Association of interleukin-6 and CD4+ T cells and two-week prognosis of patients with COVID-19: a predictive role.

OBJECTIVE:  The aim of this study was to determine the association of inflammation and immune responses with the outcomes of patients at various stages, and to develop risk stratification for improving clinical practice and reducing mortality. PATIENTS AND METHODS: We included 77 patients with primary outcomes of either death or survival. Demographics, clinical features, comorbidities, and laboratory tests were compared. Linear, logistic, and Cox regression analyses were performed to determine prognostic factors. RESULTS: The average age was 59 years (35-87 years). There were 12 moderate cases (16.2%), 42 severe cases (54.5%), and 23 critical cases (29.9%); and 41 were male (53.2%). Until March 20, 68 cases were discharged (88.3%), and nine critically ill males (11.7%) died. Interleukin-6 (IL-6) levels on the 1st day were compared with IL-6 values on the 14th day in the severe and the critically ill surviving patients (F=4.90, p=0.034, ß=0.35, 95% CI: 0.00-0.10), and predicted death in the critically ill patients (p=0.028, ß=0.05, OR: 1.05, 95% CI: 1.01-1.10). CD4+ T-cell counts at admission decreased the hazard ratio of death (p=0.039, ß=-0.01, hazard ratio=0.99, 95% CI: 0.98-1.00, and median survival time 13.5 days). CONCLUSIONS: The present study demonstrated that IL-6 levels and CD4+ T-cell count at admission played key roles of predictors in the prognosis, especially for critically ill patients. High levels of IL-6 and impaired CD4+t cells are seen in severe and critically ill patients with COVID-19.

REAL-WORLD EFFECTIVENESS OF mRNA, SUBUNIT, AND VECTOR-BASED VACCINES AGAINST COVID-19

Background: Limited Covid-19 vaccine effectiveness (VE) studies address the mRNA, adenoviral vector-based, and protein subunit vaccines and their mix and match in real-world settings. BNT162v2 (Pfizer-BioNTech), mRNA- 1273 (Moderna), AZD1222 (AstraZeneca), and locally produced MVC-COV1901 (Medigen) are provided under the National Vaccination Program. Taiwan maintained a low circulation of Covid-19 infection until a major epidemic Omicron BA.2, began in April 2022. The study aimed to estimate the VE against moderate and severe (severity) and fatal diseases (death) associated with SARS-CoV-2 among individuals administered one, two, and three doses of vaccination and categorized by vaccine type combinations in this predominantly infection-naive population. Method(s): The study included CDC's administrative records from National Immunization Information System and National Infectious Disease Reporting System from March 21, 2021, to September 30, 2022. Criteria for Covid-19 severity followed WHO's guidelines, and the committee reviewed the records. The study calculated each individual's last administered date to disease onset (incidence rate (IR) per 100,000 person-days) to explore the incidence rate to compare the presence of risk probabilities. Multiple logistic regression was used for vaccine effectiveness analysis. Result(s): Of 23,933,482 individuals included in the study, and 6,202,496 infections, 30,976 severity, and 10,851 deaths were observed. Compared with three doses administered, three doses of AZD1222 or it as primary series plus mRNA or protein-based vaccines were at higher risk of severity (IR: 0.390-0.762), followed by mRNA-1273 (IR: 0.316-0.471), MVC-COV1901 (IR: 0.044-0.196) and BNT162v2 (IR: 0.061-0.197). As for the death outcome, AZD1222 was at higher fatal risk (IR: 0.127-0.269), followed by mRNA-1273 (IR: 0.086-0.125), MVC-COV1901 (IR: 0.013-0.064) and BNT162v2 (IR: 0.015-0.045). VE against the severity of AZD1222 or it as primary series ranged from 65.9% to 77.7%;mRNA vaccines ranged from 86.4% to 96.1%;and protein-based vaccines ranged from 91.4% to 96.2%. A similar pattern of VE against death ranged from 60.9% to 73.7%, 88.2% to 96.2%, and 90.3% to 95.6%. Conclusion(s): Individuals who received their primary series as AZD1222 might not have adequate protection against Covid-19 severity so encourage those vulnerable groups to receive additional booster doses. The study also indicated that protein subunit vaccines provide similar protection against severity and death as mRNA vaccines. (Table Presented).

