Search Results (36)

Background: In Pakistan, the number of Human immunodeficiency virus (HIV) cases is increasing significantly, attributed to risk factors such as injection drug use, sexual transmission, etc. However, transmission through hemodialysis units is not well documented. In 2024, an outbreak of HIV cases in Multan, Pakistan, drew alarm from local health authorities due to reports linking it to a large public hospital in South Punjab. Here, we report the molecular epidemiological investigation of the outbreak. Methods: Twenty-five hemodialysis patients identified during the outbreak were enrolled. Blood samples were subjected to DNA extraction and polymerase chain reaction (PCR) amplification. Phylogenetic analysis was conducted using the maximum-likelihood approach in IQ-TREE. For dating phylogenetics, a maximum clade credibility tree (MCC) was constructed using the BEAST tool. The MCC tree was constructed using the Bayesian Skyline model with an uncorrelated lognormal relaxed clock. The VESPA program was used to identify amino acid signatures unique to outbreak sequences compared with Pakistani reference sequences. Results: A total of 25 patients (identified as part of the HIV outbreak) were enrolled. 96% (24 out of 25) also tested positive for Hepatitis C, while none tested positive for Hepatitis B. The age range of patients in the study was 23 to 72 years (median age: 44.88 years). In terms of gender distribution, 13 out of 25 were male. All the sequences were identified as HIV subtype CRF02_AG. Phylogenetic analysis revealed that Multan sequences formed a well-supported monophyletic cluster, indicating shared recent origin. Signature pattern analysis identified a unique molecular fingerprint at 26 nucleotide positions, whereas molecular dating placed the emergence of the cluster between 2023 and 2024, consistent with the outbreak timing. Conclusions: Findings provide biologically plausible evidence of a point-source HIV outbreak linked to lapses in infection prevention and control practices at the hemodialysis unit. Full article

Beverages, particularly sugar-sweetened beverages (SSBs), pose a significant public health concern globally. Changing eating habits among Pakistani young adults have led to higher sugary drink consumption, underscoring the need for a suitable cultural assessment tool. A cross-sectional study was conducted among 381 university students aged 18–26 years from three major cities of Pakistan. Following World Health Organization (WHO) guidelines, the original Beverage Intake Questionnaire (BEVQ-15) was modified by removing four items (including alcoholic beverages), adding two culturally relevant types (flavored milk and refreshing drinks), and converting measurement units to milliliters, resulting in a 13-item Beverage Intake Questionnaire-Pakistan (BEVQ-PK). Validity was assessed by comparing BEVQ-PK1 (test) with three 24 h dietary recalls. Test–retest reliability was evaluated after a 14-day interval by comparing BEVQ-PK1 (test) and BEVQ-PK2 (retest). Analyses included descriptive statistics, paired sample t-tests, Intraclass Correlation Coefficients (ICC), Bland–Altman plots, and Spearman’s correlations. The BEVQ-PK (13-item) demonstrated moderate to strong validity (r = 0.2–0.8, p < 0.001) and strong reliability (r = 0.5–0.9, p < 0.001). Most beverage categories showed no significant intake differences between test and retest. Tea/coffee with milk was the most frequently consumed beverage, followed by soft drinks and green/black tea. Overall, BEVQ-PK is a valid and reliable tool for assessing SSB intake among Pakistani university students and can support future nutrition and public health research. Full article

To ensure reliable, efficient and sustainable operation of modern power networks, accurate load forecasting is an important task in system planning and control. It is also a crucial task for the efficient operation of smart grids to maintain a balance between load shifting, load management and power dispatch. In this regard, this research study aims to investigate the efficiency of various machine learning models for whole-house energy consumption prediction and appliance-level load disaggregation using Non-Intrusive Load Monitoring (NILM). The primary objective is to determine which model offers the most accurate forecasts for both individual appliance consumption patterns and the total amount of energy used by the household. The empirical study presents comparative performance analysis of machine learning models, i.e., Random Forest, Decision Tree, K-Nearest Neighbors (KNN), Extreme Gradient Boosting (XGBoost), Gradient Boosting and Support Vector Regressor (SVR) for load forecasting and load disaggregation. This research is conducted on PRECON: Pakistan Residential Electricity Dataset consisting of 42 Pakistani households. The dataset was recorded originally as one minute per sample, but the proposed study aggregated it to hourly samples to evaluate models’ alignment with the typical sampling rate of smart meters in Pakistan. It enables the models to more accurately depict implementation scenarios in real-world settings. The statistical measures MAE, MSE, RMSE and R² have been employed for performance evaluation. The proposed Random Forest algorithm out-performs all other employed models, with the lowest error values (MAE: 0.1316, MSE: 0.0367, RMSE: 0.1916) and the highest R² score of 0.9865. Furthermore, for detecting appliance events from aggregate power data, ensemble models such as Random Forest performed better than other models for ON/OFF prediction. To evaluate the suitability of machine learning models for real-time, appliance-level energy forecasting using Non-Intrusive Load Monitoring (NILM), this study presents a novel evaluation framework that combines learning speed and edge adaptability with conventional performance metrics (e.g., R², MAE). This paper introduces a NILM-based approach for load forecasting and appliance-level ON/OFF prediction, representing its capacity to improve residential energy efficiency and encourage sustainable energy consumption, while emphasizing operational metrics for implementation in embedded smart grid systems—an area mainly neglected in prior NILM-based research articles. The results provide useful information for improving demand-side energy management, facilitating more effective load disaggregation, and maximizing the energy efficiency and responsiveness of smart grids. Full article

