An Empirical Analysis of the Dimension of Loyalty to Determine Customer Retention for E-Commerce

COVID-19 has fostered the growth and transformation of digital media in every aspect, importantly in the area of electronic commerce. During these days, many new practices inhabiting in human behaviour bring new norms for the marketers. Use of online shopping has increased incrementally due to the government advisory, changing consumer buying behaviour as well. An amalgamation of the old and new medium of selling goods and services are now bringing new business challenges post pandemic for the marketer, and customer retention is one of them. Henceforth, there is a dearth of studies addressing the impact of dimension of loyalty (behaviour/ attitude) on customer retention in online shopping platforms post pandemic. This study considers post pandemic as the context of research to determine the impact of behavioural and attitudinal loyalty on customer retention for the online shopping platforms. Further research also aims to determine whether the brand image plays a critical role in mediating the relationship between dimensions (Behavioural/ Attitudinal) of loyalty and customer retention for online shopping platforms or not? In the research, primary data represent the respondent from Delhi NCR. The author applied linear regression to validate the research idea. The findings indicate that attitudinal loyalty significantly enforces customer retention over behavioural loyalty. Also, brand image mediates the impact of attitudinal loyalty on retention. © 2023 SAGE Publications.

Willingness To Take The COVID-19 Vaccine: Motivator And Barrier Factors Associated With Vaccine Acceptance Decision Among Healthcare Students Of India

Background: Healthcare students are among the group of frontline healthcare providers being exposed to COVID-19. As future healthcare providers, they will be responsible for recommending vaccination to their future patients and entrusted with counseling to their future vaccine-hesitant patients. Thus, it is very important to achieve high COVID-19 vaccination acceptance rates in these groups. This study aims to explore the level of the acceptability of a COVID-19 vaccine among healthcare students in India and determine the motivators and barriers factors that may affect vaccine acceptance decision-making. Method(s): After the second wave of the pandemic in 2021, an online cross-sectional questionnaire survey study was carried out among the intended population in many states of India. Bivariate analysis and multivariable logistic regression models were utilized to describe and formulate the frequency of all the variables, including the sociodemographic characteristics, and the factors associated with vaccine acceptance and hesitancy. Result(s): Among 596 respondents, 89.3% would willing to get accept a COVID-19 vaccine. Urban students were 2.5 times more willing to take vaccines compared to rural students. Motivator factors behind the willingness to get vaccinated were to know someone who had COVID-19 and wanted to protect own selves from COVID-19 (87.1%). Concerns regarding the COVID-19 vaccine's side effects (50%), poor vaccine efficacy (48.4%), unduly rapid vaccine development (39.1%), belief regarding the non-existence of COVID-19 (32%), and insufficient information regarding the COVID-19 vaccine's benefits (28.1%) as some of the possible barrier factors associated with hesitancy. Conclusion(s):The results highlight the need for an evidence-based educational interventional curriculum to provide adequate information regarding the Vaccine's safety/efficacy, promote uptake of the COVID-19 vaccine, and alleviate any fear/disbelief associated with the COVID-19 vaccine. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Osmotic Demyelinating Syndrome and COVID-19