When and how digital platforms empower professional services firms: an agility perspective

PurposeDrawing on a strategic agility perspective, the authors develop a theoretical framework and empirically examine how digital platform adoption and capability impact business performance via digital-enabled strategic agility in the context of professional service firms.Design/methodology/approachThe authors propose and examine a conceptual framework based on survey data from 127 professional service firms in New Zealand.FindingsThis study reveals the impact of digital platform capability on the business performance of professional service firms that employ digital platform technologies. The results suggest that organizational innovation and managers' creative efficacy will be used as distal antecedents and contribute to digital platform capabilities. In addition, digital strategic agility can mediate the link between digital platform capabilities and business performance.Originality/valueThis study is one of the first to investigate when and how digital platforms empower professional service firms. This study reveals the role of digital strategic agility and digital platform capabilities in knowledge-intensive enterprises. This research advances the development of knowledge-based economy in the information age by applying and extending strategic agility to the uncertain and volatile business environment. The authors' new conceptualization provides a deeper understanding of how and why professional services business and organizations can adapt to the post-COVID era smoothly and successfully.

The Security of Blockchain-Based Medical Systems: Research Challenges and Opportunities

The current COVID-19 pandemic has, perhaps, expedited the move to electronic medical systems (e.g., telemedicine). However, in the digitalization of healthcare services, we have to ensure the security and privacy of (sensitive) healthcare data, often stored locally in the hospital's server or remotely within a trusted cloud server. There have been many attempts to design blockchain-based approaches to support security and privacy in medical systems, and this is the focus of this article where we systematically review the existing literature on blockchain-based medical systems. We then categorize the existing security solutions into three categories, namely, 1) decentralized authentication, 2) access control, and 3) audit, and discuss the privacy protection technologies in blockchain-based healthcare systems. Based on our analysis, we identify a number of challenges, including performance limitations and inflexible audit, as well as future research opportunities (e.g., the need for lightweight security schemes for blockchain-based medical systems).

[To take the initiative in the prevention and control of the coronavirus disease 2019 epidemic in the changing and unchanged strategies].

In early 2020, an outbreak of coronavirus disease 2019 (COVID-19) epidemic happened in China. In the following three months, 42 600 medical personnels and more than 9 000 public health employees were "rushed out" of their own position and onto Wuhan and other areas in Hubei Province. They helped to strengthen the treatment of severe cases and the isolation of mild cases, and actively carried out community screenings, and eventually won victory in the defense of Wuhan. During the normalization stage of prevention and control of the epidemic of COVID-19, China adopted the expanded preventive strategy by focusing on widely implement PCR testing, and integrate general and emergency departments to improve the performance of public health system. In this stage, China put out the cluster of epidemics that have occurred in several places one after another, and effectively controlled the spread of the epidemic in 2 to 3 incubation periods. In the stage of "dynamic zeroing", China emphasized the strategy of "grasping early, grasping the basics", focused on specific measures such as precise prevention in key areas. The rule of golden 24 hours was used to control the spread of the epidemic within one incubation period. During the epidemic, China continues to adopt active prevention and control strategies. This self-confidence and determination depends on adhering to the leadership of the Communist Party of China, the distinct essence of medical and health services, and significant advantages of social governance on health.

MARKETING MIX PLUS DIGITAL PLATFORM INNOVATION IN PHARMACEUTICAL INDUSTRY: WHERE WE ARE AND HOW TO MOVE FORWARD UNDER COVID-19

Today more so than ever, a 'megabrand' is not something that is just discovered in the lab, but something that is taken from a 'promising molecule' to 'blockbuster product' through the coordinated and planned efforts of cross-functional teams, including R&D, medical and marketing and functions. Within global pharmaceutical industries portfolio, there is considerable potential for several products to be taken to megabrand status and make an important contribution to our business in the future. Marketing plays a critical and central role in the creation of a megabrand and, within that, effective communication support is vital in marketing mix innovation. This research thesis was through cases study to find out what are the keys to be responsible for creating and sustaining a megabrand? Why to be successful? And how to success? Maybe it can provide an overview of the key communication activities used to support a brand, from the perspective of launching a megabrand, through examples drawn from previous campaigns, many from within global pharmaceutical industry in Taiwan. In the same time, hope to offer the guidance and advice on the critical communication areas for megabrands: Issues preparedness, competitor strategies, opinion leader support, working with third-party organisations, working with the media, internal communications, working with agencies, and the use of digital/internet marketing. After COVID-19 situation impact, the new digital marketing platform will be more active to discuss and implement in the pharmaceutical companies and create new open innovation for science communication and business impact. Based on marketing-mix modelling 12 P's theories (product, price, place, promotion, power, public relations, probing, partitioning, prioritizing, positioning, people, and packaging), add on new “platform” of digital/internet marketing to analysis the business effect in the global pharmaceutical companies through product life cycle and marketing mix modelling. Finaly, the cases pharmaceutical companies (AstraZeneca/Pfizer/Johnson & Johnson) show different business impact in core therapy area products after new innovation platform of digital/internet marketing. Modern marketing relies on digital technology to analyze the comprehensive performance of a marketing campaign, and help guide future strategies and decision-making. The best way to define a digital marketing platform is to break it down into its two parts: digital marketing and digital business platforms. It also seems to provide us the new innovation marketing mix 13P's theories in global pharmaceutical industry. Copyright © 2021 by Naudé Scribante. Permission granted to IAMOT to publish and use.

