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The COVID-19 pandemic has had a significant impact on religion and its practice. This paper aims to examine how the pandemic affects religious activities, donations, and finances over time and across regions within the United Methodist Church (UMC) in the USA. To address this question, we analyze survey data collected during the pandemic from 2963 churches in the USA by United Methodist Communications. Our analysis utilizes several quantitative techniques, including Z-tests, one-way analysis of variance (ANOVA), and multinomial logistic regressions. The results indicate a decrease in church attendance over time, with a more pronounced effect observed in non-urban areas (suburban, small town, and rural). Similarly, while church donations and finances mitigate over time across churches, churches in urban areas experience a quicker rebound compared to those in non-urban areas. Lastly, we find that church attendance and donations positively affect finances. These findings hold important implications for churches in various regions, offering insights to develop strategies for navigating the challenges posed by the COVID-19 pandemic.
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COVID-19 , População Urbana , COVID-19/epidemiologia , Humanos , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , SARS-CoV-2 , Pandemias/economiaRESUMO
The emergence of ChatGPT, a generative artificial intelligence tool, has sparked a revolution in the finance industry, enabling individuals to interact with technology in natural language. However, the use of ChatGPT in finance presents a profound array of ethical considerations that demand careful scrutiny to ensure its responsible and ethical use. After a concise exploration of ChatGPT's applications in finance, this policy article delves into the ethical challenges arising from the use of ChatGPT in finance, including outcomes contaminated with biases, incorporation of fake information in the financial decisions, concerns surrounding privacy and security, lack of transparency and accountability in the decision-making processes and financial services, human job displacement, and the intricate web of legal complexities. Our article asserts that financial institutions employing ChatGPT must proactively devise strategies to confront these burgeoning challenges, mitigating their adverse effects on both individuals and society as a whole. Additionally, we propose relevant policies to tackle these ethical quandaries head-on. In essence, this article illuminates the imperative need for a meticulous ethical framework, facilitating an informed and responsible use of ChatGPT in the realm of finance, safeguarding the welfare of individuals and society. While our work significantly contributes to the research and practice of finance, we also identify future research avenues.
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Transgender patients continue to receive suboptimal health care due to transphobia and inadequate trans-competency of health care professionals. Lack of adequate training and exposure may lead to improper bedside manners. This factor is among many other systemic and latent ones that inculcate a feeling of iatrophobia in transgender patients. This damages the patient-doctor relationship severely and ultimately results in suboptimal health care outcomes. This paper discusses the causes of iatrophobia in transgender patients and the steps that health care professionals can take to address this phenomenon. The authors believe that health care professionals that pay heed to this paper will greatly improve the competency of their care toward their transgender patients.
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Transtornos Fóbicos , Pessoas Transgênero , Humanos , Emoções , Atitude do Pessoal de SaúdeRESUMO
Social distancing served as a principal strategy to curtail the spread of COVID-19. However, congregational activities in mosques made it challenging to practice social distancing and led to a rapid surge in virus infections in several Muslim countries. This study uses nationally representative cross-sectional data from Pakistan, a Muslim-majority country, to examine the relationship of practicing preventive measures (such as social distancing, wearing mask and hand washing) and mitigation measures (like avoid going to the market, social gatherings, healthcare seeking, use of public transport, and long-distance travel) with mosque visits by utilizing logistic regressions. The results show that individuals adhering to preventive and mitigation measures also avoid visiting mosques and other religious gatherings. From a policy perspective, these results suggest that the government of Pakistan can avoid direct religious confrontation when it needs to minimize mosque visits to curtail the spread of the virus by implementing preventive and mitigation measures.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Paquistão/epidemiologia , Distanciamento Físico , ViagemRESUMO
INTRODUCTION AND IMPORTANCE: Lipomas of the gastrointestinal tract are a rare entity compared to the more common tumors of the gut, such as adenomatous polyps and carcinomas. They were first described by Bauer in 1757. Gastrointestinal lipomas can grow in all segments of the gut, with the highest frequency in the colon. In this case report, we present a rare case of gastrointestinal lipoma mimicking colonic malignancy and causing intussusception, necessitating emergent surgery. This paper highlights the potential diagnostic challenges and therapeutic interventions associated with GI lipomas. CASE PRESENTATION: A 28-year-old female presented with symptoms of abdominal pain, weight loss, vomiting, and changes in bowel habits. Initially, she received a misdiagnosis of Irritable Bowel Syndrome. Subsequent investigations indicated the possibility of colonic malignancy. During the intra-operative biopsy, it was ultimately discovered that she had a colonic lipoma. CLINICAL DISCUSSION: CT revealed an abdominal mass and an intussusception, indicating the need for surgical intervention. A laparoscopic procedure was performed to remove the mass, which alleviated the symptoms. Subsequently, a histological examination confirmed the mass to be a lipoma. CONCLUSION: Differentiating a gastrointestinal lipoma from malignancy is crucial, and careful investigation is necessary to determine if a local excision can be performed instead of a wide excision.
