Comparison of a single session of tDCS on cerebellum vs. motor cortex in stroke patients: a randomized sham-controlled trial.

OBJECTIVE: The purpose of this study was to determine whether a single session of trans-cranial direct current stimulation (tDCS) of the cerebellum and M1 has any advantages over one another or sham stimulation in terms of balance, gait and lower limb function. METHODS: A total of 66 patients who had experienced their first ever stroke were recruited into three groups for this double-blinded, parallel, randomized, sham-controlled trial: cerebellar stimulation group (CbSG), M1 stimulation group (MSG) and sham stimulation group (SSG). A single session of anodal tDCS with an intensity of 2 mA for a duration of 20 min was administered in addition to gait and balance training based on virtual reality using an Xbox 360 with Kinect. Balance, gait, cognition and risk of fall were assessed using outcome measures before intervention (T0), immediately after intervention (T1) and an hour after intervention (T2). RESULTS: Across group analysis of all outcome measures showed statistically non-significant results (p > .05) except for Six Minute Walk Test (p value T0 = .003, p value T1 = .025, p value T2 = .016). The training effect difference showed a significant difference in balance, gait and cognition, as well as cerebral and cerebellar stimulation, in comparison to sham stimulation (p < .05). The risk of falls remained unaffected by any stimulation (p > .05). CONCLUSIONS: In addition to Xbox Kinect-based rehabilitation training, a single session of anodal tDCS to the M1 or cerebellum may be beneficial for improving lower limb function, balance and gait performance.

Exploring the Students' Perceived Effectiveness of Online Education during the COVID-19 Pandemic: Empirical Analysis Using Structural Equation Modeling (SEM).

The world faced COVID-19, which was a threat to public health and disturbed the educational system and economic stability. Educational institutes were closed for a longer period, and students faced difficulty to complete their syllabus. The government adopted a policy of "suspending classes without stopping learning" to continue education activities. However, student satisfaction with online education is a growing concern. Satisfaction of students is an important indicator of academic quality. Therefore, this study attempts to investigate the influencing factors behind learning satisfaction using information from 335 students from various institutes in Pakistan. This research examined the impact of computer and internet knowledge, instructor and course material, and Learning Management Systems (LMS) on learning satisfaction. The path coefficients were obtained via Partial Least Square-Structural Equation Modeling (PLS-SEM). The LMS is a tool that facilitates the learning process with the provision of all types of educational material. The path coefficient was more in the case of LMS (0.489), which indicates its positive and significant role to attain learning satisfaction. The instructor and course material ordered second (0.261), which shows that the quality of an instructor and course material also plays a positive role to attain learning satisfaction. The computer and internet are essential ingredients of online education, showing a significant and positive path coefficient (0.123), implying that computer and internet knowledge could enhance learning satisfaction. The universities should develop their LMS to implement online education with quality course materials. It is also vital that the instructor should be up to date with modern learning techniques while ensuring internet connectivity, especially in rural areas. The government should provide an internet connection to students at discounted rates.

Do natural disasters affect economic growth? The role of human capital, foreign direct investment, and infrastructure dynamics.

Natural disasters do occur and have become a global problem due to increasing intensity. Developing countries are mostly affected due to natural disasters owing to a poor environment, feeble adaptation, impoverished socioeconomic conditions, poor infrastructure, limited resources, and unstable institutions. The SDG 11.5 target which highlights the mitigation of loss due to natural disasters--remains crucial to achieving sustainable cities and human settlements--but the literature is limited on this scope. Thus, this research contributes to the literature by incorporating an infrastructure index, foreign direct investment (FDI), human capital index, globalization, and capital formation into the disaster-growth debate across four-income groups in 98 countries from 1995 to 2019. We developed infrastructure and human capital indices using a standard procedure across all income groups. The two-step generalized method of moments employed herein confirmed the income reduction effect of natural disasters. While the economic cost of natural disasters is relatively high in low-income countries and mild in high- and upper-middle-income countries. Besides, infrastructural development, FDI, human capital, globalization, and gross fixed capital formation also affect economic growth across income groups. Thus, the enhancement of socio-economic policies could decline economic losses, especially in vulnerable and poor settlements in developing countries.

Estimation of economic, environmental, and social efficiency for sustainable development in G-8 and SAARC countries: a data envelopment analysis.

