Mubashir Zafar

@iau.edu.sa

Assistant Professor and Public Health
Imamm Abdul Rehman Bin Faisal University



              

https://researchid.co/29999
43

Scopus Publications

Scopus Publications

  • LATS2 and FAT4 as key candidate genes of hippo pathway associated with the risk and progression of breast cancer: an in-silico approach
    Sadaf, Mubashir Zafar, Sheersh Massey, Abdulaziz A Aloliqi, Sadaf Anwar, Abrar Ali, Malik Asif Hussain, Tulika Bhardwaj, and Kapil Dev

    Springer Science and Business Media LLC

  • Association between pelvic inflammatory disease and risk of ovarian, uterine, cervical, and vaginal cancers—a meta-analysis
    Azharuddin Sajid Syed Khaja, Mohd Saleem, Mubashir Zafar, Soha Moursi, Ghorashy Eltayeb Yousif Mohammed, Syed Monowar Alam Shahid, Sahar Hammam, Safia Moussa, Mohammed Salem Alharbi, and Ahmed Nawi Alshammari

    Springer Science and Business Media LLC

  • Unravelling the therapeutic potential of forkhead box proteins in breast cancer: An update (Review)
    Sadaf Anwar, Mubashir Zafar, Malik Asif Hussain, Naveed Iqbal, Abrar Ali, Sadaf, Simran Kaur, Mohammad Z Najm and M. A. Kausar


    Breast cancer, a prominent cause of mortality among women, develops from abnormal growth of breast tissue, thereby rendering it one of the most commonly detected cancers in the female population. Although numerous treatment strategies are available for breast cancer, discordance in terms of effective treatment and response still exists. Recently, the potential of signaling pathways and transcription factors has gained substantial attention in the cancer community; therefore, understanding their role will assist researchers in comprehending the onset and advancement of breast cancer. Forkhead box (FOX) proteins, which are important transcription factors, are considered crucial regulators of various cellular activities, including cell division and proliferation. The present study explored several subclasses of FOX proteins and their possible role in breast carcinogenesis, followed by the interaction between microRNA (miRNA) and FOX proteins. This interaction is implicated in promoting cell infiltration into surrounding tissues, ultimately leading to metastasis. The various roles that FOX proteins play in breast cancer development, their intricate relationships with miRNA, and their involvement in therapeutic resistance highlight the complexity of breast cancer dynamics. Therefore, recognizing the progress and challenges in current treatments is crucial because, despite advancements, persistent disparities in treatment effectiveness underscore the need for ongoing research, with future studies emphasizing the necessity for targeted strategies that account for the multifaceted aspects of breast cancer.

  • Enhancing University Students’ Mental Health under Artificial Intelligence: Principles of Behaviour Therapy
    Mubashir Zafar

    LIDSEN Publishing Inc
    The increasing prevalence of mental health issues among university students has become a growing concern globally. This review explores the potential of Artificial Intelligence (AI) integrated with principles of behaviour therapy to address mental health challenges among university students. The paper examines how AI technologies, including chatbots, virtual reality, and machine learning algorithms, can be harnessed to provide accessible, personalized, and effective mental health interventions. Furthermore, it discusses applying behaviour therapy principles within AI-driven mental health interventions, focusing on techniques such as cognitive restructuring, exposure therapy, and reinforcement strategies. The review highlights the promising outcomes and challenges of integrating AI and behaviour therapy principles in university mental health services, emphasizing the need for ethical considerations, privacy protection, and cultural sensitivity. By synthesizing current research findings and theoretical frameworks, this paper provides insights into the potential of AI-driven behaviour therapy interventions to enhance university students’ mental health and well-being.

  • Assessment of lifestyle changes in combating the COVID-19 pandemic among people of Karachi, Pakistan
    Mubashir Zafar, Tafazzul Hyder Zaidi, Nadira Hyder Zaidi, Muhammad Waqas Nisar Ahmed, Mahjabeen Shah, Umm e Habiba, Marrium Sultan Dar, Noor ul Ain, Fatima Shahid, and Hiba Hamid Meer

    Informa UK Limited
    Aim: COVID-19 arose as a pandemic that wreaked havoc all over the world. Study determines lifestyle changes adopted by people of Karachi in response to COVID-19 pandemic. Methods: This was the cross-sectional study and carried out at public sector hospital and 218 participants were selected through random sampling method. Results: Lifestyle changes a statistically significant difference in nutrition (p = 0.000), physical activity (p = 0.000), workout (p = 0.000), smoking (p = 0.000), sleep hours (p = 0.000), and supplements (p = 0.000) before and during lockdown. Face masks were utilized by 38% of individuals, gloves by 19%, and social isolation was observed by 26%. 11% of participants did not follow any protocols. Conclusion: Study found significant differences in lifestyle habits such as diet, sleep, smoking and physical activity.

