Exploring the potential of bacterial-augmented floating treatment wetlands for the remediation of detergent-contaminated water.

Due to industrialization and urbanization, the use of detergents inadvertently led to contamination of aquatic environments, thus posing potential threat to aquatic organisms and human health. One of the main components of detergents is linear alkylbenzene sulfonate (LAS), which can cause toxic effects on living organisms, particularly aquatic life in the environment. In this study, floating treatment wetlands (FTWs) mesocosms were developed and augmented with LAS-degrading bacteria. The plant species, Brachiaria mutica (Para grass), was vegetated to establish FTWs and bacterial consortium (1:1:1:1) of Pseudomonas aeruginosa strain PJRS20, Bacillus sp. BRRH60, Acinetobacter sp. strain CYRH21, and Burkholderia phytofirmans Ps.JN was augmented (free or immobilized) in these mesocosms. Results revealed that the FTWs removed LAS from the contaminated water and their augmentation with bacteria slightly increased LAS removal during course of the experiment. Maximum reduction in LAS concentration (94%), chemical oxygen demand (91%), biochemical oxygen demand (93%), and total organic carbon (91%) was observed in the contaminated water having FTWs augmented with bacterial consortium immobilized on polystyrene sheet. This study highlights that the FTWs supported with immobilized bacteria on polystyrene sheets can provide an eco-friendly and sustainable solution for the remediation of LAS-bearing water, especially for developing countries like Pakistan.

This pilot-scale study provided insights to resolve the detergent-contaminated wastewater issue, using floating treatment wetlands (FTWs) augmented with bacteria. The FTWs augmented with bacteria immobilized on a polystyrene sheet and vegetated with Brachiaria mutica led to high degradation of LAS, a toxic compound of detergent, from the contaminated water.

Opportunities and constraints for cleaner production policy in the developing world: a case study of Sindh Region, Pakistan.

The current industrial and economic activities in Sindh Province, Pakistan, polluted the region's water, air, soil, and marine resources. However, there is a rising demand for eco-friendly production, and it is important to develop new policies and tools to combat environmental degradation and enhance economic development. Cleaner Production (CP) provides opportunities to address many of these issues. Employed method for this study was based on three approaches: a literature review and stakeholder mapping; a collection of data and information from key stakeholders through focal group discussions, consultative workshops, and one-on-one meetings; and analysis and synthesis of data that were gathered from different sources. The analysis of collected information provides an overview of CP strategies moving forward. Participant workshops gave in-depth information on policy implementation, technological impediments to methods that have been employed elsewhere, and needed capacity building as well as financial consequences of policy implementation. Through increasing financial resources and institutional resources, the expansion of CP will help to replace the conventional methods of waste treatment with an eco-efficiency approach to preventing pollution at the source, thus reducing the need for expensive pollution control and management costs for environmental compliance. Experiences, achievements, and implementation pitfalls from this study can provide a lesson to other developing countries to improve their economic and environmental sustainability.

Ramification of healthcare expenditure on morbidity rates and life expectancy in the association of southeast asian nations countries: A dynamic panel threshold analysis.

OBJECTIVE: This study has investigated the impact of healthcare expenditure on life expectancy and morbidity rates in the Association of Southeast Asian Nations to analyse whether health expenditure remains a critical component of improving health status and to determine the threshold value at which health strategy becomes cost-effective from 2000 to 2019. METHODS: The techniques employed include the Dynamic Panel Threshold model advanced by Seo et al. (2019) to implement Seo and Shin's (2016) proposed first-differenced generalised method of moments (GMM) estimation. Furthermore, the dynamic system GMM and Pooled Ordinary Least Squares (OLS) techniques were also employed for robustness check. RESULTS: The findings revealed that healthcare expenditure raises life expectancy and lowers the crude death rate, infant mortality rate, and maternal mortality rate. Therefore, healthcare expenditure is increasing life expectancy and reducing crude death rate, infant mortality rate, and maternal mortality rate. However, when disaggregating the impact, that of public healthcare expenditure is higher than that of private except in the case of infant mortality rate where that of private is higher. In addition, it found that the threshold value at which health strategy becomes cost-effective, thus the amount which the countries should spend for health status improvement is at least 6% and above of their Gross Domestic Product (GDP). CONCLUSION: Healthcare expenditure is raising life expectancy and lowering the morbidity rate of the countries. Furthermore, the cost-effective level of the country's healthcare expenditure as a proportion of GDP is 6% and above.

Coagulation Gene Expression Profiling in Infants With Necrotizing Enterocolitis.