Introduction: Osmotic demyelination syndrome (ODS) is a dreaded complication of rapid sodium correction in high-risk hyponatremic patients. Predisposing factors include chronic alcoholism, malnourishment, severe hyponatremia. SARS-Cov2 infection may also be a risk factor as it is linked with multiple patterns of brain injury, renal damage and hyponatremia. Case Description: Patient is a 48-year-old female with history of alcohol use disorder who presented with malaise, vomiting, diarrhea for 3 days. On admission, the patient was stuporous and confused. She was clinically hypovolemic. Initial labs demonstrated severe hyponatremia (102 mmol/L), hypokalemia (2.2 mmol/L), HCO3 of 35mmol/L, lactic acid of 4 mmol/L, no EtOH, preserved GFR. SARS-CoV2 PCR was positive. She was not hypoxic, her chest X-ray was clear. The patient was resuscitated with 1L of isotonic saline, potassium correction was attempted. Her bloodwork 4 hours later showed Na of 113 mmol/L and K of 2.4 mmol/L. At this point patient had prominent diuresis, UNa was 13mmol/L, Uosm 175mOsm/kg and U spec gravity 1.006. Immediately DDAVP and D5W were started. She had a poor response to this therapy and her sodium continued raising even at maximal doses. At 24h her sodium was 118 mmol/L and at 48h it was 125mmol/L with stabilization at this level. She had clinical improvement and was more responsive on day 3. On the following days, sodium gradually drifted toward 132 mmol/L. On day 5 she developing worsening mental status. She was found poorly responsive with fixed gaze, aphasia, minimally removing extremities from pain, able to blink when asked. Brain MRI revealed signal abnormalities in the central pons, bilateral thalami, caudate, basal ganglia, subinsular regions consistent with ODS. Intensive treatment was restarted with D5W and DDAVP. Na of 124mmol/L was achieved at 24h. Over the course of the following days, she had partial recovery. She was discharged to rehab, able to smile, move her head and partially move her extremities. Discussion(s): SARS-Cov2 causes hyponatremia through several mechanisms. Poor oral intake, gastrointestinal loses, kidney injury and SIADH have been described. All of them may occur at the same time and cause hypovolemic/euvolemic states with high ADH. Volume replacement rapidly shuts off the ADH drive predisposing patients to get sodium overcorrection.

MEDIA HABITS OF YOUNGSTERS IN TIMES OF PANDEMIC: A STUDY OF PODCASTING LISTENERSHIP

The outbreak of Covid-19 epidemic has been a once in an event which had altered the life as we had known. Governments and authorities across the world had taken every possible cautious action to avoid the spread of this unusual corona virus outbreak with prime concern over quarantines and lock downs forcing people to stay at their homes. This epidemic had ramifications in the media and entertainment industries, with severe consequences for films, entertainment events, theme parks and other conventional sources of entertainment. As a diversion from boredom, the first lockdown imposed behavior modifications and promoted experimentation. This has made the entertainment business significantly less predictable, necessitating far more flexible and reactive content suppliers, particularly traditional broadcasters. However, as the duration of these lockdowns stretched, people started to look for alternative sources of entertainment to keep their sanity in such stressful periods. This in turn resulted into an increase in digital media consumption in India. The purpose of this study is to determine the most powerful source of entertainment of this period, including a change away from conventional media, particularly among the younger generation, while also analyzing the demands of their forefathers. It has been observed that the millennial generation doesn't prefer radio as compared to older generations do, and the decline in usage and shift in behavior is striking. The younger generation has stopped listening to the radio and has instead resorted to streaming, with many of those surveyed preferring on-demand choices. This illustrates that younger music enthusiasts just aren't as interested in radio as their elder siblings, parents, and grandparents were, which also demonstrates that streaming is generally more desirable. As part of the research, a response from more than 100 persons was sought from various generations which have formed the basis of conclusions of this study.

Air Pollution Trend and Variation during a Mega Festival of Firecrackers (Diwali) in Context to COVID-19 Pandemic