  • Identification of TBK1 inhibitors against breast cancer using a computational approach supported by machine learning
    Arif Jamal Siddiqui, Arshad Jamal, Mubashir Zafar, and Sadaf Jahan

    Frontiers Media SA
    Introduction: The cytosolic Ser/Thr kinase TBK1 is of utmost importance in facilitating signals that facilitate tumor migration and growth. TBK1-related signaling plays important role in tumor progression, and there is need to work on new methods and workflows to identify new molecules for potential treatments for TBK1-affecting oncologies such as breast cancer.Methods: Here, we propose the machine learning assisted computational drug discovery approach to identify TBK1 inhibitors. Through our computational ML-integrated approach, we identified four novel inhibitors that could be used as new hit molecules for TBK1 inhibition.Results and Discussion: All these four molecules displayed solvent based free energy values of −48.78, −47.56, −46.78 and −45.47 Kcal/mol and glide docking score of −10.4, −9.84, −10.03, −10.06 Kcal/mol respectively. The molecules displayed highly stable RMSD plots, hydrogen bond patterns and MMPBSA score close to or higher than BX795 molecule. In future, all these compounds can be further refined or validated by in vitro as well as in vivo activity. Also, we have found two novel groups that have the potential to be utilized in a fragment-based design strategy for the discovery and development of novel inhibitors targeting TBK1. Our method for identifying small molecule inhibitors can be used to make fundamental advances in drug design methods for the TBK1 protein which will further help to reduce breast cancer incidence.

  • Lifestyle Determinants Associated with Tinnitus among Young Adults: Systematic Review and Meta-analysis
    Mubashir Zafar and Abdullah D. Alotaibi

    Medknow
    Background: Sensorineural hearing loss (tinnitus) is common among young adults. There are different medical determinants which caused tinnitus symptoms, but lifestyle determinant is an important cause of tinnitus. This study determines the relationship between lifestyle determinants with tinnitus among adults through systematic review and meta-analysis. Methods: The study design for this study is a systematic review and meta-analysis; different search engines were used for the literature review: Web of Science, Scopus, and PubMed/MEDLINE. Those article in which tinnitus caused by tumors, syndrome and medical or surgical caused were excluded. Data synthesis was done, and a total of 10 studies were pooled. Results: Smoking more than four times (odds ratio [OR]: 4.11, 95% confidence interval [CI]: 1.01–4.45), alcohol consumption 27% less likely (OR: 0.73, 95% CI: 0.03–0.96), obesity two times more likely (OR: 2.30, 95% CI: 1.71–5.20), and leisure noise exposure more than one time more likely (OR: 1.62, 95% CI: 1.05–3.78) were significantly associated with tinnitus. Conclusion: There is enough evidence that lifestyle determinants (smoking, obesity, and leisure noise exposure) are related to tinnitus. This study highlights the knowledge gap in association of tinnitus with lifestyle determinants and it will help the future direction of research in this domain of tinnitus.

  • Attitude towards seeking professional help for mental health among medical students In Karachi, Pakistan
    Mubashir Zafar, Tafazzul H Zaidi, Nadira H Zaidi, Muhammad WN Ahmed, Sobia Memon, Faheem Ahmed, Amal Siddiqui, Abeen Fatima, Ayesha Shahid, Balaj Hussain,et al.

    Informa UK Limited
    Aim: In Pakistan, seeking help for mental health is considered a social stigma and a large number of medical students are suffering from mental health. This study aimed to investigate the attitude toward seeking professional care for mental health issues among medical students. Methodology: A cross-sectional study was conducted with a total of 316 students selected through multistage stratified cluster sampling. With each academic year 500 students were enrolled. Linear regression analysis was used to find the association of outcome and independent variables. Results: Around 56% of students had a negative attitude toward seeking professional help. Common predictors associated with a negative attitude were age (p < 0.001), academic year (p < 0.001) and with self-harm behavior (p < 0.001). Conclusion: University students generally had moderate intentions to seek counseling regarding mental health.