In the recent era, economic growth is not enough to represent sustainable development. Sustainable development has three dimensions (i.e., economic, social, and environment). This study estimated the economic, social, and environmental efficiency using data from 2000 to 2021. Input-oriented data envelopment analysis shows strong heterogeneity across developed (G-8) and developing countries (SAARC). There is a potential to increase economic and environmental efficiency in the G-8 and SAARC countries. The average economic efficiencies are 0.682 and 0.414, which implies the possibility of the same output (GDP/capita) by using 31.8% and 58.6% fewer inputs in G-8 and SAARC countries, respectively. The social efficiency score is more than 0.980 in both panels. The average environmental efficiencies are 0.712 and 0.724, which implies that selected countries can obtain the same output (CO2 emission reduction) by using 28.8% and 27.6% fewer inputs in G-8 and SAARC countries, respectively. The top three economically efficient countries are (a) the USA, the UK, and Japan in the G-8 panel and (b) Maldives, Sri Lanka, and Pakistan in the SAARC panel. The top three environmentally efficient countries are (a) France, the UK, and Italy in the G-8 panel and (b) Afghanistan, Nepal, and Bangladesh in the SAARC panel. It is recommended to adopt suitable policies to reduce emission, minimize waste, efficient utilization of resources, increase forest cover, and incentive for clean technologies. It is suggested to promote renewable energy through the provision of micro-credit to the poor, subsidizing renewable energy technologies, implementation of stringent environmental policies, and increasing awareness. It is essential to invest in eco-friendly and innovative technologies; thus, the government should encourage green practices in production. Human development is recommended to increase the living standard and healthy life. The government should invest in the health system and conduct seminars on general health awareness. Investment in basic infrastructure (drinking water, sanitation, and clean fuel) is essential to increase the living standard. The G-8 countries should provide financial and technological help to the SAARC countries.

Short term effects of anodal cerebellar vs. anodal cerebral transcranial direct current stimulation in stroke patients, a randomized control trial.

Background: Balance and gait impairments are major motor deficits in stroke patients that require intensive neuro-rehabilitation. Anodal transcranial direct current stimulation is a neuro-modulatory technique recently used in stroke patients for balance and gait improvement. Majority of studies focusing on tDCS have assessed its effects on cerebral motor cortex and more recently cerebellum as well but to our best knowledge the comparison of stimulating these two regions in stroke patients is not investigated so far. Objective: The current study aimed to compare the effect of anodal transcranial direct current stimulation on cerebellar and cerebral motor cortex M1 in stroke patients. Materials and methods: This double-blinded, parallel, randomized, sham controlled trial included 66 patients with a first-ever ischemic stroke were recruited into three groups; Cerebellar stimulation group (CbSG), M1 Stimulation Group (MSG), and Sham stimulation group (SSG). A total of three sessions of anodal transcranial direct current stimulation were given on consecutive days in addition to non-immersive virtual reality using Xbox 360 with kinect. Anodal tDCS with an intensity of 2 mA was applied for a duration of 20 min. Primary outcome measures berg balance scale (BBS), timed up and go test (TUG), BESTest Balance Evaluation-Systems Test (BESTest) and secondary outcomes measures montreal cognitive assessment (MoCA), mini mental state examination (MMSE), Johns Hopkins Fall Risk Assessment Tool (JHFRAT), twenty five feet walk test (25FWT), six minute walk test (6MWT), and tDCS Adverse Effects was assessed before initiation of treatment (T0) and at the end of third session of stimulation (T1). Results: The results of between group's analysis using mean difference showed a significant difference with p-value <0.05 for balance (BBS, TUG, BESTest), walking ability (6MWT, 25FWT), risk of fall (JHFRAT). Cognitive function did not show any significant change among the groups for MoCA with p-value >0.05 but MMSE was improved having significant p-value (p = 0.013). However, 6MWT and 25FWT showed non-significant results for both between group and within group analysis. In pairwise comparison both the cerebellar and cerebral stimulation groups showed Significant difference with p-value <0.05 in comparison to sham stimulation; BBS (cerebellar vs. sham p ≤ 0.001, cerebral vs. sham p = 0.011), TUG (cerebellar vs. sham p = 0.001, cerebral vs. sham p = 0.041), Bestest (cerebellar vs. sham p = 0.007, cerebral vs. sham p = 0.003). Whereas for JHFRAT only cerebellar stimulation in comparison to sham and motor cortex stimulation showed significant improvements (cerebellar vs. M1 p = 0.037, cerebellar vs. sham p = 0.037). MMSE showed significant improvement in M1 stimulation (M1 vs. cerebellar p = 0.036, M1 vs. sham p = 0.011). Conclusion: Findings of the study suggest anodal tDCS stimulation of the cerebellum and cerebral motor cortex both improves gait, balance and risk of fall in stroke patients. However, both stimulation sites do not induce any notable improvement in cognitive function. Effects of both stimulation sites have similar effects on mobility in stroke patients.