The present study was conducted in Lucknow city to assess the impact of firecracker burning during Diwali, from 2 November 2021-6 November 2021 including the pre and post-Diwali days. The concentrations of PM10, PM2.5, SO2, NO2, CO, O3, benzene and toluene, were monitored from the Central Pollution Control Board site on an hourly basis. The Air Quality Index was also recorded for PM10, PM2.5, SO2 and NO2. A questionnaire survey was done with 51 doctors to know the reported complaints post-Diwali. On Diwali night the PM2.5 value reached 262 μg m-3 around 22:00 hours and the maximum value (900 μg m-3) was obtained on 5 November, reported from the Central School monitoring station. From Gomti Nagar highest PM2.5 value obtained on Diwali day was 538 μg m-3 at 23:00 hours reaching 519 μg m-3 post-Diwali. Areas belonging to the old part of the city witnessed higher variations as PM2.5 crossed 900 μg m-3, in Lalbagh and Talkatora areas. The multivariate analysis showed that on Diwali night there was an increase of 204, 386, 344 and 341 in the PM2.5 concentration reported from Gomtinagar, Central School, Talkatora and Lalbagh stations, showing that firecracker burning resulted in a significant increase in air pollution. The Toluene/Benzene ratio was mostly more than 1 indicating that toluene and benzene may be emitted from other sources as well including the mobile sources. Around 50-75% rise was seen in the number of patients post-Diwali. 57.1% of the reported cases had respiratory issues, followed by allergic reactions. The data obtained from Lalbagh, Talkatora and Central School showed that although the values remained high, a decreasing trend was seen in the AQI compared to previous years which is a good sign and may be attributed to public awareness and the ongoing pandemic making people conscious © 2022 by Asian Association for Atmospheric Environment

Effect of intensive weight-loss intervention on metabolic, ultrasound and anthropometric parameters among patients with obesity and non-alcoholic fatty liver disease: an RCT.

BACKGROUND: Lifestyle intervention is the mainstay therapy for Non-Alcoholic Fatty Liver Disease (NAFLD). We aimed to assess the efficacy of an intensive (9 contact points in 6 months) weight-loss intervention among patients with obesity (BMI 25-39.9 kg/m2) and NAFLD in north India. METHODS: A total of 140 patients (18-60 years) with obesity and NAFLD were randomized into intervention (n = 70) and control (n = 70) groups, at a tertiary-care hospital. Weight, anthropometric parameters, Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM), liver enzymes, grade of fatty liver and HOMA-IR were measured at baseline (T0) and 6 months (T6). There was a high drop-out, exacerbated by the Covid-19 pandemic. Completers comprised of 59 participants (n = 30 intervention, n = 29 control). Intention to treat analysis was done. RESULTS: At T6, ALT normalized in significantly higher (p = 0.03) number of cases in the intervention arm (66.7%) versus control arm (18.2%). No significant improvement was seen in other metabolic, ultrasound or anthropometric outcomes. Weight (p < 0.001), AST (p = 0.01), ALT (p = 0.02), body fat% (p < 0.001), WC (p < 0.001) and CAP (p < 0.001) significantly improved within the intervention arm along with a trend of improvement in steatosis and HOMA-IR. Control group showed significant decrease in weight (p < 0.001), WC (p < 0.001) and CAP (p = 0.02). Twice the number of patients in intervention arm (46.7%) lost ≥5% weight, compared to control arm (24.1%) (p = 0.07). CONCLUSION: The intensive weight-loss intervention was not effective in improving the treatment outcomes among patients with obesity and NAFLD. However, given the potential of our intervention, we recommend larger trials with more intensive weight-loss interventions.

Comparative study of vaccine safety surveillance on COVID-19

Vaccine among people globally preparations must be made within countries for covid-19 vaccine safety surveillance on an urgent basis. Safety surveillance must be capable of investigating adverse event of special interest (AESI) and adverse event following immunization to determine a change in the benefit-risk profile of the vaccine. COVID-19 vaccine is the most important tool to stem the pandemic. WHO emergency use listing, while using regulatory pathway through national regulatory authorities. Vaccine safety communication plan should be developed. Expending the global vaccine safety system to meet the needs of covid-19 and other emergency and routine use vaccine is a priority currently. The protective efficacy and the short term and long-term side effect of the vaccine are of major concern. Various strategies have been designed the covid-19 pandemic. The highly infectious corona virus disease 2019 associate with me pathogenic severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) has spread to become a global pandemic. The development of covid-19 vaccine is crucial for the world to return to pre-pandemic normalcy and the collective global effort has been invested into protective against SARS-CoV2.