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INTRODUCTION: Mycetoma is a rare tropical fungal infection characterized by a clinical triad of subcutaneous swelling, multiple discharging sinuses, and a purulent discharge containing granules. If left untreated, the disease can progress from cutaneous to intraosseous and can cause osteomyelitis. In very rare instances labeled "primary mycetoma", the fungus is insidiously inoculated directly into the bone and causes osteomyelitis without any preceding cutaneous involvement. This can make the diagnosis very difficult. PRESENTATION OF CASE: A twelve-year-old girl with a history of walking barefoot, presented with pain and inability to bear weight on her left foot. There was no overlying cutaneous involvement. X-ray showed an osteolytic lesion in the calcaneum. After the failure of antibiotic treatment, the diseased bone was excised. Black granules were discovered inside the lesion and their histopathology confirmed a diagnosis of primary eumycetoma. After some time, the disease relapsed, necessitating another debridement. This occurred many times with worsened severity in each successive episode. Because of worsening disease and failure of both antifungal and surgical treatment, foot amputation was done. DISCUSSION: Primary mycetoma is an insidious fungal infection that causes osteomyelitis without any cutaneous findings. Timely diagnosis and treatment provide the best chance of preventing an amputation. CONCLUSION: A high index of suspicion must be maintained for patients presenting with symptoms of osteomyelitis without any skin involvement so that timely diagnosis and treatment can prevent the progression of the disease and the need for amputation.
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Neuro-robots are a class of autonomous machines that, in their architecture, mimic aspects of the human brain and cognition. As such, they represent unique artifacts created by humans based on human understanding of healthy human brains. European Union's Convention on Roboethics 2025 states that the design of all robots (including neuro-robots) must include provisions for the complete traceability of the robots' actions, analogous to an aircraft's flight data recorder. At the same time, one can anticipate rising instances of neuro-robotic failure, as they operate on imperfect data in real environments, and the underlying AI behind such neuro-robots has yet to achieve explainability. This paper reviews the trajectory of the technology used in neuro-robots and accompanying failures. The failures demand an explanation. While drawing on existing explainable AI research, we argue explainability in AI limits the same in neuro-robots. In order to make robots more explainable, we suggest potential pathways for future research.
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Within the national innovation system literature, the low- and middle-income countries (LMICs) eligible for the World Bank's International Development Association (IDA) support, are rarely part of empirical discourses on growth, development, and innovation. One major issue hindering empirical analyses in LMICs is the lack of complete data availability. This work offers a new full panel dataset with no missing values for IDA-eligible LMICs. I use a standard, widely respected multiple imputation method (specifically, Predictive Mean Matching) developed by Rubin in the 1980s, which conforms to the structure of multivariate continuous panel data at the country level. The incomplete input data consisting of many variables come from publicly available established sources. These variables, in turn, capture six crucial country-level capacities: technological capacity, financial capacity, human capital capacity, infrastructural capacity, public policy capacity, and social capacity. Such capacities are part and parcel of the National Absorptive Capacity Systems (NACS). The dataset (MSK dataset) thus produced contains data on 47 variables for 82 LMICs between 2005 and 2019. The dataset has passed a quality and reliability check and can therefore be used for comparative analyses of national absorptive capacities and development, transition, and convergence among LMICs.
