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We report results from the first randomization of a regulatory reform in the health sector. The reform established minimum quality standards for patient safety, an issue that has become increasingly salient following the Ebola and COVID-19 epidemics. In our experiment, all 1348 health facilities in three Kenyan counties were classified into 273 markets, and the markets were then randomly allocated to treatment and control groups. Government inspectors visited health facilities and, depending on the results of their inspection, recommended closure or a timeline for improvements. The intervention increased compliance with patient safety measures in both public and private facilities (more so in the latter) and reallocated patients from private to public facilities without increasing out-of-pocket payments or decreasing facility use. In treated markets, improvements were equally marked throughout the quality distribution, consistent with a simple model of vertical differentiation in oligopolies. Our paper thus establishes the use of experimental techniques to study regulatory reforms and, in doing so, shows that minimum standards can improve quality across the board without adversely affecting utilization.
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Background Understanding health trends and estimating the burden of disease at the national and subnational levels helps policy makers track progress and identify disparities in overall health performance. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides comprehensive estimates for Pakistan. Comparison of health indicators since 1990 provides valuable insights about Pakistan's ability to strengthen its health-care system, reduce inequalities, improve female and child health outcomes, achieve universal health coverage, and meet the UN Sustainable Development Goals. We present estimates of the burden of disease, injuries, and risk factors for Pakistan provinces and territories from 1990 to 2019 based on GBD 2019 to improve health and health outcomes in the country. Methods We used methods and data inputs from GBD 2019 to estimate socio-demographic index, total fertility rate, cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years, healthy life expectancy, and risk factors for 286 causes of death and 369 causes of non-fatal health loss in Pakistan and its four provinces and three territories from 1990 to 2019. To generate estimates for Pakistan at the national and subnational levels, we used 68 location-years of data to estimate Pakistan-specific demographic indicators, 316 location-years of data for Pakistan-specific causes of death, 579 location-years of data for Pakistan-specific non-fatal outcomes, 296 location-years of data for Pakistan-specific risk factors, and 3089 location-years of data for Pakistan-specific covariates. Findings Life expectancy for both sexes in Pakistan increased nationally from 61 center dot 1 (95% uncertainty interval [UI] 60 center dot 0-62 center dot 1) years in 1990 to 65 center dot 9 (63 center dot 8-67 center dot 8) years in 2019;however, these gains were not uniform across the provinces and federal territories. Pakistan saw a narrowing of the difference in healthy life expectancy between the sexes from 1990 to 2019, as health gains for women occurred at faster rates than for men. For women, life expectancy increased by 8 center dot 2% (95% UI 6middot3-13middot8) between 1990 and 2019, whereas the male life expectancy increased by 7 center dot 6% (3 center dot 5-11 center dot 8). Neonatal disorders, followed by ischaemic heart disease, stroke, diarrhoeal diseases, and lower respiratory infections were the leading causes of all-age premature mortality in 2019. Child and maternal malnutrition, air pollution, high systolic blood pressure, dietary risks, and tobacco consumption were the leading all-age risk factors for death and disability-adjusted life-years at the national level in 2019. Five non-communicable diseases-ischaemic heart disease, stroke, congenital defects, cirrhosis, and chronic kidney disease-were among the ten leading causes of years of life lost in Pakistan. Burden varied by socio-demographic index. Notably, Balochistan and Khyber Pakhtunkhwa had the lowest observed gains in life expectancy. Dietary iron deficiency was the leading cause of years lived with disability for both men and women in 1990 and 2019. Low birthweight and short gestation and particulate matter pollution were the leading contributors to overall disease burden in both 1990 and 2019 despite moderate improvements, with a 23 center dot 5% (95% UI 3 center dot 8-39 center dot 2) and 27 center dot 6% (14 center dot 3-38 center dot 6) reduction in age-standardised attributable DALY rates during the study period. Interpretation Our study shows that progress has been made on reducing Pakistan's disease burden since 1990, but geographical, age, and sex disparities persist. Equitable investment in the health system, as well as the prioritisation of high-impact policy interventions and programmes, are needed to save lives and improve health outcomes. Pakistan is facing several domestic and foreign challenges-the Taliban's return to power in Afghanistan, political turmoil, catastrophic flooding, the COVID-19 pandemic-that will shape the trajectory of the country's health and development. Pakistan must address the burden of infectious disease and curb rising rates of non-communicable diseases. Prioritising these three areas will enhance Pakistan's ability to achieve universal health coverage, meet its Sustainable Development Goals, and improve the overall health outcomes.
