Exploring and establishing the barriers to sustainable humanitarian supply chains using fuzzy interpretive structural modeling and fuzzy MICMAC analysis

Purpose: The continual onset of natural and manmade disasters propels the humanitarian supply chain (HSC) efforts (by organizations, groups and individuals) to always be on a stand-by mode with more and more sustainable solutions. Despite all the sincere and coordinated efforts from all the humanitarian agents and bodies, the likely sustainable outputs are hampered by certain barriers (impediments) which exist at different levels of the HSCs. A better understanding of such barriers and their mutual relationship is deemed helpful in improving the outcomes of humanitarian efforts. Thus, the purpose of this paper is to explore, refine, establish and classify these barriers which thwart the sustainable efforts of the HSCs individually as well as collectively. Design/methodology/approach: An extensive literature review is conducted to identify these barriers which were followed by soliciting the experts’ inputs to update, refine and retain the contextually relevant ones. The opinions about the nine identified and refined barriers are taken from eight experts based in the Northern India who are having at least five years of experience in humanitarian operations. Fuzzy interpretive structural modeling (FISM) is used to examine and establish a hierarchical relationship among these barriers, whereas fuzzy Matrice d’impacts croisés multiplication appliquée á un classment analysis is carried out to further classify these barriers into dependent, autonomous, linkage and dependent barriers. Findings: The analysis led to the formation of a FISM model where the operational challenges affecting the performance occupy the topmost position in the hierarchy. The results reveal that inconsistent motives, coordination and communication and operational challenges affecting the performance are the dependent, poor strategic planning, capacity-related challenges and poor performance measurement system are the autonomous, and financial challenges, locational challenges and lack of proper awareness are the independent barriers. Research limitations/implications: The focus of the researchers was to study and examine these barriers to sustainable HSCs with special reference to the epidemics and pandemics (especially COVID-19), and it sheds light particularly arising during and post disaster phases. Practical implications: The structural model contributed by this study is expected to be meaningful for practitioners besides enriching the body of literature. In the context of pandemics, it distinguishes itself from the other available frameworks. Social implications: As this research has been carried out in the context of the novel COVID-19, the framework is expected to assist policymakers in comprehending the issues impeding the sustainability of noble humanitarian efforts. Thus, ultimately it is expected to contribute to the ultimate cause of society at large. Originality/value: This research endeavor distinguishes itself from the other accessible published resources in terms of the specific context, the methodological approach and the nature of respondents. This paper concludes with the practical implications and directions for future research. © 2021, Emerald Publishing Limited.

Spiking dependence of SARS-CoV-2 pathogenicity on TMPRSS2.

Epidemiological data shows a discrepancy in COVID-19 susceptibility and outcomes with some regions being more heavily affected than others. However, the factors that determine host susceptibility and pathogenicity remain elusive. An increasing number of publications highlight the role of Transmembrane Serine Protease 2 (TMPRSS2) in the susceptibility of the host cell to SARS-CoV-2. Cleavage of viral spike protein via the host cell's TMPRSS2 enzyme activity mediates viral entry into the host cell. The enzyme synthesis is regulated by the TMPRSS2 gene, which has also been implicated in the entry mechanisms of previously reported Coronavirus infections. In this review, we have investigated the pathogenicity of SARS-CoV-2 and disease susceptibility dependence on the TMPRSS2 gene as expressed in various population groups. We further discuss how the differential expression of this gene in various ethnic groups can affect the SARS-CoV-2 infection and Coronavirus disease (COVID)-19 outcomes. Moreover, promising new TMPRSS2 protease blockers and inhibitors are discussed for COVID-19 treatment.

Posterior Reversible Encephalopathy Syndrome in Patients with Coronavirus Disease 2019: Two Cases and A Review of The Literature.

INTRODUCTION: Encephalopathy is a common complication of coronavirus disease 2019. Although the encephalopathy is idiopathic in many cases, there are several published reports of patients with posterior reversible encephalopathy syndrome in the setting of coronavirus disease 2019. OBJECTIVE: To describe the diverse presentations, risk factors, and outcomes of posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019. METHODS: We assessed patients with coronavirus disease 2019 and a diagnosis of posterior reversible encephalopathy syndrome at our institution from April 1 to June 24, 2020. We performed a literature search to capture all known published cases of posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019. RESULTS: There were 2 cases of posterior reversible encephalopathy syndrome in the setting of coronavirus 2019 at our institution during a 3-month period. One patient was treated with anakinra, an interleukin-1 inhibitor that may disrupt endothelial function. The second patient had an underlying human immunodeficiency virus infection. We found 13 total cases in our literature search, which reported modest blood pressure fluctuations and a range of risk factors for posterior reversible encephalopathy syndrome. One patient was treated with tocilizumab, an interleukin-6 inhibitor that may have effects on endothelial function. All patients had an improvement in their neurological symptoms. Interval imaging, when available, showed radiographic improvement of brain lesions. CONCLUSIONS: Risk factors for posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019 may include underlying infection or immunomodulatory agents with endothelial effects in conjunction with modest blood pressure fluctuations. We found that the neurological prognosis for posterior reversible encephalopathy syndrome in the setting of coronavirus disease 2019 infection is favorable. Recognition of posterior reversible encephalopathy syndrome in this patient population is critical for prognostication and initiation of treatment, which may include cessation of potential offending agents and tight blood pressure control.