Ethnic minority embroidery from Guizhou is an important part of Chinese culture, reflecting the history, beliefs, and artistic traditions of the region’s diverse ethnic groups. However, challenges in automatic recognition arise due to data scarcity, complex textures, and the flexibility of handmade designs. This study constructs the Guizhou Province Intangible Cultural Heritage Embroidery dataset and proposes an improved MobileViT-DDC model to address the issues of complex textures and data scarcity. The model integrates Dilatefomer, Deformable Dilatefomer (DefDilatefomer), and Context Broadcasting Module (CBM) to capture local details and global information in embroidery patterns. Experimental results show that the MobileViT-DDC model achieves an accuracy of 98.40% on the Guizhou embroidery dataset (a 2.17% improvement over the original baseline model) with a 14% reduction in computational load; on the Pakistani National Dress Dataset, it reaches an accuracy of 79.07%, representing a 2.63% increase compared to the original baseline model of the same scale. This study is the first to apply a CNN-ViT hybrid model to ethnic embroidery recognition, providing a new solution for the digital preservation of cultural heritage. The model’s cross-cultural adaptability was further validated through its application to the Pakistani National Dress dataset. Full article

Among begomovirus species, tomato leaf curl New Delhi virus (ToLCNDV) is significant and stands out as a mechanically transmissible bipartite begomovirus originating from the Old World. However, the mechanisms underlying the mechanical transmission of different ToLCNDV strains remain understudied, as their natural transmission occurs via insect vectors. In this study, we investigated the mechanical transmissibility of two ToLCNDVs, one from Italy and another from Pakistan, in host plants. Several cucurbit species were screened, and symptom differences between the two ToLCNDV clones were observed only in zucchini when subjected to rubbing inoculation. The Italian isolate (ToLCNDV-ES) induced typical disease symptoms such as leaf curling, yellow mosaic, and internode stunting, whereas a normal phenotype was observed in zucchini mechanically infected with ToLCNDV-In (Pakistani isolate). Subsequently, a gene-swapping experiment between the two ToLCNDVs was conducted, and ToLCNDV-ES DNA-B was identified as a crucial factor in mechanical transmission. We then constructed chimeric mutant clones based on the DNA-B sequence and assessed their ability to induce symptoms in zucchini. These results indicated that the nuclear shuttle protein is a determinant of symptom development during ToLCNDV mechanical transmission. Moreover, several defense-related host genes showed significant changes in relative expression in different ToLCNDV clones, indicating their potential role in disease symptom development through the mechanical transmission of ToLCNDV. This is the first report comparing the mechanical transmissibility of two isolates of different ToLCNDV strains from the Mediterranean region and the Indian subcontinent in the same host plant, providing new insights into the virus’s pathogenicity across different geographic regions. Full article

This paper analyses the socio-economic disadvantages of women from different ethnic minority heritages in the UK. Using data from the Labour Force Survey (2014–2023), which contains detailed information on parental class and respondents’ socio-economic conditions, we examine four domains of life chances which are crucial for ethnic integration: educational attainment at the degree level, risks of unemployment, access to professional-managerial (salariat) position and earning power. We proceeded with the gross differences and then examined the differences by ethno-gender status and parental class combinations, controlling for many confounding factors. We also examined the net ethno-gender differences over the life course and the trends of social fluidity over the period covered and across the ethno-gender groups. We found that women from all ethnic origins were doing well in education but faced multiple disadvantages in the labour market, especially in access to the salariat and in earning power. Women of Pakistani/Bangladeshi heritages faced pronounced unemployment risks, especially at the earlier life stages. There is a significant increase in fluidity over the period covered, but this is marked by considerable ethnic and class differences, with Black Caribbean, Black African, Pakistani and Bangladeshi women from more advantaged class origins being unable to secure advantaged class positions and those from working-class families unable to make long-range upward mobility as effectively as White men. Overall, Bangladeshi, Pakistani, Black African and Black Caribbean women are found to be considerably disadvantaged, but there are also signs of social progress. Full article