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COVID-19 known as coronavirus disease, has been dominating the headlines all over the world since about a year ago which is now almost under control. The World Health Organization (WHO) has labeled it a pandemic. Bangladesh is struggling with this virus with its scarce resources. Nearly two million people have been reported as confirmed cases of coronavirus disease in 185 countries worldwide in the five months after the virus first emerged in December 2019. The COVID-19 pandemic affected people directly or indirectly all over the world. There has been a slowdown in all sectors worldwide and most of the global population was placed under lockdown. The families of 43.9 percent of the students might live in poverty, and export revenues from RMG fell by 18.12% from the previous year. Households in Chittagong city corporation experienced the least decrease in average income (11.7%) while the households in Sylhet city corporation experienced the most reduction in average income (63.4%). This COVID-19 created a widespread global shock. The government of Bangladesh has declared several stimulus plans worth a combined total of about USD 11.90 billion for the agricultural sector to ensure the country's food and nutritional security, for doctors, nurses, and the homeless for social safety, and for business sectors including small and medium enterprises and cottage industries at the early age of pandemic. There were 23 COVID-19 stimulus packages total across the nation, with a total outlay of USD 1.23 billion which is 4.44% of GDP. Approximately USD 3,529 million for the service sector and the impacted industries, USD 589 million to cover workers' salaries/allowances, and those of staff working in industries focused on exports were allocated as a package to tackle the serious impact of the COVID-19 pandemic.Copyright © 2023, Science Publications. All rights reserved.
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The coronavirus pandemic was a global health crisis taking away millions of lives worldwide. People diseased by the virus, differ in the extent of severity of the infection. While it turns out to be fatal for some, for several others the extent of severity is as ordinary as common cold. These people are reported to have recovered from the disease without hospitalization and consuming some relevant medicine and home remedies. But people who have comorbidity like geriatric, high blood pressure, heart and lung problems, diabetes, cancer etc. are at high risk of developing serious illness from the infection. This study is an application of the Cox proportional hazard model with an aim to identify the risk factors that affect the recovery time of the COVID-19 patients. The model is an advanced regression technique that can be utilized to evaluate simultaneously the effect of several factors on the possibility of instantaneous failure in patients. The paper also uses the Mental-Heinzen test (Log-Rank test) to compare if the probability of survival of different treatment procedures or different groups of patients differ significantly. The information is collected from 129 respondents of Assam, India. The study identifies that the significant risk factors that prolong the recovery time from COVID-19 are pre-disease, location, and food habits.