Impact of Green HRM Practices on Environmental Performance: The Mediating Role of Green Innovation.

Numerous organizations have faced substantial environmental performance challenges resulting from more than a half-century of worldwide industrialization. Grounded in social learning theory and recourse-based view theory, this study explores environmental performance and its impact on employees and industry outcomes. Drawing on a cross-sectional online survey of 500 full-time employees working in the chemical industry in Lahore, Pakistan. The results revealed a significant positive influence of Green HRM practices on employees' Green innovation as well as on environmental performance. Additionally, significant influences of study variables were recorded on outcomes such as green compensation and reward, green performance management and appraisal, green training and development, and green recruitment and selection. Several key policy insights related to consumer resistance to innovation in low income societies and future research directions are suggested, along with theoretical and practical implications.

UV/Vis dose response of a reusable PMMA-NaCl polymer composite.

PURPOSE: Two-dimensional dosimeters are convenient tools for quickly checking the radiation profile in radiotherapy. The currently used solution is costly, especially in busy institutions with extensive quality control procedures. This study fabricates a reusable 2-mm-thick PMMA-NaCl polymer composite sheet and assesses its dosimetric properties. METHODS: The PMMA-NaCl composite sheets were prepared using hot melting procedures. For dosimetric evaluations, the samples were irradiated using 6 MV X-ray photons from a medical linac. The absorbed doses were measured as changes in the optical absorption spectrum using a UV-Vis spectrometer. RESULTS: The lowest dose detected by the samples was 5 Gy, with a linear dose response of at least 20 Gy. The repeatability of the measurements was good, with a standard deviation of 5.03%. The signal was bleachable by using a 100 W filament-type lamp for dosimetric reuse. CONCLUSION: The 2-mm-thick PMMA-NaCl polymer-composite sheet could measure absorbed radiation doses from 6 MV X-ray photons down to 5 Gy. Because the sample is reusable, it can be used in a cost-effective two-dimensional radiation dosimeter to ensure the quality of medical linacs.

Impulsive and Compulsive Buying Tendencies and Consumer Resistance to Digital Innovations: The Moderating Role of Perceived Threat of COVID-19.

Based on the theory of reasoned action and innovation resistance theory, this study aims to explore the tendencies of consumer resistance to digital innovation and the moderating role of a perceived threat of coronavirus disease 2019 (COVID-19). Data were collected using a cross-sectional online survey of 1,000 consumers of fast-moving consumer goods (FMCGs) in Pakistan. The results revealed several significant relationships between tendencies (impulsive and compulsive) of consumer resistance to digital innovation and the perceived threat of COVID-19. This study brings several key insights for consumers of FMCG products from Pakistan, and many theoretical and practical implications and future research directions are suggested.

The role of infrastructure, socio-economic development, and food security to mitigate the loss of natural disasters.

This study shows the impact of risk (hazard, exposure, and vulnerability) and resilience (infrastructure, information and communication technology, institutional quality, food security, women empowerment, economic performance, human capital, emergency workforce, and social capital) indicators on losses due to natural disasters in 24 high-income, 24 upper-middle-income, 30 lower-middle-income, and 12 low-income countries from 1995 to 2019. It develops a new disaster risk index and disaster resilience index using standard index-making procedure (indicators selection, winsorization, normalization, aggregation). The generalized additive modeling was used to explore the non-linear relationship between response and explanatory variables. There exists a positive link between damage due to natural disasters and hazard index (all panels) and exposure index in high-income countries. The decrease in damage due to natural disasters was observed due to an increase in infrastructure (upper-middle-, lower-middle-, and low-income countries), information and communication technology (high-income countries), institutional quality (high-income countries), food security (high- and upper-middle-income countries), women empowerment (lower-middle-income countries), economic performance (high- and low-income countries), human capital (low-income countries), and emergency workforce (upper-middle and lower-middle-income countries). The governments should enhance disaster resilience through Sendai Framework, having seven targets and four priority areas to increase disaster resilience.

