Evaluating the Performance of Sector Mutual Funds

The growth in the US mutual fund industry has remained slow, despite the recent upside blow in the overall market attributed to the global pandemic. The mutual fund industry is still observing a fee crisis and slower yearly growth, but the compression occurs short-term with more drastic results. Mutual funds that would serve these “new normal” requirements need to be future-fit. In this dissertation, I focus on the following questions: Do sector mutual funds add value to investors` portfolios by contributing a better risk-adjusted rate of return? Is there evidence of performance consistency? Do portfolio managers require different skills in portfolio management mutual funds? Should mutual fund portfolio managers opt for interactive planning as compared to predictive modeling for managing the mutual fund? The study found that the benchmarked index outperformed the sector mutual fund and provided a better risk-adjusted return. This suggests that investors would be better off using a benchmarked index rather than a sector mutual fund. Additionally, the manager\u27s experience does not seem to impact the return from a sector mutual fund, indicating that investors do not need to worry about who is managing their mutual fund. Finally, collective aspects of sector mutual funds (e.g., portfolio returns and performance) are two different scenarios, so investors should be careful when comparing these metrics

Teratoma with Malignant Transformation: A Case Report with Pathological, Cytogenetic, and Immunohistochemistry Analysis

Background. Teratoma with malignant transformation (TMT) is rare and most commonly encountered in adult patient with germ cell tumor (GCT). Method. We report a rare case of testicular teratoma with metastatic TMT/embryonal rhabdomyosarcoma (ERMS). A 44-year-old man underwent right orchiectomy which revealed a malignant teratoma, he subsequently had right pneumonectomy with two pulmonary masses containing a high-grade embryonal rhabdomyosarcoma. The patient developed liver metastasis three months after initial diagnosis. He was treated with a chemotherapy regimen with vincristine, dactinomycin, and cyclophosphamide (VAC) alternating with vincristine and irinotecan (VI) with complete resolution of his liver lesion. The tumors were examined with a battery of cytogenetic, immunohistochemical, and molecular assays. Results. The malignant cells were immunohistochemically positive for desmin, myogenin, and MyoD1. Molecular cytogenetics of embryonal rhabdomyosarcoma tissue revealed the presence of i(12p). The tumor expressed high level of TOPO2A, TOPO1, MRP1, MGMT, BCRP, ERCC1, RRM1, and TS. Conclusion. The activity of topoisomerase inhibitors and the potential usefulness of topoisomerase expression as biomarkers should be further tested in aprospective study

Association of Physical Activity with Co-morbid Conditions in Geriatric Population

To find out association of physical activity with co-morbid conditions in geriatric population, a cross-sectional study was conducted in different cties of Pakistan in 2015. A total of 114 participants were inducted by non-probability convenience sampling technique. Data was collected after informed verbal consent by a validated questionnaire that is Rapid Assessment of Physical Activity (RAPA). Participants were categorized into two groups i.e. physically active and physically inactive. Data was entered and analyzed in SPSS version 20. There were 66 (57.9%) males and 48 (42.1%) females with mean age of 57.04±7.348 years. Among hypertensive individuals (n=43, 37.7%) there were 39 (90.7%) physically inactive, among individuals having angina (n=17, 14.9%) there were 15 (88.2%) physically inactive. Out of 37 (32.5%) diabetics, 35 (94.6%) were physically inactive. Among individuals suffering from arthritis (n=40, 35.1%), there were 38 (95%) physically inactive. A significant association was found between physical activity and diabetes and arthritis with p-value of 0.048 and 0.029 respectively. Physical activity is significantly associated with diabetes and arthritis in geriatric population. Adequate physical activity should be performed to reduce the risk of co-morbid conditions and improve the quality of life in geriatric population

Metastases From Nested Variant Urothelial Carcinoma of the Urinary Bladder in Pancreatic Allograft Mimicking Graft Rejection

While not an uncommon tumor, urothelial carcinoma of the urinary bladder is rare in bladders draining pancreatic allografts. A case of urothelial carcinoma directly involving a pancreatic allograft with metastasis that occurred in a 49-year-old pancreas and kidney transplant recipient is described. Her initial clinical presentation and findings of CT scan of the abdomen suggested pancreatitis with features worrisome for rejection. A biopsy of her pancreatic allograft contained poorly differentiated carcinoma and cystoscopic biopsy disclosed an invasive high grade urothelial carcinoma arising in the background of extensive urothelial carcinoma in situ. Exploratory laparotomy revealed that the tumor invaded the right ovary and fallopian tube, cecum, and allograft with extensive retroperitoneal involvement. She underwent en bloc resection of distal ileum and cecum, resection of transplant pancreas, partial cystectomy, ileocolostomy anastomosis, and right salpingo-oophorectomy. Postoperatively, the patient was treated with four cycles of carboplatin and gemcitabine. She ultimately succumbed to her disease approximately 1 year after diagnosis. This case should alert physicians and radiologists to be aware of atypical presentation of urothelial carcinoma in bladder-drained pancreas grafts, the aggressiveness of such lesions, and the need for early biopsy to avoid diagnostic confusion with rejection

