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The phase 3 MOMENTUM study (NCT04173494) of the ACVR1/JAK1/JAK2 inhibitor momelotinib (MMB) vs. danazol (DAN) in patients with myelofibrosis (MF) previously treated with a JAK inhibitor (JAKi) met the primary endpoint and all key secondary endpoints at week 24 (W24). We provide updated results from week 48 assessments. Eligible patients had primary or post-ET/ PV MF;DIPSS high, Int-2, or Int-1 risk;Total Symptom Score (TSS) >=10;haemoglobin (Hb) <10 g/dL;platelets >=25 x 109/L;prior JAKi for >=90 days (>=28 days if red blood cell [RBC] transfusions >=4 units in 8 weeks or grade 3/4 thrombocytopenia/anaemia/ hematoma);and palpable spleen >=5 cm. Randomisation was 2:1 to MMB 200 mg/day or DAN 600 mg/day for 24 weeks, followed by open-label (OL) MMB. Week 48 endpoints included durations of response (TSS, transfusion independence [TI], splenic) and overall and leukaemia-free survival (OS, LFS). As of 17 May 2022, 93/130 (72%) MMB -> MMB and 41/65 (63%) DAN -> MMB patients received OL MMB;mean MMB durations were 48 weeks and 24 weeks, respectively. Analyses for W24 responders showed the following: of TSS responders, 31/32 (97%) MMB -> MMB and 6/6 DAN -> MMB patients had TSS < baseline;of TI responders, 36/40 (90%) and 10/13 (77%) had no RBC transfusions or Hb <8 g/dL;and of spleen responders, all patients had splenic volume < baseline. In the OL phase, the most common grade >=3 treatment-emergent adverse events (TEAEs) were thrombocytopenia (MMB -> MMB, 9%;DAN -> MMB, 15%) and anaemia (MMB -> MMB, 9%;DAN -> MMB, 2%). Grade >=3 infections occurred in 19% of MMB -> MMB and 10% of DAN -> MMB patients, including grade >=3 (nonfatal) COVID-19. Peripheral neuropathy (PN) occurred in 2% of patients in each arm, and none discontinued MMB due to PN. TEAEs led to MMB discontinuation in 18% (MMB -> MMB) vs. 10% (DAN -> MMB). A trend towards improved OS up to W24 was previously observed with MMB vs. DAN (hazard ratio [HR], 0.506;p = 0.0719);after all patients crossed over to OL MMB, OS and LFS curves for both arms converged (HR, 0.945, 95% CI, 0.528-1.693;HR, 0.830, 95% CI, 0.473-1.4555). Sixty of 81 (74%) MMB -> MMB and 29 of 43 (67%) DAN -> MMB patients with baseline platelets <=150 x 109/L entered the OL phase. Efficacy and safety results in thrombocytopenic subgroups in the OL period were consistent with the intent-to- treat (ITT) population. OL MMB maintained symptom, TI, and spleen responses with continued good survival and safety in the ITT and low platelet populations. MMB may address an unmet need in anaemic patients with MF.
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In early December 2019, several cases of pneumonia of unknown etiology were reported from Wuhan, Hubei province, China. The disease resembles severe acute respiratory syndrome coronavirus (SARS CoV) of 2012 and was subsequently named SARS CoV-2 causing the 2019-novel coronavirus disease (COVID-19) by the World Health Organization (WHO). The first case of COVID-19 in India was reported on January 30, 2020. In the first wave, daily cases peaked in mid-September 2020 and began to drop by January 2021. However, a second wave beginning in March 2021 was experienced which was much larger than the first, with extreme shortages of hospital beds, oxygen cylinders, and other medicines including vaccines in parts of the country. In the second wave, an association of COVID-19 patients with mucormycosis further complicated the situation. COVID-19 associated mucormycosis (CAM) has been increasingly reported particularly among patients with uncontrolled diabetes. An increase in CAM cases could be probably due to immunosuppression caused by the use of steroids, other immunomodulators like tocilizumab. Rhino-orbitalcerebral mucormycosis is the most common presentation. The most common causative agent isolated is Rhizopus arrhizus. Simple KOH examination with broad, ribbon-like, aseptate hyphae that branch at right angles is diagnostic of mucormycosis. This can be further confirmed by culture examination. However, newer tests like MALDI-TOF for species identification are also being explored. The main treatment modality is surgical debridement, removing all the infected, dead, and necrotic tissue followed by simultaneous administration of antifungal antibiotics in the form of Amphotericin B. Liposomal amphotericin B is the drug of choice, however, if not available, amphotericin B deoxycholate, posaconazole, and isavuconazole can be given for the treatment of CAM. Prognosis and clinical improvement depend upon the stage of disease, the surgical management as well as the availability and administration of antifungal drugs. In media, mucormycosis is being projected as black fungus throughout this pandemic, though it is a misnomer and should not be used in the medical literature. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.
