A document by Qiaozhi Zhang. Click on the document to view its contents.

Hereditary angioedema (HAE) is a relatively uncommon condition, affecting estimated 1 in 50,000 people and presents with potentially life threatening angioedema involving mucosal and/or cutaneous surfaces [1-3]. We describe a case of a newly identified a likely pathogenic heterozygous variant of Leu197Pro Serping 1 of the SERPING1 gene associated with hereditary angioedema in an Italian family based in Australia.

The prevalence of sophisticated ransomware attacks targeting critical infrastructure, financial systems, and government networks demands detection methodologies capable of adapting to an evolving threat landscape. Autonomous Patternbased Signature Extraction (APSE), a novel ransomware detection framework, introduces an innovative approach to threat detection through autonomous signature generation and multi-level pattern recognition, advancing beyond conventional signature and heuristic-based techniques. APSE operates independently, leveraging unsupervised learning algorithms to analyze and classify ransomware behavior in real-time, generating dynamic and highly specific signatures without reliance on manual updates. Through extensive evaluation, APSE demonstrated high accuracy in detecting known and zero-day ransomware variants, outperforming traditional methods by effectively minimizing false positives and false negatives. Efficiency testing further revealed APSE's ability to operate within resource-constrained environments, optimizing memory and processing requirements without compromising detection rates. The system's modular design enhances scalability across diverse network architectures, making it suitable for integration within large-scale, automated cybersecurity infrastructures. By advancing the field of autonomous threat detection, APSE establishes a new standard in proactive ransomware mitigation, promising heightened resilience and security across critical domains vulnerable to ransomware attacks.

Note: One of the issues that has not yet been well resolved in nanotechnology  is how to  establish electrical communication between nanoelectronic devices and the macroscopic world without  losing the capabilities of these nanoelements. One of these new areas and functions of nanotechnology is nanoantennas  , which are used  in various fields such as nanosensors, communication nanonetworks  , electrical energy generation and other similar topics and are considered as one of the current areas of nanotechnology development.  At the nanoscale, graphene-based antennas  are used to transmit EM waves. Graphene is a very thin single-atom sheet  of confined carbon atoms placed on a crystal lattice  . Given the very small dimensions of nanosensors, nanoantennas  need to have a very high operating frequency to be usable. However, the use of  graphene helps to solve this problem to a large extent. The nanonetwork has greater communication and processing potential that overcomes the limitations of independent nanodevices through the cooperation of nanodevices.

Background: Actinomycosis is a rare, chronic granulomatous infection caused by Actinomyces species, often affecting the cervicofacial region, particularly the submandibular gland.Case Presentation: We report a unique case of actinomycosis in a 47-year-old male with a history of recurrent sialolithiasis. The patient presented with swelling, tenderness, and discharge from the submandibular region. Despite prior surgical interventions and antibiotic treatments, symptoms persisted, leading to a thorough evaluation. Imaging studies indicated significant sialolithiasis. A biopsy of the affected gland revealed actinomycotic granulomas, confirming the diagnosis.Management: The patient was treated with prolonged high-dose penicillin therapy and underwent surgical resection of the affected gland.Conclusion: This case underscores the importance of considering actinomycosis in differential diagnoses of chronic submandibular infections, especially in patients with recurrent sialolithiasis. Early recognition and appropriate management, including long-term antibiotic therapy and surgical intervention, are crucial for effective treatment.

This article develops a duality principle applicable to some originally non-convex primal variational formulations. More specifically, in a first step, we develop applications to a Ginzburg-Landau type equation. The results are obtained through basic tools of functional analysis, calculus of variations, duality and optimization theory in infinite dimensional spaces. It is worth emphasizing we have obtained a convex dual variational formulation which may be applied to a large class of similar models in the calculus of variations. Finally, in the last sections we present a numerical example and related software.

The mechanisms of action of probiotics at the molecular level remain an active subject of discussion and study. It is evident that the bioactive metabolites of probiotic strains exhibit not only antimicrobial and antifungal properties but also more subtle regulatory effects. Of particular interest are the anticancer effects of probiotics, with increasing data accumulating in recent years regarding this area. In this study, we have investigated one such potential mechanism. Bioactive peptides are characteristic of Bacillus strains, known for their probiotic capabilities in veterinary medicine and aquaculture, and were tested for their ability to interact with several key eukaryotic proteins involved in important intracellular signalling pathways. Short peptides such as bacillomycin, fengycin, and others obtained from Bacillus were selected for docking with the targets NOX4, EGFR, PDGFR, and OCTN2. Iturin D showed high binding energy values with NOX4 and PDGFR (−17.996 and −21.11 kcal/mol respectively), while fengycin showed even higher free binding energy with these receptors (−28.21 and −24.51 kcal/mol respectively), indicating its potential binding capability with these key receptors. Furthermore, fengycin was ranked second in binding energy with EGFR and OCTN2 (−21.97 and −24.35 kcal/mol respectively), and plipastatin showed the best results with EGFR (−21.34 kcal/mol) and was second-ranked with NOX4 and OCTN2 (−23.20 and −28.95 kcal/mol respectively).Overall, plipastatin and fengycin exhibited significant activity in binding with all receptors, making them promising candidates for further research as modulators of these receptors.

Malaria remains a significant global health problem, mainly due to Plasmodium falciparum, which is responsible for most fatal infections. Infected red blood cells (iRBCs) evade spleen clearance by adhering to endothelial cells (ECs), triggering capillary blockage, inflammation, endothelial dysfunction and altered vascular permeability, prompting an endothelial transcriptional response. The iRBC IT4var04/HBEC-5i model, where iRBCs present IT4var04 (VAR2CSA) on their surface, was used to analyse the effects of iRBC binding on ECs at different temperature (37°C vs. 40°C). Binding of non-infected RBCs (niRBCs) and fever alone altered the expression of hundreds of genes in ECs. Comparing the expression profile of HBEC-5i cells cultured either in the presence of iRBCs or in the presence of niRBCs revealed significant upregulation of genes linked to immune response, nucleosome assembly, NF-kappa B signaling, angiogenesis, and antiviral immune response/interferon-alpha/beta signaling. Raising the temperature to 40°C, simulating fever, led to further upregulation of many genes, particularly those involved in cytokine production and angiogenesis. In summary, the presence of iRBCs stimulates ECs, activating several immunological pathways and affecting antiviral (-parasitic) mechanisms and angiogenesis. Our data uncovered the induction of the interferon-alpha/beta signaling pathway in ECs in response to iRBCs.

River networks are the major pathways for microplastic (MP) transport from terrestrial environments to oceans. It is essential to understand where MPs reside and how they move along river networks because of their potential to negatively impact ecosystems. However, the ability to quantify the water-sediment exchange of MPs, locations of deposition, and the time scales over which burial occurs is limited. To fill this gap, previous work on processes that control MP deposition are briefly reviewed in this Perspective paper, with the aim of enhancing our understanding of the dynamic interplay between flow, sediment transport, and MP movement through river networks. Detailed studies on MP deposition onto surficial sediment show that MP transport can be explained by the shear stress theory, hyporheic exchange, and bioturbation. Nevertheless, these processes cannot fully explain the observed distribution of MPs in deeper river sediments. It is proposed that bedform movement, channel reworking, bar formation, and aggradation/degradation at the river network scale should be included when estimating MP deposition. It is argued that incorporating data on MP distribution in riverbeds with fluvial geomorphological and particle transport models will improve the current evaluation of MP transport in river networks and their burial residence time distribution.

Note: Due to the specific surface area and high surface energy, the coating or stabilizing agent of the produced nanoparticles stick together and form a mass. This phenomenon leads to the loss of properties resulting from the small size of these particles.To prevent the accumulation of nanoparticles in the synthesis stage, stabilizers are used. Usually, two types of electrostatic and spatial drift methods are used to stabilize nanoparticles. In this model, two methods of stabilizing particles are used. In the first method,  ions are used to stabilize nanoparticles. These ions are absorbed into the particles and form an electrically charged layer around the nanoparticles, and as a result, the Raman covalent drift becomes from the accumulation of particles. In the second method, macromolecules are used to stabilize nanoparticles. Macromolecules stick to the surface of the particles and occupy the space around the nanoparticle. As the particles get closer to each other, these molecules become entangled and become Raman from the particles sticking together. It is from the interactions between nano layers and fat as a function of nanoparticle structure, morphology and surface electrochemistry.  This broad target consists of a number of nanomolecules obtained from coarse-grained molecular simulations. 