OBJECTIVES: Coagulopathy and mesenteric thrombosis are common in premature neonates with necrotizing enterocolitis (NEC). This pilot study aimed to investigate the hypothesis that there are changes in the gene expression related to the coagulation and anticoagulation systems in NEC. METHODS: Consecutive neonates (n = 11) with NEC (Bell stages 2-3) were recruited. Two comparison groups, matched for birth weight and corrected gestational age, were selected based on the absence of inflammation and coagulopathy (healthy control, n = 10), or the presence of a confirmed blood infection (sepsis control, n = 12). A pathway-specific quantitative polymerase chain reaction array was used to determine the expression of 94 genes involved in human blood coagulation and anticoagulation cascade. RESULTS: Twelve genes of the coagulation and anticoagulation systems were significantly altered in the patients with NEC compared with healthy controls. In particular, neutrophil elastase, CD63, PROS1, HGF, and F12 were significantly upregulated (mean fold changes [FCs] +2.74, P < 0.05) with an overall procoagulant effect; MFGE8, factor II (thrombin) receptor-like 1 (F2RL1), FGL2, PLAT, PROCR, SERPIND1, and HNF4A were significantly downregulated (mean FCs -2.45, P < 0.05) with a reduction in fibrinolysis and endothelial regeneration. In the comparison between NEC and sepsis, we did observe a significant difference in expression of F2RL1 (FC -2.50, P = 0.01). CONCLUSIONS: We have identified potential biomarkers associated with coagulopathy and disease progression in NEC. In particular, the overall procoagulant status, at the transcriptional level, should be further investigated to unveil molecular mechanisms leading to intestinal necrosis, multiorgan failure, and death.

Exploring the interrelationship among health status, CO2 emissions, and energy use in the top 20 highest emitting economies: based on the CS-DL and CS-ARDL approaches.

Carbon dioxide emissions (CO2e) which is caused by energy use contributes to the global average surface temperature increase by 1.5 °C as compared to the mid-1800s which is causing a certain change in the climate and becoming an adverse effect on health and economy. The relationship between health status, CO2e, and energy use has yet to be thoroughly investigated in the top 20 highest emitting economies. The data from 2000 to 2019 is analyzed by using advanced techniques of cross-sectional augmented distributed lag (CS-DL) and cross-sectional augmented autoregressive distributed lag (CS-ARDL) which take into consideration crucial elements of panel data, namely dynamics, heterogeneity, and cross-sectional dependence. Moreover, cross-sectional augmented error correction method (CS-ECM) and the common dynamic process of the augmented mean group (AMG) are applied for robustness checks. The empirical findings revealed that (i) CO2e weakens the health status only in the short-run, whereas health expenditure improves the health status in the both short- and long-runs, while economic growth is not contributing to the health status in the both short- and long-runs; (ii) health expenditure and economic growth only help to mitigate CO2e in the long-run, whereas energy use causes CO2e in the both short- and long-runs; (iii) energy use causes high economic growth in the both short- and long-runs, whereas CO2e aids economic growth in the short-run but is extremely damaging to economic growth in the long-run, while in the both short- and long-runs health expenditure is not aiding the economic growth. This study provides policy recommendations on improving human health by advocating massive health expenditures, CO2e easing, promoting renewable energy use or low-emission energy, and steering the economy toward green economic growth.

Transformative role of educational funding in shaping national development across SAARC countries in the 21st century: A panel NARDL approach.

Since the beginning of this century, there has been evidence of a rise in educational funding among the South Asian Association for Regional Cooperation (SAARC). However, there has been a decline in recent years despite South Asia being a highly populated and poverty-ridden region. Thus, the present study comes to assess how well the countries are doing in relation to the effect of educational funding on national development indicators, namely economic growth, human capital development, and the unemployment rate among the SAARC countries in the 21st century using Panel Nonlinear Autoregressive Distributed Lag (PNARDL) model formulated in Salisu and Isah (2017). The findings revealed that the impact of educational funding on economic growth and the unemployment rate is an asymmetry in the long run and symmetry in the short run but on the human development index, it is an asymmetry in both terms. However, educational funding is influencing economic growth in the long run, but in the short run is not. Furthermore, educational funding influences human capital development in both terms, but in the long run is negligible. Moreover, educational funding is negligibly discouraging the unemployment rate in both terms.

How to eradicate polio in Pakistan: Insights from community health workers.