Chronic beryllium disease (CBD), or berylliosis, is an interstitial lung disease caused by the chronic inhalation of finely particulate beryllium, frequently mistaken for sarcoidosis. It is rarely associated with skin nodular lesions, asymptomatic granulomatous hepatitis or calcium nephrolithiasis. To date, it has never been reported as a diffused multi-organ granulomatous disease. A 60-year-old Pakistani man, a former excavation worker with ancient history of suspected sarcoidosis, underwent a left nephroureterectomy for suspected papillary kidney carcinoma. The histopathological analysis showed a benign non-necrotic granulomatous infiltration of the renal pelvis and ureter. Six months later, he suffered from two consecutive episodes of acute kidney failure. Bladder biopsies found similar noncaseous granulomatosis and kidney biopsies showed interstitial nephritis. Known for suspected asthma, sleep apnea, and usual interstitial pneumonia, the patient would regularly consult for episodes of pyrexia, chills, nocturnal coughing, and wheezing. As kidney function gradually worsened, he ultimately started hemodialysis and was transferred to our facility. A positive blood beryllium lymphocyte proliferation test confirmed the diagnosis of CBD. This original report is the first description of multi-organ berylliosis with diffused urothelial granulomatosis and pseudo-tumor. The patient’s pulmonary disease is minimal compared with renal and urinary tract involvement, eventually responsible for end-stage kidney disease. Berylliosis usually responds to glucocorticoids. This case report highlights the importance of evoking the diagnosis of CBD in the presence of any granulomatosis, even extra-thoracic, especially if associated with pulmonary symptoms, however atypical. Full article

Myogenic transcription factors with a basic helix–loop–helix (bHLH) such as MYOD, myogenin, MRF4, and MYF5 contribute to muscle differentiation and regulation. The MYF5 gene located on chromosome 12 encodes for myogenic factor 5 (MYF5), which has a role in skeletal and extraocular muscle development and rib formation. Variants in MYF5 were found to cause external ophthalmoplegia with rib and vertebral anomalies (EORVA), a rare recessive condition. To date, three homozygous variants in MYF5 have been reported to cause EORVA in six members of four unrelated families. Here, we present a novel homozygous MYF5 frameshift variant, c.596dupA p. (Asn199Lysfs*49), causing premature protein termination and presenting with external ophthalmoplegia, ptosis, and scoliosis in three siblings from a consanguineous family of Pakistani origin. With four MYF5 variants now discovered, genetic testing and paediatric assessment for extra-ocular features should be considered in all cases of congenital ophthalmoplegia. Full article

The aim of this project was to explore the understanding and awareness of dementia in the Pakistani-origin community in a deprived urban region of the UK. The study was unique in accessing and interviewing Pothwari speakers, some of whom could not read or understand spoken English. Data generated from an earlier study were used to construct five scenarios, which were used as the basis for face-to-face semi-structured interviews with 11 male and female participants from the Pakistani-origin community spanning two generations. Braun and Clarke’s six phases of thematic analysis were used to analyse the data to answer the research questions. Themes constructed from these interviews indicated a lack of awareness and understanding of dementia, a range of attitudes and assumptions, reluctance to seek external support, and a significant role for the cultural background in shaping the individuals’ responses. The study found that poor understanding, cultural differences, and language issues presented barriers to accessing services in the British Pakistani community, particularly among those who had been born in Pakistan and/or spoke Pothwari in preference to English. Services and information may need to be offered by Pothwari speakers in order to reach this neglected sector of the population. Full article