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Background: The World Health Organization (WHO) designated SARS-CoV-2 infection as coronavirus disease 2019 (Covid-19).Due to the government implication of Covid-19 specific guideline of using mask, there could be a significant decrease in the allergic rhinitis. Objective(s): Present study aims to analyze the changes in the trends of nasal allergies from hilly regions of Himachal Pradesh following Covid-19 pandemic. Method(s): The prospective data obtained from January 2022 to November 2022 was compared from the retrospective data available between January 2019 to November 2019. Prospectively, a total of 596 patients were included in the study. All these patients underwent Skin prick tests for common allergens. All these patients also underwent testing for total IgE levels in biochemistry lab of the hospital by chemiluminescence method.The results were compared with retrospective dataof 728 age sex match patients. Result(s): A significant difference in the allergen sensitivity was observed. The number of patients who were sensitized during Covid was comparatively less than those during Pre covid period.Dust mite, Cockroach, Peanut and Wheat revealed a non-significant odds ratio indicating that they were not true predictors for sensitization and non-sensitization. Whereas Grass pollen, Mould mix and Pine mix revealed a significant odds ratio. Usage of mask found to have an impact on improvement in symptoms. Majority of the patients who did not use mask had no improvement in symptoms. Majority of the patients had high IgE levels in pre covid period whereas it was normal for majority of them during covid. Conclusion(s): In our study, allergic rhinitis incidence decreased throughout the pandemic period. After pandemic, there was a noticeably decreased level of sensitivity to grass pollen, mould, and pine mix. Use of face masks lead to significant decrease in symptoms of allergic rhinitis.Copyright © 2022, Anka Publishers. All rights reserved.
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Background: The Coronavirus Disease (COVID-19) pandemic continues its deadly reign all over the world. Devising effective strategies for detecting and controlling the infection has become ever more critical. Effective prevention and control of the pandemic is entirely dependent on human behavior in terms of practicing preventive and curative measures. During the second wave of COVID-19, people's perceptions of preventive and curative measures changed.Objective: To study healthcare-seeking behavior of hospitalized COVID-19 patients.Methods: Hospitalized patients due to COVID-19 in the month of March, April and May of 2021 were included in the study. Their attendants/close relatives were contacted telephonically to know about the admitted patients' healthcare-seeking behavior. Verbal consent was taken from attendants before the commencement of the interview, followed by informing them about the purpose of the interview.Results: Amongst the subjects, there were more males than females (67.5 vs 32.4%), age ranged between 18 to 88 with a mean value of 56.61 +/- 14.7 years. Self-medication was significantly associated with study subjects' mortality (p=0.03).Conclusion: Elderly people were having higher mortality rate than their younger counterparts. People were hesitant to visit primary care physicians after having symptoms of COVID-19.
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When the nation is facing a great downfall of economic activities leading to many disturbances in the daily life of people, savings and investment plan can hold the hands of employees belonging to private sector from financial fall down. The present study exposes the savings and investment preferences of private sector employees due to the effect of COVID-19 pandemic. As information shows that salary reduction and job termination have become common events in private sector due to the present pandemic, it becomes necessary to understand how far the pandemic has influenced their savings and investment. Likert scale and Garret ranking are two statistical tools used in the study to analyse major influencing factors of COVID-19 pandemic and the mostly preferred factor by the private sector employees. The study concludes that this pandemic has a significant influence leading to deregulating existing plans as well as decline in proportion of savings and investments.
