Assessment of general awareness among Pakistani students regarding COVID-19 outbreak.

At the end of 2019, a novel infectious agent known as severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) originated from Hubei, China; from where it spread to other regions of the globe. In March 2020, World health organization (WHO) expressed fears that Pakistan might emerge as the next epicenter of corona virus infectious disease 2019 (COVID-19). Since proper preventive and curative measures are currently unavailable, only remedy is self-isolation which necessitates ample awareness among people. In this regard, Pakistan faces a unique challenge as it is a populous country with a record of contagious outbreaks in the past. Therefore, it is crucial to evaluate the general understanding regarding the cause, spread, control and psychological consequences of this pandemic in Pakistani population, especially in the youth that represents over 60% of the population. In this study, we have collected and analyzed responses related to awareness and attitude of students through a self-designed questionnaire. In total 1822 responses were collected and subjected to descriptive and frequency analysis. Outcomes of the survey suggest that majority of the respondents are well aware of the disease outbreak, complications and its mode of transmission. It is also evident from the obtained responses that youth of the country is willing to opt the precautionary measures and avoid mass gatherings.

Bayesian sample size determination for coefficient of variation of normal distribution.

Sample size determination is an active area of research in statistics. Generally, Bayesian methods provide relatively smaller sample sizes than the classical techniques, particularly average length criterion is more conventional and gives relatively small sample sizes under the given constraints. The objective of this study is to utilize major Bayesian sample size determination techniques for the coefficient of variation of normal distribution and assess their performance by comparing the results with the freqentist approach. To this end, we noticed that the average coverage criterion is the one that provides relatively smaller sample sizes than the worst outcome criterion. By comparing with the existing frequentist studies, we show that a smaller sample size is required in Bayesian methods to achieve the same efficiency.

Use of improved memory type control charts for monitoring cancer patients recovery time censored data.

Control charts are a statistical approach for monitoring cancer data that can assist discover patterns, trends, and unusual deviations in cancer-related data across time. To detect deviations from predicted patterns, control charts are extensively used in quality control and process management. Control charts may be used to track numerous parameters in cancer data, such as incidence rates, death rates, survival time, recovery time, and other related indicators. In this study, CDEC chart is proposed to monitor the cancer patients recovery time censored data. This paper presents a composite dual exponentially weighted moving average Cumulative sum (CDEC) control chart for monitoring cancer patients recovery time censored data. This approach seeks to detect changes in the mean recovery time of cancer patients which usually follows Weibull lifetimes. The results are calculated using type I censored data under known and estimated parameter conditions. We combine the conditional expected value (CEV) and conditional median (CM) approaches, which are extensively used in statistical analysis to determine the central tendency of a dataset, to create an efficient control chart. The suggested chart's performance is assessed using the average run length (ARL), which evaluates how efficiently the chart can detect a change in the process mean. The CDEC chart is compared to existing control charts. A simulation study and a real-world data set related to cancer patients recovery time censored data is used for results illustration. The proposed CDEC control chart is developed for the data monitoring when complete information about the patients are not available. So, instead of doping the patients information we can used the proposed chart to monitor the patients information even if it is censored. The authors conclude that the suggested CDEC chart is more efficient than competitor control charts for monitoring cancer patients recovery time censored data. Overall, this study introduces an efficient new approach for cancer patients recovery time censored data, which might have significant effect on quality control and process improvement across a wide range of healthcare and medical studies.

Bidirectional Lifetime Tuning of Er 1530 nm Emission Induced by Yb.