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Países em Desenvolvimento , Desenvolvimento Econômico , Humanos , Reprodutibilidade dos Testes , RendaRESUMO
European law now requires AI to be explainable in the context of adverse decisions affecting the European Union (EU) citizens. At the same time, we expect increasing instances of AI failure as it operates on imperfect data. This paper puts forward a neurally inspired theoretical framework called "decision stacks" that can provide a way forward in research to develop Explainable Artificial Intelligence (X-AI). By leveraging findings from the finest memory systems in biological brains, the decision stack framework operationalizes the definition of explainability. It then proposes a test that can potentially reveal how a given AI decision was made.
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Mirtazapine is a tetracyclic anti-depressant with poor water solubility. The aim of this study was to improve the dissolution rate of mirtazapine by delivering the drug as a liquisolid compact. Central composite design (CCD) was employed for the preparation of mirtazapine liquisolid compacts. In this, the impacts of two independent factors, i.e., excipient ratio (carrier:coating) and different drug concentration on the response of liquisolid system were optimized. Liquisolid compacts were prepared using propylene glycol as a solvent, microcrystalline cellulose as a carrier, and silicon dioxide (Aerosil) as the coating material. The crystallinity of the formulated drug and the interactions between the excipients were examined using X-ray powder diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR), respectively. The dissolution study for the liquisolid compact was carried out as per FDA guidelines. The results showed loss of crystallinity of the mirtazapine in the formulation and was completely solubilized in non-volatile solvent and equally dispersed throughout the powder system. Moreover, drug dissolution was found to be higher in liquisolid compacts than the direct compressed conventional tablets (of mirtazapine). The liquisolid technique appears to be a promising approach for improving the dissolution of poorly soluble drugs like mirtazapine.
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Excipientes , Dióxido de Silício , Excipientes/química , Mirtazapina , Pós , Dióxido de Silício/química , Solubilidade , Solventes/química , Comprimidos/químicaAssuntos
COVID-19 , Vacinas contra COVID-19 , Humanos , Paquistão , Políticas , SARS-CoV-2 , VacinaçãoRESUMO
Introduction Worldwide the chronic suppurative otitis media (CSOM) is one of the most common infectious diseases in childhood and is a common cause of impaired hearing. The disease remains a challenging entity for the healthcare system of resource-limited nations despite the advances in modern medicine. The nature of hearing loss in CSOM is mainly conductive, the sensorineural hearing loss (SNHL) is also reported in such patients. The purpose of the study was to identify SNHL in patients with the mucosal type of CSOM and to find the impact of long-term discharging ears on bone conduction (BC) thresholds. Methods Patients with a diagnosis of the mucosal type of CSOM were identified from the record of ENT, Head and Neck Surgery clinic between January 2019 and January 2020. The patients were divided into three groups based on the duration of the disease: groups I, II, and III for 1-5 years, 5-10 years, and 10-15 years, respectively. Pure tone audiogram was reviewed, and data of BC was recorded for 500, 1000, and 2000 Hz. The descriptive frequency was calculated for SNHL in each group and group I was compared with other groups using a chi-square test. The mean BC threshold of group I was compared with other groups using a t-test. SPSS version 26 (IBM Corp., Armonk, New York) was used for statistical analysis. Results A total of 154 patients were included in the study. There were 73 males and 81 females. The mean age was 26 years. The minimum age was 12 years and the maximum age was 58 years. Active ear discharge was the presenting complaint in 84 patients. The right ear was involved in 88 patients, and the left ear was involved in 66 patients. SNHL was present in 30 out of 154 patients, i.e., 19.5%. The number of patients in each of the groups I, II, and III was 95, 28, and 31, respectively. The group I was compared with group II using the