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Background: COVID-19 has caused pandemic during 2019-2020 and has presented with illnesses ranging from the usual mild flu to serious respiratory problems/complications, even leading to considerable mortality. Recent literatures have suggested that the health (especially psychological) impacts of quarantine are substantial and can be long lasting. Aim: The purpose of this study was to assess the mental health status (psychological distress) of experienced quarantine and compliance to quarantine during the outbreak of COVID-19 in Nuh district. Methods: The study included 543 subjects (adults aged 18 years or more) who were sent for quarantine at home or state-run facilities and included "Flu corner " screened patient and health-care staff working in COVID-19 outpatient and wards. The psychological impact was assessed using the Kessler Psychological Distress Scale (K10). Categorical data were presented as percentages (%), and bivariable logistic regression was applied to find out the association, and it was considered significant if the P < 0.05. Results: The doctors and nursing staff were among two-fifth of the subjects (217/543, 40.1%), and only 11.6% of quarantined subjects (63/543) were compliant with all protective measures. The mean score obtained on Kessler Psychological Distress Scale (K10) subjects was 18.69 +/- 4.88, whereas out of 543 subjects, 152 (27.9%) had a score of 20 or more, and it has a significant association with the elderly age group, female gender, and workplace as exposure setting (P < 0.05). Conclusion: Given the developing situation with coronavirus pandemic, policymakers urgently need evidence synthesis to produce guidance for the public. Thus, the outcomes of this study will positively help authorities, administrators, and policymakers to apply quarantine measures in a better way.
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2-Deoxy-D-glucose (2-DG) is a non-metabolizable glucose analog that has shown promising pharmacological activities and has been used to study the role of glucose in cancer cells. 2-DG is an inhibitor of glycolysis, potential Energy Restriction Mimetic agent and inhibits pathogen-associated molecular patterns. Its radioisotope derivatives have application as tracers. Recently, 2-DG has been used as an anti-COVID-19 drug lowering the need for supplemental oxygen. In this review, different synthetic strategies for preparation of 2-DG including enzymatic synthesis have been discussed. The understanding of these methods would help in developing therapeutics or diagnostic agents aimed at exploring therapeutic targets related with energy metabolism. © AUTHOR(S).
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Face recognition in the industry now is playing an important role in each sector. Each person has different type of features and face;therefore, each identity is unidentical. In this COVID outbreak, a major crisis has occurred due to which preventions are to be made. One such prevention is use of a face mask which is very much important. Nowadays, various firms and organizations are using facial recognition systems for their own general purpose. We all know that it has now been a crucial task to wear a mask every time, when we go somewhere. But as we know it is not possible to keep track of who wears a mask and who does not. We make the use of AI in our daily life. We achieve this with the help of a neural network system, which we train so that it can further describe people's features. Even though the original dataset was limited, the Convolutional Neural Network (CNN) model achieved exceptional accuracy utilizing the deep learning technique. With the use of a face mask detection dataset that contains both with and without face mask photographs, we are able to recognize faces in real-time from a live webcam stream using OpenCV. We will develop a COVID-19 face mask detection system using our dataset, along with Python, OpenCV, Tensor Flow, and Keras. © 2022 IEEE.
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The data age information is considerably more significant in open life, since individuals' well-being information just concluded regardless of whether COVID-19 impacted, and furthermore connected with all medical problems information. These information used to examine and anticipate the medical problems information by Machine Learning Algorithm, and afterward anticipated information need greater security. In this way, we applied the current strategy ChaCha technique and that strategy zeroed in as it were "encryption execution” so security is less. In this paper, to apply the new ES-BR22-001 strategy, this technique has 7 stages. The 1st stage is finding the K value. The 2nd stage is applying the K value in Eq. (1). The 3rd stage is finding the Sk values by using Eq. (1). The 4th stage is applying the Sk values in the sparse matrix. The 5th stage is sparse matrix values are converted into single line. The 6th stage is pairing all the values. The final stage is all paired values will be applied in the matrix. The new ES-BR22-001 method provides security and performance is good while compared to ChaCha method. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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In this paper, we investigate (a) what are the factors that affect the mispricing in benchmark and sectoral indices;(b) the role of economic policy uncertainty (EPU) on the mispricing in future indices;and (c) is there any relationship between the magnitude of mispricing in future indices and the number of factors affecting it. The study deploys regression analysis on the 6930 observations during the period of 2009-2019 for three major indices i.e., Nifty, Nifty Bank and Nifty IT respectively. The study reports that (a) time to maturity and lag of mispricing affect all three indices positively whereas open interest affects Nifty Bank and Nifty IT negatively and spot volume affects only Nifty IT positively;(b) EPU affects positively to all three indices, reflecting that uncertainty increases the mispricing in the stock market;(c) magnitude of the mispricing is directly related to the number of factors affecting that mispricing. Copyright © 2022 Inderscience Enterprises Ltd.