Stem Cell Therapy against COVID-19

The term corona virus (Latin: Corona, crown) is coined due to presence of spikes glycoproteins on the surface that gives it a crown-like appearance. Coronaviruses came from the family Coronaviridae and the order Nidovirales. Novel Corona Virus Disease outbreak happened in January 2020 subsequently dispersed around the world and reason for death of several million people worldwide. Currently, no effective treatment for severe COVID-19 patients is present. Now days, patients are only treated symptomatically. Scientific community working to develop novel antiviral drugs, vaccines, immunomodulatory medications. In the recent scenario of COVID-19 pandemic, we lack any better therapeutic option for treatment of severe COVID-19 patients. MSCs may be a better option for providing emergency therapy. Vast number of studies and clinical trials are warranted regarding the safety and efficacy stem cell therapy in COVID-19 and other respiratory disorders.

COVID-19 vaccines: A ray of hope

Coronavirus-induced disease (COVID-19) has emerged as a dreaded pandemic which is a threat to the entire world. It all began in Wuhan, China, in December 2019 and rapidly spread over the world. It is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) which is an enveloped virus single-stranded, positive-sensed ribonucleic acid virus that enters the host cell lungs via endocytosis or membrane fusion utilizing the ACE-2 receptor. The virus particles release and replicate into new progenies, which cause cytokine storm in some cases by releasing pro-inflammatory mediators into the lungs. It dominantly manifests as SARS-CoV-2 and eventually involves all systems of human body. As of July 15, 2021, approximately 189 million COVID-19-infected cases have been reported worldwide, with over 4 million individuals dying as a result. In India, so far there are approximately 31 million infected cases and 4 lakhs human lives have been lost. Various antivirals, antibiotics, corticosteroids, and other adjuvant therapies were being experimentally employed for COVID-19 prophylaxis and treatment. Many pharmaceutical companies have worked on COVID-19 vaccinations to stop the virus progression and transmission. In several countries, including India, the United States, and Russia, the COVID-19 vaccine has already been approved for human use. India has been able to produce two vaccines, namely Covaxin and Covishield, and launches a massive vaccination drive for people above 18 years adults. Till now, approximately 304 million subjects have been partially vaccinated and 73 million subjects are fully vaccinated. Various other COVID-19 vaccines are in Phase 3 of clinical development. Vaccines against COVID are a major tool against the progression and prevention of COVID-19.

Impact on particulate matters in India's most polluted cities due to long-term restriction on anthropogenic activities.

Our purpose of this research is to study the variation in air quality during lockdown (LD) and Post-lockdown (Post-LD) with respect to Pre-lockdown (Pre-LD) in most polluted cities of India by comparing the data of PM10 and PM2.5 in different periods: Pre-LD, LD and post-LD. We have selected top five cities of India out of the 20 most polluted cities across the world including Ghaziabad, Delhi, Noida, Greater Noida, and Lucknow (LKO). Historical data of atmospheric PM10 and PM2.5 for all cities were obtained from the Central Pollution Control Board (CPCB) online web portal of air quality data, except LKO. However, atmospheric PMs was monitored in LKO and samples of PM10 and PM2.5 were collected. During the LD and Post-LD period, due to anthropogenic emissions switch-off' a sharp decline was observed in concentrations of PM10 and PM2.5 in both circumstances (monthly and mean variation) as compared to Pre-LD in all selected cities. The Percentage changes (PCs) was found in mean concentrations of PM10 and PM2.5 during LD** and Post-LD*** with respect to Pre-LD at selected cities; Delhi -40.78%**, -58.42%*** and -57.60%**, -70.11%***; Ghaziabad -31.20%**, -53.91%*** and -57.29%**, -44.82%***; Noida -36.59&**, -53.95&*** and -58.36%**, -68.49%***; Greater Noida -39.39%**, -55.75%*** and -61.07%**, -71.56%***; LKO -57.95%**, -65.01%*** and -63.31%**, -59.95%*** respectively. The PCs of both pollutants exhibited a significant decrease in mean concentrations in all selected cities during LD and Post-LD with respect to Pre-LD period. Consequently, the results of current studies suggest that due to COVID-19 pandemic national LD restriction on anthropogenic activities, both coarse and fine pollutants have significantly reduced and air quality greatly improved during LD and Post-LD as compared to pre-LD period in all selected cities of India.