chi-square test, the p-value was found not significant, i.e., >0.05. The group I was then compared with group III using the same statistical test, and the p-value was found significant, i.e., <0.05. The mean BC threshold for an average of three speech frequencies for each of the three groups was 16.9, 18.7, and 22.9, respectively. The mean BC threshold of group I was compared with that of group II using a t-test, and the p-value was found not significant, i.e., >0.05. The mean BC threshold of group I was then compared with that of group III using a t-test, and the p-value was found significant, i.e., <0.05. Conclusions The findings of our study reproduce the presence of SNHL in a sizable proportion of the patients with a mucosal type of CSOM. Furthermore, the elevation of the BC threshold also appears statistically significant on analysis in association with the protracted duration of CSOM, highlighting the adverse impact of delaying the surgical repair. However, the clinical importance remains unclear because the maximum losses in the BC threshold seen in the patients are not severe enough to necessarily make them hard of hearing. Nevertheless, these statistically significant results influence clinical thought process and measures for an early remedy, including surgery, and need to be considered in time to prevent progressively worsening hearing loss in such cases.
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The extensive use of nitrogen (N) fertilizers implicates a paradox: while fertilizers ensure the supply of a large amount of food, they cause negative environmental externalities, including reduced biodiversity, and eutrophic streams and lakes. Moreover, such fertilizers may also result in a major public health hazard: increased antibiotic resistance. This article discusses the critical implications of perturbations in N cycle caused by excessive use of fertilizers and resulting policy implications as they relate to ecosystem services. While there are solutions such as cover crops, these solutions are expensive and inconvenient for farmers. We advocate the use of biological fixation (BF) for staple crops-microbiome mediated natural supply of fixed N. This would involve engineering a microbiome that can be grown cheaply and at industrial scale. Fertilizers resulting from such innovation are termed as "biofertilizers" in this article. Following a qualitative cost-benefit analysis broken down by key stakeholders and a quick exploration of policy frameworks as they relate to the advancement of biofertilizers, we propose a practical pathway of where and how research investments should be directed to make such a solution feasible. We make five policy recommendations for decision-makers to facilitate a successful trajectory for this solution: (1) Future agricultural science should seek to understand how BF might be employed as a practical and efficient strategy. This effort would require that industry and the government partner to establish a pre-competitive research laboratory equipped with the latest state-of-the-art technologies that conduct metagenomic experiments to reveal signature microbiomes and form novel symbiotic connections. (2) To have a smooth ride in the market, ag-bio companies should: (i) create awareness among farmers; (ii) impart skills to farmers in testing and using biofertilizers, and (iii) conduct extensive field tests and more research in studying the scalability potential of such fertilizers. (3)The United States Department of Agriculture (USDA) and state governments should provide research and development (R&D) tax credits to biotech companies specifically geared towards R&D investments aimed at increasing the viability of BF and microbiome engineering. (4) To control agricultural pollution in the biosphere, federal governments should consider passing a Clean Agriculture Act (CAA), including a specific clause that regulate the use of chemical fertilizers. (5) Governments and the UN Food and Agriculture Organization (FAO) should coordinate Biological Advanced Research in Agriculture (BARA)-a global agricultural innovation initiative for investments and research in biological fixation and ethical, legal, and social implications of such innovation. While biological fixation will be central in BARA, we envision it to conduct research around other agricultural innovations as well, such as increasing photosynthetic efficiency.
