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How can we close persistent gender gaps in political participation? We develop a theory highlighting the role of male household members as “gatekeepers” of women’s participation in patriarchal settings and argue that the answer involves targeting these men. We conduct a field experiment in Pakistan and find that targeting women with a nonpartisan get-out-the-vote campaign has no effect on their turnout in a national election. However, women’s turnout increases substantially when male household members are canvassed to support women’s participation. Households where both men and women are canvassed see the largest increases in women’s turnout and additional increases in political discussion and men’s practical support to help women vote. Using a costly behavioral measure, we also demonstrate lasting effects on men’s supportive behavior in these households two months after the election. Our results address the importance, and tangible benefits, of engaging men to ease constraints that hinder equal participation.

Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs., Survey data collected across ten low-income and middle-income countries (LMICs) in Asia, Africa and South America compared with surveys from Russia and the United States reveal heterogeneity in vaccine confidence in LMICs, with healthcare providers being trusted sources of information, as well as greater levels of vaccine acceptance in these countries than in Russia and the United States.

Easier said than done High-profile instances of police brutality in the last few years have brought attention to patterns of abuse that have existed since the inception of modern policing. There have been many calls for police reform, a process that in many countries has taken the form of increased police engagement with communities. Blair et al . report the results of a large-scale experiment testing the effectiveness of this approach across six countries in the Southern Hemisphere (see the Perspective by Tobon). They found that such community engagement did not increase trust in the police and it did not reduce crime. Improving relationships between police and community may require deeper structural changes before or in addition to approaches such as community policing. —SNV

BACKGROUND & OBJECTIVE: Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease, showing the exaggerated response of airways to any injurious stimulus. It is no longer considered as the disease of men as it is becoming increasingly prevalent in females. Evidence suggests that gender affects the clinical presentation of the disease. The objectives of the study is to compare spirometry data between male and female smokers with COPD and to study the association of cough, sputum, and dyspnea with gender in smokers with COPD. METHODOLOGY: This descriptive study was conducted at the University of Health Sciences Lahore. The study sample included 41 COPD patients with a history of smoking. After taking written informed consent, patients were recruited from the outpatient departments of tertiary care hospitals of Lahore by convenience sampling technique. A complete history was taken, and spirometry was done on each subject. The subjects were divided into male and female groups, followed by the comparison of Spirometry data between the groups and association of symptoms with gender using appropriate statistical techniques. RESULTS: The results of this study demonstrated females were significantly younger and exhibited a greater decline of lung functions with similar pack-years history compared to male smokers with COPD. The most common presentation of females was breathlessness compared to male patients, who had sputum production as the most common presentation. CONCLUSION: Significant differences were seen in spirometry and clinical presentation of the disease in male and female COPD groups, showing the onset and symptomology of the disease.

Necrotising fasciitis is a bacterial infection of subcutaneous tissue and fascia, which can rapidly progress to septic shock. Diagnosis is frequently delayed or missed due to non-specific presentation. The laboratory risk indicator for necrotising fasciitis (LRINEC) stratifies risk based on biochemical results, but external validation revealed limited accuracy. A 78-year-old female with significant co-morbidities presented with right foot pain and erythema. Vital signs were normal and C-reactive protein was 18 mg/l. LNIREC was 0. She was treated for cellulitis, but within 24 h developed skin blistering and necrosis. After consideration of risks, washout and debridement was performed under popliteal block. Recovery was prolonged and complicated by nosocomial infection. This case highlights the importance of clinical suspicion for necrotising fasciitis and the complexity of management decisions considering recovery can be protracted.

We analyze COVID-19 vaccine acceptance across 15 survey samples covering ten low- and middle-income countries (LMICs) in Asia, Africa, and South America, Russia (an upper-middle-income country), and the United States, using survey responses from 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in LMIC samples (80% on average) compared to the United States (65%) and Russia (30%). Vaccine acceptance was primarily explained by an interest in personal protection against COVID-19, while concern about side effects was the most commonly expressed reason for reluctance. Health workers were the most trusted sources of information about COVID-19 vaccines. Our findings suggest that prioritizing vaccine distribution to LMICs should yield high returns in promoting global immunization coverage, and that vaccination campaigns in these countries should focus on translating acceptance into uptake. Messaging highlighting vaccine efficacy and safety, delivered by healthcare workers, may be most effective in addressing remaining hesitancy.