Note: Lithium with the chemical symbol Li is a silver-white and soft alkaline metal with an atomic number of 3. This element is the lightest metal and the least dense solid element under standard conditions of temperature and pressure. Like other alkali metals, lithium is very reactive and flammable, that's why most of them keep it under industrial oil or petroleum. If there is a cut on it, the cut part will have a metallic polish, but due to its high reactivity, it reacts very quickly with the moisture in the air, the air causes it to corrode, and it turns into a dark grayish silver color and then black. comes

Numerous researchers are extremely concerned about the depletion of mineral oil caused by the decades-long production of commercial products such as grease. The issue may be resolved through the utilisation of waste cooking oil (WCO). Many individuals, due to a lack of environmental consciousness, inadequately dispose of the WCO that are the by-products of consuming fresh vegetable oil (VO). As a result, the objective of this research was to develop a grease made from WCO by employing a range of different amounts of sodium soap thickener (SST). At the beginning, SST was generated via a saponification process involving stearic acid and sodium hydroxide. The lubricant formulation immediately started with the treatment of WCO in order to remove any impurities present in the used oil. After that, the greases were made using a weight percentage ratio that included additives. They were then tested for dropping point value, oil bleeding value, oil separation value, consistency value, and rusting ability to find out what the grease is made of. In spite of this, the research findings indicate that every lubricant possesses an acceptable dropping point value, an NLGI value of 00-4, oil bleeding values ranging from -15% to 15% (SG40 being the exception), oil separation values falling below 4%, and corrosion test results classified within the mildly tarnish category. Nonetheless, SG60 was selected as the optimal lubricant due to the fact that it satisfies every one of the required criteria, rendering it the most refined option. This study indicates that WCO can be utilised as the base oil for greases on account of their satisfactory performance.

Background Co-infections in COVID-19 patients can worsen disease severity by enhancing SARS-CoV-2 replication and pro-inflammatory cytokine levels. This study analyzes the characteristics of co-infected COVID-19 patients across the pandemic and their association with in-hospital mortality. Methods We retrospectively examined data from 351 COVID-19 patients hospitalized in a Spanish secondary Hospital between March 2020 and February-March 2021. Nasopharyngeal swabs from 340 patients were analyzed using multiplex RT-PCR to identify 26 respiratory pathogens. Results 136 patients were co-infected with 191 bacteria (100 gram-negative, 91 gram-positive), 20 viruses, 18 fungi, and one protist. In 2021, empirical cephalosporin use increased (p=0.009). The incidence of enterococcal co-infections tripled from 2020 to 2021(p<0.001). In 2021, a greater proportion experienced urine(p=0.001) and bloodstream(p=0.010) co-infections. In 2020, there was one bloodstream infection, while in 2021 there were seven, half of them fatal. Co-infected patients experienced longer hospital stays and higher odds of long-COVID (p<0.001; p=0.014; p=0.045). Non-respiratory co-infections in 2021 correlated with increased mortality (p=0.002). Antimicrobial resistance remained stable (p=0.149). Conclusions Rise in cephalosporin use correlated with increased Enterococcus infections, notably bloodstream infections, linked to mortality (p=0.016). Nearly 70% of deceased patients in 2021 had co-infections which were associated with extended hospital stays and higher mortality risk.

Translation of video content into many languages is effectively and accurately feasible with existing solutions but still poses a great challenge. This work outlines a sophisticated advanced system that satisfies quality and accessibility improvements in multilingual video translation. The proposed method includes extracting audio from video, transcribing the audio using an innovative speech recognition model, and then translating the transcribed text into various languages. Using Google’s translation API, and then converting the translated text into speech with Google’s Text-to-Speech library—all in complete synchrony with the original video. The BhashaBlend model achieved a strong word error rate of 12.4%, significantly better than many of the major ASR systems: Google at 15.82%, and Microsoft at 16.51%. The model’s performance was powerful on languages with the simplest phonetic realization, such as for example, German, English, and Spanish, which proves its dependability also to deliver multilingual transcription and dubbing. This highlights the potential of the model to produce results where excessive lingual complexity is involved and points towards the high applicability scope of BhashaBlend in language-polyvalent applications.

TO THE EDITOR:We have recently had the privilege of reading the article by Zhang et al. (1) who provided significant insights into how the SARS-CoV-2 infection affected the occurrence of mental disorders in children and adolescents. The number of accumulative COVID-19 cases reported to WHO was 776 million until September 2024, while that of the deaths was 7.1 million. (2) These figures demonstrate that SARS-CoV-2 has notably influenced people’s lives globally, research of which has blossomed afterward. The results in this article indicate that SARS-CoV-2 infection can potentially risk both children’s and teenagers’ mentality. In order to promote further research on similar topics, we would like to underline some limitations of the experiment design observed in this article, as well as some vague definitions used in this article.  As for the propensity score matching, we found that though the study took age, sex, social and health factors, etc., into account, it failed to consider the impact of comorbidities. Comorbidities might affect mental health as well in different aspects, while it may make the patients more vulnerable to infectious diseases, including SARS-CoV-2. For instance, we have read another article about the relationship between childhood-onset immune-mediated diseases, especially pediatric inflammatory bowel disease, and mental illness. It concludes that specific diseases might be associated with psychiatric disorders, anxiety, mood disorders, and suicide attempts, for instance. (3)  Simultaneously, the use of immunosuppressive medications and immune response dysregulated by the diseases themselves might make patients more susceptible to infection. Therefore, we argue that comorbidities could be a confounding factor in this study. Surveillance bias might exist in this study, precisely because psychiatric and psychological disorders are inherently prone to being underdiagnosed. Though the authors had taken ADHD into account, the diagnostic rate of other diseases mentioned in the article might also be affected when comparing patients with SARS-CoV-2 infection or other respiratory infections with those without infection. For instance, an article discusses the underdiagnosis of sleep disorders and the relationship between sleep disorders and suicidal ideation and suicide attempts. (4) Among those patients in that study, only 0.32% possessed any diagnosis of sleep disturbance while other surveys mentioned in that article reported that the point prevalence of insomnia was 9.4%. The underdiagnosed mental disorders might be more probable to be detected if the patients need to undergo other examinations, and the infectious disease might increase the opportunities for them to seek health services, which might increase the diagnostic rate.  In terms of the definition of the “diagnosed COVID-19” cohort and “SARS-CoV-2 test–positive” cohort, the authors defined the former according to International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) U07.1 or U07.2 and the diagnostic code for pneumonia due to COVID-19, J12.82. Nonetheless, we found the definitions of U07.1 and U07.2 on the WHO website, which means COVID-19, virus identified, and COVID-19, virus not identified, respectively. (5) As for the later cohort, the authors defined it as patients with any positive laboratory test result for SARS-CoV-2 but without the diagnostic codes used in the “diagnosed COVID-19” cohort. We found it confusing when the authors assumed patients in the “diagnosed COVID-19” cohort might be more serious than those in the “SARS-CoV-2 test–positive” cohort since the authors did not explain the “diagnostic criteria” mentioned in the article, and those in “SARS-CoV-2 test–positive” cohort might meet the diagnostic criteria as those in “diagnosed COVID-19” cohort. Furthermore, in Taiwan, for example, the diagnostic criteria have been changed in accordance with the severity and prevalence of the epidemic. This might make the boundary between groups ambiguous, which can affect the results of the study. In conclusion, the aforementioned factors, including comorbidities, surveillance bias, and disease definition might affect the outcome of the study. Reference:1.        Zhang-James, Y., Clay, J. W. S., Aber, R. B., Gamble, H. M., & Faraone, S. V. (2024). Post-COVID-19 Mental Health Distress in 13 Million Youth: A Retrospective Cohort Study of Electronic Health Records. Journal of the American Academy of Child and Adolescent Psychiatry, S0890-8567(24)00263-6. Advance online publication. https://doi.org/10.1016/j.jaac.2024.03.0232.        World Health Organization. (n.d.). COVID-19 deaths dashboard. Retrieved October 8, 2024, from https://data.who.int/dashboards/covid19/deaths?n=o3.        Jansson, S., Malham, M., Wewer, V., & Rask, C. U. (2022). Psychiatric comorbidity in childhood onset immune-mediated diseases-A systematic review and meta-analysis. Acta paediatrica (Oslo, Norway : 1992), 111(3), 490–499. https://doi.org/10.1111/apa.162464.        Carbone, J. T., & Casement, M. D. (2023). Sleep disorders and relative risk of suicidal ideation and suicide attempts in youth presenting to emergency departments. Sleep health, 9(4), 537–543. https://doi.org/10.1016/j.sleh.2023.05.0145.        World Health Organization. (n.d.). Emergency use ICD codes for COVID-19 disease outbreak. https://www.who.int/standards/classifications/classification-of-diseases/emergency-use-icd-codes-for-covid-19-disease-outbreak

BACKGROUND: Chronic myeloid leukemia (CML) is a rare disease in children, distinct from its adult counterpart in terms of presentation and management. This study aims to evaluate the clinical characteristics and treatment outcomes of pediatric CML patients treated at the National Bank of Kuwait (NBK) Children Specialty Hospital in Kuwait over a decade. METHODS: A retrospective review was conducted on the medical records of children diagnosed with CML between 2010 and 2020. Data on patient demographics, clinical presentation, treatment regimens, and outcomes were collected and analyzed. RESULTS: All patients presented with leukocytosis and most had splenomegaly. Imatinib, a first-line tyrosine kinase inhibitor (TKI), achieved a good response rate, with none of the patients requiring bone marrow transplantation. Despite some patients required dose adjustments or second-line TKIs due to complications or loss of response, the overall outcomes were positive, reinforcing the efficacy of TKIs in pediatric CML. CONCLUSION: This study highlights the distinct clinical presentation and response to TKI therapy in children with CML, compared to adults. The rarity of pediatric CML presents challenges in understanding disease characteristics and optimizing treatment approaches. Further research is needed to determine optimal treatment duration for this population.

