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Antibiotic resistance of Vibrio parahaemolyticus and Vibrio vulnificus in various countries: A review

Elmahdi S, DaSilva LV, Parveen S

Food Microbiol, 2016 Aug;57:128-34.
PMID: 27052711 DOI: 10.1016/j.fm.2016.02.008

Vibrio parahaemolyticus and Vibrio vulnificus are the leading causes of seafood associated infections and mortality in the United States. The main syndromes caused by these pathogens are gastroenteritis, wound infections, and septicemia. This article reviewed the antibiotic resistance profile of V. parahaemolyticus and V. vulnificus in the United States and other countries including Italy, Brazil, Philippines, Malaysia, Thailand, China, India, Iran, South Africa and Australia. The awareness of antimicrobial resistance of these two pathogens is not as well documented as other foodborne bacterial pathogens. Vibrio spp. are usually susceptible to most antimicrobials of veterinary and human significance. However, many studies reported that V. vulnificus and V. parahaemolyticus showed multiple-antibiotic resistance due to misuse of antibiotics to control infections in aquaculture production. In addition, both environmental and clinical isolates showed similar antibiotic resistance profiles. Most frequently observed antibiotic resistance profiles involved ampicillin, penicillin and tetracycline regardless of the countries. The presence of multiple-antibiotic resistant bacteria in seafood and aquatic environments is a major concern in fish and shellfish farming and human health.
Fulltext Evaluating the effects of environmental management practices on environmental and financial performance of firms in Malaysia: the mediating role of ESG disclosure

Ali Q, Salman A, Parveen S

Heliyon, 2022 Dec;8(12):e12486.
PMID: 36590548 DOI: 10.1016/j.heliyon.2022.e12486

The concepts of environmental and business sustainability are well-established in the business lexicon of progressive firms. However, firms are yet to examine the effects of environmental management practices (EMPs) on environmental performance (EP) and financial performance (FP) by connecting the missing linkage of environment, social, and governance disclosure (ESGD). This study analyses the impact of EMPs on EP and FP and offers empirical evidence of whether ESGD mediates the relationship between EP and FP of firms in Malaysia. The data from 141 listed firms on Bursa Malaysia was extracted between 2009-2020. The data was analyzed using data envelopment analysis (DEA) and the generalized method of moments (GMM) technique. The findings reflect that EMPs have a significant positive effect on EP and all five proxies of EP have a significant positive effect on ESGD (except 'S') and FP. Also, ESGD together with its three proxies mediates the relationship between EP and FP. The findings of this research offer an empirical rationale for regulators and policymakers of industrial firms to accelerate their EMPs and improve ESGD mechanisms for better environmental and financial outcomes.
Quality Assessment of Systematic Reviews of Temporomandibular Joint Ankylosis Surgical Treatment Outcomes

Kattimani VS, Jairaj A, Govindan NO, Mathai P, Sahu S, Patley A, et al.

J Contemp Dent Pract, 2020 Mar 01;21(3):337-349.
PMID: 32434984

AIM: Temporomandibular joint ankylosis (TMJA) management involves many surgical treatment modalities depending on the experience of the operator. A lot of literature has been published on various treatment modalities. Many systematic reviews (SRs) were published without any published prior protocol. So, the study aimed to evaluate the quality of SRs with meta-analysis of TMJA management.
MATERIALS AND METHODS: Systematic reviews with meta-analysis were included for the quality assessment using AMSTAR (assessment of multiple SRs) and Glenny et al. checklist by two independent teams. The search was limited to the Medline database archival (from January 1980 to December 2018).
RESULTS: The primary search identified 1,507 related articles. After activation of different filters, abstracts screening, and cross-referencing, finally, a total of six studies were assessed to make the overview up-to-date.
CONCLUSION: The articles scored 8 to 11 with AMSTAR and 7 to 13 with the Glenny et al. checklist. None of the published reviews received maximum scores. The methodology and heterogeneity are essential factors to assess the quality of the published literature.
CLINICAL SIGNIFICANCE: None of the included meta-analysis was registered or published protocol with Prospero or Cochrane before publication for better validity of the studies. The authors are advised to follow reporting criteria so that in the future it is possible to provide the standards of care for TMJA with the highest quality of evidence.
Computer assisted diagnostic system in tumor radiography