Additional Effects of Xbox Kinect Training on Upper Limb Function in Chronic Stroke Patients: A Randomized Control Trial.

BACKGROUND: Xbox Kinect-based virtual reality, being a novel approach, has therapeutic benefits in rehabilitation and its use is encouraged in stroke rehabilitation of upper extremities. OBJECTIVE: Primary aim of the current study is to investigate the additional effects of Xbox Kinect training in combination with routine physiotherapy exercises based on each component of Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE). Moreover, effect of upper limb rehabilitation on cognitive functions was also assessed. METHODS: This study was a parallel arm randomized control trial. Fifty-six participants were recruited and randomly allocated to either an Xbox Kinect training group (XKGT) or exercise training group (ETG). Measures of concern were recorded using FMA-UE, Box and Block Test (BBT), and Montreal Cognitive Assessment (MOCA). Evaluation was conducted at baseline and after completion of intervention at the sixth week. RESULTS: There were significant differences from pre- to post-intervention scores of FMA-UE and BBT (p < 0.001) in both groups, whereas no difference was observed for MOCA (XKTG p value 0.417, ETG p value 0.113). At six-week follow-up there were significant differences between both groups in FMA-UE total score (p < 0.001), volitional movement within synergies (p < 0.001), wrist (p = 0.021), hand (p = 0.047), grasp (p = 0.006) and coordination/speed (p = 0.004), favoring the Xbox Kinect training group. CONCLUSION: To conclude, results indicate repetitive use of the hemiparetic upper extremity by Xbox Kinect-based upper limb rehabilitation training in addition to conventional therapy has a promising potential to enhance upper limb motor function for stroke patients.

Association between meteorological indicators and COVID-19 pandemic in Pakistan.

This study was designed to investigate the impact of meteorological indicators (temperature, rainfall, and humidity) on total COVID-19 cases in Pakistan, its provinces, and administrative units from March 10, 2020, to August 25, 2020. The correlation analysis showed that COVID-19 cases and temperature showed a positive correlation. It implies that the increase in COVID-19 cases was reported due to an increase in the temperature in Pakistan, its provinces, and administrative units. The generalized Poisson regression showed that the rise in the expected log count of COVID-19 cases was 0.024 times for a 1 °C rise in the average temperature in Pakistan. Second, the correlation between rainfall and COVID-19 cases was negative in Pakistan. However, the regression coefficient between the expected log count of COVID-19 cases and rainfall was insignificant in Pakistan. Third, the correlation between humidity and the total COVID-19 cases was negative, which implies that the increase in humidity is beneficial to stop the transmission of COVID-19 in Pakistan, its provinces, and administrative units. The reduction in the expected log count of COVID-19 cases was 0.008 times for a 1% increase in the humidity per day in Pakistan. However, humidity and COVID-19 cases were positively correlated in Sindh province. It is required to create awareness among the general population, and the government should include the causes, symptoms, and precautions in the educational syllabus. Moreover, people should adopt the habit of hand wash, social distancing, personal hygiene, mask-wearing, and the use of hand sanitizers to control the COVID-19.

Modeling smallholder livestock herders' intentions to adopt climate smart practices: An extended theory of planned behavior.

Climate change is persistently causing adverse effects to the agriculture sector of developing countries, specifically in Asia. Pakistan is no exception to this effect and is ranked among the top 10 countries, which are most vulnerable to climate change. A huge upcoming challenge is to sustain an equilibrium among production and environmental protection. In this context, adaptation to climate change is considered as a win-win strategy for agriculture sectors in developing countries. However, numerous studies have focused on current farm-level adaptation while a scant interest has been shown on the role of physiological factors in the process of shaping small livestock herders' intentions towards environmental enrichment measures. A possible explanation of their lagging intentions is particular significance as they may comply with requisite climate adaptation measures or not. For deeper understanding, the current study investigates different psychological factors that affect the small livestock herder's intentions on adopting climate smart practices by using theory of planned behavior (TPB) with additional constructs (moral norms, risk perception, and social attributes). To this end, 405 small livestock herders from Punjab, Pakistan, were selected on the basis of multistage random sampling. The results of structural equation model showed that all constructs accounted for 57% of the variances in small livestock herders' adoption intentions. The outcome of this research offers a new indication regarding the interrelationship of numerous variables which are crucial to understand behavioral changes and psychological interventions. Overall attitude was the most prominent construct in the extended TPB model, which is mainly influenced by risk perception awareness. The results suggest that veterinary experts and extension agents should focus on psychological factors to explore different prospects to increase the involvement of livestock herders in environmental enrichment measures with little effort rather than tackling with traditional practices because it will be more likely to affect people's consideration of the external obstructions to act. Findings also offer public and private intervention for enabling technical and policy environment and strengthen social networks to keep livestock herders on track of updates of running government policies to ensure them to adopt climate change measures for their prosperous future.