As biodiversity is declining, the dynamics of species interactions is a growing conservation concern. However, estimating and monitoring species interactions across large spatial and temporal scales remain challenging, and thus changes in species interactions and the subsequent networks of interactions remain relatively unexplored. Here, we assess changes in the network structure of common bird communities from France. We estimate associated species pairs using spatial and temporal information for 109 species monitored across 1,969 sites during 17 years. We validate the ecological significance of associated species pairs by testing the relationship between the propensity to be associated and species functional proximity or shared habitat preference. We reconstruct association networks for these intra-guild bird communities and track temporal changes in network layout in terms of size, density of links, modularity and degree distribution. We show that, beyond species change, birds' local association networks become smaller with a similar relative number of associations that becomes unevenly distributed. These structural changes vary among types of bird communities and may impact community functioning and how communities can cope with global change.

Molluscs, characterised by various shapes and sizes, represent the most diverse group of animals after arthropods. This morphological disparity has historically complicated the establishment of phylogenetic relationships among the different classes of molluscs and subclasses of gastropods and their positions within the lophotrochozoans. In recent decades, ultraconserved elements (UCEs) have emerged as an effective technique for capturing large numbers of genes from preserved museum specimens across various animal groups. This study evaluates the efficiency of UCE capture across all classes of molluscs using a probe set designed for heterobranch gastropods. We analysed the effects of missing data using three levels of the GBLOCKS masker, ZORRO, and by generating various occupancy matrices. Our analyses successfully captured 2,119 out of 2,259 possible UCEs, recovering many genes from all molluscan classes and gastropod subclasses (144–1,604). As expected, efficiency decreases in groups more distantly related to gastropods, particularly heterobranchs. The more stringent maskers recovered shorter sequences with less missing data, yet fewer informative sites. Thus, our primary analyses focused on the use of more relaxed masking settings and the 50% occupancy matrix. These analyses resolved the well-established Conchifera and Aculifera hypothesis and further recovered a close relationship between Bivalvia and Scaphopoda (Diasoma). Moreover, with a wider taxon sampling, the interrelationships within, e.g., Gastropoda and Solenogastres are well resolved, highlighting the true universality of the probe set and encouraging its use for future research on any mollusc class.

Coevolution in trophic interactions is often considered as a major factor underlying diversification in both interacting species. Empirical examples of tight cospeciation are however rare. We argue that this lack of examples may reflect reality, and one reason is that speciation through bottom-up and top-down processes are not symmetric, partly because enemies are able to select the best host whereas hosts are not able to choose their enemies. In the paper, we discuss how the oscillation hypothesis through network rewiring and geographic range shifts have different consequences for the two interacting partners, leading up to differences in their capacity for local adaptations. We also argue that these processes have been poorly explored in theoretical models that focus mainly on the gene dynamics and then overlook trait asymmetries.

Youth Entrepreneurship in South Asia: Structural Constraints and Strategic Pathways in Pakistan and Sri Lanka Abstract This paper offers a critical review of the attitudes to youth entrepreneurship in Pakistan and Sri Lanka, two youthful countries that are continuing to experience systemic economic uncertainty and structural unemployment. The paper discusses both the enabling conditions and the barriers to youth entrepreneurship experiences, which include limited access to capital, gaps in entrepreneurship education, and socio-cultural barriers. The review encompasses policy documents, analysis of institutions, and a review of digital and occupational ecosystems to assess the effectiveness of government policy and identify gaps in support systems. The conclusion offers a number of policy-oriented conclusions about the role of youth entrepreneurship as one means of promoting inclusive economic growth and democratic resilience in South Asia. Introduction South Asia has one of the youngest populations on the planet, with a median age below 30 in most constituent nations. For this reason, youth entrepreneurship represents a potentially powerful lever to combat mass unemployment, stimulate innovation and growth, and achieve sustainable development. Pakistan and Sri Lanka are particularly informative but distinct cases within this regional context. They share socio-economic challenges, including high youth unemployment rates, disparities between urban and rural, and weak welfare systems. At the same time, they have traveled along distinctive pathways with respect to policy frameworks, technology adoption, and support systems for entrepreneurs.While some positive steps have been made, young entrepreneurs in Pakistan and Sri Lanka face major obstacles, including structural barriers to credit, little to no access to supportive entrepreneurial ecosystems, and cultural values that valorize stability over risk-taking. This paper employs a comparative, policy-oriented framework in order to examine how policy-making, technology development, and education either facilitate or hinder youth entrepreneurship. Ultimately, this will contribute to more coherent approaches to unleash youth potential across South Asia. Youth Entrepreneurship in Pakistan and Sri Lanka: Policy Ambitions and Structural LimitationsPakistanIn the last few years, Pakistan has introduced a number of national programs to try to stimulate youth entrepreneurship, namely the National Youth Development Framework and the Kamyab Jawan Program, that provide financial assistance, training programs and mentorship programs to young entrepreneurs all across the country. However, the problem remains largely in implementation as bureaucracy is inefficient, there is a continuous lack of venture capital, and society has a deep-rooted bias against bold entrepreneurial risk taking -- especially women and rural youth (Ali, 2020).Also, the finance ecosystem is still controlled by risk-averse banks that expect to negotiate collateral that most young aspiring entrepreneurs can never afford. The absence of investment networks focused on youth also limits greater innovation. So while there is policy speak in place, it is simply not empowered out-of-action in respect of youth entrepreneurship, largely due to systemic constraints in terms of regulation and finance.Sri LankaLike Pakistan, Sri Lanka has attempted to institutionalize youth entrepreneurship through organizations such as the National Enterprise Development Authority (NEDA) and the Small and Medium Enterprise Development Program. These organizations have provided credit facilities, business development training, and incubation services. Nevertheless, Sri Lanka has significant underdevelopment of digital infrastructure to address entrepreneurial transition to the digital economy, especially in areas outside urban centers (Perera, 2019).Bureaucratic resistance and educational failures constrain youth innovation. For example, entrepreneurship is rarely incorporated into the mainstream education system, mentor networks are often disjointed and poorly funded, and young people often lack accessibility to entrepreneurship as a gendered social or class-based exclusion, and in the case of conflict-affected districts, layer a challenging context to greater inequalities or exclusions. Youth Entrepreneurial Opportunities: Institutional, Technological, and Educational Dimensions1. Governmental Interventions and Policy InstrumentsPakistan and Sri Lanka have both taken steps to create institutional policy frameworks for youth entrepreneurship. Pakistan’s Prime Minister’s Youth Business Loan Scheme (2021) and Kamyab Jawan; provide subsidized loans and entrepreneurial training but have very little reach to rural areas and post-loan institution supports are lackluster. Furthermore, same as Pakistan, Sri Lanka's NEDA, management, and staff have partnered with organizations such as the Federation of Chambers of Commerce and Industry of Sri Lanka to foster and encourage youth entrepreneurship at a regional level. Similar issues exist in both Pakistan and Sri Lanka. They have both created some form of space for youth entrepreneurship but do not have strong monitoring and evaluation systems to enable the development of scale and sustainability (Rahman, 2021).2. Digital Technologies and E-Commerce PlatformsWhile the digitisation