Lighting the path forward? The impact of rural road construction on structural transformation in India: new evidence from the PMGSY Scheme and two complementary natural experiments

1 billion people worldwide live over 2 km from a paved road. Consequently, I investi-gate medium-run impacts of rural road construction on structural transformation in India- identifying how responsive such benefits are based on a) external market condi¬tions and b) in-village electrification. I leverage a regression discontinuity design and triple difference strategy, exploiting discontinuities in population-based eligibility and staggered rollout of the Indian PMGSY rural road program- which aimed to provided all-weather road (AWR) connectivity to 115, 000 villages nationwide. I combine the program with a unique natural experiment induced by the US fracking boom, which created a parallel agricultural commodity boom in the price of guar, a crop provid¬ing a necessary fracking input. I compare heterogeneous impacts of AWRs in villages with high and low-intensity exposure to the fracking boom, and separately investigate heterogeneity of roads by village electrification access, exploiting variable implemen-tation intensity of the nationwide RGGVY electrification program. My results im¬ply structural transformation benefits of AWRs are relatively unresponsive to village electrification, whereas external economic conditions can drastically influence these impacts. RD analysis showcases labor reallocation gains from AWRs were entirely concentrated in non-Boom villages- where roads caused a 12.1-7 percentage-point reduction in share of workers employed in agriculture, and 9.2-8 percentage-point in-creased share employed in non-agricultural manual labour. Conversely, AWRs caused significantly reduced (net zero) structural transformation benefits in boom villages. My findings are robust to multiple specification tests, varying electrification levels, and suggest substantial within-village heterogeneity, with largest discrepancies in new labor market entrants. A plausible mechanism is reduced out-migration impacts of AWRs in boom-villages. These results confirm theoretical predictions that local eco¬nomic conditions can drastically influence the impact of infrastructure investments suggesting the need for effective spatial and temporal targeting

Enabling Community and Trust: Shared Leadership for Collective Creativity

The strength of nonprofit organizations comes from well-developed human connections that spur productive collaboration across levels of hierarchy. This article, exploring the experience of the Fetzer Institute, demonstrates that workplace creativity is best fostered if it is matched by a style of leadership that invites a wider spectrum of internal actors to actively participate. While acknowledging the significance of shared leadership, this article does not necessarily advocate for the dissolution of hierarchy; rather, it points out that the key lies in finding the sweet spot between organizational structure and a creative community. The article describes tools that are particularly effective and elaborates how, through a process of establishing trust and mutual respect, a collective generative impulse emerges when social and structural goals coalesce

A rare presentation of hypothyroidism

In this case report, we have brought out a very rare presentation of hypothyroidism in the form of cataplexy and this case is of significance because there have been no similar case reports of hypothyroidism presenting as cataplexy so far. The other highlight of the case is that treatment of hypothyroidism alone resulted in complete freedom from cataplexy without the need for agrypnotic drugs

A Review of Autoimmune Diseases Associated with Cancer

The focus of this review is on the relationships between autoimmune diseases and cancer from two closely related perspectives: 1.Those autoimmune diseases which are often associated with malignancies. 2.Those prevalent cancers which may increase the risks of developing autoimmune disorders. The review concludes with a brief discussion of some selected innovative approaches to cancer immunotherapy

Designing an Artifact to Empower Chronic Patients for Monitoring Health During a Pandemic: A COVID-19 Screening App

Chronic diseases have been declared an invisible epidemic by the World Health Organization (WHO, 2005). Over the past fifty years, the prevalence of chronic conditions has increased, leading to the disease burden caused by cancer, cardiovascular diseases, diabetes, and mental and substance use disorders (DOH, 2021). Chronic patients need to reimagine how they will empower themselves to effectively manage and monitor their health and wellbeing in a COVID-19 era when frequent in-person health care visits will no longer be feasible. In this study, we propose the dimensions for the design of a mobile-based application that will aid chronic patients and end-users in self-managing and monitoring their health during the pandemic era. Based on an empirical investigation involving pharmacists and researchers, we designed and developed a prototype capable of empowering chronic patients. This study particularly focuses on how technological interventions can help chronic patients self-manage and monitor their health and well-being related to COVID-19 where the user expectations are met with less attrition rates

Case Report: Concomitant Diagnosis of Plasma Cell Leukemia in Patient With JAK2 Positive Myeloproliferative Neoplasm.