Faisal A, Parveen S, Badsha S, Sarwar H, Reza AW

J Med Syst, 2013 Jun;37(3):9938.
PMID: 23504472 DOI: 10.1007/s10916-013-9938-3

An improved and efficient method is presented in this paper to achieve a better trade-off between noise removal and edge preservation, thereby detecting the tumor region of MRI brain images automatically. Compass operator has been used in the fourth order Partial Differential Equation (PDE) based denoising technique to preserve the anatomically significant information at the edges. A new morphological technique is also introduced for stripping skull region from the brain images, which consequently leading to the process of detecting tumor accurately. Finally, automatic seeded region growing segmentation based on an improved single seed point selection algorithm is applied to detect the tumor. The method is tested on publicly available MRI brain images and it gives an average PSNR (Peak Signal to Noise Ratio) of 36.49. The obtained results also show detection accuracy of 99.46%, which is a significant improvement than that of the existing results.
Fulltext COVID-19 and dynamics of environmental awareness, sustainable consumption and social responsibility in Malaysia

Ali Q, Parveen S, Yaacob H, Zaini Z, Sarbini NA

Environ Sci Pollut Res Int, 2021 Oct;28(40):56199-56218.
PMID: 34050516 DOI: 10.1007/s11356-021-14612-z

Despite a profound evidence of the human unsustainable behaviours' impact on the environment, stark disparities prevail on this narrative especially in the context of the current epidemiological situation ushered by the COVID-19. The ongoing pandemic is a global public health concern due to its sagacious impacts on environmental sustainability, social responsibility and people's quality of life. This study primarily focuses on analysing the impact of COVID-19 (COV) on the environmental awareness (EA), sustainable consumption (SC) and social responsibility (SR). Additionally, we aspire to investigate the impact of demographics of generations and religion on the proposed nexus in this study. The data was collected from 700 participants of different age groups and religious backgrounds in Malaysia, and structural equation modelling (SEM) was used to analyse this data and test the hypotheses. The findings indicate that COVID-19 has a significantly positive impact on EA, SC and SR, and the generations and religiosity moderate the relationship between COVID-19 and its impact on sustainable behaviours. This study contributes to analyse the difference in the perception of EA, SC and SR among the people that eventually will stimulate the scientific reasoning among the governments, policymakers and scientists to develop a holistic framework to combat unprecedented event such as COVID-19 and ensure the authentication of sustainable environment and exceptional quality of life. The policymakers in Malaysia may use the findings of this study to inspect the social and environmental aspects of the people during the transformation events.
Urbanization and energy consumption effects on carbon dioxide emissions: evidence from Asian-8 countries using panel data analysis

Abbasi MA, Parveen S, Khan S, Kamal MA

Environ Sci Pollut Res Int, 2020 May;27(15):18029-18043.
PMID: 32170610 DOI: 10.1007/s11356-020-08262-w

The developing world is facing pivotal challenges in recent times. Among these, global warming has ominous repercussions on every segment of society, thus tracing its underlying causes is imperative. This research attempts to investigate the impact of urbanization and energy consumption on carbon dioxide emissions (CO2) for a panel of 8 Asian countries (Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, and Sri Lanka) over the period 1982 to 2017. The analyses are executed using panel co-integration and Granger causality techniques. The main findings of panel co-integration reveal a long-run relationship between urbanization, energy consumption, and CO2 emissions. Furthermore, the results indicate a positive and significant impact of urbanization and energy consumption on CO2 emissions, indicating that urban development and high energy consumptions are barriers to improve environmental quality in the long run. The results also highlight bi-directional causality between energy consumption and urbanization, while unidirectional causality exists between energy consumption and CO2 emissions. Based on the obtained results, this study offers useful policy implications for plummeting carbon emissions.
Fulltext Perceptions and attitudes towards dementia among university students in Malaysia

Griffiths AW, Cheong WL, Saw PS, Parveen S

BMC Med Educ, 2020 Mar 20;20(1):82.
PMID: 32192471 DOI: 10.1186/s12909-020-1972-5