  • Relationship between attention deficit hyperactive disorders with life satisfaction among medical students in city of Hail, KSA
    Mubashir Zafar, Alaa Y. S. Alhelali, Mohamed S. M. Alfuwis, and Waleed Z. Al-logan Alshammari

    Medknow
    BACKGROUND: Attention deficit hyperactive disorder (ADHD) begins in childhood, and its symptoms persist into adulthood. Students with ADHD symptoms will be at increased risk of antisocial behavior, depression, and loss of inhibition. This study determines the relationship between ADHD and life satisfaction level among medical students in the city of Hail, KSA. MATERIALS AND METHODS: This is a cross-sectional study that was conducted in a public-sector medical college. A total of 200 students were recruited through stratified cluster sampling. Validated, structured scales of ADHD and life satisfaction were used, and known psychiatric disorders among students were excluded from the study. Correlation and linear regression analyses were used to determine the relationship between ADHD and life satisfaction and identify the determinants of ADHD. P value < 0.05 was considered statistically significant. RESULT: The prevalence rate of ADHD among medical students was 33.3%. Female gender, third-year academic year student, and 21–26-year-old age group were the high-risk groups of ADHD. Inattention (r = -0.263, P value -0.000) and hyperactivity (r = -0.260, P value 0.000) were significantly correlated with life satisfaction level, with 92% of the variability in life satisfaction determined by inattention and hyperactivity. CONCLUSION: The burden of ADHD is high among medical students, and it negatively correlates with life satisfaction level. Students' academic and social functioning was affected due to ADHD. There is a need to address this issue with early diagnosis and management of this disorder.

  • Acne Vulgaris and Its Association with Dietary Habits at a Tertiary Care Hospital in Karachi, Pakistan
    Tafazzul Hyder Zaidi, Mubashir Zafar, Bahram Khan Khoso, Rabia Ghafoor, Saba Asghar, Saima Parveen, and Usaid Ahmed

    African Journals Online (AJOL)
    BACKGROUND: Acne is a common skin disorder among younger age group. Dietary pattern are the key determinants among acne patients. The objective of this study is to determine the association of acne vulgaris with dietary habits among patients at tertiary care hospital in Karachi, Pakistan.METHODS: it is a cross sectional study and participants were selected through simple random sampling from outpatient department of tertiary care hospital in Karachi, Pakistan. Patients presenting with acne irrespective of severity and treatment were included in the study. Bivariate analyses conducted at 95% CI and p=<0.05 considered statistically significant.RESULTS: Females gender (62%) and family history (61%) was significantly associated with acne. Face region was most (92%) affected by acne. GI upset most common co-morbid illness with Acne (p=0.006). After adjustment of covariate, those consume oily food [Daily oily food; Twice a weekly oily food)]; sugar rich food [Daily consumed sugar; Twice a weekly consumed] and less glass of water [8-10 glass per day; 6-8 glass per day; less than 6 glass per] were significantly associated with acne.CONCLUSION: Study found that un-healthy diet is significantly associated with acne. Common dietary predictors for acne were frequent use of oily food, sugary food, and less amount of drink water.

  • Association of Burnout and Depression symptoms and their prevalence among medical students in Karachi, Pakistan
    Tafuzzal Hyder Zaidi, Mubashir Zafar, Amber Ilyas, Momina khan, Rafia Ghani, Rahat Naz, and Ayesha Mubbashir

    LLC Science and Innovations
    Background — The mental health of medical students has long been a concern. Symptoms of depression and burnout are common among medical students, but the overlap of symptoms of both diseases with risk factors remains unclear. The goal of this study was to determine the prevalence of burnout and depression symptoms’ overlap in medical students. Methods — This cross-sectional study was conducted among students of the clinical course (3rd, 4th and 5th years). A multistage stratified random sampling design was used to select 284students that were offered a validated and structured questionnaire that included a modified Oldenburg Burnout Inventory and Patient Health Questionnaire-9 to assess their emotional burnout and depression, respectively. Chi-square and multinomial regression analyses were done to identify overlapping symptoms of burnout and depression with association of risk factors with dependent variable. Results — Out of 284 students, 13% had symptoms of severe depression, 24% had high burnout symptoms, and 32% had overlapping symptoms of burnout and depression. In regression analysis, higher academic year more than 2 times (5th year, OR 2.03, 95% CI 1.42-7.96, p-value 0.004) and living at dormitory more than 3 times (OR 3.97, 95% CI 1.97-5.01, p-value 0.003) were more likely associated with more extensive overlap of burnout and depression symptoms. Conclusion — There is a high prevalence of burnout and depression symptoms among medical students, with a strong association between the two disorders. Early burnout detection and psychiatric therapies given to affected students and these disorders management training at medical school, may help reduce negative consequences of these conditions.