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We are fond of varied colors and they are strongly bonded in our life. In most cases, even a child looks eagerly for colorful toys, bottles and with passage of time desire to have attractive textiles to psychological imprints for colorful life with individual perceptions. Thus, dyes and pigments are integral part of our civilization and documented since prehistoric days. They may be classified as natural and synthetic, application or solubility based with continual efforts to have best combinations. There is growing demand as well as concern over the adverse implication of synthetic colorants on both the consumer, environment, ecosystem and thus need for safe, nontoxic, sustainable coloring alternatives have increased multifold for varied applications in food additives, cosmetics, textiles, pharmaceuticals, packaging, automobiles, defense sectors, etc. They may be amine, nitro, Sulfur based azodyes, or others with established reports on usage at levels above than the permissible regulatory limits. The usage of bacterial and fungal biobased pigments is increasing gradually due to advantages over the synthetic pigments. They are preferred because of simple culturing, pigment extraction procedures, ease of scale-up, and economic viability in less time amidst few limitations. Liposome-dependent innovative pathways may be potential to meet the demand of next generations and developing cost-effective, environment-friendly biobased products with economical feasibility in a time bound manner. For effective decision-making in terms of market share, it is necessary to address market intelligence, consider Covid-19 or similar impacts for assessing the market trends, forecast, and human behavior for comprehensive scientific mapping. The strict implementations of updated holistic, industry-driven standards with compliances to international norms are vital from safety and quality perspective. We must strategically solve environmental issues faced by the current markets as a challenge and safeguard the environment for future generations. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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It has been two years since the global outbreak of the highly contagious and deadly corona virus disease (COVID-19) caused by SARS-CoV-2 first emerged in China. Since then, various diagnostic, prognostic and treatment strategies undertaken to address the pandemic have been dynamically evolving. Predictive and prognostic role of various biomarkers in COVID-19 has been a subject of intense exploration. We aimed to determine the association of Carcinoembryonic antigen (CEA) and various surrogate inflammatory biomarkers with the severity of COVID-19 disease. This retrospective cohort study was carried out on 98 patients admitted in Jaypee Hospital, Noida with COVID-19 disease. Information regarding demographics, laboratory parameters and clinical history was collected from Hospital Information System. Serum levels of CEA and other biomarkers such as Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), Interleukin-6 (IL-6), Ferritin, and Procalcitonin (PCT) were assessed. Correlation analyses were performed between the parameters and acute respiratory distress syndrome (ARDS) stages. Logistic regression and ROC curve analysis were performed to assess the various parameters for distinguishing COVID-19 patients requiring ICU admission. Mean hospital stay, NLR, CEA, IL-6, CRP, Ferritin (P <0.0001) and PCT (P = 0.01) were significantly higher in ICU patients when compared to general ward patients. NLR, median serum CEA, IL-6, and CRP levels were significantly higher in non-survivor compared to the survivors (P <0.0001, 0.0341 and 0.0092). CEA correlated well with disease severity based upon ARDS classification and was a better marker to differentiate patient according to ARDS stages (ARDS 0 vs 2 P = 0.0006;0 vs 3 P <0.0001;ARDS 1 vs 2 P = 0.0183;1 vs 3 P = 0.0006). The area under the Receiver operating characteristic (ROC) curve for CEA was 0.7467 (95% CI-0.64885-0.84459) which revealed the potential of CEA as a biomarker to distinguish COVID-19 patients requiring ICU admission. CEA can be used to predict the severity of COVID-19 associated ARDS as well as patients requiring ICU admission. Along with routine inflammatory biomarkers (NLR, CRP, IL-6, PCT, and ferritin), CEA should be used for early identification of critical COVID-19 positive patients and for assessing prognosis. © 2022, National Institute of Science Communication and Information Resources. All rights reserved.
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Covid-19 has brought various complications in our day-to-day life leading to a disruption in overall movements across the world. Although still researchers and scientists are working on finding more effective ways to deal with it, wearing a face is one of the most simplistic yet efficient ways to overcome this. Wearing a face mask all the time in public places has become a new normal. Therefore, face mask detection for monitoring of people in public places has become a crucial task. Deep learning has been used to make recent advances in the field of object detection. To accomplish this objective, this research employs three state-of-the-art object identification models, notably YOLOv4 and YOLOv4-tiny. The models were trained using a dataset that included photos of persons wearing and not wearing masks. Considering it for surveillance purposes, it can also be used for detection of face and mask in motion. The models employ an approach that involves drawing bounding boxes (red or green) around people's faces and determining whether or not they are wearing a face mask. Further, the performance of these models was compared using mAP, recall F1-score and FPS © 2021 IEEE.