Wide-range NIR lifetimes of lanthanide ion-doped nanocrystals are highly desired for numerous bioapplications. As one of the most promising NIR emission bands, the lifetime of Er3+ at 1.5 µm can be as long as ∼10 ms and be greatly shortened by increasing the doping level of either activator Er3+ or sensitizer Yb3+. However, the shortened lifetime is mostly accompanied by the quenching effects, highly restraining the light signal intensity. Alternatively, prolonging the lifetime of Er3+ NIR lifetime without luminescence quenching is of vital significance as it raises the upper limit of the lifetime range and maintains the effective signal intensity. In this work, we revealed that Yb3+ can bidirectionally tune the NIR lifetime of Er3+. By introducing Yb3+, in addition to the substantially improved luminescence intensities, the prolonged NIR lifetime can be generated in low-Er3+-doped NaYF4 nanocrystals, while monotonously decreased lifetime appears in Er3+ heavily doped nanocrystals. To investigate the mechanisms of this bidirectional lifetime tuning and meanwhile avoid additional structural influences, the size and morphology of nanocrystals with different doping compositions were controlled to be similar. The decay dynamics of Er3+ NIR emissions of different nanocrystals were simulated to explain the effects of Yb3+. This work provides insights into the manipulation of the NIR lifetime in Er3+/Yb3+-codoped nanocrystals.

Exploring the asymmetric effects of urbanization and trade on CO2 emissions: fresh evidence from Pakistan.

Over the past few decades, rapid or unplanned urbanization has been a major problem for developing countries, affecting the environment very badly. Pakistan is also the fifth most vulnerable country in terms of environmental impact from socio-economic activities. Mostly, this type of research has been conducted across countries. So, this study intends to analyze the role of urbanization in energy consumption, economic growth, trade, and technology in carbon emissions by evaluating data from 1985 to 2021 in the context of Pakistan. Autoregressive distributed lag (ARDL) and non-linear autoregressive distributed lag (NARDL) with Granger causality assessment are employed to experimentally examine the variables' short and long-term associations. The ARDL result demonstrates that carbon dioxide (LCO2) emissions are increased by energy consumption (LEC) and technology (LTech), while they are decreased by economic growth (LEG) and trade (LT). In NARDL, rising and falling urbanization (LU) lead to increased carbon emissions, but insignificantly. Ascending LEC leads to increased emissions, whereas descending LEC leads to reduced emissions in the context of short and long-term asymmetry. Yet, the opposite is true in the case of trade: a rise in LT decreases emissions significantly, whereas a fall in LT increases emissions insignificantly. This paper highlights the importance of international trade for a country facing these challenges. This means that LT is at the forefront of emission-reducing technology. A Granger causality analysis results show that LU and LTech are two critical determinants of LCO2 emissions. Diagnostic tests ensure the model's reliability, ensuring that it could potentially be used without adverse intent. The research concludes that in order to minimize carbon dioxide emissions, the government should encourage the adoption of low-carbon technology through international trade (the exchange or import of low-carbon products) and implement policies tailored to urbanization and energy demand.

Investigation of resource curse hypothesis: the role of renewable energy and urbanization in realizing environmental sustainability in China.

This research investigates the resource curse hypothesis and environmental sustainability by integrating China's natural resources, renewable energy, and urbanization. However, the EKC N shape describes the complete picture of the EKC hypothesis for the growth-pollution relationship. The findings of FMOLS and DOLS show that economic expansion positively drives carbon dioxide emissions in the beginning, then negatively so after the target level of growth is reached. Continuing economic expansion in China does not maintain the intended level and again has a beneficial impact on the country's carbon dioxide emissions. However, the EKC U, inverted U, and N shapes persist in the growth-pollution connection over the long term. Although adopting renewable energy and urbanization help reduce carbon dioxide emissions, the formation of fixed capital worsens environmental conditions. Natural resource rents are a major cause of environmental degradation and the resource curse that has plagued China. Economic growth, as well as its square and cube, has a causal effect on CO2 emissions, as shown by the frequency domain causation. Carbon dioxide emissions at frequencies of 0.05, 1.50, and 2.50 are momentarily predicted by the use of renewable energy and urbanization. The investigation recommends switching to renewable energy sources owing to low cost and the potential to limit the overuse of non-renewables. To balance the overdo of natural resources and ensure continued long-term growth-environment sustainability, technological advancement is recommended as a countermeasure as a mitigating mechanism.

Impact of technology on the relation between disaggregated energy consumption and CO2 emission in populous countries of Asia.