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Background: COVID-19 is a new, health-threatening infectious disease in the world in 2020 and is caused by a novel coronavirus SARS-CoV-2. As of July 13, 2020, 4,881,579 active cases of COVID-19 were diagnosed, and 571,080 deaths were reported globally. In India, 301,850 active cases and 23,187 deaths were reported. To date, no effective treatment is available against the deadly virus SARS-CoV-2. Drug manufacturers, institutional laboratories, and other organizations have started developing vaccines to combat COVID-19 infection. Method(s): Science Direct, Elsevier, PubMed, Scopus, and Nature databases were referred to know the current scenario of the disease. Moreover, recent data have been obtained from the World Health Orga-nization, Centre of Disease Control, case studies, newspapers, and Worldometer reports. Data of Vaccine Centre at the London School of Hygiene & Tropical Medicine, Clinicaltrials.gov, and US National Library of Medicine have also been accessed to obtain the latest information about ongoing clinical tri-als. Result(s): The primary source of the SARS-CoV-2 outbreak is connected to the Hunan seafood and live animal market in Wuhan city, Hubei Province, China. Like;SARS-CoV, and MERS-CoV, SARS-CoV-2 is also a zoonotic virus affecting the lower respiratory tract in humans. The pathogenesis of COVID-19 involves attachment of its Spike (S) protein to the angiotensin-converting enzyme 2 (ACE2) receptor in the lower respiratory tract in humans. The most common symptoms of COVID-19 are fever, cough, sore throat, fatigue, headache, myalgia, septic shock, and breathlessness. Few patients with COVID-19 infection experience diarrhea, vomiting, and abdominal pain. Currently, FDA approved drugs being used to treat COVID-19. Conclusion(s): This review article presents the importance of traditional Indian herbs recommended by AYUSH as precautionary and curative measures of COVID-19 until vaccines and drugs are made avail-able. Moreover, this article discussed the origin, symptoms, mode of transmission, management, and diagnostics techniques for the detection of the SARS-CoV-2 virus.Copyright © 2021 Bentham Science Publishers.
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This paper describes the emerging role of robots in health care and integrated environments with special concerns related to the management and control of the spread of novel coronavirus 2019. The primary use of such robots is to reduce human interaction and ensure cleanliness, fertility, and support in the hospitals and facilities such as isolation. This will lead to a reduction in the life-threatening risk for medical professionals and physicians who have played a significant role in the management of infectious diseases like coronavirus. The purpose of this work is to highlight the importance of medical robots in general and to link their use in the field of medical assistance so that hospital administrators can use the medical robots for different treatment processes. The work involves the design and development of an AUTONOMOUS and IoT CONTROLLED MEDICAL ASSISTANCE ROBOT (AIMED), which is designed as a potential answer for any irresistible ailment, particularly for Coronaviruses Outbreak. AIMED ROBOT is utilized to limit individual to-individual contact and to guarantee cleaning, sanitization and backing in emergency clinics and comparable offices, for example, food and medication conveyance in isolate emergency clinics/offices. Voice communication can also be established between the control room and patient through a wireless network. This data is sent to the doctor and staff using a communication network that helps in monitoring the patient's condition without human interaction. Hand Sanitization, food delivery and waste collection system are also provided in the robot for quarantine zones. This is despite the popularity of telemedicine, which also applies to similar situations. In fact, the recent success of the Korean and Chinese health sectors in gaining effective control of the coronavirus epidemic would not have been possible without the use of state-of-the-art technology. Background(s): In the quick advancement of innovation, there are numerous sorts of robots with different details and capacities. The AIMED Robots are being developed for hospitals to deliver medicines, food and for taking live data from the patient directly. A few issues are confronted in regards to the limitation of explicit places around and inside the clinic because different robots were utilizing landmark recognition. Moreover, the issues faced when the robot is to convey things to any patient from any place should be taken care of. Objective(s): The objective of this work is to highlight the importance of medical robots in general and to link their use in the field of medical assistance so that hospital administrators can use the medical robots for different treatment processes. Method(s): The work involves the design and development of an AUTONOMOUS and IoT CONTROLLED MEDICAL ASSISTANCE ROBOT (AIMED), which is designed as a potential answer for any irresistible ailment particularly for