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Covid-19 was declared as a pandemic by World Health Organization on March 11, 2020. Soon thereafter, it has changed the history by transforming populations, states, societies, economics, norms, and governing structures. Through detail analysis, it can be assumed that impact of Covid-19 is highly disruptive in the short run and highly unpredictable for the days to come. It can’t be denied that it has affected many nations and their population in different ways and at different timescale. It not only has changed the life and lifestyle of people, but also altered the scopes and opportunities of many commercial sectors. The implementation digitalization in India has been observed in true sense after the breakthrough of SARS-COV-2. Though the pandemic became a curse for many businesses, yet this brought a golden time for tech companies, because it has become the only way of communication during and after lockdown. The partnership of public and private enterprises worked like magic and became the only way to face this crisis. The combined effort of big tech companies and government results in innovative ways to help frontline workers, undertaking concerted action in manufacturing and distributing essential medical equipment. This collaboration has worked well in this situation and generated the ideas related to innovation through technology hubs. It has created an environment to leverage efforts among companies, research universities and skilled young talents for product, services and solutions to mitigate the vulnerability raised due to Covid pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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To study tolerability and outcome of oral favipiravir treatment among COVID-19 patients in Nepal. In this multi-centered randomized, open-labelled phase III clinical trial, we enrolled 18-80 years old, RT-PCR confirmed patients with mild to moderate COVID-19 infection from 9 participating hospitals of Nepal, within 6 days of onset of symptoms. The investigational product (Favipiravir) was compared against placebo in patients with mild infection and against Remdesivir in moderate infection. Patients who met the eligibility criteria were randomly enrolled in the study after taking informed consent. This is a preliminary report of the data analysis. At the time of this preliminary data analysis, 90 cases were enrolled in the study including 70 mild and 20 moderate cases (see table). Among the participants with mild COVID19 infection, clinical improvement was noted in 30 (78.9%) and 27 (84.4%) patients who received Favipiravir and placebo, respectively (p=0.78). While among the participants with moderate infection, 9 (81%) and 8 (88.9%) patients who received Favipiravir and Remdesivir, respectively, had clinical improvement (p=1). Patients tolerated Favipiravir well with only 3 (6.12 %) patients showing adverse events, which were mainly elevated liver function test & uric acid level, both considered minor. None of the patients receiving placebo or remdesivir reported any adverse events. The investigational product has been tolerated well by this group of patients with only mild and reversible side effects in 6.12 % cases. The outcomes between the study groups were comparable. [ FROM AUTHOR] Copyright of International Journal of Infectious Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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The present study attempts to examine the behavior of the Indian stock market during the COVID 19 pandemic. In the study, a systemic approach is undertaken, where three significant events, namely declaration of COVID 19 as a pandemic, first death in India by COVID 19 and imposition of the nationwide lockdown, have been considered and the market reaction around the events is studied. The study employed event study methodology with daily return series of hundred and one firms, constituting the BSE 100 index. The study observed that the investors did not provide much attention to the announcement of the COVID 19 as a pandemic. However, the investors started panicking after the first death by the pandemic was reported, as witnessed from the negative abnormal returns the return further declined on the announcement of nationwide lockdown. However, the sectors like FMCG, Health and Technology earned an abnormal positive return on the announcement of the nationwide lockdown. The study further employed GARCH Model and observed high volatility in the return series during the events. Overall, the study concludes that the events have a significant negative impact on the Indian stock market.
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The purpose of the present study is to explore the undergraduate student's social network addiction levels and relationship with academic performance. In addition to that, this research compares the undergraduate students' social networking sites addiction levels with respect to gender, habitat, age, semester of study, type of institution they graduate, experiences in social networking environments (years), time spent in social networking sites. This study was quantitative in nature. For this current research, a descriptive survey method was adopted. Data were collected through online survey dropping a mail on a large population of undergraduate students. Using convenience sampling techniques, 125 undergraduate students responded to the survey and it was taken for research. Collected data were analysed using SPSS and the hypotheses were tested using descriptive analysis, t-test, ANOVA and correlation analysis. Results revealed 65% undergraduate students addicted to social network sites and there was a linear relationship between social networking sites addiction levels and academic performance. Also, there was no significant difference in undergraduate student's social networking sites addiction with respect to gender, habitat, age, semester of study, type of institution they graduate, experiences in social networking environments (years), but there was a significant difference in undergraduate student's addiction and time spent in social networking sites.