Demantoid is the green variety of andradite [Ca₃Fe₂(SiO₄)₃], an exceptionally rare and precious gemstone worldwide. In recent years, a small amount of gem-quality demantoid has been found in Pakistan. This research focuses on nine demantoids sourced from Muslim Bagh, Baluchistan, Pakistan, presenting a comprehensive analysis of the spectral characteristics and inclusions of Pakistani demantoid using classical gemological methods, energy dispersive X-ray fluorescence (EDXRF) chemical analyses, Fourier transform infrared (FTIR) spectroscopy, Raman spectroscopy, and ultraviolet and visible (UV-vis) spectroscopy. The results show that the content of Cr and V in most samples is lower than the detection line of EDXRF, with only one sample containing a Cr₂O₃ content of 0.032%. The extremely low Cr content sets Pakistani demantoid apart from demantoid of the serpentinite type found in other regions. Notably, the UV-vis spectrum reveals characteristic absorption at 443 nm due to Fe³⁺, while a further contribution from Cr³⁺ would be highly likely, and weak absorption at 550 nm caused by Fe³⁺. This suggests that iron (Fe) is the primary chromogenic element of Pakistani demantoid, but the role of Cr³⁺ cannot be ignored. The FTIR spectrum of Pakistani demantoid displays the absorption peaks associated with [SiO₄]⁴⁻ groups at 937 cm⁻¹, 848 cm⁻¹, and 817 cm⁻¹, while the absorption peaks resulting from trivalent cations appear at 481 cm⁻¹ and 442 cm⁻¹, which are the characteristic FTIR spectra of demantoid. Raman spectroscopy further reveals absorption peaks are displayed near 994 cm⁻¹, 843 cm⁻¹, 818 cm⁻¹, associated with (Si–O)_Str vibrations (Si–O stretching vibration), and absorption peaks are displayed near 350 cm⁻¹ and 310 cm⁻¹, related to the rotation of SiO₄–R(SiO₄)⁴⁻, and the peaks near 514 cm⁻¹ and 494 cm⁻¹ are related to (Si–O)_bend vibrations (Si–O bending vibration). Additionally, related absorption peaks near 168 cm⁻¹ are attributed to the translation of SiO₄–T(SiO₄)⁴⁻, and absorption peaks near 234 cm⁻¹ are associated with the translation of X²⁺–T(X²⁺) (X²⁺ represents divalent ions). The common dark opaque inclusions found in Pakistani demantoid consist of a combination of magnetite and hematite. Additionally, some samples of Pakistani demantoid display inclusions of calcite. This unique combination of inclusions differentiates Pakistani demantoid from demantoids sourced from other regions. It signifies that Pakistani demantoid has a distinctive geological origin resulting from the interplay of serpentinization and skarnization processes. This geological formation distinguishes it from demantoids solely hosted in serpentinite or skarn environments in other origins. The identification of these characteristics holds significant importance for accurately determining the origin of Pakistani demantoid. Full article

This study explored the relationship between Perceived Stress and Religious Coping levels among Muslim emerging adults of Pakistani origin living in Pakistan and Muslim emerging adults of Pakistani origin living in the United States (US). Participants (Pakistani Origin Muslims Living in Pakistan, n = 103; and Pakistani Origin Muslims Living in the US, n = 50) were between 18–25 years old. The Perceived Stress Scale (PSS-10) and Brief R-Cope scale were administered using an online format. Results indicated that negative religious coping strategies were associated with higher perceived stress in both groups while positive religious coping strategies showed a weaker association with lower perceived stress levels, and this finding appeared only in the US sample. Marital status was also an important predictor of perceived stress. These findings demonstrate that Muslim emerging adults, irrespective of culture, show moderately similar patterns in their perception of stress and their utilization of religious coping strategies. Full article

This qualitative study explored the commonalities and differences among the experiences of visible minority Transnational Carer–Employees (TCEs) before and after COVID-19. TCEs are immigrants who live and work in the country of settlement while providing caregiving across international borders. Purposive and snowball sampling resulted in the participation of 29 TCEs of Pakistani, Syrian, African, and South American origin living in London, Ontario. Thematic analysis of the dataset using the ATLAS.ti software, Version 23.2.1., generated three themes: (1) feelings associated with transnational care; (2) employment experiences of TCEs; and (3) coping strategies for well-being. The results of the secondary analysis conducted herein suggested that there are more similarities than differences across the four cohorts. Many participants felt a sense of satisfaction at being able to fulfill their care obligations; however, a different outlook was observed among some Syrian and African origin respondents, who disclosed that managing care and work is overwhelming. Most TCEs also reported facing limited job options because of language barriers. While various interviewees experienced a lack of paid work and reduced income after COVID-19, a distinct perspective was noted from African descent TCEs as they expressed facing increased work demands after the pandemic. Participants additionally revealed four common coping strategies such as keeping busy, praying, family support, and staying active. Study implications include the promotion of Carer-Friendly Workplace Policies (CFWPs) that can facilitate the welfare of unpaid caregivers. This research is important as it may inform policymakers to create opportunities that may not only foster economic stability of TCEs and the Canadian economy, but also contribute towards a more equitable society. Full article