Plasma cell dyscrasias and myeloproliferative neoplasms (MPN) are hematologic malignancies arising from two distinct hematopoietic cell lineages. They rarely occur concomitantly. Here, we report a case of a patient with a recent diagnosis of a JAK2 V617F positive MPN who presented with a new diagnosis of plasma cell leukemia. The patient had presented to the hospital with a leukocytosis predominantly comprised of plasma cells, followed by work-up involving peripheral blood flow cytometry, FISH analysis, and bone-marrow biopsy. FISH analysis was suggestive of a common progenitor cell for these distinct hematologic malignancies. To our knowledge, this case represents the second reported instance of a concomitant JAK2 positive MPN with primary plasma cell leukemia

Endocrinal assessment of chronic obstructive pulmonary disease patients as compared to control groups

Background: Hormones also take part in respiratory control via peripheral chemo receptors or by their local effects on the lungs and the airways. In chronic obstructive pulmonary disease patients, respiratory muscles are required to work efficiently than normal individuals to establish a sufficient respiration. Changes in serum hormone levels of COPD patients adversely affect functioning of respiratory muscles. Objective of the study was to assess endocrinal profile in COPD patient with comparable control groups.Methods: A Hospital based Case control study conducted at Department of Pulmonary Medicine, Late B.R.K.M Government Medical College, Jagdalpur, Chhattisgarh, India during July 2016 to January 2017. Study included 75 diagnosed cases of COPD in which moderate, severe, very severe COPD was 25 in each of this group (per GOLD ‘s guideline) and compared to age matched 25 healthy control.Results: In this study serum growth hormone and serum testosterone showed significant difference between COPD cases and control group and fair significant difference in serum FSH between COPD cases and control groups. There was no significant correlation between serum growth hormone, serum testosterone and serum FSH with COPD grading. There was no statistically difference observed in serum LH (p=0.425) level between COPD cases and control groups. Present study showed there was statistically difference in FT3, FT4 and TSH level between COPD cases and control groups. There was significant negative correlation between FT4 levels between COPD grading. But no correlation seen between COPD grading and control with respect to serum FT3 and TSH level.Conclusions: Endocrinal assessment in present study showed significant decrease in serum growth hormone and serum testosterone in COPD patients, which are anabolic hormones. Early detection and correction of such an anabolic hormonal abnormality may prevent skeletal and diaphragmatic muscle weakness, and improve respiratory drive of COPD patients

Histological correlates of gastro esophageal reflux disease in South Indian population

Background: Diagnosing gastroeosopageal reflux disease (GERD) accurately is a complex problem. This study was conducted to examine the histological findings of GERD in Indian subjects. Esophageal biopsy can be combined with pH monitoring and endoscopy to define the histological damage that occurs due to acid regurgitation. The sensitivity and specificity of the individual findings needs clarity in this clouded area in order to be of use to the pathologist.Methods: A total of 102 patients with dyspepsia were included in this study. Those with heartburn and /or regurgitation were identified as patients with GERD and those without these symptoms were treated as cases of non GERD dyspepsia. Biopsies were taken 2cm above 'Z' line in all cases. The biopsies were read by a single pathologist. Basal cell hyperplasia (BCH), neutrophilic exocytosis (NE), dilated intercellular spaces (DIS), papillary elongation (PE) and lymphoid aggregates (LA), necrosis (NEC) and eosinophilic infiltration were studied. Results: 68 patients had GERD dyspepsia and 34 had non GERD dyspepsia. The histological findings of BCH, NE, PE, DIS, LA were found to be found much more often in patients with GERD symptoms (p values ranged from 0.0001 to 0.0008). We found BCH and papillary elongation together were the most sensitive histological findings. Specificity was highest when DIS combined with NE.Conclusions: In this study we found basal cell hyperplasia is the most common histological finding, and when combined with DIS or papillary elongation enhances its sensitivity. However to exclude other causes of dyspepsia, a combination of DIS, PE and NE can be used effectively.

Effect of thiourea on human chorionic gonadotrophin (hCG) induced spermatogenesis in the frog Rana Tigerina during the postbreeding regression phase

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