of infrastructure is happening at different rates in both countries, there are huge opportunities afforded to the younger tech-savvy generation of entrepreneurs. For example, youth entrepreneurs in Pakistan have been able to harness the advantages of digital connectivity to overcome the barriers of formalized marketplace through Daraz and Telemart, national informal marketplaces, as well as freelance markets such as Fiverr and others. Kapruka in Sri Lanka stands out as a prime example of a successful localised example of e-commerce innovations. Both Sri Lanka and Pakistan continue to experience challenges in digital literacy, barriers to cybersecurity, as well as the inequity of access to connectivity especially in peri- urban and rural areas (Fernando et al. 2020).3. Vocational Training and Skills Development There is increasing recognition of vocational and technical training programs, led by organizations like Pakistan's Technical Education and Vocational Training Authority (TEVTA) and Sri Lanka's Youth Empowerment Project, that are working to improve youth employability and promote their entrepreneurial skills. Many of these programs are built around digital skills, financial literacy, and business planning. While welcomed, it is noted that many of these training programs don't link to an actual business incubation or mentorship support, which diminishes the sustainability of the projects overall (Ali, 2020). Challenges for Young Entrepreneurs: Structural Barriers and Cultural Inhibitions1. Access to Finance and Investment Ecosystems Access to capital is one of the most considerable and debilitating barriers to youth entrepreneurship in Pakistan and Sri Lanka. In Pakistan, formal banks show a clear bias against youth-led businesses, often claiming that these businesses cannot borrow because they do not have collateral or experience. Young entrepreneurs are often forced to turn to informal lenders, deplete their family's savings, or pursue predatory microfinance services that are neither scalable nor sustainable (Rahman, 2021). The issue is formed in Sri Lanka as well, but the challenge is more about not having long-term products specifically aimed at youth, as well as high-interest rates. Although microfinance institutions exist to fill the gap, the vast majority of their lending is directed towards marginalized yet established borrowers. In both countries, venture capital is virtually non-existent, with little to no funds focused on supporting youth-led venture capital innovation in its earliest stages.2. Limited Entrepreneurial Exposure and Institutional Disconnect An essential but often neglected challenge is the absence of early access to entrepreneurial thinking. In both countries, the education systems are largely a vehicle for traditional forms of educational success and public-sector employment, not for creativity, critical thinking, and risk. In Pakistan, the gap in entrepreneurial education is mainly the province of a small group of elite business schools meant for a selective few. While most of the youth emerge without real exposure to entrepreneurship (Ali, 2020).Sri Lanka's secondary and tertiary education structures present little entrepreneurial models in a mostly theoretical fashion, supplemented by limited case studies, practical projects, or networks/mentorships. Consequently, the entrepreneurial mindset (resilience, experimentation, and innovation) is hardly developed in their formative years.3. Socio-Cultural Constraints and Gendered Expectations Cultural narratives that value stability, hierarchical employment, and familial consent lead many young people to reject even the notion of a career in entrepreneurship. In Pakistan, risk aversion is supported by family and community preference for salaried work, especially in the public sector. Gender traditions for many women further deny mobility, independence, and business connections.Sri Lanka faces similar challenges. Young people—especially women—have been faced with family constraints and community condemnation that erodes entrepreneurial confidence and personal agency. Since cultural expectations are so ingrained, long-term strategies of re-socialization and public discourse are necessary for effective change. Illustrative Case Studies: Youth-Led Innovation in ActionPakistan: Rozee.pk — Reimagining Employment Services Founded by a young Pakistani entrepreneur, Rozee.pk has grown into Pakistan's largest digital job market. By linking job seekers and employers across different sectors and industries, Rozee.pk has transformed traditional recruitment by creating a new online employment environment. It success illustrates how digital entrepreneurship can disrupt traditional markets and respond to structural inefficiencies in labor intermediation (Ali, 2020).Sri Lanka: PickMe — A Disruptive Force in Urban Mobility PickMe, a localized ride-hailing application developed by young Sri Lankan innovators, is a clear demonstration of youth engagement with technology, adapting to local needs. It competes directly with multinational categories like Uber while also localizing logistics, harvesting mobile tuk tuk traffic, and clearly and simply distributing a user-friendly payment system based on how Sri Lankans use the economy. This venture has also created both direct and indirect employment, and improved urban mobility (Perera, 2019).These examples show that youth entrepreneurship is not only a livelihood strategy, but potentially a transformative way of re-imagining entire sectors of the economy. Strategic Policy Recommendations: Toward an Enabling Ecosystem1. Expand Financial Inclusion through Targeted Instruments Policymakers should focus on creating financial instruments geared specifically towards young traders, including low-collateral lending, innovation grants and youth-targeted equity funds. Public-private partnerships may develop venture capital markets for early-stage youth-led businesses. Regulatory frameworks must also be simplified to reduce barriers to entry for startups and facilitate transition to formalization (Rahman, 2021).2. Institutionalize Entrepreneurial Education and Mentorship Curricular reforms must include entrepreneurship education at the secondary and tertiary levels, with an emphasis on experiential learning, design thinking, and local case studies. In addition, governments should encourage the formation of regional entrepreneurship hubs, connecting young entrepreneurs with incubation space, mentorship, and networking opportunities, especially for marginalized and rural youth (Ali, 2020).3. Address Socio-Cultural Barriers through Public Campaigns and Community EngagementCultural change is necessary for sustained entrepreneurial participation. Governments and civil society need to support campaigns that highlight local success stories and women’s entrepreneurial initiatives, while also normalizing the experience of failure. Community leaders, educators, and religious leaders have a power to support communities in changing perceptions of innovation and self-employment (Fernando, 2020). Conclusion Youth entrepreneurship in Pakistan and Sri Lanka exists between (a) demographic opportunity and (b) structural limitation. While both countries have established various policy programs and institutional arrangements to support young entrepreneurs, the underlying structural barriers (particularly related to finance, education, socio-cultural norms) persist and persistently restrict the transformative contributions of these initiatives.Rozee.pk and PickMe document cases of youth-led enterprises that can deliver scale through innovation, contribute to improved delivery processes, and create jobs, as long as the entrepreneurial ecosystem is set up to support their disruption. The challenge is resolve and generate these individual successes as consequences, rather than as exceptions, and that task demands developmental ecosystemic change.To be forward-looking, there is an integration of financial inclusion, innovative curriculums and/or cultural change. To support youth entrepreneurship in the Dilip Narayan sense takes collective accountability from state institutions, educational systems, financial institutions, and civil society, to tap in to opportunities available now to build entrepreneurial-focused economies in South Asian nations such as Pakistan and Sri Lanka. This is worth doing for its systemic outcomes against crises of high unemployment and economic stagnation; but it also opens up the possibilities of building democratic economies with consuming citizenry.References ・Ali, M. (2020). The role of youth entrepreneurship in Pakistan’s economic development. Pakistan Economic Journal, 18(3), 147–162. ・Fernando, R. (2020). Digital entrepreneurship and youth employment in Sri Lanka. Journal of South Asian Economics, 22(1), 89–104. ・Perera, S. (2019). Challenges facing young entrepreneurs in Sri Lanka: An analysis of socio-cultural and financial barriers. Sri Lanka Business Review, 15(2), 115–128. ・Rahman, F. (2021). Financial barriers to youth entrepreneurship in Pakistan and Sri Lanka. Asian Journal of Economic Policy, 24(1), 132–145.