Coronaviruses Outbreak. Result(s): AIMED Robot goes through three testing stages. In the final stage, one complete embedded system is designed by embedding each tested sub-system and then this final embedded system is tested. All the project goals, which were planned as 'Solution to Problem Statement', have been achieved properly. Conclusion(s): This paper provides an overview of the robotics and therapeutic potential of robotics in specific environments with COVID-19 epidemic control. The AIMED robot introduced in this paper is a piece of emergency clinic and care focus computerization framework. Multiple patients are placed for stop-over and doctor's prescription regarding patient health. It can be very useful to counter infectious diseases like SARS, MERS or Covid-19 etc. This work confirms that the introduction of medical robots has significantly increased the safety and quality of health care systems compared to manual systems due to the digitalization of health care.Copyright © 2021 Bentham Science Publishers.
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Pandemic situations impact the ability of the startups to identify the product features that have match with market needs: the activity that requires direct interaction with the customers at the same physical space. Online tools can overcome this limitation, but early-stage startups have too limited resources and lack of access to the potential customers, which make their online interactions quite limited. The divergent creativity is required to identify the requirement elicitation methods and tools that could help startups to identify product/market fit with limited same physical space interaction with customers. The open innovation involving academia, experts, and researchers could help startups to get access to the market needs. This chapter reports one such consulting experience of the author with the Madrid (Spain)-based startup which successfully identified its market in pandemic time through global market research driven by secondary studies, primary research involving potential clients (or users) through online means, and limited interactions at the same physical space. Daily brainstorming with a team of researchers, experts, and professors helped to generate divergent ideas about identifying markets amid the pandemic and testing them in real context that proved to be successful for the startup. Overall impact is the ability of startup to innovate its business model for foreign markets. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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This chapter provides background information on innovating value propositions that are a component of business model innovations that underlie market research for market expansion in both domestic and international markets. The theoretical backdrop is then provided in order to highlight the gaps that this work aims to fill. The knowledge presented in this book is then positioned in relation to previously established practices for implementing business model improvements in both domestic and international markets, which is challenged by startups in reality. This book's key part on business model developments during the epidemic imparts important lessons for the startup community that is battling to compete in the pandemic and could also be valuable in the "new normal.” © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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BACKGROUND: Currently, AVFs are created by vascular surgeons urologists and nephrologists. Nephrologists may be better placed to create AVFs and conduct follow-up as they re well versed with the usage of AVF. AIM OF THE STUDY: This observational prospective study aims to find the outcome of AVFs created by nephrologists over two years in a tertiary level hospital. METHOD(S): All the patients in whom an AVF was created by nephrologists between March 2020 and August 2022 were included. On the day of surgery vitals were recorded and vein mapping was done. Side-to-side anastomosis with 6-0 proline between artery and vein were performed under local anesthesia in a single sitting. Patients were observed for post-op complications. During the COVID-19 pandemic, RT PCR was only performed in suspected in suspected patients indentified during screening. All patients staff and surgeons wore N-95 masks in addition to usual sterile measures. Patients were followed up at 6th week and 12th week post-AVF construction to do clinical examination and evaluate blood flow diameter of AVF by high-quality Doppler. Patients were asked to use AVF for dialysis after 6th week of creation after they have matured. AVF maturation was defined radiologically as a combination of blood flow of 600 ml/min and diameter of 6 mm or more and clinically usable. Else it was considered immature. Primary failure was defined as AVFs that had not matured till 12th week of creation. All the data were analyzed by appropriate statistical tools using the SPSS software RESULTS: A total of 1323 fistulae (including 376 during COVID-19 pandemic) were created in 1102 patients. Of them 928 (84.21%) were males, and 537 (48.72%) of the patients were having underlying diabetes mellitus. A total of 1008 (76.19%) were radio-cephalic while 262 (19.8%), 19 (1.43%) were brachio-cephalic, and brachio-basilic respectively. 