Estimativa da irradiação solar difusa no plano inclinado de painéis solares fotovoltaicos

Solar energy, in the recent decades has gained a great attention due to its clean, simple and easy adaptable process. The effective utilization of solar energy is possible only if proper data of incident solar radiation is available. There are number of solar models based on different climatical factors, for the assessment of radiation on plane and sloped surfaces are available in the literature but the selection of best possible model is a challenging task. Here, different isotropic and anisotropic solar models have been utilized for the estimation of overall radiation incident on the sloped surface in Karachi then estimation was compared with the experimental values. The models selected for this study includes Liu and Jordan, Koronakis, Badescue, Hay and Davies, Temps and Coulson and HDKR. The predicted values and measured values are compared by using different statistical techniques like Mean Absolute Percentage Error (MAPE), Mean Biased Error (MBE), Root Mean Square Error (RMSE) and t-stats. The outcomes revealed that isotropic models are more suitable model than the anisotropic models. Among all models, Badescue is the best suitable model for the estimation of radiations on sloped surfaces with lowest value of MBE, RMSE and t-stats while Temps and Coulson model, on the basis of MAPE, MBE, RMSE and t-stats is the most inappropriate correlation for the assessment of solar radiations on sloped surface. Overall, for the solar radiation estimation on any sloped plane in Karachi isotropic models have shown a good agreement.La energía solar, en las últimas décadas ha ganado una gran atención debido a su proceso limpio, simple y fácilmente adaptable. La utilización eficaz de la energía solar solo es posible si se dispone de datos adecuados de la radiación solar incidente. Hay varios modelos solares basados en diferentes factores climáticos, para la evaluación de la radiación en superficies planas e inclinadas están disponibles en la literatura, pero la selección del mejor modelo posible es una tarea desafiante. Aquí, se han utilizado diferentes modelos solares isotrópicos y anisotrópicos para la estimación de la radiación total incidente en la superficie inclinada de Karachi y luego se comparó la estimación con los valores experimentales. Los modelos seleccionados para este estudio incluyen a Liu y Jordan, Koronakis, Badescue, Hay y Davies, Temps y Coulson y HDKR. Los valores pronosticados y los valores medidos se comparan utilizando diferentes técnicas estadísticas como el error porcentual absoluto medio (MAPE), el error sesgado medio (MBE), el error cuadrático medio (RMSE) y t-stats. Los resultados revelaron que los modelos isotrópicos son un modelo más adecuado que los modelos anisotrópicos. Entre todos los modelos, Badescue es el modelo más adecuado para la estimación de radiaciones en superficies inclinadas con el valor más bajo de MBE, RMSE y t-stats mientras que el modelo de Temps y Coulson, basado en MAPE, MBE, RMSE y t-stats es la correlación más inapropiada para la evaluación de las radiaciones solares en superficies inclinadas. En general, para la estimación de la radiación solar en cualquier plano inclinado en Karachi, los modelos isotrópicos han mostrado una buena concordancia.A energia solar, nas últimas décadas, ganhou grande atenção devido ao seu processo limpo, simples e de fácil adaptação. A utilização efetiva da energia solar só é possível se dados adequados da radiação solar incidente estiverem disponíveis. Existem vários modelos solares baseados em diferentes fatores climáticos, para a avaliação da radiação em superfícies planas e inclinadas estão disponíveis na literatura, mas a seleção do melhor modelo possível é uma tarefa desafiadora. Aqui, diferentes modelos solares isotrópicos e anisotrópicos foram utilizados para a estimativa da radiação total incidente na superfície inclinada em Karachi, então a estimativa foi comparada com os valores experimentais. Os modelos selecionados para este estudo incluem Liu e Jordan, Koronakis, Badescue, Hay e Davies, Temps e Coulson e HDKR. Os valores previstos e os valores medidos são comparados usando diferentes técnicas estatísticas como Erro Percentual Médio Absoluto (MAPE), Erro Viés Médio (MBE), Erro Quadrático Médio Raiz (RMSE) e t-stats. Os resultados revelaram que os modelos isotrópicos são modelos mais adequados do que os modelos anisotrópicos. Entre todos os modelos, Badescue é o modelo mais adequado para a estimativa de radiações em superfícies inclinadas com o menor valor de MBE, RMSE e t-stats, enquanto o modelo Temps e Coulson, com base em MAPE, MBE, RMSE e t-stats é o correlação mais inadequada para a avaliação de radiações solares em superfície inclinada. No geral, para a estimativa da radiação solar em qualquer plano inclinado em Karachi, os modelos isotrópicos mostraram uma boa concordância