Economic Impact of Remittances on Household Welfare in South Asia: A Study of Nepal and Bangladesh AbstractThe paper provides a thorough investigation of economic implications of remittance inflows and household welfare in Nepal and Bangladesh--two South Asian economies where labor migration, and the resulting remittances, represent an appreciable percentage of the national GDP. Drawing from current economic and development literature, the analysis seeks to assess the role of remittances in relation to income (in)security, healthcare and education and financial (dis)resilience in the household economy. The analysis suggests that while remittances have proven to be an effective mechanism for reducing poverty and developing human capital, they also create systemic dependencies and expose the household to macroeconomic uncertainties and fluctuations in the global labor market. The paper ends with some policy recommendations focusing on institutionalizing financial literacy, building skills in the economy to diversify income sources and endogenous growth to use remittances as a basis to ensure sustainable and equitable development.IntroductionThe role of international labor migration and remittances has become increasingly crucial within the economic landscape of South Asia. Most notably, Nepal and Bangladesh—two countries with high rates of labor outmigration and scarce economic opportunities domestically—have developed important influxes of international remittances. Remittances in Nepal and Bangladesh are changing household economies, enhancing social indicators, and transforming regional consumption patterns. However, the benefits of remittances come at a cost, considering nagging issues of structural dependency, inflation, and social inequality.This paper aims to interrogate the ambivalence of remittance inflows for Nepal and Bangladesh. It looks at how households expend remittances especially in terms of health, education, and capital formation; and examines whether remittances should be viewed as what they have been contended to be—a sustainable development tool or ultimately as a pathologie's of vulnerability. Through the employment of a comparative case method based on primary data and policy analysis, the paper analyzes remittances as not a pure good but instead as a problematic socio-economic phenomenon with varying implications for households that require selective analysis and governance. The Role of Remittances in Nepal and BangladeshNepalRemittances currently represent around a quarter of national GDP in Nepal, making it one of the most remittance-dependent economies in the world. The long-standing lack of formal job opportunities, particularly in rural and rural-adjacent areas of Nepal, has normalized labor migration as a potential socio-economic solution to survival. Remittances beneficiaries spend on family essentials, such as health, education, nutrition, and housing. There is evidence that remittances have improved household consumption levels and reduced measures of poverty.However, this reliance has also introduced structural vulnerabilities. Fluctuations in global labor markets, as observed by Shrestha (2020) particularly in the Gulf Cooperation Council (GCC) countries, mean that these changes translate into immediate economic consequences for households relying on remittances. Other than the economic stagnation associated with remittances, in some cases, they have reduced the incentive to gainfully participate in the economy domestically, especially for young people, and deepened Nepal's dependence on global labor market participation.BangladeshSimilarly, in Bangladesh, remittances have a critical role in GDP and household income as especially those families that have males work in the Middle East and Southeast Asia, funds from remittance payments plays an important part. This money is very important to households especially in paying for day-to-day expenses, servicing household debt, renovation/improvement of their house, and education. Also, remittance flows have added to foreign currency reserves and impact the macroeconomic balance of the economy.Ahmed (2019) points out that the structural nature of the foreign labour deployment exposes Bangladeshi households to a number of external risk factors including host country immigration policies and economic or political instability in the world. And further, the nature of low skill jobs also exposes them to the fragility of low skill jobs in terms of risks and potential upward economic mobility for the worker and for their households and communities, but also for the country. Economic Impact on Household WelfareRemittances have significantly altered the welfare environments found in Nepal and Bangladesh , especially around addressing multidimensional poverty and improving household capacity. This section provides a detail analysis of the key areas where remittances have asserted transformative impact: income stability, healthcare access, and education outcomes . It is in emphasizing these effects separately that this study will show both the possibilities for development and the limits of a remittance household economy. Poverty Reduction and Income StabilityWhile remittances act as an almost social safety net to many households, particularly in rural, less developed areas, there is data in Nepal that show remittances are positively correlated with poverty reduction. For example, Bhandari (2019) shows that remittance receiving households exhibit significantly more income stability and capacity to manage shocks to the economy. Many remittance receiving households enjoy better food security, living conditions, and ability to absorb economic shocks.This reliance has its downside. The economic resiliency created through remittance income can camouflage some of the structural weaknesses, such as poor domestic job markets and a lack of state-sponsored welfare. Over time, this reliance can create dependency to the point of undermining local entrepreneurial potential.The situation is similar in Bangladesh. Remittance flows allow families to enjoy lower income volatility, lower vulnerability to poverty traps, and the financial ability to respond to sudden expenditures, particularly in health services and education-related expenditures (Rahman, 2021). However, the buffering effect of remittances could potentially disincentive household members, especially women and younger members, from entering the labor force and perpetuating a passive economy, predicated upon work outside the household economy. Healthcare Access and OutcomesThe link between remittances and healthcare investment is especially significant in places where there is little or nonexistent public health infrastructure. In Nepal, remittances allow households to spend money towards healthcare services, such as outpatient treatment, diagnostics, or hospital care. The ability to afford travel to cities and access specialized care is a major qualitative shift in health-seeking behavior among rural households (Shrestha, 2020).Remittances also facilitate preventive care and improve outcomes in maternal and child health. Even so, persistent under-provisioning in rural health care has not been addressed, and continued remittance income can either compensate for, or augment, public services, which reveals a governance gap.Households receiving remittances in Bangladesh have shown improved health indicators, particularly in terms of seeking private health care and access to essential medicines. Ahmed (2019) suggests that these families are less likely to forgo treatment due to costs, and more likely to engage in treatment early, and taking the perspective that health-seeking behavior is the ultimate objective, these positive actions lead to better health outcomes. However, that makes it clear that remittances are filling systemic gaps in health financing, which raises the longer term questions of whether this model may be sustainable in light of a lack of overall public health reform. Educational AttainmentThe improvement of education outcomes is perhaps the most promising developmental dividend of remittance flows. In Nepal, it is often possible to trace remittance income into formal education via the provision of school fees, repairs for learning, and support in post-secondary training. In this way, remittances are not simply improving household literacy but also creating pathways to upward socio-economic mobility (Bhandari, 2019). More importantly, remittances enable families to support female children with their education, which are often the marginalized interests of low-income educational planning, without the necessary accompaniment of institutional reforms (like improvements in public schooling quality) to maximize that investment.Similar dynamics are evident in Bangladesh. Rahman (2021) provides evidence of the significant relationship between remittance receipts and school completion rates, particularly at secondary and tertiary levels. Children in remittance-receiving households attend private school and retain tutoring services at higher frequencies and ratios, which gives them an advantage in both the national and regional job market compared to their counterparts. However, in overall terms, the intersection of ‘remittance’ and ‘non-remittance’ households looks very different— raising equity concerns and suggesting permanence to educational inequalities. Socio-Economic Challenges and Dependency on RemittancesWhile remittances serve critical developmental functions, they carry with them structural and socio-economic issues that need attention. Economically vulnerable, inflationary pressure and local economic dynamism vulnerability are primary issues. Economic Vulnerability and Overreliance on Foreign LaborBoth Nepal and Bangladesh's macroeconomic frameworks have been increasingly drawn into remittance flows, making the national economy's dependent on remittances vulnerable to external shocks. Migration has made dependency on global labor demand generated from host countries, mainly the Middle East, cantilever income received by migrant families. Shrestha (2020) highlights the significant income drops due to crises in host countries. For example, political tension, reductions in the price of oil, or restrictive visa in the host country contributed to substantial decreases in remittance receipts to Nepal, creating severe household distress. Bangladesh similarly is a case study of this circumstance. It has continued labor exports as a developmental strategy, and it subjects its economy to global labor market shocks, while simultaneously reducing the development of indigenous employment sectors domestically. Moreover, the significance of low skilled labour migration limits the potential for productivity improvements and perpetuates vulnerable externally dependent livelihoods (Ahmed, 2019). Inflation and the Rising Cost of LivingOne neglected implication of consistent remittance inflows is the inflationary pressure created. In Nepal, these higher levels of liquidity at the household level increased consumer prices, particularly in housing and food prices. Bhandari (2019) warns that this impact is unequally borne by non-recipients so that it adds greater inequality and diminishes the relative value of the gains of income derived from remittances.This trend is evident in urban Bangladesh, as remittance-induced demand increases prices for other goods and services thereby raising the overall cost of living, especially in areas where real estate speculation generated by remittance investment is seen. In these cities, this creates inflationary bubbles of prices that put pressure on both recipients and non-recipients there by reinforcing social stratification (Rahman, 2021). Recommendations for Sustainable Impact of RemittancesTo evolve remittances from a fragile lifeline to a self-sustaining development actor, and to build resilience, Nepal and Bangladesh will need to pursue a broader policy agenda. To illustrate:1. Promoting Financial Literacy and Domestic InvestmentThe government will have to build financial literacy programs, which will assist remittance-receiving households in developing the capacities to adequately utilize their incomes. The aim is to build the capacity of households to mobilize savings, productively invest, and create a portfolio of assets. Bhandari (2019) argues that public policy supports may also be required, to closely target remittance investment in small business, cooperatives, and locality infrastructure that unlock remittance's transformational potential.2. Expanding Access to Formal Financial InstitutionsThe rural finance sector in South Asia is nascent. Accessing formal banking products – that can safeguard remittances, increase savings behaviour, and build gateways for households to utilize financial products and instruments for sustainable future growth - cooperatively with banks can support government development of low barrier savings accounts, mobile banking, as well as products like remittance based insurance and credit (Ahmed, 2019).3. Investing in Skill Development for Migrant WorkersThe geography of low-skilled, semi-skilled, and skill-based labor migration is changing. Rahman (2021) promotes that vocational training programs should be part of domestic employment policy, allowing potential migrants to maximize their earning potential and successfully transition into higher value labor markets. The programs further build pathways for migrants to re-enter local labour markets when they return home. ConclusionThis study demonstrates that remittances are a key feature of household welfare and national economic security in Nepal and Bangladesh. The positive aspects of remittances—poverty alleviation, improved access to health care, improved education—are sizeable, however, the developmental potential of remittances remains undermined by systemic vulnerabilities such as inflation, labor market dependence, and socio-economic inequality.Achieving sustainable development in remittance-dependent economies requires a shift from passive consumption to active investment; from structural dependency to economic diversification. By integrating remittance management into national development policies, while empowering households through financial inclusion and skills development, both countries can leverage the potential of remittances inducing inclusive and resilient growth. References・Ahmed, S. (2019). Remittances and Economic Stability in Bangladesh. Journal of South Asian Economics, 14(2), 132–145. ・Bhandari, R. (2019). Poverty Alleviation Through Remittances in Nepal: Opportunities and Challenges. Nepal Economic Review, 18(3), 189–202. ・Rahman, M. (2021). Impact of Remittances on Education and Healthcare in Bangladesh. Asian Journal of Social Policy, 23(1), 98–115. ・Shrestha, P. (2020). Remittance Dependency and Economic Vulnerability in Nepal. South Asian Development Studies, 12(4), 203–217.