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Poluição do Ar/análise , Produtos Agrícolas , Política Ambiental , Nitrogênio/análise , Agricultura , Poluição do Ar/legislação & jurisprudência , Poluição do Ar/estatística & dados numéricos , Biodiversidade , Conservação dos Recursos Naturais , Produção Agrícola , Ecossistema , Poluição Ambiental , FertilizantesRESUMO
Objective To determine the relationship between physical activity and depression between the two genders amongst the young adults of Islamabad. Methods We conducted a cross-sectional study of students who were studying in various colleges and universities of Islamabad. Students who were willing to participate in the study and who were studying in the institute for more than six months were included in the study. The data was collected through a self-reporting questionnaire and a self-constructed questionnaire. Cronbach's alpha was used to assess the internal consistency of the self-constructed questionnaire, and it was found to be 0.69. The data obtained were analyzed on IBM's Statistical Package for the Social Sciences (SPSS) version 21 (IBM, Armonk, NY, US). Results Out of 298 participants, 113 (38%) were males and 185 (62%) were females. The mean age of the participants was 21.60±1.39 years. One-hundred twenty-six participants were found most likely to suffer from depression. Out of these 126 participants, 42 (33%) were females and 84 (67%) were males. Thirty-nine percent of the participants reported fatigue and inability to attend to their normal routine. Pearson correlation was calculated for the association of depression and age, and it was found to be significant (p-value less than 0.05). The correlation for depression with respect to physical activity was also found to be significant (p-value less than 0.05). Conclusions Low levels of physical activity can be a major risk factor for the development of depression and the possible exacerbation of any pre-existing mental disorder. There is a need to combat this problem to decrease the use of pharmaceutical means for curing depression.
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Background The prevalence of autism is growing worldwide. Owing to parents being the primary caregivers in most situations, their ability to recognize the signs and symptoms of autism and respond appropriately is of paramount importance in aiming to provide the best healthcare to autistic individuals. This study was conducted with the aim of ascertaining the parent's knowledge and awareness of autism. Methods A cross-sectional survey was conducted among parents residing in Karachi, Pakistan. We excluded any individuals belonging to the medical profession, those who have autistic children, and those who couldn't completely comprehend English and Urdu. A sample size of 339 parents was selected. A validated and pre-tested questionnaire was administered among the study participants to record demographic information, knowledge, and perceptions regarding autism and its signs and symptoms. Data were analyzed using Statistical Package for Social Sciences (SPSS version 23.0, IBM Corp., Armonk, NY, US). A knowledge score was calculated for opinions about autism and its sign and symptoms individually to reflect a participant's overall knowledge regarding autism. Results From our study population, 75% of our population had heard of autism, with those who knew of someone with the disorder displaying greater awareness. However, our participants displayed poor knowledge scores, with a mean score of 5.59 in the section concerning correct opinions on autism and that of 6.84 in the section testing knowledge of signs and symptoms. Despite this, 95.6% of the participants were willing to get their children treated, in the event of them being diagnosed with autism. Conclusion Unfortunately, our population displayed a lack of awareness and knowledge regarding autism. To fill this gap, awareness programs should be conducted to promote parent's knowledge regarding autism, so as to allow for early diagnoses and an appropriate treatment plan/therapy. On a positive note, most were willing to get their children tested and treated in case of a diagnosis. However, only a small number of participants knew of autism centers in Karachi. General practitioners are needed to play a key role in counseling parents about autism.
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Background The prevalence of colorectal cancer (CRC) is growing in Pakistan; however, there are no national screening programs or guidelines in place to curb its development. This study was conducted with the aim of ascertaining public awareness and attitudes regarding CRC and current screening practices. Furthermore, the study assessed perceived barriers which could impact future screening processes. Methods A cross-sectional, questionnaire-based study was conducted among urban dwellers of Karachi, Pakistan. We excluded any individuals belonging to the medical profession, those diagnosed previously with CRC or having any significant co-morbidity. The validated and pre-tested questionnaire was administered among the study participants to record demographic information, awareness of CRC risk factors, symptoms and screening tests. Attitudes towards screening and perceived barriers to screening were also assessed. Data were analyzed using Statistical Package for Social Sciences (SPSS version 20.0) (IBM Corp., Armonk, NY). A knowledge score, out of a total of 14 points was calculated to reflect a participant's overall knowledge regarding CRC risk factors and signs/symptoms. Results The prevalence of CRC screening in eligible individuals (50 years or older) was 2.6% in our study population. Positive attitudes towards CRC management and screening were observed, with 75.1% (n = 296) acknowledging the preventive role of screening tests. Despite this only 14.9% (n = 58) of study participants expressed a future desire to undergo screening. Major barriers to screening were reported to be "a lack of knowledge regarding the screening procedure", a "lack of screening facilities" and that the "screening procedure is too expensive". A majority (n = 285, 72.3%) of the participants expressed a greater willingness to undergo screening if their doctor recommended it. Conclusion A national CRC screening and awareness program should be launched to promote awareness and facilitate screening in risk groups. General practitioners are needed to play a key role in counseling patients and endorsing healthy screening practices.