The impact of temperature, rainfall, and health worker density index on road traffic fatalities in Pakistan.

A road traffic accident is a burning issue because the cost of road accidents is about 2% of gross domestic product in Pakistan. This paper explores the relationship between health force density index, temperature, rainfall, road lengths, and road traffic fatalities in Pakistan from 1985 to 2016. The stationarity was determined with the help of four-unit root tests. The existence of long-run cointegration was determined by using the autoregressive distributing lag bound test. The vector error correction model showed the long-run causality of road traffic fatalities, which implies that road traffic fatalities were affected by selected variables in the long-run. The short-run unidirectional causality was running from road traffic fatalities to health force density index; temperature to health force density index; rainfall to health force density index; health force density index to rainfall; road traffic fatalities to high type road length; health force density index to high type road length; and temperature to high type roads. The reduction in road fatalities was 1.713% due to a 1% increase in health force density. But, road fatalities increase by 3.628% due to a 1% increase in temperature. The road fatalities increase by 0.255% and 0.485% due to a 1% increase in rainfall and high type road length, respectively. The governments should increase the number of doctors and nurses for the life-saving of an injured person. Due to the adverse impact of temperature on road safety, the government should formulate a comprehensive environmental policy in order to mitigate global warming. It is recommended to increase the forest area to reduce the level of emission. It is required to modify the system of transportation according to the guidelines of international transportation associations with respect to the quality and maintenance of vehicles, medical check-up of drivers, and construction of roads. Installation of speed cameras is also needed on high type roads to ensure road safety. It is also recommended to increase traffic law enforcement. It is difficult for the Pakistani government to effectively execute road safety plans due to the limitation of resources. However, the government should invest the revenue collected through tax violation fine for the improvement in road safety. It is also needed to invest in the health sector and up-gradation of the hospitals for the safety of human beings. The government should ensure the availability of the latest medical technology in the hospitals and the improvement of emergency services. It is required to develop coordination between various ministries such as transportation, planning, law, education, public health, and information. It is necessary to make the public aware of the social and economic cost of road accidents using electronic, print, and social media. Graphical abstract.

Road traffic fatalities and its determinants in high-income countries: a continent-wise comparison.

Road traffic accidents (RTAs) are accountable for 1.2 million deaths and road safety is the part of sustainable development goals, which aims to provide a safe, accessible, affordable, and sustainable transport system by 2030. This study discovered the nexus of road traffic fatalities (RTFs) with its determinants in Asia, Europe, and America. Vector error correction model established the causality of RTFs (Asia, Europe), urbanization (Asia), physicians (Asia, Europe), traffic law enforcement index (Europe, America), vehicles (America), and paved roads (America). Short-run bidirectional causality of RTFs was established with educational expenditures (Asia, Europe), GNI (Europe), and urbanization (Europe). The fall in RTFs was 0.359% (Europe) and 0.957% (America) for 1% rise in GNI. The RTFs were decreased by 0.498% (Europe) and 0.390% (America) due to 1% rise in urbanization. Education shows 0.952% reduction in RTFs in Europe. The 1% increase in the number of physicians causes 0.793% reduction in RTFs in America. The RTFs were increased by 0.617% and 1.705% for 1% rise in the number of vehicles in Asia and America. The fall in RTFs was 3.604%, 0.134%, and 0.950% for 1% rise in paved roads in Asia, Europe, and America, respectively. Results show a reduction of 0.744% (Asia), 0.712% (Europe), and 0.312% (America) in RTFs due to 1% increase in traffic law enforcement index. The governments of all countries should expand and improve their paved road network and increase the enforcement of traffic laws. The government should make strict traffic laws like regular inspection of vehicles, strict inspection for the driving license, electronic challan, and medical fitness of drivers. The government should ensure the medical checkup of drivers at subsidized rates. It is useful to include the traffic rules in the educational syllabus due to the significant role of law enforcement in road safety. The government should use different media channels for the awareness of the public about loss due to road accidents.

The Association Between Physical activity with Cognitive And Cardiovascular Deconditioning In Age Related Decline Of College Students.