Mental Health Infrastructure and Stigma in South Asia: A Critical Analysis of Systemic Barriers to Mental Health Access in Bhutan and Sri Lanka AbstractThis research critically examines the systemic barriers to equitable mental health service delivery in Bhutan and Sri Lanka specifically relating to structural impediments and sociocultural stigma. Mental healthcare is routinely sidelined in national health systems and yours' practice varies by experience and expectations with physical health often held more prominent purpose and sociocultural stigma overriding healthcare considerations. We assess how poor infrastructure, staff shortages, and sociocultural definitions of mental illness weight on treatment access to care and treatment quality. We evaluate new Moshe funding schemes through evidence of need and usefulness for addressing persistent stigma and to assess the usefulness of potentially viable alternative forms of mental health support in Bhutan and Sri Lanka. Our research findings suggest that while some policy development has occurred (largely at a nominal level), sociocultural stigma around mental illness, lack of training for professionals, and a poor system of resources continues to act a major barriers against access to competent mental health care. The study outlines a range of evidence informed recommendations for Bhutan and Sri Lanka including decentralising services, public education in culturally relevant manners and educating the government on fresh investments in workforce and infrastructure. IntroductionAlthough there is an increasing global recognition of the importance of mental health as an essential element of comprehensive well-being and public health, it continues to be neglected in large parts of South Asia. Bhutan and Sri Lanka are two examples of neglect of mental health services in this region where mental health care is underfunded, underprioritized and structurally marginalized. Both Bhutan and Sri Lanka have healthcare systems that have historically prioritized communicable diseases and basic physical health over mental health, rendering mental health services underdeveloped and stigmatized.This paper endeavors to unpack the multiple barriers to accessing mental health services in Bhutan and Sri Lanka, encompassing limited physical infrastructure, acute shortages of professionals, and ingrained sociocultural stigmatization and delegitimation of mental illnesses. Utilizing government policy documents, research literature, and field-based programs, this paper critically examines both the institutional structure and the socio-cultural context that shape the delivery of mental health care. The intention of this paper is to develop strategic recommendations for mental health systems that are more inclusive, contextually appropriate, and adaptable in both countries. Mental Health Infrastructure: Institutional Capacities and LimitationsBhutanIn recent years, Bhutan has clarified a number of symbolic policy-level commitments to embed mental health in broader public health reform, consistent with the principle of Gross National Happiness (GNH). These commitments can be characterized as symbolic, as they have not yet translated into material investment. National mental health services remain primarily urban-based, with specialist services restricted to tertiary hospitals in major urban centers. The rural population remains underserved, typically having access only to medicine and general practitioners, some of whom receive minimal training in psychiatry. While there have been nominal commitments to integrating mental health into primary care, the lack of dedicated psychiatric facilities, specialist personnel, or long-term rehabilitation severely diminishes the capacity for truly fulfilling comprehensive care (Wangchuk, 2020).Sri LankaThe healthcare system in Sri Lanka has primarily been recognized for its universal access model, and mental health services are included within the nation's district health systems in the hospital context. However, access to health services and effective service delivery remains limited. There are no specialist mental health facilities, psychiatric services are often poorly integrated into primary care, and while the National Mental Health Policy offered great promise, it has suffered from poor implementation, primarily due to chronic underfunding and bureaucratic slowness. In addition, there are not enough qualified mental health professionals (i.e., psychiatrists, psychologists, psychiatric nurses, social workers) and this lack of health professionals within the system has created systemic bottlenecks to service delivery; particularly in rural and conflict-affected areas (Fernando, 2019). Societal Stigma and Cultural Constructs of Mental IllnessBhutanIn Bhutanese community, mental illness is typically viewed via spiritual cosmology. Many traditional worldviews ascribe psychiatric symptoms to possession by evil spirits, karmic retribution, or moral inadequacies. As a result, more people experiencing psychological distress will seek intervention from religious healers such as Buddhist lamas or shamans than would seek help from anybody in the medical field. These cultural paradigms shape a social space where mental illness is shrouded in shame and honored with silence in families and community. The stigma of the illness commits long delays before clinical intervention is made, considers psychiatric care as a healing unique unto itself, and legitimizes and encourages this form of healing" (Dorji, 2019).Sri LankaIn Sri Lanka, stigma surrounding mental health exists at the intersection of personal morality, familial honor, and possible social banishment. Therefore, mental illness is largely recognized as a type of personal weakness or familial curse, particularly in rural places with conservative values and traditional norms. Stigmatization has caused a lessened tendency to seek care for mental distress or to disguise or deny distress in others. Such studies have reported wide-ranging discrimination with regards to employment, education, or marriage prospects for those with known histories of mental health problems. The cultural construction of mental illness as deviance helps to further enshrine structural exclusion and psychological damage (Jayasinghe, 2020). Case Studies: Innovations and Limitations in Community-Level Mental Health InterventionsBhutan: Primary Healthcare Integration InitiativesThe Royal Government of Bhutan has established programs to integrate mental health services in primary healthcare at rural health centers and to train general health providers to identify and treat commonly experienced mental health disorders. By embedding mental health services into existing health service infrastructure, the government intends to reduce stigma and increase access. Nevertheless, the integration of mental health into primary care is limited by a lack of refresher training opportunities, inadequate referral pathways and systems, a lack of clinical supervision -- complex psychiatric cases will exceed the capacity of any one primary care site, and specialist assistance is not available, either geographically or in terms of professional support (Wangchuk, 2020).Sri Lanka: Community-Based Mental Health ProgrammingSri Lanka has embraced a decentralized approach to mental healthcare with community-focused mental health programs backed by the World Health Organization and other NGOs. These community-based programs train community health workers, adding the basic mental health support skills, psychoeducation, and referral. Programs have also assisted in the management of trauma-related disorders in the Northern and Eastern Province, conflict-affected areas. While much can be achieved in terms of access and care in mental health services while addressing stigma, sustainability is still a problem. The serious problems include a chronic lack of and unreliable funding, no systems for sustainable monitoring, and dependence on donor funded programs and systems impeding real and lasting systemic change (Fernando, 2019). Barriers to Mental Health Service Accessibility1. Severe Shortage of Mental Health ProfessionalsIn both Bhutan and Sri Lanka, mental health human resource shortages are acute. Bhutan reported to have fewer than ten (10) psychiatrists in the whole country, while clinical psychology services were almost nonexistent. Sri Lanka reported that there's more than ten (10) psychiatrists but still under recommended levels put forth by WHO, specifically in rural areas. While there are some mental health professions in rural areas, and more overall, the concentration of mental health professionals in urban areas creates a structural inequity that makes psychiatric care practically inaccessible to stigmatized or marginalized populations. This results in an excessive demand on primary care practitioners, making quality of care suffer and potential outcomes poor due to misdiagnosis and/or neglect (Jayasinghe, 2020).2. Financial Constraints and Budgetary UnderallocationMental health continues to be allocated patently lower portions of national health finances. Although Bhutan does not possess adequate financial resources to build specialized facilities or expand psychiatric services outside major cities, Sri Lankan health budgets also include a small percentage for mental health therefore about have ageing facilities, very few psychotropic drugs, and weak service delivery systems; which is compounded by dependence on international donors and of course also changing donor agendas (Dorji, 2019; Fernando, 2019).3. Cultural, Linguistic, and Epistemological BarriersAccess to care is further complicated by cultural and linguistic incongruity between health care providers and patients. In Bhutan, the mental health services often fit poorly with indigenous cosmologies, leaving some people to distrust or reject psychiatric treatments. Language barriers can inhibit communication, particularly in ethnolinguistically diverse spaces. In Sri Lanka, both Sinhala and Tamil are recognized languages, but, the delivery and provision of services in minority languages is incredibly inconsistent. Cultural epistemologies of distress, for example, framing mental illness as a punishment from God, or an imbalance of karma, undermine biomedical paradigms, (Fernando, 2019) and support alternative health-seeking behaviours while delaying more formalized or institutionalized care. Recommendations: Toward a Culturally Responsive and Systemically Integrated Mental Health Framework1. Expand Mental Health Infrastructure and Regional EquityGovernments in Bhutan and Sri Lanka, should commit to building mental health systems with a decentralized approach, which may include the establishment of district psychiatric units, and the use of telepsychiatry for remote populations and mobile mental health clinics. This should be along the lines of areas with current gaps, and should also attempt to include culturally relevant notions of care that honour local beliefs.2. Enhance Workforce Capacity through Targeted TrainingA national plan for the training of mental health professionals and retention is greatly needed. The medical schools should have a mandatory psychiatry rotation and add benefits for workers in rural or conflict-affected areas. Adequate education and ongoing and continual mental health training for general healthcare workers is necessary, and they should have means for supervision, peer support, and ongoing professional development.3. Launch National Anti-Stigma and Mental Health Literacy CampaignsReform must center on educational systems. Government must invest in sustained and culturally responsive anti-stigma campaigns which include mass media, religious institutions, and community leaders. Education material should also be delivered in local language using indigenous epistemologies with the view that mental illness is no longer scary, to foster compassionate understanding and promote early intervention.4. Strengthen and Sustain Community-Based Mental Health ModelsCommunity-based mental health models have shown potential, but require institutionalization through national health systems. This means budget lines, standardized training processes, and monitoring and evaluation. The sustainability and impact can be exponentially strengthened by incorporating these programs into the public systems and local governance structure. ConclusionThe structural architecture of Bhutan and Sri Lanka's mental health systems remains frail, grossly under-resourced, and often culturally immured. Though new policy arrangements suggest a burgeoning recognition of mental health as a public priority, they are far from effective in overcoming the entrenched combinations of barriers to service access, including infrastructural inadequacies, a critical shortage of trained professionals, chronic under-funding, and especially, sociocultural stigma. Collectively, this amalgamation of barriers serves to limit equity of access, primarily affecting rural and marginalized cohorts of communities.Nonetheless, both countries provide models for optimistic change: Bhutan's inclusive definitions of mental health in the context of Gross National Happiness and primary care; Sri Lanka's decentralized, community-based initiatives. These efforts will need to be scaled, supported and modified based on local cultures and needs. We need a shift in perspective: practicing mental health being regarded as priority NOT as a peripheral concern; mental health as a considered action of human development, social justice, and national resilience.This perspective requires collaboration among multi-sectoral actors, including: policymakers, health providers, education professionals, religious leaders, and civil society. The only way for Bhutan and Sri Lanka to dismantle the persistent barriers to mental health and build a compassionate, accessible, and just mental health system is through coalescence, convergence, and cultural relevance. References・Dorji, T. (2019). Traditional Beliefs and Mental Health Care in Bhutan. Bhutan Journal of Social Health, 10(3), 154–168. ・Fernando, S. (2019). Community-Based Mental Health in Sri Lanka: Challenges and Opportunities. South Asia Health Journal, 15(4), 207–221. ・Jayasinghe, L. (2020). Mental Health Stigma and Access to Services in Sri Lanka. Journal of Asian Psychology, 14(2), 121–136. ・Wangchuk, P. (2020). Integrating Mental Health into Bhutan’s Primary Healthcare System. Bhutan Journal of Public Health, 18(1), 98–112.