1013 (76.56%) fistulae were left sided. 944 (85.66%) were already on hemodialysis while 158 (14.33%) were planned for elective initiation after fistula maturation. Of the 1102 patients, 150 patients required fistula creation twice, 17 patients thrice, and 4 patients underwent fistula creation four times. Out of 556 (50.45%) patients who completed three months follow-up, 65 patients (11.69%) expired. Primary failure was observed in 107 (19.21%) fistulae and 24 (4.30%) patients developed local site infection. 8 (1.43%) and 4 (0.71%) patients developed fistula rupture and aneurysms respectively requiring admission for AVF closure. Mean AVF blood flow and diameter were 674.92 +/- 317.40 and 5.42 +/- 1.33 at 6th week and 983.60 +/- 289.41 and 9.36 +/- 54.58 at 12th week respectively. During the COVID-19 pandemic, out of 376, 15 (7.1%) patients were found to be COVID-19 positive during follow-up, and only 2 out of 18 staff and 4 nephrologists were found to COVID-19 positive. CONCLUSION(S): Nephrologists are well positioned to create AVFs successfully. However, collaboration with vascular surgeons and radiologists will further improve the success rate and management of complications. AVF creation is safe during pandemics and should be continued.
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The coronavirus disease 2019 (COVID-19) pandemic led to a turbulent business environment, resulting in market uncertainties, frustrations, and rumors. Wrongly held beliefs—or myths—can hinder startups from turning new market opportunities into their favor (e.g., by failing at diversification decisions) or undertaking wrong business decisions (e.g., diversifying in industries that have products of no real market value). The objective of the chapter is to identify the beliefs that drive the business decisions of startups in a pandemic and to isolate those beliefs that are merely myths. Further, this chapter proposes strategic guidelines in the form of a framework to help startups make sound decisions that can lead to market success. The two-step research method involved multiple case studies with five startups based in India, France, Italy, and Switzerland, to identify perceptual beliefs that drove strategic business decisions, followed by a case study of 36 COVID-19 solution-focused startups, funded by the European Union (EU). The findings were validated through a survey that involved 102 entrepreneurs. The comparative analysis of two multiple case studies helped identify beliefs that were merely "myths,” myths that drove irrational strategic decisions, resulting in business failures. The results indicate that startups make decisions in pandemic situations that are driven by seven myths, pertaining to human, intellectual, and financial resources. The decision on whether to diversify or continue in the same business operation can be divided into four strategic options of the Competency-Industry Relatedness (C-IR) framework: ignore, delay, phase-in, and diversify. Diversification in the same (or different industry) is less risky for startups if they have the skills, as needed, to diversify in related industries. Diversification in related industries helps startups leverage their experiences and learning curves (those associated with existing product lines) to adapt their existing products in new markets or utilize their technologies to solve new problems via new products. The desired outcome for these startups should be sustainable business growth—to meet sustainability goals by contributing to the society and the economy. The Competency-Industry Relatedness (C-IR) framework is a strategic guide for startups to make business decisions based on internal factors, rather than myths. Accurately assessing skill diversity and the nature of new industries will help startups leverage their existing resources optimally, without the need for (pricey) external funding. This will foster sustained business growth resulting in a real contribution to the nation economy. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Pandemic situations impact the ability of the startups to identify the product features that have match with market needs: the activity that requires direct interaction with the customers at the same physical space. Online tools can overcome this limitation, but early-stage startups have too limited resources and lack of access to the potential customers, which make their online interactions quite limited. The divergent creativity is required to identify the requirement elicitation methods and tools that could help startups to identify product/market fit with limited same physical space interaction with customers. The open innovation involving academia, experts, and researchers could help startups to get access to the market needs. This chapter reports one such consulting experience of the author with the Madrid (Spain)-based startup which successfully identified its market in pandemic time through global market research driven by secondary studies, primary research involving potential clients (or users) through online means, and limited interactions at the same physical space. Daily brainstorming with a team of researchers, experts, and professors helped to generate divergent ideas about identifying markets amid the pandemic and testing them in real context that proved to be successful for the startup. Overall impact is the ability of startup to innovate its business model for foreign markets. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