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Manifestation of microbial spoilage of any product by bacteria and to assess the effectiveness of the anti-microbial preservatives (parabens) used for the prevention and stability purpose. The aim of the present work is to study the effectiveness of preservatives used in the antacid suspensions and to analyze the effect of microbial growth on the quality of respective antacid suspensions. Samples of various antacid suspensions were randomly collected from local market and Government hospital pharmacies. Three different antacid formulations were prepared in the laboratory. All the formulations were preliminarily evaluated on the basis of organoleptic characteristics, pH, viscosity and assay. Efficacy of the preservative system in suspension formulation was determined by inoculating the samples in its final container, with specific strains of bacteria i.e. Escherichia coli ATCC 8739, Pseudomonas aeruginosa ATCC 9027 and Staphylococcus aureus ATCC 6538, taking samples from the inoculated preparation at specified intervals of time i.e. 0 time, 07 days, 14 days and 28 days, growing it on nutrient agar medium and colony forming units (CFUs) were scored by plate count. At the same time the samples were also subjected to qualitative and quantitative testing. The decrease in CFU and alteration in assay, pH and viscosity was observed in all the formulations except formulation M2 and F3 that showed stability throughout the study period.
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Antiácidos/química , Contaminação de Medicamentos , Conservantes Farmacêuticos/farmacologia , Bactérias/isolamento & purificação , Química Farmacêutica , Estabilidade de Medicamentos , Suspensões , ViscosidadeRESUMO
A fast, simple, and a reliable high-performance liquid chromatography linked with electrochemical detector (HPLC-ECD) method for the assessment of lipoic acid (LA) and dihydrolipoic acid (DHLA) in plasma was developed using naproxen sodium as an internal standard (IS) and validated according to standard guidelines. Extraction of both analytes and IS from plasma (250 µl) was carried out with a single step liquid-liquid extraction applying dichloromethane. The separated organic layer was dried under stream of nitrogen at 40°C and the residue was reconstituted with the mobile phase. Complete separation of both compounds and IS at 30°C on Discovery HS C18 RP column (250 mm × 4.6 mm, 5 µm) was achieved in 9 min using acetonitrile: 0.05 M phosphate buffer (pH 2.4 adjusted with phosphoric acid) (52:48, v/v) as a mobile phase pumped at flow rate of 1.5 ml min(-1) using electrochemical detector in DC mode at the detector potential of 1.0 V. The limit of detection and limit of quantification for lipoic acid were 500 pg/ml and 3 ng/ml, and for dihydrolipoic acid were 3 ng/ml and 10 ng/ml, respectively. The absolute recoveries of lipoic acid and dihydrolipoic acid determined on three nominal concentrations were in the range of 93.40-97.06, and 93.00-97.10, respectively. Similarly coefficient of variations (% CV) for both intra-day and inter-day were between 0.829 and 3.097% for lipoic acid and between 1.620 and 5.681% for dihydrolipoic acid, respectively. This validated method was applied for the analysis of lipoic acid/dihydrolipoic acid in the plasma of human volunteers and will be used for the quantification of these compounds in patients with oxidative stress induced pathologies.