Exploring the impact of control powers and agency philosophy on the creative identity: an exploratory case study on a Pakistani advertising agency.

Creative advertising is considered as vital ingredient for any advertising agency to sell their services. However, in any advertising agency, the creative department serve as a backbone for campaign or any marketing collateral development. Whereas, the client and account managers are also considered as the key factors in a service-oriented advertising business. This study aims explore the impact of client’s power, account manager’s power and agency’s philosophy over the creative identity of advertising professionals, working in a local Pakistani advertising agency. In the context of understanding the impact of each of these factors over the creative identity, the study sought to explore the experiences of these creatives through the lens of realism and interpretivist approach. For this purpose, a qualitative interview-based study had been conducted with ten creatives of a local Pakistani advertising agency, belonging to different functions. The research revealed that the client has the outmost authority over their marketing collateral, and they influence the operations of agency as account manager represent them, due to their monetary involvement. Whereas, the client’s influences the creative identity in negative manner as through ambiguous or no feedback over an idea. Likewise, the account manager also impacts in negative way due to their attitude towards creative and control over the agency. But on the other hand, agency’s philosophy contributes positively towards the strengthening the creative identity of Pakistani creatives, working in this agency. Moreover, the unrealistic deadlines and Budget constraints are also mentioned as significant factors influencing their identities. This study suggests that creatives should have in person communication with client and account managers along with keeping a written record of conversations for smooth flow of creative process

Assessment of WT1 expression as a marker of treatment outcome in karyotype normal acute myeloid leukemia patients in Pakistan

Currently, there is an effort to predict relapse by follow-up monitoring of MRD and subsequently to begin the treatment of the patients during their clinical and hematological remission prior to overt hematological relapse. Expression of WT1 in AM Lis known to be independently associated with significant inferior response to therapy and short survival outcome. Follow-up monitoring of WT1 gene expression during or after therapy would be a valuable predictive marker for early recurrence or relapse of AMLdisease. This pilot study evaluated newly diagnosed and post-induction or consolidation chemotherapy of AMLpatients who were registered with the Oncology Clinics of the Aga Khan University Hospital, Karachi. High WT1 burden (\u3e 5000 copies/ml) in 2 patients was indicative of early recurrence of the disease along with shorter disease-free and overall survival. Low WT1 expression (\u3c 200 copies/ml) in 2 patients after induction and consolidation therapy, respectively, was suggestive of better prognosis

Therapeutic Targets and Signaling Pathways for Diagnosis of Myeloma

Multiple myeloma (MM) is a malignancy of plasma cells that not only shows different clinical behavior but also depicts heterogeneous groups at molecular level. The prognosis of the disease has been dramatically changed with the arrival of new drugs in the past few years. In this context of better therapeutic agents, there are important challenges for accurate evaluation of patients by better prognostic and predictive tools. Transcriptomic studies have largely added to decipher MM heterogeneity, dividing MM patients into different subgroups according to prognosis. Micro-arrays and more recently RNA sequencing have helped in evaluating coding and non-coding genes, mutations, unique transcriptome convertors and different splicing events giving new information concerning biology, outcome and treatment options. Initial data from gene expression profiling studies have also pointed out genes that predict prognosis, i.e., CSK1-B, and can deliver pharmacogenomics and biologic vision into the pathophysiology, targeted treatment, and future direction. Importantly, we suggest that all prospective studies and clinical trials now accept genetic testing and risk stratification of MM patients. In this review, we discuss the part and effect of gene expression profiling in myeloma

Social relationship analysis using state-of-the-art embeddings.

Detection of human relationships from their interactions on social media is a challenging problem with a wide range of applications in different areas, like targeted marketing, cyber-crime, fraud, defense, planning, and human resource, to name a few. All previous work in this area has only dealt with the most basic types of relationships. The proposed approach goes beyond the previous work to efficiently handle the hierarchy of social relationships. This article introduces a novel technique named Quantifiable Social Relationship (QSR) analysis for quantifying social relationships to analyze relationships between agents from their textual conversations. QSR uses cross-disciplinary techniques from computational linguistics and cognitive psychology to identify relationships. QSR utilizes sentiment and behavioral styles displayed in the conversations for mapping them onto level II relationship categories. Then, for identifying the level III relationship categories, QSR uses level II relationships, sentiments, interactions, and word embeddings as key features. QSR employs natural language processing techniques for feature engineering and state-of-the-art embeddings generated by word2vec, global vectors (glove), and bidirectional encoder representations from transformers (bert). QSR combines the intrinsic conversational features with word embeddings for classifying relationships. QSR achieves an accuracy of up to 89% for classifying relationship subtypes. The evaluation shows that QSR can accurately identify the hierarchical relationships between agents by extracting intrinsic and extrinsic features from textual conversations between agents

Distribution of chromosomal abnormalities commonly observed in adult acute myeloid leukemia in Pakistan as predictors of prognosis