Comparative effectiveness of enalapril, lisinopril, and ramipril in the treatment of patients with chronic heart failure: a propensity score-matched cohort study

Background: Angiotensin converting enzyme inhibitors (ACEIs) are recommended as first-line therapy in patients with heart failure with reduced ejection fraction (HFrEF). The comparative effectiveness of different ACEIs is not known. Methods and results: 4,723 out-patients with stable HFrEF prescribed either enalapril, lisinopril, or ramipril were identified from three registries in Norway, England, and Germany. In three separate matching procedures, patients were individually matched with respect to both dose equivalents and their respective propensity scores for ACEI treatment. During a follow-up of 21,939 patient-years, 360 (49.5%), 337 (52.4%), and 1,119 (33.4%) patients died amongst those prescribed enalapril, lisinopril, and ramipril, respectively. In univariable analysis of the general sample, enalapril and lisinopril were both associated with higher mortality as compared with ramipril treatment (HR 1.46, 95% CI 1.30-1.65, p < 0.001, and HR 1.38, CI 1.22-1.56, p < 0.001, respectively). Patients prescribed enalapril or lisinopril had similar mortality (HR 1.06, 95% CI 0.92-1.24, p = 0.41). However, there was no significant association between ACEI choice and all-cause mortality in any of the matched samples (HR 1.07, 95% CI 0.91-1.25, p = 0.40; HR 1.12, 95% CI 0.96-1.32, p = 0.16; and HR 1.08, HR 1.10, 95% CI 0.93-1.31, p = 0.25 for enalapril vs. ramipril, lisinopril vs. ramipril, and enalapril vs. lisinopril, respectively). Results were confirmed in subgroup analyses with respect to age, sex, left ventricular ejection fraction, NYHA functional class, cause of HFrEF, rhythm, and systolic blood pressure. Conclusion: Our results suggest that enalapril, lisinopril and ramipril are equally effective in the treatment of patients with HFrEF when given at equivalent doses

Social Media in Virtual Marketing: Antecedents to Electronic Word of Mouth Communication

Social media usage in the world and especially in Pakistan has a high growth due to which it (social media) has a potential of becoming an effective marketing tool. Despite its compar-atively low cost and significance, marketers are not effectively utilizing social media. Thus the aim of this study is to measure the influence (effect) of four social variables: social capital, trust, homophily and interpersonal influence on electronic word of mouth (eWOM) communi-cation. The sample size for the study is 300 and preselected enumerator's collected the data from the leading shopping malls of the city. Although the scales and measures adopted for this study have been earlier validated in oth-er countries, however the same were re-ascertained on the present set of data. After prelimi-nary analysis including normality and validity the overall model was tested through Structural Equation Model (SEM). This was carried out in two stages - initially CFA for all the constructs was ascertained which was followed by CFA of the overall model. Developed conceptual framework was empirically tested on the present set of data in Pa-kistan which adequately explained consumer attitudinal behavior towards electronic word of mouth (eWOM) communication. Three hypotheses failed to be rejected and one was rejected. Trust was found to be the strongest predictor of electronic word of mouth (eWOM) communi-cation, followed by homophily and social capital. Interpersonal influence has no relationship with electronic word of mouth (eWOM) communication. The results were consistent to earlier literature. Implication for markers was drawn from the results.Keywords: eWOM, social capital, trust, homophily and interpersonal influence, social medi

Evidence for a Founder Effect among HIV-infected injection drug users (IDUs) in Pakistan.