  • Knowledge and attitude regarding HIV/AIDS in general population of Northern region of Saudi Arabia
    Mubashir Zafar, Syed Monwar Alam Shahid, Abdul Aziz Alazmmy, Mohammed Hammed Altarjami, Mohammed Ayedh Alswaidan, Abdul Rehman Alasiri, Hammed Ali Alshammari, and Abdullah Aziz

    Termedia Sp. z.o.o.

  • Glycation of Immunoglobulin-G from Pentose Sugar: A Cause for Structural Perturbations
    Fahaad Alenazi, Saheem Ahmad, Mohd Saleem, Azharuddin Sajid Syed Khaja, Mubashir Zafar, Mohammed Salem Alharbi, Turki Al Hagbani, and Mohd Yasir Khan

    Bentham Science Publishers Ltd.
    Background: Glycation of immunoglobulin-G (IgG) molecule with monosaccharides may cause significant structural disability thus resulting in their loss of function. The accumulation of AGEs formed from glycation play an important role in the aliments associated with metabolic diseases. Therefore, excess of sugar in plasma, interferes with the functioning of IgG and may contribute to wide range of diabetes-associated complications. The long-term formation of these heterogeneous AGEs may accumulate and can affect plasma proteins, especially long-lived proteins. In this study, we analyze glycation of immunoglobulin-G (IgG) with 2’-deoxyribose (deoxyribose) instigated modification in IgG structure and AGEs formation. Methods: This study aims to glycate IgG from varying concentrations of a pentose sugar, 2’-deoxy-ribose (deoxyribose). Post glycation of IgG, both the native and its glycated analogue were characterized by various physicochemical methods and techniques. The glycated protein will be assessed for its stability and perturbations by UV-VIS., fluorescence and FT-IR spectroscopic techniques. Moreover, the early glycation product will be done by NBT assay and other biochemical parameters like HMF, carbonyl content and thioflavin-T assays were also performed to see the biochemical changes induced in the glycated IgG macromolecule. Results: Glycation of protein macromolecules generates stable early glycation products (Amadori products). Later on, these Amadori products involve in series of chemical reactions to form more stable advanced glycation end products (AGEs).Our experimental study results could validate the modification in IgG structure and AGEs formation. Conclusion: The formation of IgG-AGEs from glycation of IgG with deoxyribose could exert cellular toxicity and might initiates secondary complications of diabetes. Therefore, this study emphasized on glycation reaction of IgG from deoxyribose and which has not been reported yet.

  • Prevalence, determinants of chronic rhinosinusitis and its impact on quality of life among students in Karachi, Pakistan
    Tafazzul Hyder Zaidi, Mubashir Zafar, Zafar Haleem Baloch, Alisha Shakeel, Nouman Mansoor Ali, Beenish Nisar Ahmed, Muhammad Amash Khan, Rafia Masood, Iman Fatima, and Sarah Shakeel

    Future Science Ltd
    Background: Chronic rhinosinusitis (CRS) is a common public health issue among students. Methodology: A total of 300 undergraduate students were selected through multistage cluster sampling from three public-sector universities. Sino-nasal Outcome Test (SNOT-22) and Rhinosinusitis Disability Index (RSDI) were used for determining the quality of life. Chi-square and independent t-test were used. Results: About 46% and 54% (p = 0.001) of social science and health science students were suffering from CRS, respectively. Around 7% and 9% of CRS patients had poor quality of life according to SNOT-22 and RSDI, respectively (p = 0.042 and p = 0.032, respectively). Conclusion: Quality of life was affected in all domains of SNOT-22 and RSDI.