BACKGROUND: One of the major challenges worldwide is the stigma associated with dementia. There is limited dementia awareness within Malaysian communities, including levels of confusion regarding the differences between dementia and the usual ageing progress, which can lead to delays in support seeking. The need for additional training and education for healthcare professionals has been highlighted. The present study aimed to evaluate the benefits of a one-hour dementia education session (Dementia Detectives workshop) for pharmacy and medicine undergraduate students at a Malaysian university.
METHODS: Participants attended the workshop and completed pre- (Time 1) and post-workshop (Time 2) questionnaires consisting of validated measures exploring attitudes towards dementia and older people more broadly.
RESULTS: A total of 97 students were recruited. Attitudes towards people with dementia showed significant positive changes between Time 1 and Time 2, whereas no differences were found for attitudes towards older people.
CONCLUSIONS: As medical and pharmacy students develop theoretical knowledge, practical skills and professional attitudes during their undergraduate studies, it is important for students to also learn about the humanistic side of diseases and conditions through workshops such as the one presented here. Further research should now be conducted to consider how Dementia Detectives can be delivered to non-healthcare students and what the barriers and facilitators to wider delivery are.
REPORT- Some ethanobotanically important plants from Cholistan area for anti avian influenza virus (AIV) H9N2 screening

Shahzad MI, Ashraf H, Aslam A, Parveen S, Kamran Z, Naz N, et al.

Pak J Pharm Sci, 2019 Nov;32(6):2751-2756.
PMID: 31969311

Avian influenza or bird flu is a common problem of domestic and wild birds. Some of its strains are able to cross the species barrier and cause infection in various members of class Mammalia. In view of relatively lesser efficacy of vaccines, antiviral therapies remain the only choice for the sustenance of mammals acquiring this highly devastating infection. This study is based on the evaluation of antiviral potential of methanol extracts of eleven selected Cholistani plants. The methanol extracts were prepared by using dried plants material followed by concentrating in a rotary evaporator and finally air dried before dissolving in nanopure water. The suspension was filter sterilized and subjected to in ovo antiviral assays. The allantoic fluids were harvested and haemagglutinin (HA) titers were determined. Among the eleven plants evaluated all methanol extracts were found effective against AIV H9N2 except S. baryosma extract. The medicinal plants O. compressa, N. procumbens, and S. surattense were found to be more effective than others and they retained HA titers at 0 after challenge. The next in order were extracts of O. esculentum, H. salicornicum and S. fruticosa which kept HA titers at 4, 8 and 16 respectively. The extracts of H. recurvum, P. antidotale, S. icolados and A. aspera were found less effective than above mentioned plant extracts and they kept the HA titers at 32, 64, 128 and 256 respectively. These results led us to conclude that the medicinal plants of Cholistan region are a rich source of antiviral agent(s) against AIV H9N2 and could be a source of cost effective alternate therapeutics.
Remarkable migration propensity of dental pulp stem cells towards neurodegenerative milieu: An in vitro analysis

Senthilkumar S, Venugopal C, Parveen S, K S, Rai KS, Kutty BM, et al.

Neurotoxicology, 2020 12;81:89-100.
PMID: 32905802 DOI: 10.1016/j.neuro.2020.08.006

Stem cell therapy provides a ray of hope for treating neurodegenerative diseases (ND). Bone marrow mesenchymal stem cells (BM-MSC) were extensively investigated for their role in neuroregeneration. However, drawbacks like painful bone marrow extraction, less proliferation and poor CNS engraftment following systemic injections of BM-MSC prompt us to search for alternate/appropriate source of MSC for treating ND. In this context, dental pulp stem cells (DPSC) could be an alternative to BM-MSC as it possess both mesenchymal and neural characteristic features due to its origin from ectoderm, ease of isolation, higher proliferation index and better neuroprotection. A study on the migration potential of DPSC compared to BM-MSC in a neurodegenerative condition is warranted. Given the neural crest origin, we hypothesize that DPSC possess better migration towards neurodegenerative milieu as compared to BM-MSC. In this prospect, we investigated the migration potential of DPSC in an in vitro neurodegenerative condition. Towards this, transwell, Matrigel and chorioallantoic membrane (CAM) migration assays were carried-out by seeding hippocampal neurons in the lower chamber and treated with 300 μM kainic acid (KA) for 6 h to induce neurodegeneration. Subsequently, the upper chamber of transwell was loaded with DPSC/BM-MSC and their migration potential was assessed following 24 h of incubation. Our results revealed that the migration potential of DPSC/BM-MSC was comparable in non-degenerative condition. However, following injury the migration potential of DPSC towards the degenerating site was significantly higher as compared to BM-MSC. Furthermore, upon exposure of naïve DPSC/BM-MSCs to culture medium derived from neurodegenerative milieu resulted in significant upregulation of homing factors like SDF-1alpha, CXCR-4, VCAM-1, VLA-4, CD44, MMP-2 suggesting that the superior migration potential of DPSC might be due to prompt expression of homing factors in DPSC compared to BM-MSCs.
Fulltext Pattern of medication utilization in hospitalized patients with COVID-19 in three District Headquarters Hospitals in the Punjab province of Pakistan