All around the world, but particularly in developing nations, carbon dioxide emissions are on the rise, and climate change and global warming are brought on by an increase in CO2 emissions. This article provides an overview of the technological effect on energy consumption in the residential, transport, and industrial sector and its ultimate effect on the environment. Using the STIRPAT-Kaya-EKC model for the years 1990 to 2020, this study looked at the threshold impact of technological advancements on the link between disaggregated energy use and CO2 emissions for a panel of 10 Asian countries using the panel threshold regression. Findings demonstrate that the EKC phenomenon is present in the chosen Asian region. Findings also suggest that technology has a threshold influence on the relationship between energy use and carbon emissions; however, this effect varies across sectors.

Analyzing the Asymmetric Effect of Renewable Energy Consumption on Environment in STIRPAT-Kaya-EKC Framework: A NARDL Approach for China.

This study aims to analyze the asymmetric relation between renewable energy consumption and CO2 emissions in China using the STIRPAT-Kaya-EKC framework. To delve into the asymmetric effect of renewable energy consumption on the environment, the non-linear ARDL model is used. The results of this study confirm the asymmetric impact of renewable energy on the environment in the long run as well as in the short run. However, the negative shocks to renewable energy have a greater detrimental influence on the environment than the benign effect due to the positive shock to renewable energy. Population growth affects the environment in the short run, whereas technology only affects environment quality in the long run. Moreover, the study supports the EKC theory in China. This research emphasizes that the administration can improve the economy's lifespan by allocating substantial funds to establish legislation to maintain a clean environment by subsidizing renewable energy infrastructure and research and innovations for low-carbon projects.

ICT, renewable energy, financial development, and CO2 emissions in developing countries of East and South Asia.

This study aims to analyze the impact of ICT, renewable energy consumption, and financial development on CO2 emissions in selected developing countries of East and South Asia. Using panel data spanning 1985-2020, Pooled Mean Group (PMG) estimator is used to analyze the short-run and long-run effects. Results suggest that ICT and financial development positively contribute to the degradation of the environment in the long run, while their impact on CO2 emissions is insignificant in the short run. On the other hand, renewable energy consumption affects environmental quality positively in both the long run and short run. It is also examined that economic growth affects CO2 emissions positively but the squared economic growth reduces CO2 emissions which validates inverted U-shaped EKC hypothesis. The empirical findings of the Granger Causality test suggest unidirectional causality from ICT and financial development to CO2 emissions, while a bi-directional relationship is found among renewable energy and CO2 emissions. Results imply that governments in these countries need to invest in renewable energy to control environmental degradation.

Knowledge, awareness and practices of Pakistani professionals amid-COVID-19 outbreak.

End of the year 2019 marks an unprecedented outbreak of a pandemic named COVID-19 caused by the SARS-CoV-2. It was first discovered in China and later spread to the whole world, currently inflicting almost 200 countries. After China, few other countries have emerged as potential epicenters of this disease including the US, Italy, Spain and Pakistan, as indicated by the World Health Organization (WHO). Since proper preventive and curative measures in the form of a vaccine or medication are currently unavailable throughout the world, the only remedy devised to stop the spread of this virus is self-isolation. Such a measure necessitates ample awareness and understanding among people to avoid actions that lead to the spread of this virus. Pakistan is the fifth-most populous country in the world (212.2 million) and has a record of contagious outbreaks in the past. Therefore, it is key to evaluate the general understanding regarding the cause, spread and control of this disease in Pakistani population and acquire data to anticipate the possible spread and persistence of this disease to design relevant preventive measures. We have attempted to collect such data from professionals who are susceptible to acquiring the infection due to an unavoidable exposure. Keeping in view the current lock down, we have relied on an internet based collection of data by filling a self-designed questionnaire that is responded to by 1132. Descriptive and Frequency Analysis were performed on the responses received using MS Excel and SPSS software. A total of 1132 individuals responded to the questionnaire among which include academic (45.8%), non-academic (20.8%), healthcare (7.8%), security (5.9%) and other (19.7%) professionals. The questionnaire addressed the level of basic information regarding the cause, spread, cure and prevention of this disease among professionals, in an attempt to provide directions for awareness campaigns at different levels in Pakistan and provide a model for similar outbreaks in the future.To our expectations, almost after a month of the coronavirus outbreak in Pakistan, above 50% to up to 90% of the recorded responses against every question showed ample understanding regarding the cause, spread and control of the disease which is an indicator of effective public awareness campaigns throughout the country largely based on media drive.