Background: We have previously reported a HIV-1 subtype A infection in a community of injection drug users (IDUs) in Karachi, Pakistan. We now show that this infection among the IDUs may have originated from a single source. Methods: Phylogenetic analysis was performed of partial gag sequences, generated using PCR, from 26 HIV-positive IDU samples. Results: Our results showed formation of a tight monophyletic group with an intra-sequence identity of \u3c 98% indicating a founder effect . Our data indicate that the HIV-1 epidemic in this community of IDUs may have been transmitted by an HIV positive overseas contract worker who admitted to having contact with commercial sex workers during stay abroad. Conclusion: Specific measures need to implemented to control transmission of HIV infection in Pakistan through infected migrant workers

Accuracy of procalcitonin levels for diagnosis of culture-positive sepsis in critically ill trauma patients: A retrospective analysis

Background: Abdominal trauma and intra-abdominal sepsis are associated with significant morbidity and mortality. Microcirculation in the gut is disrupted in hemorrhagic and septic shock leading to tissue hypoxia, and the damaged gut acts as a reservoir rich in inflammatory mediators and provides a continual source of inflammation to the systemic circulation leading to sepsis. Sepsis is defined as the presence (probable or documented) of infection together with a systemic inflammatory response to infection. Blood culture is commonly considered to be the preferred approach for diagnosing sepsis, although it is time-consuming, that is, reports are normally available only after 12-48 hours. Procalcitonin levels (PCT) have recently emerged as a promising biomarker in the diagnosis of sepsis. The aim of the present study is to determine the diagnostic accuracy of PCT levels in predicting sepsis in critically ill trauma patients.Methodology: This was designed as a validation study conducted in the Indoor Department of General Surgery, Liaquat National Hospital, Karachi. The sample size was calculated by taking the estimated frequency of sepsis in suspected patients at 62.13%, expected sensitivity of PCT at 70.83%, and specificity at 84.21% and the desired precision level of 12% for sensitivity; the calculated sample size was 96. The non-probability consecutive sampling method was used to recruit participants who were diagnosed with sepsis on clinical assessment. Blood culture samples were sent for the enrolled patients and a final diagnosis was made on the blood culture report. PCT levels were measured in these suspected patients on the same day of sending blood culture. Diagnostic accuracy of PCT size was measured using the receiver operating characteristic (ROC) curve. ROC curve was formulated for PCT levels against culture-proven sepsis to determine the ideal cut-off value of PCT levels. Two different cut-offs were determined to obtain the highest sensitivity and highest specificity accordingly.Results: A total of 97 individuals met the inclusion criteria with a mean age of 34.89 ± 10.52 years. Mean PCT levels were 0.96 ± 0.59, with a gender predilection towards females (p \u3c 0.001). No age difference was documented among gender (p = 0.655). The mean duration of intensive care unit stay was 11.73 ± 3.56 days. Culture-proven sepsis was identified in 67.0% of the study participants with a higher PCT level (p \u3c 0.001). Among the 52.6% males included in the study, half were reported to have culture-positive sepsis, but among the 47.4% females culture was positive in 87% (p \u3c 0.001). ROC revealed PCT was predictive for culture-positive sepsis at a cut-off value 0.47 ng/mL (p \u3c 0.001), with a sensitivity of 92.3%, specificity of 68.7%, positive predictive value (PPV) of 85.7%, and negative predictive value (NPV) of 81.5%. By increasing the cut-off value to 0.90 ng/mL at area under the curve of 0.816, the specificity increased to 81.3% and sensitivity became 66.2%, with a PPV of 87.8% and NPV of 54.2%.Conclusion: Our study determined two cut-values for PCT to predict sepsis, one with the highest sensitivity and the other with better specificity. Other than that, higher PCT levels were significant in female trauma patients. We conclude that PCT is a reliable marker for culture-proven diagnosis of sepsis and may aid physicians/surgeons to promptly manage patients accordingly

Systematic Development of Short-Term Load Forecasting Models for the Electric Power Utilities:The Case of Pakistan

Load forecasts are fundamental inputs for the reliable and resilient operation of a power system. Globally, researchers endeavor to improve the accuracy of their forecast models. However, lack of studies detailing standardized model development procedures remains a major issue. In this regard, this study advances the knowledge of the systematic development of short-Term load forecast (STLF) models for electric power utilities. The proposed model has been developed by using hourly load (time series) of five years of an electric power utility in Pakistan. Following the investigation of previously developed load forecast models, this study addresses the challenges of STLF by utilizing multiple linear regression, bootstrap aggregated decision trees, and artificial neural networks (ANNs) as mutually competitive forecasting techniques. The study also highlights both rudimentary and advanced elements of data extraction, synthetic weather station development, and the use of elastic nets for feature space development to upscale its reproducibility at global level. Simulations showed the superior forecasting prowess of ANNs over other techniques in terms of mean absolute percentage error (MAPE), root mean squared error (RMSE) and R2 score. Furthermore, an empirical approach has been taken to underline the effects of data recency, climatic events, power cuts, human activities, and public holidays on the model's overall performance. Further analysis of the results showed how climatic variations, causing floods and heavy rainfalls, could prove detrimental for a utility's ability to forecast its load demand in future