OBJECTIVE: To determine the association between physical activity and cognition in age-related decline of college students and to find the correlation between physical activity with cardiovascular deconditioning. METHODS: The analytical cross-sectional study was conducted from January 1 to May 1, 2017, in different medical and engineering colleges of Rawalpindi and Islamabad in Pakistan.Data was collected through non-probability purposive sampling method. Demographic data was recorded and standardized assessment tools, including physical activity index and stroop colour word test for cognition, were used. Bivariate correlation analysis was used to determine association between different variables. RESULTS: Of the 702 subjects, 340(48.5%) were males and 362(51.7%) were females. The overall mean age was 21.84±1.73 years (range: 17-24 years), and mean body mass index was 22.12±3.6.Overall, 292 (41.8%) students were labelled as physically active and 410(58.8%) had sedentary lifestyle.Physical activity and cognition showed positive association (p=0.004) in students.Physically inactive participants showed cardiovascular and cognitive deconditioning with age (p = 0.68). CONCLUSIONS: Physical activity was found to be a key tool of cardiovascular health and cognition.It ameliorated overall health and brought better academic performance of students engaged in sports-related activities.

The dependency analysis between energy consumption, sanitation, forest area, financial development, and greenhouse gas: a continent-wise comparison of lower middle-income countries.

This study explored the long-run association among greenhouse gases (GHGs), financial development, forest area, improved sanitation, renewable energy, urbanization, and trade in 24 lower middle-income countries from Asia, Europe, Africa, and America (South and North) by using panel data from 1990 to 2015. Granger causality was tested by Toda and Yamamoto approach. The bi-directional causality was established among urbanization and GHGs (Asia), financial development and forest (Asia), energy use and renewable energy (Asia), renewable energy and forest (Asia), improved sanitation and forest (Asia, Africa, America), urbanization and forest (Asia), and improved sanitation and financial development (Europe). The GHG emission also shows one-way causality is running from financial development to GHG (America), energy to GHG (Asia), renewable energy to GHG (America), forest area to GHG (America), trade openness to GHG (Africa), urbanization to GHG (Europe), GHG to financial development (Europe), GHG to energy use (Europe, Africa, and America), and GHG to trade openness (Asia). On the basis of fully modified ordinary least square and generalized method of moment, the reciprocal relationship of GHGs was observed due to financial development in Asia and Africa; renewable energy in all panels; forest area in Asia, Europe, and America; improved sanitation in Asia, Africa, and America; trade openness in Africa; and urbanization in Europe and America. Policymakers should concentrate on these variables for the reduction in GHGs. The annual convergence towards long-run equilibrium was 50.5, 31.9, and 20.9% for America, Asia, and Africa, respectively.

General dependencies and causality analysis of road traffic fatalities in OECD countries.

The road traffic accidents were responsible for material and human loss which was equal to 2.8 to 5% of gross national product (GNP). However, literature does not explore the elasticity coefficients and nexus of road traffic fatalities with foreign direct investment, health expenditures, trade openness, mobile subscriptions, the number of researchers in R&D department, and environmental particulate matter. This study filled this research gap by exploring the nexus between road traffic fatalities, foreign direct investment, health expenditures, trade openness, mobile subscriptions, the number of researchers, and environmental particulate matter in Organization for Economic Cooperation and Development (OECD) countries by using panel data from 1995 to 2015. The panel Autoregressive Distributed Lag (ARDL) bound test was used for the detection of cointegration between the variables after checking the stationarity in selected variables with different panel unit root tests. Panel vector error correction model explored the causality of road traffic fatalities, foreign direct investment, PM2.5 in the environment, and trade openness in the long run. Road traffic fatalities showed short run bi-directional causality with foreign direct investment and health expenditures. The short run bi-directional causality was also observed between trade and foreign direct investment and cellular mobile subscriptions and foreign direct investment. The panel fully modified ordinary least square (FMOLS) and panel dynamic ordinary least square (DOLS) showed the 0.947% reduction in road fatalities for 1% increase in the health expenditures in OECD countries. The significant reduction in road fatalities was also observed due to 1% increase in trade openness and researchers in R&D, which implies the importance of trade and research for road safety. It is required to invest in the health sector for the safety of precious human lives like the hospitals with latest medical equipment and improvement in the emergency services in the country. The research and development activities should be enhanced especially for the health and transportation sectors. The trade of environment-friendly technology should be promoted for the protection of environment.