Mustafa ZU, Kow CS, Salman M, Kanwal M, Riaz MB, Parveen S, et al.

Explor Res Clin Soc Pharm, 2022 Mar;5:100101.
PMID: 34977851 DOI: 10.1016/j.rcsop.2021.100101

Purpose: In Pakistan, a wide range of repurposed drugs are recommended to manage hospitalized patients with COVID-19. Therefore, the current study was conducted to evaluate the pattern of utilization of repurposed drugs and other potential therapeutic options among hospitalized patients with COVID-19 in Pakistan.
Methods: This retrospective, multicenter, descriptive study enrolled consecutive hospitalized patients with COVID-19 who were admitted between March 1, 2021, and April 30, 2021, from three District Headquarter Hospitals in the Punjab province of Pakistan. We described patient and clinical characteristics and medications, stratified by COVID-19 severity during hospitalization: mild, moderate, and severe. In addition, an analytical study of drug utilization was conducted.
Findings: A total of 444 hospitalized patients with COVID-19 were included. Remdesvir, corticosteroids, antibiotics, and antithrombotics were administered to 45.0%, 93.9%, 84.9%, and 60.1% of patients, respectively. Specifically, dexamethasone was the most commonly used corticosteroid among the included patients (n = 405; 91.2%), irrespective of their clinical severity. Only 60.1% of patients hospitalized with COVID-19 in our cohort received antithrombotic therapy, and the prevalence of use was especially low (27.8%) in patients with mild illness. Of 444 patientsscreened, 399 (89.9%) patients had been discharged, and 45 patients (10.1%) died.
Implications: We provided an important glimpse into the utilization patterns of several medications of interest for the treatment of COVID-19 in Pakistan, which had not been entirely evidence-based, especially concerning systemic corticosteroids and antibiotics.
Microbial Metabolites-induced Epigenetic Modifications for Inhibition of Colorectal Cancer: Current Status and Future Perspectives

Singh V, Shirbhate E, Kore R, Vishwakarma S, Parveen S, Veerasamy R, et al.

Mini Rev Med Chem, 2025;25(1):76-93.
PMID: 38982701 DOI: 10.2174/0113895575320344240625080555

Globally, one of the most prevalent cancers is colorectal cancer (CRC). Chemotherapy and surgery are two common conventional CRC therapies that are frequently ineffective and have serious adverse effects. Thus, there is a need for complementary and different therapeutic approaches. The use of microbial metabolites to trigger epigenetic alterations as a way of preventing CRC is one newly emerging field of inquiry. Small chemicals called microbial metabolites, which are made by microbes and capable of altering host cell behaviour, are created. Recent research has demonstrated that these metabolites can lead to epigenetic modifications such as histone modifications, DNA methylation, and non-coding RNA regulation, which can control gene expression and affect cellular behaviour. This review highlights the current knowledge on the epigenetic modification for cancer treatment, immunomodulatory and anti-carcinogenic attributes of microbial metabolites, gut epigenetic targeting system, and the role of dietary fibre and gut microbiota in cancer treatment. It also focuses on short-chain fatty acids, especially butyrates (which are generated by microbes), and their cancer treatment perspective, challenges, and limitations, as well as state-of-the-art research on microbial metabolites-induced epigenetic changes for CRC inhibition. In conclusion, the present work highlights the potential of microbial metabolites-induced epigenetic modifications as a novel therapeutic strategy for CRC suppression and guides future research directions in this dynamic field.
Strategies to Combat Resistance to Anti-angiogenesis Therapies in Cancer: Current Status and Future Prospects

Patel VK, Shirbhate E, Singh V, Parveen S, Veerasamy R, Tiwari AK, et al.