  • Antiglycation potential of plant based TiO<inf>2</inf> nanoparticle in D-ribose glycated BSA in vitro
    Fahaad Alenazi, Mohd Saleem, Azharuddin Sajid Syed Khaja, Mubashir Zafar, Mohammed Salem Alharbi, Turki Al Hagbani, Mohd Yasir Khan, Waseem Ahmad, and Saheem Ahmad

    Wiley
    Biosynthetic procedure is one of the best alternatives, inexpensive and ecologically sound for the synthesis of titanium dioxide (TiO2) nanoparticles using a methanolic extract of medicinal plant. The main prospect of this study was to investigate the antiglycation activity of the TiO2 nanoparticles (TNP) prepared by ethanolic leaf extract of the Coleus scutellarioides. In this study, biosynthesized TNP characterized with UV‐Visible spectroscopy, X‐ray diffraction, Fourier transform infrared spectroscopy and scanning electron microscope. These TNP were further investigated with respect to their antiglycation property and it was checked in the mixture of d‐ribose glycated bovine serum albumin (BSA) by measuring ketoamine, carbonyl content, Advanced glycation end products (AGEs) and aggregation of protein instigated by glycation process. The inhibitory effect of TNP to restore the structure of BSA in presence of d‐ribose were also characterize by biophysical techniques mentioned above. Therefore, the findings of this study suggest repurposing of TNP for its antiglycation property that could be helpful in prevention of glycation instigated AGEs formation and structural loss of proteins.

  • Metformin encapsulated gold nanoparticles (MTF-GNPs): A promising antiglycation agent
    Fahaad Alenazi, Mohd Saleem, Azharuddin Sajid Syed Khaja, Mubashir Zafar, Mohammed Salem Alharbi, Turki Al Hagbani, Jalaluddin Mohammad Ashraf, Mohammad Qamar, Zeeshan Rafi, and Saheem Ahmad

    Wiley
    The generation of advanced glycation end products (AGEs) through nonenzymatic protein glycation contributes to the pathogenesis of long‐lived diabetic problems. Metformin (MTF) is the very first drug having antihyperglycemic effects on type II diabetes mellitus which also possess interaction with dicarbonyl compounds and blocks the formation of AGEs. In the current study, MTF is bioconjugated with glycation‐derived synthesized gold nanoparticles (GNPs) of significant size. Additionally, using various biophysical and biochemical approaches, we investigated the antiglycating capacity MTF‐GNPs in contrast to MTF against d‐ribose‐derived glycation of bovine serum albumin. Our key findings via utilizing various assays demonstrated that MTF‐GNPs were able to inhibit AGEs development by reducing hyperchromicity, early glycation products, carbonyl content, hydxoxymethylfurfural content, production of fluorescent AGEs, normalizing the loss of secondary structure (i.e., α‐helix and β‐sheets) of proteins, elevating the levels of free lysine and free arginine more efficiently compared to pure MTF. Based on these results, we concluded that MTF‐GNPs possess a considerable antiglycation property and may be developed as an outstanding anti‐AGEs treatment drug. Further in vivo and clinical research are necessary to determine the therapeutic effects of MTF‐GNPs against AGE‐related and metabolic disorders.




  • Knowledge and attitude regarding rotavirus and its vaccination among medical students in Karachi, Pakistan
    Tafazzul Hyder Zaidi, Mubashir Zafar, Rahat Naz, Syed Shoeb Ahmed, Ishaa Saleem, Koonj Sundardas, Aiman Aamir, Misbah Yousuf, Rubab Zehra, and Tehreem Siraj

    Elsevier BV

  • Lifestyle risk factors associated with tuberculosis patients in Asir Region of Saudi Arabia
    Faisal Alsharani, M. Zafar, Eltigani Osman Omar and Muzaheed