This chapter provides background information on innovating value propositions that are a component of business model innovations that underlie market research for market expansion in both domestic and international markets. The theoretical backdrop is then provided in order to highlight the gaps that this work aims to fill. The knowledge presented in this book is then positioned in relation to previously established practices for implementing business model improvements in both domestic and international markets, which is challenged by startups in reality. This book's key part on business model developments during the epidemic imparts important lessons for the startup community that is battling to compete in the pandemic and could also be valuable in the "new normal.” © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Objectives: Coronavirus disease 2019 (COVID-19) has neurologic manifestations associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to retrospectively analyze SARS COVID-19 patients with neurological manifestations and identify patterns of presentation including the site of neuroaxis involvement, neuroimaging, and associated systemic involvement. Methods and subjects: This retrospective observational study was conducted at two tertiary care hospitals in western Rajasthan. Data on age, sex, presenting symptoms, and comorbidities (hypertension, diabetes, cardiac, cerebrovascular disease, and cancer) were collected from 28th February 2020 to 31st December 2020 through medical records, discharge summaries, and radiological studies. Verbal/written patient consent was obtained due to the prevailing COVID-19 norms at the time of the first wave. Major inclusion criteria were as follows: age >18 years, consent from patient/surrogate, positive RT-PCR report in case of active COVID cases, or positive COVID antibody test in case of post-COVID neurological sequelae. All neurological manifestations were reviewed by at least two neurologists and were divided into central nervous system (CNS) and peripheral nervous system (PNS) manifestations. Systemic features and their temporal relationship with neurological features were recorded. Various other specialized assessments and therapeutic interventions were conducted. Statistical analysis was performed using the SPSS software. A Chi-square test was performed to determine the association between variables. Student's t-test and one-way analysis of variance were used to determine differences in mean values. Statistical significance was set at p < 0.05. Results: The mean age was 57.32 years for the CNS group and 40 years for the PNS group (p = 0.025). Age was significantly lower in the PNS group than in the CNS group (p = 0.025). Anemia, leucocytosis, and elevated serum creatinine were more commonly seen in the CNS group, although the difference was not statistically significant. The most common CNS manifestations were stroke (41.8%), of which ischemic stroke constituted 83% of cases, followed by seizure (22%), encephalopathy (20.9%), headache (15.1%), and vertigo (3.8%). The most common PNS manifestation was neuropathy (57%), which included Guillain-Barré syndrome (GBS), critical illness neuropathy, and autonomic neuropathy. Conclusion: CNS symptoms of COVID-19 are more common than PNS symptoms. Stroke is the most frequent (46%) COVID-CNS symptom, which occurs in people of age above 35 years and is associated with high mortality. © The Author(s). 2022Open Access This article is distributedunder the terms ofthe Creative Commons Attribution 4.0InternationalLicense (https://creativecommons.org/licenses/by-nc/4.0/)
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We explore the challenges of teaching "hardware-embedded Robotic Operating System (ROS) skills" online in a lockdown situation to participants through a hands-on competition. Teamwork is a vital skill in solving modern engineering problems. During Covid-19 lockdown situations, the interaction between teammates significantly reduced compared to regular times. This prompted us to design an engineering problem statement with scaffolding that improves engineering education learning efficacy. A total of 465 teams (1860 participants) were introduced to a problem statement comprising of a autonomous robot navigation, manipulation and a perception task for an indoor unmanned ground vehicle. We study the performance of teams based on several factors such as participant's score, task's difficulty level, number of resources given and the nature of online sessions by instructors. We found the scaffolding approach helped teams in implementing a solution by exploring alternative methods and thus their knowledge. © ISLS.