Curr Top Med Chem, 2025 Feb 06.
PMID: 39936438 DOI: 10.2174/0115680266324868250123052818

Anti-angiogenic therapy represents a promising approach to cancer treatment by targeting the vascular support systems of tumors rather than the tumor cells themselves. Antiangiogenic agents face numerous obstacles that impede their efficacy, notwithstanding their potential: mechanistic complexity, toxicity, resistance, and the lack of validated predictive biomarkers. Resistance mechanisms may encompass genetic modifications, alternative angiogenic pathways, or the recruitment of cells derived from bone marrow. This work examines present problems and approaches to overcome resistance against anti-angiogenic treatment. Treatment response is predicted by biomarker-guided therapy; patterns of circulating endothelial cells, IL-8 levels, and VEGFR expression indicate possible therapeutic monitoring value. Multi-targeted approaches including drugs that block VEGFR, PDGFR, FGFR, and c-MET concurrently have shown more efficacy than single- pathway inhibition. Additional research indicates that combining treatments has positive results. Combining anti-angiogenic agents with cancer vaccines increases immune responses and tumour regulation. Combining radiotherapy with chemotherapy increases drug delivery and efficacy utilizing vascular normalisation. Techniques based on nanotechnology such as gold nanoparticles and carbon-based materials may enhance medicinal efficacy and delivery. These results reveal that to overcome resistance mechanisms and enhance patient outcomes anti-angiogenic therapy must combine focused therapies with precision medicine approaches.
Isolation and identification of salt-tolerant plant-growth-promoting rhizobacteria and their application for rice cultivation under salt stress

Sultana S, Paul SC, Parveen S, Alam S, Rahman N, Jannat B, et al.

Can J Microbiol, 2020 Feb;66(2):144-160.
PMID: 31714812 DOI: 10.1139/cjm-2019-0323

Growth and productivity of rice are negatively affected by soil salinity. However, some salt-tolerant rhizosphere-inhabiting bacteria can improve salt resistance of plants, thereby augmenting plant growth and production. Here, we isolated a total of 53 plant-growth-promoting rhizobacteria (PGPR) from saline and non-saline areas in Bangladesh where electrical conductivity was measured as >7.45 and <1.80 dS/m, respectively. Bacteria isolated from saline areas were able to grow in a salt concentration of up to 2.60 mol/L, contrary to the isolates collected from non-saline areas that did not survive beyond 854 mmol/L. Among the salt-tolerant isolates, Bacillus aryabhattai, Achromobacter denitrificans, and Ochrobactrum intermedium, identified by comparing respective sequences of 16S rRNA using the NCBI GenBank, exhibited a higher amount of atmospheric nitrogen fixation, phosphate solubilization, and indoleacetic acid production at 200 mmol/L salt stress. Salt-tolerant isolates exhibited greater resistance to heavy metals and antibiotics, which could be due to the production of an exopolysaccharide layer outside the cell surface. Oryza sativa L. fertilized with B. aryabhattai MS3 and grown under 200 mmol/L salt stress was found to be favoured by enhanced expression of a set of at least four salt-responsive plant genes: BZ8, SOS1, GIG, and NHX1. Fertilization of rice with osmoprotectant-producing PGPR, therefore, could be a climate-change-preparedness strategy for coastal agriculture.
Fulltext Health management during COVID-19 pandemic-contribution of women health informaticians, medical physicists and veterinarians from Bangladesh and Malaysia during the world crisis

Yeong CH, Azhari HA, Parveen S, Juyena NS, Nahar N, Islam MA, et al.

Health Technol (Berl), 2021;11(5):1149-1163.
PMID: 34485010 DOI: 10.1007/s12553-021-00588-w

This article aims to highlight some of the contributions from Bangladeshi and Malaysian women scientists in the fields of health informatics, medical physics and biomedical engineering, and veterinary science in combating the COVID-19 world crisis. The status of COVID-19 situations in Bangladesh and Malaysia in respect to global scenario, some relevant government policies, lessons learnt from previous pandemics, socio-economic impacts of COVID-19, the impact on healthcare system and health management approaches taken by individual/institutional research group led by women scientists during the COVID-19 pandemic have been discussed and demonstrated in this article. These promising activities and initiatives will eventually motivate other women in science and extend their roles from laboratory to society in more aspects.
Fulltext Effect of Silymarin as an Adjunct Therapy in Combination with Sofosbuvir and Ribavirin in Hepatitis C Patients: A Miniature Clinical Trial

Ahmed S, Ullah N, Parveen S, Javed I, Jalil NAC, Murtey MD, et al.