The non-linear relationship between carbon dioxide emissions, financial development and energy consumption in developing European and Central Asian economies.

A sizeable amount of scholarly work has been done on different aspects of financial, economic, and environmental factors. In the present study, the nonlinearity is determined between financial development and carbon dioxide emissions in the long-run and short-run periods. According to the finding, the continued financial development initially increases the carbon dioxide emissions in the short and long run. Simultaneously, the square term of financial development reduces carbon dioxide emissions and proves the inverted U-shaped hypothesis in the short and long periods. The consumption of fossil fuels produces carbon dioxide emissions, leading to environmental pollution. In contrast, renewable energy sources have fostered ecological sustainability by reducing CO2 emissions in the long and short term. At the same time, a positive response from labor productivity to carbon dioxide emissions causes environmental pollution, while capital formation is not acknowledged as a significant contributor to CO2 emissions. The Error Correction term has ascertained the reduction in error and convergence of the model from short to long term with a speed of 8% per annum. The study suggested that renewable energy and financial development should be indorsed for environmental preservation in developing European and Central Asian economies. Financial development in favor of low-cost renewables, advancing cleaner production methods, solar paneling, and electrification are a few possible remedies to achieve environmental sustainability in the short-run as well as long-run time frame.

Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multicenter Study.

OBJECTIVE: Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality. METHODS: A multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality. RESULTS: A total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than during the pre-COVID-19 period (12 cases; P < 0.0001). Complications, length of hospital stay, and 30-day mortality did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24-2.67), 1 (1-24 h) (OR, 1.63; 95% CI, 1.10-2.41), and 4 (OR, 0.28; 95% CI, 0.19-0.42) showed significant differences. CONCLUSIONS: During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties.

Experience of Liver Transplant in Patients Diagnosed with Budd-Chiari Syndrome.

OBJECTIVES: Budd-Chiari syndrome can lead to fulminant hepatic failure and cirrhosis. The treatment depends on the severity of disease. Liver transplant is a successful treatment option for those with advanced-stage disease. MATERIALS AND METHODS: In this retrospective study, we analyzed all liver transplants conducted for Budd-Chiari syndrome at the organ transplant unit of Shiraz University of Medical Sciences, Iran, from 1993 to January 2016. Overall, 3201 liver transplant procedures were performed. Among these, 68 presented with Budd-Chiari syndrome. RESULTS: The median age was 31 years among 27 male and 41 female patients. Five patients received pretransplant interventions, with 2 treated with inferior vena cava stenting and 3 having transjugular intrahepatic portosystemic shunts. Sixty-five patients with Budd-Chiari syndrome received deceased-donor grafts and 3 received living-donor grafts. Among the Budd-Chiari transplant patients, 6 patients died. Five deaths occurred in the early posttransplant period, and 1 patient retransplanted after 2 years for recurrence of disease died due to graft failure. The five-year survival rate was 89% among patients with Budd-Chiari syndrome. CONCLUSIONS: Liver transplant along with posttransplant anticoagulation therapy can improve the survival of patients with advanced-stage Budd-Chiari syndrome.

On-call emergency workload of a general surgical team.

BACKGROUND: To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. PATIENTS AND METHODS: During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E) and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. RESULTS: Total 456 patients (326 males and 130 females) were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9%) were received from 8 am to 5 pm. 224 (49.1%) calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0%) patients. Total 73 (16.0%) calls were received for trauma. Total 131 (28.7%) patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5%) patients were discharged from A and E. 92 (20.1%) patients were referred to other units with medical referral accounts for 45 (9.8%) patients. Total 104 (22.8%) emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7%) patients. CONCLUSION: Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.