AbstractThis paper explores the socio-cultural, economic, and legal factors driving child marriage in Pakistan and Bangladesh, focusing on how this practice perpetuates gender inequality. Despite laws prohibiting child marriage, socio-economic conditions, cultural norms, and enforcement challenges continue to sustain high rates of early marriage in both countries. This study examines the impacts of child marriage on educational attainment, economic opportunity, and health outcomes for girls, while analyzing recent policy reforms aimed at curbing this practice. The findings indicate that although both countries have taken steps to address child marriage, stronger policy enforcement, community involvement, and educational interventions are essential to promote gender equality and protect young girls from the lifelong consequences of early marriage.IntroductionChild marriage remains a significant issue in South Asia, particularly in Pakistan and Bangladesh, where cultural norms and socio-economic challenges contribute to one of the highest rates of child marriage globally. While both countries have implemented legal frameworks to prevent child marriage, these laws often lack effective enforcement, allowing the practice to persist. Child marriage not only infringes on girls’ rights but also perpetuates gender inequality, affecting educational attainment, health outcomes, and economic opportunities for women.This paper presents a comparative analysis of child marriage in Pakistan and Bangladesh, examining the root causes, societal impacts, and policy interventions aimed at addressing this issue. Through this analysis, the study aims to provide insights into potential strategies to reduce child marriage rates and promote gender equality in South Asia.Causes of Child Marriage in Pakistan and BangladeshPakistanIn Pakistan, child marriage is influenced by a complex interplay of cultural, economic, and religious factors. In rural areas, traditional beliefs regarding family honor and the perception of girls as financial burdens drive families to marry off daughters at a young age. Poverty also plays a significant role, as families struggling financially often view marriage as a way to reduce economic strain. Additionally, religious interpretations and the influence of conservative groups can complicate efforts to enforce minimum age laws for marriage (Ahmed, 2020).BangladeshBangladesh faces similar challenges, with economic factors and cultural norms strongly influencing child marriage rates. Poverty remains a critical factor, as families facing financial hardship view marriage as a means to ensure their daughters' security. Additionally, concerns about sexual harassment and family honor often lead parents to marry daughters early to protect their reputations. Although the legal age of marriage in Bangladesh is 18, weak enforcement and social acceptance of child marriage contribute to high prevalence rates (Islam, 2019).Impacts of Child Marriage on Gender InequalityEducational AttainmentChild marriage significantly impacts educational opportunities for girls in both Pakistan and Bangladesh. Early marriage often forces girls to leave school, limiting their access to education and reducing future employment prospects. In Pakistan, studies indicate that the majority of girls married before 18 drop out of school due to marital responsibilities, reinforcing the cycle of poverty and dependency. In Bangladesh, where education has been linked to delayed marriage, girls who leave school early are less likely to acquire the skills needed for economic independence, further entrenching gender inequality (Khan, 2020).Health and Well-beingChild marriage has severe health implications, including higher risks of maternal mortality, early pregnancies, and limited access to healthcare. Young brides in Pakistan and Bangladesh often lack knowledge about reproductive health, making them vulnerable to complications during pregnancy and childbirth. In Bangladesh, adolescent mothers are at higher risk of anemia and malnutrition, impacting both their health and that of their children. This cycle of poor health outcomes perpetuates gender-based health disparities, limiting girls’ long-term well-being (Rahman, 2019).Economic OpportunitiesThe economic repercussions of child marriage are profound, as girls who marry young are less likely to join the workforce or pursue income-generating activities. In Pakistan, child brides are often confined to domestic roles, with limited access to vocational training or employment opportunities. In Bangladesh, married girls face similar constraints, as early marriage disrupts education and prevents them from achieving economic self-sufficiency. This lack of economic empowerment perpetuates gender inequality, as women are unable to participate fully in economic development or decision-making (Islam, 2019).Policy and Legal FrameworksPakistan’s Legal FrameworkPakistan’s Child Marriage Restraint Act (1929), amended in 2019, sets the legal age of marriage at 18 for girls. However, enforcement remains a challenge, particularly in rural areas where conservative norms prevail. Law enforcement agencies often hesitate to intervene in cases of child marriage due to cultural and religious sensitivities, limiting the law’s effectiveness. Additionally, limited awareness among families regarding the legal ramifications of child marriage restricts compliance (Siddiqui, 2021).Bangladesh’s Legal FrameworkBangladesh implemented the Child Marriage Restraint Act in 1929, later amended in 2017, setting the legal age of marriage at 18 for girls and 21 for boys. Despite this legal framework, loopholes allow for “special circumstances,” which can lead to child marriages with parental and judicial consent. This exception has weakened enforcement efforts and allows for continued high rates of child marriage. Community awareness campaigns have been introduced to inform families of the legal age, but enforcement remains inconsistent (Rahman, 2019).Case Studies: Community and NGO InterventionsPakistan: Girls’ Education and Community AdvocacyIn Pakistan, NGOs such as Sahil and the Aurat Foundation have initiated programs that promote girls' education and raise awareness about the harms of child marriage. By engaging local leaders and religious figures in advocacy, these organizations have successfully increased community acceptance of delaying marriage. Programs that offer scholarships and vocational training to girls have proven effective in encouraging families to prioritize education over marriage, though such initiatives are limited by funding and reach (Ahmed, 2020).Bangladesh: Empowerment Programs and Economic IncentivesBangladesh has seen positive results from NGO-led initiatives such as the BRAC Adolescent Development Program, which provides life skills training, health education, and economic opportunities for girls. By creating girls’ clubs that focus on leadership skills and entrepreneurship, BRAC has empowered young girls to advocate for their rights and delay marriage. Additionally, government incentives, such as financial support for families who keep daughters in school, have contributed to reducing child marriage rates in targeted communities (Islam, 2019).Challenges and Limitations in Addressing Child MarriageSocial and Cultural ResistanceOne of the primary challenges in addressing child marriage is resistance from communities that view early marriage as a cultural or religious practice. In Pakistan, conservative communities often view government intervention as an infringement on their cultural values, limiting the effectiveness of legal enforcement. Similarly, in Bangladesh, efforts to curb child marriage are often hindered by social norms that prioritize family honor and security over the well-being of young girls (Siddiqui, 2021).Economic Constraints and Lack of ResourcesEconomic factors play a significant role in perpetuating child marriage, as poverty drives families to see marriage as a form of economic security. Both Pakistan and Bangladesh face challenges in providing financial support and resources to low-income families, limiting the impact of policy reforms. In areas where poverty is pervasive, families continue to marry off daughters at young ages as a means of reducing household financial burdens (Rahman, 2019).Enforcement ChallengesWeak enforcement mechanisms further hinder efforts to eliminate child marriage. In both countries, legal frameworks are often undermined by insufficient resources, limited training of law enforcement personnel, and lack of public awareness. Police and local authorities may be unwilling to intervene in cases of child marriage due to cultural norms or limited understanding of the law. This gap between policy and enforcement highlights the need for improved legal training and awareness initiatives (Khan, 2020).Recommendations for Reducing Child MarriageStrengthening Legal EnforcementBoth Pakistan and Bangladesh should focus on enhancing enforcement mechanisms for existing child marriage laws. This could include training law enforcement personnel on the importance of preventing child marriage, establishing monitoring systems to track cases, and promoting transparency in judicial processes. Additionally, efforts to close legal loopholes, particularly in Bangladesh, would prevent the misuse of exceptions that allow for early marriage (Siddiqui, 2021).Promoting Education and Economic EmpowermentInvesting in education and economic opportunities for girls is essential for addressing the root causes of child marriage. Governments and NGOs should expand scholarship programs, vocational training, and economic incentives for families to keep daughters in school. By empowering girls with education and skills, they are more likely to delay marriage and pursue economic independence, reducing gender inequality in the long term (Ahmed, 2020).Community Awareness and Advocacy CampaignsEngaging communities through awareness campaigns can help shift cultural perceptions around child marriage. Collaborating with local leaders, religious figures, and educators to advocate for delayed marriage and gender equality can foster community-driven change. Education campaigns that highlight the health, social, and economic benefits of delaying marriage are crucial in changing attitudes and practices in communities where child marriage is prevalent (Islam, 2019).ConclusionChild marriage remains a persistent issue in South Asia, perpetuating gender inequality and limiting opportunities for young girls. While both Pakistan and Bangladesh have implemented legal frameworks to curb child marriage, socio-cultural norms, economic challenges, and weak enforcement continue to sustain the practice. Addressing child marriage requires a multi-faceted approach that combines policy reform, community engagement, education, and economic empowerment.Efforts to empower girls through education, raise awareness within communities, and strengthen legal enforcement can contribute to reducing child marriage rates in both countries. Achieving gender equality and improving the well-being of girls in Pakistan and Bangladesh will require sustained commitment from governments, NGOs, and communities to create a future where every girl has the opportunity to reach her full potential.ReferencesAhmed, R. (2020). Community Interventions and Gender Equality in Pakistan. Journal of South Asian Gender Studies, 15(3), 145-160.Islam, N. (2019). Addressing Child Marriage in Bangladesh: Socio-Cultural and Economic Challenges. Bangladesh Journal of Social Policy, 22(2), 105-120.Khan, M. (2020). The Impact of Early Marriage on Education and Health in South Asia. Asian Journal of Development Studies, 18(1), 89-104.Rahman, F. (2019). Health Consequences of Child Marriage in Bangladesh. South Asia Medical Journal, 12(4), 210-225.Siddiqui, A. (2021). Legal and Cultural Barriers to Ending Child Marriage in Pakistan. Pakistan Law Review, 19(2), 312-327.

