-driven edge computing networks; to implement a novel QoS optimization strategy in V2V during multimedia transmission over IoT-based edge computing platforms; to propose QoS metrics such as greenness (i.e., energy efficiency), sustainability (i.e., less battery charge consumption), reliability (i.e., less packet loss ratio), and availability (i.e., more coverage) to analyze the performance of V2V networks. Finally, the proposed QGSRA algorithm has been validated through extensive real-time datasets of vehicles to demonstrate how it outperforms conventional techniques, making it a potential candidate for multimedia transmission in V2V over self-adaptive edge computing platforms

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Influence of Industry 4.0 on the Production and Service Sectors in Pakistan: Evidence from Textile and Logistics Industries

This research aims to investigate the role of Industry 4.0 in the production and service sector in Pakistan. It therefore considers five Industry 4.0 factors, namely big data, smart factory, cyber physical systems (CPS), Internet of things (IoT), and interoperability. In order to analyze the role of Industry 4.0, the textile industry is taken as a production industry, while the logistics industry is considered as a service industry. Both are facing various challenges in production and services causing below standard overall performance. To address this issue, a quantitative research approach with cross-sectional research design was selected. First hand data was collected through a survey questionnaire from a total of 224 employees of textile and logistics companies. Smart partial least square-structural equation modeling (PLS-SEM) was preferred to analyze the collected data. Findings of the study revealed that Industry 4.0 has a key role in promoting the production and services sector in Pakistan, as it has a significant impact on the overall performance of the considered sectors. This research is one of the pioneer studies that examines the role of Industry 4.0 on the textile and logistics industry of Pakistan. Thus, this research also contributes in a practical dimension by explaining the implementation of Industry 4.0 for improving the performance of the textile and logistics industries

Effect of increasing dietary metabolizable protein on nitrogen efficiency in Holstein dairy cows

Objective The objective of the study was to determine the effects of increasing levels of metabolizable protein (MP) on lactation performance and nitrogen (N) efficiencies in lactating dairy cows. Methods Nine multiparous cows in mid lactation [113±25 days in milk] received three treatments in a 3×3 Latin square design with a period length of 21 days. The treatments were three diets, designed to provide similar energy and increasing supply of MP (g/d) (2,371 [low], 2,561 [medium], and 2,711 [high] with corresponding crude protein levels [%]) 15.2, 18.4, and 20.9, respectively. Results Increasing MP supplies did not modify dry matter intake, however, it increased milk protein, fat, and lactose yield linearly. Similarly, fat corrected milk increased linearly (9.3%) due to an increase in both milk yield (5.2%) and milk fat content (7.8%). No effects were observed on milk protein and lactose contents across the treatments. Milk nitrogen efficiency (MNE) decreased from 0.26 to 0.20; whereas, the metabolic efficiency of MP decreased from 0.70 to 0.60 in low to high MP supplies, respectively. The concentration of blood urea nitrogen (BUN) increased linearly in response to increasing MP supplies. Conclusion Increasing MP supplies resulted in increased milk protein yield; however, a higher BUN and low MNE indicated an efficient utilization of dietary protein at low MP supplies

<i>Crohn&#x2032;s disease</i> among Saudis in Al-Gassim region

Background: Crohn&#x2032;s disease is being increasingly reported from Saudi Arabia and information about its pattern is still accumulating. Aim of the study: To describe and classify the disease and assess the response to therapy in patients referred to a tertiary care centre in Gassim region, Kingdom of Saudi Arabia (KSA). Patients and Methods: Fifteen Saudi patients found to have Crohn&#x2032;s disease over an eight-year period were studied. The presenting symptoms, area of involvement and the response to therapy were assessed. Results: There were five males and ten females. The age of 14 patients was less than 40 years. Symptoms had existed for more than one year before diagnosis in 14 patients. Common symptoms were diarrhea, pain during defecation, blood in stool and weight loss. The ileum was involved in three patients, the colon in four and the involvement was ileocolonic in eight patients. The behavior of the disease was non-stricturing nonpenetrating in eight, stricturing in two, penetrating in one and stricturing as well as penetrating in four patients. Three patients presented as acute appendicitis, four as intestinal obstruction and five with perianal disease. Histological diagnosis was possible in 12 patients. Thrombocytosis was present in seven patients and three had episodes of deep vein thrombosis. Eight patients responded to medical therapy. Surgical intervention was necessary in seven patients and three had multiple operations. One patient died during a median follow-up period of 18 months (range: 6 months to 8 years). Conclusion: Crohn&#x2032;s disease occurs more commonly in young Saudi females. Patients are symptomatic for almost a year prior to diagnosis. The presentation is variable and response to therapy is satisfactory. Surgery is necessary in a high number of patient

Enabling Technologies for Next-Generation Sensor Networks: Prospects, Issues, Solutions, and Emerging Trends

This paper firstly investigates the problem of uplink power control in cognitive radio networks (CRNs) with multiple primary users (PUs) and multiple second users (SUs) considering channel outage constraints and interference power constraints, where PUs and SUs compete with each other to maximize their utilities. We formulate a Stackelberg game to model this hierarchical competition, where PUs and SUs are considered to be leaders and followers, respectively. We theoretically prove the existence and uniqueness of robust Stackelberg equilibrium for the noncooperative approach. Then, we apply the Lagrange dual decomposition method to solve this problem, and an efficient iterative algorithm is proposed to search the Stackelberg equilibrium. Simulation results show that the proposed algorithm improves the performance compared with those proportionate game schemes.Godkänd; 2016; 20151218 (andbra);Full text license: CC BY</p