Maximum likelihood (ML) estimation requires precise knowledge of the underlying statistical model. In quasi ML (QML), a presumed model is used as a substitute to the (unknown) true model. In the context of independent vector analysis (IVA), we consider the Gaussian QML estimate (QMLE) of the demixing matrices set and present an (approximate) analysis of its asymptotic separation performance. In Gaussian QML the sources are presumed to be Gaussian, with covariance matrices specified by some “educated guess”. The resulting quasi-likelihood equations of the demixing matrices take a special form, recently termed an extended “sequentially drilled” joint congruence (SeDJoCo) transformation, which is reminiscent of (though essentially different from) classical joint diagonalization. We show that, asymptotically, this QMLE, i.e., the solution of the resulting extended SeDJoCo transformation, attains perfect separation (under some mild conditions) regardless of the sources’ true distributions and/or covariance matrices. In addition, based on the “small-errors” assumption, we present a first-order perturbation analysis of the extended SeDJoCo solution. Using the resulting closed-form expressions for the errors in the solution matrices, we provide closed-form expressions for the resulting interference-to-source ratios (ISRs) for IVA. Moreover, we prove that, asymptotically, the ISRs depend only on the sources’ covariances, and not on their specific distributions. As an immediate consequence of this result, we provide an asymptotically attainable lower bound on the resulting ISRs. We also present empirical results, corroborating our analytical derivations, of three simulation experiments concerning two possible model errors—inaccurate covariance matrices and sources’ distribution mismodeling.

Independent Vector Analysis (IVA) has emerged in recent years as an extension of Independent Component Analysis (ICA) into multiple sets of mixtures, where the source signals in each set are independent, but may depend on source signals in the other sets. In a semi-blind IVA (or ICA) framework, information regarding the probability distributions of the sources may be available, giving rise to Maximum Likelihood (ML) separation. In recent work we have shown that under the multivariate Gaussian model, with arbitrary temporal covariance matrices (stationary or non-stationary) of the source signals, ML separation requires the solution of a "Sequentially Drilled" Joint Congruence (SeDJoCo) transformation of a set of matrices, which is reminiscent of (but different from) classical joint diagonalization. In this paper we extend our results to the IVA problem, showing how the ML solution for the Gaussian model (with arbitrary covariance and cross-covariance matrices) takes the form of an extended SeDJoCo problem. We formulate the extended problem, derive a condition for the existence of a solution, and propose two iterative solution algorithms. In addition, we derive the induced Cram\'er-Rao Lower Bound (iCRLB) on the resulting Interference-to-Source Ratios (ISR) matrices, and demonstrate by simulation how the ML separation obtained by solving the extended SeDJoCo problem indeed attains the iCRLB (asymptotically), as opposed to other separation approaches, which cannot exploit prior knowledge regarding the sources' distributions.

Objective: The occurrence of gallstone pancreatitis of acute nature is very common in whole world. This research work aimed to evaluate the safety and feasibility of LC (Laparoscopic Cholecystectomy) as a decisive therapy among patients suffering from mild or resolving gallstone pancreatitis. Methodology: This study was a prospective research work carried out from August 2017 to July 2019. We diagnosed the patients with clinical examination, bio-chemical tests, ultrasound and enhanced computed tomography. The patients who were suffering from the disease of mild nature and offered Laparoscopic Cholecystectomy in hospital. We referred the patients for endoscopic sphincterotomy who were not fit for surgery. We excluded the stones of common bile duct before surgery. Results: A sum of 38 patients who were suffering from acute gallstone pancreatitis were the part of this research work in the duration of this research work. The average age of the patients was 46.3 years. We referred 26.3% (n: 10) patients for Endoscopic Retrograde Cholangio Pancreatography and endoscopic sphincterotomy. We managed 28.9% (n: 11) patients by conservative treatment. The average duration of the period from the start of symptoms and Laparoscopic Cholecystectomy was 7 days with a range from 4 to 10. The average duration of the surgery was 45 minutes and stay in the hospital was 7 days. We found no operative mortality in this research work. We recorded no major intra-surgical or post-surgical complication. Nine percent (n: 2) patients were present with complications of minor nature. Conclusion: We can perform the Laparoscopic Cholecystectomy safely in selected patients suffering from mild gallstone pancreatitis for the prevention of attacks of acute pancreatitis in future and other outcomes of late treatment. It also resolves the problem of noncompliance of treatment. Key Words: Complications, Gallstone, Cholecystectomy, Endoscopic Retrograde Cholangio Pancreatography, Laparoscopy, Mild, Pancreatitis.