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Simulations play a crucial role in robotics research and education. This paper presents the OpenUAV testbed, an open-source, easy-to-use, web-based, and reproducible software system that enables students and researchers to run robotic simulations on the cloud. We have built upon our previous work and have addressed some of the educational and research challenges associated with the prior work. The critical contributions of the paper to the robotics and automation community are threefold: First, OpenUAV saves students and researchers from tedious and complicated software setups by providing web-browser-based Linux desktop sessions with standard robotics software like Gazebo, ROS, and flight autonomy stack. Second, a method for saving an individual's research work with its dependencies for the work's future reproducibility. Third, the platform provides a mechanism to support photorealistic robotics simulations by combining Unity game engine-based camera rendering and Gazebo physics. The paper addresses a research need for photorealistic simulations and describes a methodology for creating a photorealistic aquatic simulation. We also present the various academic and research use-cases of this platform to improve robotics education and research, especially during times like the COVID-19 pandemic, when virtual collaboration is necessary. GitHub https://github.com/Open-UAV/openuav-turbovnc Webpage: https://openuav.us © 2021 IEEE.
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Oculoplastic surgeries encompass both emergency surgeries for traumatic conditions and infectious disorders as well as elective aesthetic procedures. The COVID-19 pandemic has brought about a drastic change in this practice. Given the highly infectious nature of the disease as well as the global scarcity of medical resources;it is only prudent to treat only emergent conditions during the pandemic as we incorporate evidence-based screening and protective measures into our practices. This manuscript is a compilation of evidence-based guidelines for surgical procedures that oculoplastic surgeons can employ during the COVID-19 pandemic. These guidelines also serve as the basic framework upon which further recommendations may be based on in the future, as elective surgeries start being performed on a regular basis.
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COVID19 has changed the lifestyle of many people. Also, there is an increase incriminal cases during lockdown. There can be many reasons which can influence an individual to opt for criminal path. In this study, 10 causes are listed and responses were collected from the youths, to know their opinion on criminal acts. On the basis of their response, top three causes were discussed, that can lead to criminal behaviour.
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At the time of writing this article, more than 18 million people worldwide have been infected by the severe acute respiratory syndrome-associated coronavirus-2 and about 700,000 people have died from coronavirus disease 2019 (COVID-19). In India, about 190,000 people have been infected and nearly 39,000 people have succumbed to this infection. Infection among health-care workers has emerged as one of the key problems in facing this pandemic. The purpose of this article is to describe the measures taken by the department of oncoradiology at our institution to control the infection and minimize staff exposure during the current lockdown period with reduced patient load and in the post-lockdown period with increased demand for radiology services. The key focus of this article is the continued delivery of cancer imaging services with practical precautions and optimized resources. We have also discussed algorithms and protocols unique to the practice of oncoradiology in the time of the COVID-19 pandemic. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.
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Use of sanitizers in diagnostic centres causes derangement in quality control values of lipase and triglycerides (TG) analytes during COVID-19. Our study provides a practical insight into the type of sanitizers to be used in a laboratory. Performance Verifier (PV) and reagents (lipase and TG) were contaminated with sanitizer and 70% isopropyl alcohol. Groups formed were-PVNet (G1), PV with Sanitizer (G2), PV with 70% Alcohol (G3), Sanitizer contaminated reagent (G4). Controls PV-1 and PV-2 were run. ANOVA and Tukey’s test among groups and between groups were compared. Significant difference in mean PV-1and PV-2 values of TG [PV-1, PV-2 (P <0.0001)] and lipase TG [PV-1 P <0.0001) PV-2 P <0.001] among all tested groups were observed. Between-group analysis showed significantly higher PV-1 and PV-2 values in sanitizer contaminated PV group (P <0.001) compared to Neat PVs (P <0.001), and PVs contaminated with 70% alcohol (P <0.001). sanitizer contaminated PV-1 values were significantly higher when compared to Neat PV-1 (P <0.001)for lipase. It is advised that isopropyl alcohol (70%) should be preferred over glycerol containing sanitizers to reduce pre-analytical errors for lipase and TG estimation. © 2020, National Institute of Science Communication and Information Resources. All rights reserved.