Oxid Med Cell Longev, 2022;2022:9199190.
PMID: 35154575 DOI: 10.1155/2022/9199190

Silymarin is proclaimed to be a blend of flavonolignans or phytochemicals. An era of new generation of direct-acting antivirals (DAAs) has commenced to have facet effect in swaying of the hepatitis C virus (HCV). Nonetheless, this therapy has serious side effects that jeopardize its efficacy. This study is aimed at probing the effects of ribavirin (RBV) and sofosbuvir (SOF) along with silymarin as an adjunct therapy on hematological parameters and markers of obscured oxidative stress. The effect of DAAs along with silymarin was also examined on variable sex hormone level and liver function markers such as alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and bilirubin. The study was followed to determine viral load and viral genotypes. A total of 30 patients were randomly divided into two equal groups comprising the control group (n = 15) and treatment group (n = 15). The control group was solely administered with DAAs (SOF and RBV; 400 mg/800 mg each/day). Conversely, the treatment group was dispensed with DAAs, but with adjunct therapy of silymarin (400 mg/day) along with DAAs (400/800 mg/day) over period of 8 weeks. Sampling of blood was performed at pre- and posttreatment levels for the evaluation of different propound parameters. Our data showed that silymarin adjunct therapy enhances the efficiency of DAAs. A decrease in menace level of liver markers such as ALT, ALP, AST, and bilirubin was observed (p > 0.05). The adjunct therapy concurrently also demonstrated an ameliorative effect on hematological indices and oxidative markers, for instance, SOD, TAS, GSH, GSSG, and MDA (p < 0.05), diminishing latent viral load. The silymarin administration was also found to revamp the fluster level of sex hormones. Our outcomes provide evidence that systematic administration of silymarin effectively remits deviant levels of hematological, serological, hormonal, and antioxidant markers. This demonstrates a possibly unique role of silymarin in mitigating hepatitis C.
Fulltext Nurses' Perceptions, Involvement, Confidence and Perceived Barriers Towards Antimicrobial Stewardship Program in Pakistan: Findings from a Multi-Center, Cross-Sectional Study

Mustafa ZU, Manzoor MN, Shahid A, Salman M, Hayat K, Yasmin K, et al.

J Multidiscip Healthc, 2022;15:2553-2562.
PMID: 36388630 DOI: 10.2147/JMDH.S376664

PURPOSE: Antimicrobial resistance (AMR) is leading to greater therapeutic cost, length of hospital stays, adverse events, morbidity and mortality. Hospital-based antimicrobial stewardship programs (ASPs) engaging physicians, pharmacists, microbiologists and nurses are considered as effective way to ensure appropriate use of antimicrobial agents. The aims of our study were to assess nurses' perception, involvement, confidence and barriers towards hospital-based ASPs, and use the findings to provide future guidance.
METHODS: A web-based, cross-sectional study was conducted among the nurses serving at eleven hospitals of Punjab province of Pakistan during a period of two months (December 2021-January 2022). Data were collected using a validated self-administered questionnaire. All data were analyzed using SPSS version 22.
RESULTS: A total of 583 nurses participated in the study (response rate = 77.7%). All the participants were female staff nurses and 86% had a minimum of 3 years of working experience. The overall median score on the perception towards ASPs among the nurses was 18 (IQR: 16, 19) on a 0 to 20 scale whereas median score on the involvement in ASPs was 18 (IQR: 15, 37) on a 0 to 64 scale. Median perception and involvement score were statistically significantly differed by age (p < 0.001) and years of experience (p < 0.001). The overall median score on the confidence to perform ASP activities was 22 (IQR: 14, 24) on a 0 to 28 scale. Lack of knowledge, insufficient support from administration, and heavy workload were found to be the common barriers to perform ASP.
CONCLUSION: Our study concluded that Pakistani nurses have positive perception but limited involvement in ASPs. Moreover, they are confident to perform ASP besides many barriers.

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