Objective: The aim of this study is to provide a comparison of efficacy of Morphine and MgSo4 plus Morphine in the management of pain after coronary artery bypass surgery (CABG). Methodology: This research work was carried out in Holy Family Hospital Rawalpindi. The duration of this study was from December 2018 to July 2019. SPSS V. 23.1 was in use for the analysis of the collected information. Average and standard deviations were in use for the presentation of the numerical information as visual analog scale score and Age of the patients. In the same manner, calculations of sex and status of American society of anesthesia carried out in frequencies. T-test carried out to know the importance of the visual analog scale scores. P value of less than 0.05 was the significant one. Results: A sum of total 150 patients were the part of this research work. visual analog scale score was the outcome of this research work. We observed in the research that in M group, the average visual analog scale score after 4, 12 and 24 hours of surgery were 5.24 ± 1.61, 5.8 ± 2.27 and 5.44 ± 2.27 correspondingly. In the MM group, the average visual analog scale score after 4, 12 and 24 hours of surgery were 4.36 ± 2.58, 3.48 ± 2.1 and 4.12 ± 1.05 correspondingly. The findings showed that there was an important disparity in the visual analog scale scores among both groups, the group M was present with high visual analog scale score in comparison with the visual analog scale scores of group MM. Conclusion: The effectiveness of the Morphine plus MgSo4 was much better in comparison to the Morphine for the management of pain after the coronary artery bypass surgery. Keywords: Coronary Artery Bypass Surgery, Effectiveness, Morphine, Analgesia, Visual Analog Scale, MgSo4.

Discrete multitone transmission (DMT) schemes employing real-valued constellations such as PAM (PAM-DMT) are popular multi-carrier transmission schemes for optical systems using intensity modulation and direct detection. PAM-DMT employs a data dependent cyclic prefix (CP) to maintain cyclicity. In this letter, we propose a novel DMT scheme using real-valued modulation formats where the usual CPs are replaced by a unique word (UW) that is a known deterministic sequence. This is achieved by designing a code generator matrix in the frequency domain that introduces correlation among the data symbols. The proposed PAM UW-DMT scheme shows a superior bit error ratio performance as compared with PAM CP-DMT. Moreover, the UW can be used for other purposes, such as synchronization and channel estimation.

Discrete multitone transmission (DMT) schemes, such as asymmetrically clipped DMT and DC-biased DMT, are popular multicarrier transmission schemes for dispersive optical channels employing intensity modulation and direct detection. These transmission schemes utilize a cyclic prefix (CP) to have a simple frequency domain equalization at the receiver. In this paper, we propose two novel DMT signaling schemes for such optical systems, where the guard interval is built of a unique word (UW), i.e., a deterministic data-independent sequence. This approach becomes possible since redundancy is added in the frequency domain and the UW is a part of the discrete Fourier transform interval. The results show that the proposed UW-DMT schemes outperform the conventional CP-DMT schemes in dispersive optical channels. Furthermore, the UW can be additionally used for other purposes, such as synchronization and channel estimation.

Central venous catheter have become ubiquitous with greater than 15 million catheter days/year in the intensive care setting alone. However, the procedure carries with it several immediate and other delayed complications that can result in significant morbidity, mortality, and increased healthcare cost. We report a rare case of significantly delayed complications associated with intravascular loss of guide wire during central venous catheter placement and its impact on patient's long term management. The case highlights not only the importance of proper technique and safety precaution in performing an increasingly common procedure, but also the need for timely identification and rectification of medical errors, especially in the context of improved physician-patient communication. Keywords: Foreign object, Bacteremia, Septic emboli, Retained guide wire, Medical errors

With the aging population growing significantly throughout the world, it is estimated that the number of older adults with asthma will also increase. Management of older adults with asthma is often complicated by the presence of underlying comorbidities and by the inadequate response to conventional controller therapies. Several novel targets for therapy have now been identified to treat severe asthma including biologics, macrolides, and bronchial thermoplasty. However, only few were evaluated in older adults with asthma. Alternative therapies have also been evaluated in patients with uncontrolled asthma, although their beneficial effects have not been fully evaluated in large controlled trials.

Drought has become more frequent in central Asia causing large losses in cereal yield. To surmount the existing problem, it is imperative to emphasize early maturing varietal development. However, the impact of heat units on spike morphology and its relationship with yield potential is still unclear. Thus, the current investigation was carried out to test wheat lines and varieties for variation in total heat unit’s accretion for anthesis and maturity and to understand the manipulating impact of sunlight on spike morphology, grain yield and its cognate traits. Furthermore, the gene action controlling major traits inheritance, combining ability effects, heritability, and association studies were also estimated. Following the Half Sib/Full Sib approach 27 hybrids along with 12 parents were tested. Results depicted broad variation in genetic stock. Correlation study demonstrated that earliness negatively affects the yield, while positively influencing spike density. Genetic variances were greater than variances due to environment, pointing to higher heritability (&gt, 50%) for all the characters except for grain’s weight spike−1. The degree of dominance revealed that the partial and over-dominant type of gene action conditioned inheritance of investigated traits. Thus, earliness can be used as an indirect selection criterion for yield advance.