Objective: The heterogenous response to treatment in acute myeloid leukemia (AML) can be attributed largely to the difference in cytogenetic features identified in between cases. Cytogenetic analysis in acute leukemia is now routinely used to assist patient management, particularly in terms of diagnosis, disease monitoring, prognosis and risk stratification. Knowing about cytogenetic profile at the time of diagnosis is important in order to take critical decisions in management of these patients. The study was conducted to determine the distribution of cytogenetic abnormalities in Pakistani adult patients with AML in order to have insights regarding behavior of the. method: A retrospective analysis of all the cases of AML (≥15years old) diagnosed at Aga Khan University from January 2011 to December 2016 was performed. Cytogenetic analysis was made for all cases using the trypsin-Giemsa banding technique. Karyotypes were interpreted using the International System for Human Cytogenetic Nomenclature (ISCN) criteria. Result: A total of 321 patients were diagnosed with AML during the study period, of which 288 samples successfully yielded metaphase chromosomes. The male to female ratio was 1.7:1. A normal karyotype was present in 61% (n=176) of the cases whereas, 39% (n=112) had an abnormal karyotype. Of the abnormal cases, t (8;21) (q22;q22) and t (15;17) (q22;q12) were identified in 8.3% and 4.9% cases respectively. Adverse prognostic cytogenetic subgroups including complex karyotype, monosomy 7 and t(6;9)(p23;q34) were identified in 9%, 1% and 0.7% patients respectively. Conclusion: This largest cytogenetic data in adult AML from Pakistan showed comparable prevalence of favorable prognostic karyotype to international data. The prevalence of specific adverse prognostic karyotype was low

PHYSIO-CHEMICAL EVALUATION AND BIOLOGICAL ACTIVITY OF AJUGA BRACTEOSA WALL. AND VIOLA ODOROTO LINN

Background: Ajuga bracteosa and Viola odorata are frequently used by the native people of Swat-Pakistan for the curing of fever, malaria, cough, urinary and stomach disorders with slightly different practice of usage like raw powdered, extracts, decoction etc. Methods and Materials: Disc Diffusion Method was used for determination of antimicrobial activities of both plants. Nutrient Agar Media was used for the culturing and growth of all microbial strains. Vitamin C and minerals contents were determined by standard method of AOAC. Na and K were analyzed by using flame photometric technique. Micro minerals i.e. “Ni, Cr, Fe, Cu, Zn, Mn, Ca, Pb, and Mg” were determined by Atomic Absorption Spectrophotometer (AAS). Total Soluble Solid (TSS) was determined by using abbe refractometer and pH was determined by using pH meter. Results: The present study demonstrates that both plants exhibited antibacterial activities against P. aeruginos, E. coli, S. typhi, B. subtilis and S. aureus. The examined plants showed zone of inhibition for aqueous fraction (50.90, 45.90 %) against P. aeruginosa; for EtOAc fraction (41.37, 57.62%) against C. Albicans and for hexane fraction (25.86, 40.57%) against K. pneumoniae, respectively. Total of 14 different minerals (Na, K, P, Ca, Mg, Fe, Zn, Mn, Co, Cr, Ni, Cu, Pb, Cd) were determined and it was also observed that both the examined plants contained significant level of these analyzed minerals. The subject plants contained highest level of magnesium (295.75, 145.85 mg 100-1g) and calcium (212.49, 44.00 mg 100-1g) and potassium (152.6, 437.45 mg 100-1g) while moderate level P, Zn, Na and lower amount of Cd, Ni, Mn and Cu using Atomic Absorption, Flame Photometry and spectrophotometric techniques. V. odorata was found to contain a higher amount of vitamin C (64.05±12.37mg 100-1g) as compared to A. bracteosa (45.45 ± 7.29 mg 100-1 g). Conclusion: Findings of this study can persuade researchers for future comprehensive phytochemical study of these plants using state of art techniques and instruments, which include not only isolation of secondary metabolites from these plants but biological evaluation of isolated compounds both in vivo and in vitr

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Distribution of EGFR mutations commonly observed in primary Lung Adenocarcinomas in Pakistan as predictors for targeted therapy

Background: Acquired genetic alterations and presence of sensitizing mutations in the tyrosine kinase domain of EGFR and other signaling molecules have been found in different subsets of primary lung adenocarcinoma. The commonest EGFR mutations are small in frame deletions of exon 19 and a point mutation (L858R) in exon 21, having a combined occurrence of around 90%. The objective of this study was to determine the frequency and types of EGFR mutations in primary lung adenocarcinomas in Pakistan. Materials and Methods: EGFR mutations in tumor samples were screened by multiplex real time PCR. Briefly, DNA from formalin fixed paraffin-embedded tissue was amplified with primers and probes specific to 43 different EGFR mutations in a Cobas z 480 instrument. The assay detects mutations in four exons (18-21) of the EGFR gene. Results: Out of 94 patients, 65 were males and 29 females with a M:F ratio of 2.2: 1. The median age was 62 years (range, 28 - 85 years). In our biopsy samples 70 (74%) cases were of primary lung adenocarcinoma, whereas 24 (26%) were confirmed metastatic adenocarcinoma of primary lung origin. EGFR mutation was positive in 29% of the patients. The highest frequency of L858R was observed in 48% of these, followed by deletion in exon 19 (44%). In addition, other rare mutations such as compound G718X:S768I and insertions in exon 20 insertion were detected in approximately 4% of the patients. Conclusions: This study showed that Del 19 and L858R are the most frequent mutations in Pakistani lung adenocarcinoma patients and around 29% of the patients were found eligible for erlotinib therapy