Impact of Online Lectures on Medical Students During COVID-19 Pandemic

Introduction: In recent days, trend of taking online lectures is booming in medical education all around the globe. Online lectures show its greatest importance during COVID-19 outbreak and lockdown period, where it is the only possible way to teach the international students from home. However, there are several issues including lack of support from management, ignorance & resistance of other faculty members, changes in syllabus of medical education putting extra pressure on overloaded teaching faculty, low level of satisfaction in students, poor internet connection, poor software qualities, poor language skills in students,lack of communication between teacher and students. Material and method: We ran an online survey, under which we send the set of Questions (given in the Table 1) to 54 volunteer Fourth Year Medical students, who were taking online lectures during COVID-19 Pandemic. Results: In our online survey we found that 92 % students agree with idea of saving energy and time through online lectures. 46 % students face poor internet problems, 20 % students face problems to understand online lectures because of their poor language skills,22% students reported lack of concentration during online classes, 38% students reported technical issues,42% students are satisfied, 42% partially satisfied, 10 % students not satisfied. 94% students believe that these online lectures are not enough to make students more confident and independent about medical knowledge. Additionally, 37% students (maximum number of students) reported that they like to take online lectures one zoom app. Conclusion: Online teaching in medical colleges is still a new concept;however, with improved technology, it can be a fruitful deal for the coming generations. During COVID -19, these online lectures became a crucial candlelight in the dark era of lockdown worldwide. Last but not the least, online lectures are not the substitute of face-to-face classroom lectures. Contrarily, if we solve the connectivity issues, electronic device issues, software problems, language issues etc., then only online lectures can reach up to the level of face-to-face classroom lectures.

Development and validation of a questionnaire to evaluate the impact of COVID-19 on lifestyle-related behaviours: eating habits, activity and sleep behaviour.

OBJECTIVE: This study was conducted to develop and validate a questionnaire to assess the impact of COVID-19 pandemic on lifestyle-related behaviour related to eating, activity and sleep pattern. DESIGN: Indexed study used a mixed method design. Phase I employed qualitative methods for development of questionnaire including literature review, focus group discussion, expert evaluation and pre-testing. Phase II used quantitative methods for establishing construct validity of the questionnaire via parallel factor analysis. PARTICIPANTS: Phase 1 involved participation of experts from different fields (Departments of Medicine, Nutrition and Clinical Psychology) and general adult population. For phase II, data were collected from 124 adult respondents (female = 57·26 %); mean age (36 ± 14·8 years) residing in an urban setting. RESULTS: The questionnaire consisted of three sections: (A) socio-demographic and anthropometric parameters, (B) twenty-four items each for investigating the changes in eating, activity and sleep behaviour before v. during COVID-19, (C) six items assessing COVID-19 specific reasons for lifestyle change. The Cronbach's α value of the questionnaire is 0·83 suggesting its good internal consistency. CONCLUSIONS: This appears to be a valid tool to assess the impact of COVID-19 on lifestyle-related behaviours with potential utility for public health researchers to identify these changes at community level and develop strategies to reinforce corrective behaviours.

Recent and upcoming regulatory changes in the European region: Opportunities for medical writers

The European regulatory landscape for clinical trials and medical devices is in the midst of major transformation. Older policies are giving way to new regulations that emphasise more harmonised and streamlined processes for document submittal, greater public transparency of documents, and the creation of plain language summaries of clinical trials for easier understanding by the general public. This article provides an overview of impor tant new regulations and policies, including some new guidances regarding research related to the COVID-19 pandemic. This article also discusses opportunities for medical writers working in the context of a new regulatory environment that requires balancing increased public disclosure of information and greater privacy protections for individuals. © 2020, European Medical Writers Association. All rights reserved.