Pakistan, along with Afghanistan, is one of two countries where wild poliovirus is still endemic. Frontline workers (FLWs) are the staff most intimately familiar with both implementation challenges and community context. Harnessing their expertise may be a way to improve the community-polio program interface, which has been a persistent and shifting challenge in polio-endemic areas of both countries. From 2020-2022, we engaged frontline workers in 18 Super High-Risk Union Councils (SHRUCs) in Pakistan through a Human-Centered Design ideas competition. In that competition, teams of polio FLWs identified the most significant barriers they faced in conducting their work, and suggested solutions to those problems-a window into the issues the program faces by the people who know it best. The suggestions of FLWs on how to eradicate polio fell into four main categories. First, there were suggestions to tackle community fatigue by reducing touchpoints, particularly visits solely for data collection. Second, there were calls to improve Primary Health Care in SHRUCs, as a way of addressing community frustrations over an intense focus on just one disease in the context of numerous acute needs. Third, there were suggested ways to increase community engagement through locally relevant channels. Finally, many workers suggested improvements to Human Resources processes and workplace dynamics. Across these ideas, one repeated concept is the need for balance between the intensity of polio activities required for eradication and the provision of other government services, including health services. FLWs engaged the process deeply, providing well thought out problem statements and ideas for change. It is our view that there is no one more qualified to speak to the issues on the ground than FLWs. There are critical insights available if we listen to people who are instrumental to the success of health programs, but not commonly involved with creating policy.

The nonlinearity and nonlinear convergence of CO2 emissions: Evidence from top 20 highest emitting countries.

Carbon dioxide (CO2) is the most prevalent greenhouse gas that triggers climate change, which in turn leads to catastrophic effects on trade, business, human health, and other areas. Understanding the characteristics and tendency of CO2 emissions will improve policy making and mitigation strategies. Understanding the linearity or nonlinearity and convergence or divergence of CO2 emissions is essential for selecting appropriate modeling techniques and for designing reliable policies. Therefore, this paper investigates the nonlinearity and nonlinear convergence of CO2 emissions among the world's top 20 highest emitting countries, which account for 80% of the world's total emissions. To check the nonlinearity of CO2 emissions, the McLeod-Li nonlinearity test, the Terasvirta nonlinearity test, and the Brock-Dechert-Scheinkman-LeBaron nonlinearity test are employed. The convergence or divergence of CO2 emissions is checked by using the Kilic nonlinear unit root test, the Hu and Chen nonlinear unit root test, and the Park and Shintani nonlinear unit root test. The findings revealed that the CO2 emissions process in all the 20 countries is nonlinear; 17 countries exhibit convergence in CO2 emissions while the other 3 countries diverged from 1960 to 2018. Based on the results, the nonlinear nature of CO2 emissions requires special attention from scholars when selecting estimation techniques for CO2 emissions. For countries with convergence, emissions trends can be used to forecast future values of CO2 emissions. Moreover, strong policy actions are required to achieve convergence in the countries with divergence.

Pakistan earthquake: experiences of a multidisciplinary surgical team.

INTRODUCTION: Four weeks after the earthquake in Kashmir, Pakistan, multidisciplinary surgical teams were organized within the United Kingdom to help treat disaster victims who had been transferred to Rawalpindi. The work of these teams between 05-17 November 2005 is reviewed, and experiences and lessons learned are presented. METHODS: Two self-sufficient teams consisting of orthopedic, plastic surgical, anesthetic, and theatre staff were deployed consecutively over a two-week period. A trauma unit was set up in a donated ward within a private ophthalmological hospital in Rawalpindi. RESULTS: Seventy-eight patients with a mean age of 23 years were treated: more than half (40) were <16 years of age. Fifty-two patients only had lower limb injuries, 18 upper limb injuries, and eight combined lower and upper limb. The most common types of injuries were: (1) tibial fractures (n=24), with the majority being open grade 3B injuries (n=22); (2) femoral fractures (n=11); and (3) forearm fractures (n=9). Almost half (n=34) of the fractures were open injuries requiring soft tissue cover. Over 12 days, 293 operations were performed (average 24.4 per day). A total of 202 examinations under anesthesia, washouts, and debridements were performed. The majority of wounds required multiple washouts prior to definitive procedures. Thirty-four definitive orthopedic procedures (fixations) and 57 definitive plastic procedures were performed. Definitive orthopedic procedures included 15 circular frame fixations of long bones, nine of which required acute shortening and five open reduction and internal fixation of long bones. Definitive plastic procedures included 21 skin grafts, four amputations, 11 revisions of amputations, 20 regional flaps, and one free flap. CONCLUSIONS: A joint ortho-plastic approach was key to the treatment of the spectrum of injuries encountered. Only four patients required fresh amputations. Twenty patients may have required amputation without the use of ring fixators and soft tissue reconstruction. Having self-sufficient teams along with their own equipment and supplies also was mandatory in order not to put further demand on already scarce resources. However, mobilizing such teams logistically was difficult, and therefore, an organization consisting of willing volunteers for future efforts has been established.