Background: Evidence has shown the positive impact of pharmacist involvement on the adherence and health outcomes of people living with HIV/AIDS. However, whether such intervention provides value for money remains unclear. This study aims to fill this gap by assessing the cost–effectiveness of pharmacist interventions in HIV care in Pakistan. Methods: A Markov decision analytic model was constructed, considering clinical inputs, utility data, and cost data obtained from a randomized controlled trial and an HIV cohort of Pakistani origin. The analysis was conducted from a healthcare perspective, and the incremental cost–effectiveness ratio (ICER) was calculated and presented for the year 2023. Additionally, a series of sensitivity analyses were performed to assess the robustness of the results. Results: Pharmacist intervention resulted in higher quality-adjusted life years (4.05 vs. 2.93) and likewise higher annual intervention costs than usual care (1979 USD vs. 429 USD) (532,894 PKR vs. 115,518 PKR). This yielded the ICER of 1383 USD/quality-adjusted life years (QALY) (372,406 PKR/QALY), which is well below the willingness-to-pay threshold of 1658 USD (446,456 PKR/QALY) recommended by the World Health Organization Choosing Interventions that are Cost-Effective. Probabilistic sensitivity analysis reported that more than 68% of iterations were below the lower limit of threshold. Sensitivity analysis reported intervention cost is the most important parameter influencing the ICER the most. Conclusion: The study suggests that involving pharmacists in HIV care could be a cost-effective approach. These findings could help shape healthcare policies and plans, possibly making pharmacist interventions a regular part of care for people with HIV in Pakistan. Full article

This article explores the contribution of modern Muslim revivalism to Muslims’ political decolonization, and the paradoxical role the West plays in that process. On the one hand, revivalism rejects the founding principles of liberal political theory, and on the other hand, it readily adopts the salient structures and mechanisms of the modern polity with a view to Islamize them, all the while insisting on the Muslims’ need to de-Westernize. Toward revealing the hitherto neglected dimensions of revivalism, my analysis adopts an unconventional route by subjecting revivalism to a semiotic analysis in conversation with the archetypal theories of Mircea Eliade and Carl G. Jung. The analysis unveils the universal psychological structures of revival, and their specific Muslim symbolization. I conclude (a) that depth psychology makes modern Muslim revival inevitable, which will only grow stronger and gain wider appeal while the Muslims continue to suffer decline; (b) that among the different forms of Muslim revival, revivalism ventures the farthest in decolonizing Muslim political imagination; (c) that the revivalist imagination makes their espoused caliphate imperative for the purpose of ritual participation in Islam’s sacred origins; and (d) that a critical reconstruction and evolution of revivalism holds out the promise of a greater contribution to Muslim decolonization. For my analysis, I largely turn to the Pakistani political theologian Israr Ahmad (d. 2010), whose ideas have been disseminated widely across the Muslim world, yet who has not received the requisite academic scrutiny. Moreover, intra-revivalist critique of revivalism has been a neglected aspect in the study of revival, and its careful scrutiny should become a topic of investigation in its own right. In that regard, Ahmad offers a most important critique of earlier revival efforts and their entanglement with certain aspects of coloniality. Full article

Snakebite envenoming is a neglected tropical disease prevalent in South Asia. In Pakistan, antivenoms are commonly imported from India despite the controversy over their effectiveness. To solve the problem, the locals have developed the Pakistani Viper Antivenom (PVAV), raised against Sochurek’s Saw-scaled Viper (Echis carinatus sochureki) and Russell’s Viper (Daboia russelii) of Pakistani origin. This study is set to evaluate the composition purity, immuno-specificity and neutralization efficacy of PVAV. Chromatographic and electrophoretic profiling coupled with proteomic mass spectrometry analysis showed PVAV containing high-purity immunoglobulin G with minimum impurities, notably the absence of serum albumin. PVAV is highly immuno-specific toward the venoms of the two vipers and Echis carinatus multisquamatus, which are indigenous to Pakistan. Its immunoreactivity, however, reduces toward the venoms of other Echis carinatus subspecies and D. russelii from South India as well as Sri Lanka. Meanwhile, its non-specific binding activities for the venoms of Hump-nosed Pit Vipers, Indian Cobras and kraits were extremely low. In the neutralization study, PVAV effectively mitigated the hemotoxic and lethal effects of the Pakistani viper venoms, tested in vitro and in vivo. Together, the findings suggest the potential utility of PVAV as a new domestic antivenom for the treatment of viperid envenoming in Pakistan. Full article