AbstractThis paper examines the impacts of policy reforms on food security and agricultural sustainability in Nepal and Afghanistan, two South Asian countries facing significant agricultural challenges. Both countries are vulnerable to food insecurity due to dependence on subsistence farming, climate change, and limited access to modern agricultural resources. Through an analysis of recent policy initiatives aimed at improving agricultural productivity and resilience, this study assesses the progress, challenges, and socio-economic effects of these reforms. Findings suggest that while policy reforms have introduced positive changes, such as improved access to technology and crop diversification, there remain structural barriers and implementation gaps that hinder broader impacts. Recommendations focus on strengthening policy support, enhancing rural infrastructure, and promoting community-based approaches to ensure sustainable food security and agricultural resilience.IntroductionFood security and agricultural sustainability are critical concerns in South Asia, particularly in Nepal and Afghanistan, where large portions of the population depend on agriculture for their livelihoods. Both countries face challenges related to land degradation, climate change, and inadequate agricultural infrastructure, making them vulnerable to food insecurity. In recent years, policy reforms have aimed to address these challenges by promoting sustainable agriculture practices, improving access to agricultural technology, and supporting rural development.This paper examines the effects of these policy reforms on food security and agricultural sustainability in Nepal and Afghanistan. By analyzing the achievements and limitations of these policies, this study seeks to provide insights into the ways in which targeted reforms can contribute to a more resilient and food-secure future for these countries.Background on Agricultural Policy ReformsNepalIn Nepal, agriculture accounts for approximately one-third of the country’s GDP and employs a significant portion of the population. Recognizing the need to modernize agriculture and ensure food security, the Nepalese government has implemented various policy reforms, including the Agriculture Development Strategy (ADS) launched in 2015. The ADS focuses on improving agricultural productivity, promoting sustainable land management, and increasing market access for farmers. Despite these efforts, small-scale farmers, particularly in rural areas, continue to face challenges such as limited access to irrigation, high input costs, and insufficient support for climate-resilient farming (Thapa, 2019).AfghanistanAfghanistan’s agricultural sector is similarly crucial for food security and economic stability, with around 60% of the population relying on farming as a primary livelihood source. The National Comprehensive Agriculture Development Priority Program (NCADPP) introduced reforms aimed at enhancing agricultural productivity, infrastructure, and rural development. Given the country’s challenging terrain and ongoing socio-political instability, policy implementation faces numerous obstacles, including security issues, lack of infrastructure, and limited technical expertise. Nonetheless, policy initiatives have emphasized irrigation development, crop diversification, and resilience against climate-induced disasters (Azimi, 2020).Policy Reform Impacts on Food SecurityNepal: Crop Diversification and Food AvailabilityIn Nepal, one of the main goals of recent agricultural policies has been to encourage crop diversification to reduce dependency on staple crops and improve nutritional availability. Programs promoting high-yield crop varieties and crop rotation have had a positive impact on food security, increasing production and providing more variety in local diets. For example, the introduction of winter vegetables and legumes has improved nutritional intake among rural populations while providing farmers with additional income sources (Sharma, 2021).However, challenges remain, particularly for smallholder farmers who lack the resources to adopt new crops. The costs of seeds, fertilizers, and equipment, coupled with limited access to credit, restricts farmers’ ability to diversify. Additionally, market access remains a barrier, as farmers in remote regions struggle to reach buyers, leading to post-harvest losses and reduced profitability (Thapa, 2019).Afghanistan: Irrigation Improvements and Agricultural ProductivityIn Afghanistan, the emphasis on irrigation infrastructure under the NCADPP has aimed to increase agricultural productivity and enhance food security in arid and semi-arid regions. With a reliance on rain-fed agriculture, Afghan farmers are vulnerable to droughts and irregular rainfall. The construction of small dams and irrigation canals has improved water access, enabling more consistent crop yields and reducing the risks associated with water scarcity (Azimi, 2020).While irrigation improvements have benefited some regions, implementation has been hindered by security concerns and resource limitations. Remote areas, which are often the most in need of irrigation, remain underserved due to challenges in infrastructure development and maintenance. Furthermore, the reliance on traditional irrigation practices, such as karez systems, limits water efficiency, highlighting the need for updated technologies and better training for local farmers (Khan, 2019).Agricultural Sustainability and Environmental ImpactsNepal: Sustainable Farming PracticesNepal’s policy reforms have promoted sustainable farming practices, such as organic agriculture and soil conservation techniques, to address issues of soil degradation and reduce dependency on chemical inputs. These practices aim to improve long-term agricultural sustainability and preserve soil health. Government-supported training programs in organic farming have been well-received, particularly in areas where soil fertility has declined due to overuse of chemical fertilizers (Sharma, 2021).However, transitioning to organic farming has been slow due to limited resources and the higher costs associated with organic inputs. Small-scale farmers, who make up the majority of Nepal’s agricultural sector, often cannot afford the transition to organic farming without subsidies or financial support. Additionally, market demand for organic products remains low domestically, limiting profitability for organic farmers (Thapa, 2019).Afghanistan: Climate Resilience and Crop AdaptationIn Afghanistan, climate change poses a severe threat to agricultural sustainability, with increasing temperatures and unpredictable weather patterns impacting crop yields. Policy reforms have focused on promoting drought-resistant crop varieties and providing training in climate-resilient agricultural practices. For instance, the introduction of heat-tolerant wheat and drought-resistant barley has enabled farmers in arid regions to maintain production despite environmental challenges (Azimi, 2020).Despite these efforts, climate resilience remains a critical concern. The adoption of climate-resilient crops has been slow, as many farmers lack access to seeds and other necessary resources. Moreover, rural communities face knowledge gaps in modern agricultural techniques, highlighting the need for expanded training and extension services to support sustainable agricultural practices (Khan, 2019).Socio-Economic Barriers to Policy ImplementationFinancial Constraints and Market AccessOne of the main obstacles to successful policy implementation in both Nepal and Afghanistan is financial constraints. Many farmers lack access to credit and financial services, limiting their ability to invest in new technologies or diversify crops. Additionally, the lack of market access in rural areas further restricts farmers’ ability to benefit from policy reforms. Without reliable transportation and storage infrastructure, farmers experience high post-harvest losses and reduced profitability (Sharma, 2021).Gender Inequality in AgricultureGender inequality also plays a role in limiting the effectiveness of agricultural policy reforms. In both countries, women constitute a significant portion of the agricultural workforce but have limited access to resources, training, and decision-making roles. In Nepal, cultural norms often restrict women’s participation in agricultural training programs, while in Afghanistan, security concerns further limit women’s mobility and access to agricultural resources. Addressing gender disparities in agriculture is essential for ensuring that policy reforms benefit all members of the rural community (Perera, 2020).Recommendations for Improving Food Security and SustainabilityEnhancing Rural Infrastructure and Market AccessImproving rural infrastructure, such as roads, storage facilities, and market access, is essential for enhancing the effectiveness of policy reforms. Both Nepal and Afghanistan should prioritize infrastructure development in remote areas to reduce post-harvest losses and facilitate market access. Establishing cooperative marketing systems could also help small-scale farmers reach larger markets, increasing their profitability and improving food security.Expanding Access to Agricultural Credit and Financial ServicesExpanding access to credit and financial services can empower farmers to invest in sustainable agricultural practices and diversify their income sources. Governments could partner with microfinance institutions and banks to offer low-interest loans tailored to the needs of small-scale farmers. Providing financial support for the adoption of sustainable practices and climate-resilient crops would enhance the capacity of rural communities to adapt to environmental challenges.Supporting Gender-Inclusive Policies in AgricultureAddressing gender inequality in agriculture is crucial for the success of policy reforms. Both countries should implement gender-sensitive agricultural policies that promote women’s access to resources, training, and leadership opportunities. Creating women’s cooperatives and training programs specifically for female farmers would empower women to contribute more effectively to agricultural sustainability and food security.Promoting Climate-Resilient and Sustainable AgricultureInvesting in climate-resilient agricultural practices and sustainable farming techniques is essential for long-term food security in both Nepal and Afghanistan. Governments should expand training programs on climate-adaptive techniques and provide farmers with access to drought-resistant seeds and water-saving technologies. Additionally, increasing awareness about the benefits of sustainable agriculture can encourage wider adoption of eco-friendly practices.ConclusionFood security and agricultural sustainability remain critical challenges in Nepal and Afghanistan, where recent policy reforms have made strides but face implementation barriers. While efforts to improve irrigation, promote crop diversification, and support sustainable farming have shown promise, additional measures are needed to address socio-economic and environmental challenges. Enhancing infrastructure, expanding access to financial resources, and implementing gender-inclusive policies can strengthen the impact of policy reforms and support long-term agricultural resilience.Achieving food security in South Asia requires a holistic approach that combines policy reform, community engagement, and sustainable agricultural practices. By addressing the structural barriers to food security, Nepal and Afghanistan can ensure that their agricultural sectors become more resilient, sustainable, and capable of supporting their rural populations in the face of ongoing challenges.ReferencesAzimi, H. (2020). Agricultural Policy Reforms in Afghanistan: An Analysis of NCADPP’s Impact on Food Security. Afghanistan Journal of Sustainable Development, 12(4), 233-248.Khan, R. (2019). Challenges in Climate-Resilient Agriculture for Food Security in Afghanistan. Journal of Environmental Studies, 16(2), 145-160.Perera, M. (2020). Gender Inequality and Agricultural Development in South Asia: Insights from Nepal and Afghanistan. South Asian Gender Studies, 8(1), 89-103.Sharma, D. (2021). Impacts of Agricultural Diversification and Market Access on Food Security in Nepal. Journal of Rural Development, 27(3), 198-212.Thapa, S. (2019). Sustainable Farming Practices and Food Security in Nepal: Progress and Barriers. Nepal Journal of Agricultural Policy, 22(1), 117-133.