    Background: Tuberculosis remains to be a major public health problem. Lifestyle factors that have indirectly influence to the burden of tuberculosis. The aim of this study is to determine the lifestyle risk factors associated with tuberculosis patients in Asir region of KSA. Methods: We conducted a case-control study at the military hospital of Asir region of KSA. A total of 135 sample which is divided into 67 cases and 67 controls. Cases were included from hospital database between 2017 and 2018. Control were selected from patient attending the same hospital with respiratory disease other than tuberculosis. Data collection done through interview using a structured questionnaire. Lifestyle factors and socio-demographic factors associated with tuberculosis were analyzed using logistic regression. Results: Mean age of study participants (cases and control) are 38.04 ± 9.66 and 40.16 ± 7.72 respectively. Most important factors associated with tuberculosis patients are overweight and obese [OR = 4.40, 95% CI 1.27-15.25 and 2.38 (1.61-9.22)], Smoker [OR = 1.34, 95% CI 0.52-3.43], abnormal sleep at night (<8 hours) [OR = 5.03, 95% CI 1.57-16.10], blue color job worker [OR = 2.69, 95% CI 1.02-7.28], physical exercise <3 days/week [OR = 1.41, 95% CI 1.21-3.47]. Conclusions: In Saudi Arabia, a person's lifestyle and socioeconomic condition are associated with tuberculosis. Interventions focused on improving the quality of life through a reduction of risky lifestyle which prevent the spread of Tuberculosis in Saudi society and improve the efficiency of Saudi national tuberculosis control programme.


  • Knowledge, attitudes, and barriers regarding health research among medical students in Saudi Arabia
    Mubashir Zafar, Abdul Kareem, Ali Fawaz, Reem Fares, and Wadha Saad

    Scientific Foundation SPIROSKI
    BACKGROUND: Research is the basic component of health science curriculum. AIM: The objective of the study is to determine the knowledge, attitude, and barriers regarding health research among health science students. METHODS: It is a cross-sectional study and 294 study participants were selected through stratified random sampling from different health science colleges (medicine, dental, nursing, and applied science). A validated, structured, and pre-tested questionnaire was used. Knowledge and attitudes were determined through scales. Analysis of variance and t-test were applied to determine the mean scores of knowledge and attitude, and multiple regression analysis was used to determine the factors which affect on knowledge and attitude. RESULTS: Knowledge and attitude mean scores were 4.36 ± 2.44 and 2.74 ± 1.17, respectively. Knowledge and attitude were increase significantly with increasing academic year of study in all health science colleges (Regression coefficient 0.043 [p = 0.032] and 0.005 [p = 0.040] for knowledge and attitudes, respectively). Most common barriers for research were lack of proper mentoring from the faculty staff and lack of time due to over burden with educational activities CONCLUSION: Health science students had moderate level of knowledge and attitude toward health research with common barrier which was lack of proper mentoring from the faculty. There is need for address the barrier for research and more integration of curriculum with research which improved the knowledge and attitude level.

  • Depression and associated risk factors among hypertensive patients in primary health care centers in dammam, kingdom of saudi arabia
    Sumood Abdulbaqi Albasara, Mohammad Shafee Haneef, Mubashir Zafar, and Khawaja Ghulam Moinuddin

    Pan African Medical Journal

  • Assessment of BTEX concentration around fuel station in Eastern Province Kingdom of Saudi Arabia
    Mubashir Zafar, KhaledF Salama, and EltiganiO.M Omer

    Medknow
    Aim: The aim of this study is to determine the benzene, toluene, ethylbenzene, and xylene (BTEX) concentration levels in and around the fuel station and its harmful health effects in the city of Dammam and Al Khobar, Saudi Arabia. Materials and Methods: Forty fuel-dispensing facilities were randomly selected on the basis of three different areas: residential, traffic intersection, and petrol pump locations (refueling stations). Samples were collected using coconut shell charcoal cartridges, and the portable ambient analyzer was used for measuring BTEX concentration. Results: Results shows that the average concentration of BTEX levels around fuel stations was 10.30, 4.09, and 2.47 ppm, respectively. All mean concentration values of BTEX around residential, traffic intersection, and fuel stations are exceeding the limits of air quality standards values (P < 0.01). The mean concentration of BTEX around the residential area, side street, and direct street was as follows: benzene 8, 12.2, and 11.5 ppm; toluene 2.5, 5.95, and 3.37 ppm; and xylene 2, 2.13, and 2.7 ppm. Hazard quotient was >1, which showed that carcinogenic probability has increased those exposed to this toxic chemical. Conclusion: Values for BTEX were greater than those found in the neighboring residential area of the city and even 100 m away from the fuel station which can have a negative impact on the health of several residences. The environmental contamination associated with BTEX in petrol fuel stations impulses the necessity of preventive programs to reduce further air quality deterioration and reduce the harmful health effects.