Bioinformatics analysis of high-throughput sequencing to identify key genes and signaling pathways in vero E6 cells infected by SARS-CoV-2

Background: In 2020, the coronavirus disease 2019 began spreading widely across the world. We aim to study the biological changes of SARS-CoV-2 infected Vero cells using high-throughput sequencing data, which will be helpful for vaccine development and drug screening. Methods: The data GSE153940 was obtained from the Gene Expression Omnibus database. R software was used to screen out differentially expressed genes and perform Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. The protein-protein interaction network was built by STRING. Cytoscape 3.7.2 was applied for the visualization of the protein-protein interaction network and the identification of the hub genes. GraphPad Prism 8.4.3 was used to perform the statistical analysis to verify the obtained central genes. Results: A total of 3640 differentially expressed genes were obtained. The most significant enrichment items of Gene Ontology in the biological process, cellular component, and molecular function were the regulation of mRNA metabolic process, organelle inner membrane, and cadherin binding respectively. Ten enrichment pathways were identified by the Kyoto Encyclopedia of Genes and Genomes analyses. A protein-protein interaction network with 328 nodes and 498 edges was established. Six hub genes were screened out, among which four genes (MRPS7, DAP3, CHCHD1 and MRPL3) were confirmed to be statistically significant. Conclusions: Our results suggest that mitochondrial activity has a significant role in the process of SARS-CoV-2 infecting Vero E6 cells. Further experimental studies are needed to obtain abundant data to verify the predicted results of the bioinformatics analysis.

Indoor air quality monitoring system for proactive control of respiratory infectious diseases: Poster abstract

Disease surveillance is essential for the control of flu and respiratory infectious diseases including the novel coronavirus disease (COVID-19). Indoor air quality monitoring has been shown effective in understanding the effectiveness of airflow and circulation indoors to reduce the risk of infectious diseases. In this project, we developed low-cost indoor air quality monitoring devices and systems to tackle the disease surveillance problem. The monitoring device consists of a set of air quality sensors. By strategic deployment and real-time data analysis, the system is able to yield insightful air circulation information indoors. The real-time data analysis is performed on air quality for the indoor ventilation using Long Short-Term Memory (LSTM) on sensed data. A series of user-friendly visualization interfaces and chatbot applications are designed to interact with users and ensure the successful delivery of infection control information. Finally, we work closely with the Taiwan Centers for Disease Control (CDC) and conduct field experiments in 15 locations including hospitals, long-term care centers, schools with total of 144 IAQ devices. © 2020 ACM.

Risk factors for AKI in patients hospitalized with COVID-19

Background: We evaluated risk factors and prevalence associated with AKI in our early experiences with patients hospitalized with COVID-19, 32% of whom required ICU level care, at the University of Texas Southwestern and Parkland Hospitals in Dallas, Texas from 3/13/20-5/07/20. Methods: Patients admitted with COVID-19 confirmed by SARS-CoV2 PCR test were screened for AKI. Univariate and multivariate logistic regression using backward selection identified factors associated with AKI. Results: COVID-19 was confirmed in 145 patients, of whom 62 (43%) had AKI. Patients with AKI were older, mean (SD) age 60 (17) vs. 54 (15) years without AKI, p=0.03, and were more likely to have hypertension, 74% vs. 47%, p=0.002, and diabetes mellitus, 61% vs. 31%, p<0.001. CKD was present in 42% of those with AKI vs. 7% of those without, p<0.001. Race, ethnicity, and ACEI/ARB use did not differ between groups. Patients with AKI had higher CRP, median (IQR) 102 (44-161) vs. 59 (21-116) mg/L, p=0.009, and LDH on presentation, 365 (265-493) vs. 317 (228-385) U/L, p=0.04. Ferritin, IL-6, and D-dimer was similar between groups. A higher percent with AKI received steroids, 42% vs. 16%, p<0.001. Tocilizumab was administered in 15% of AKI vs. 5% of non-AKI groups, p=0.08 while rates of hydroxychloroquine and remdesivir use did not differ. Renal replacement therapy was required in 8 patients with AKI, of whom 7 received CVVHDF and 1 HD. There were 8 (13%) deaths in those with AKI vs. 5 (6%) in those without. Factors associated with AKI are listed (Table). Conclusions: During the first weeks of COVID-19 outbreak at our hospitals, 43% of patients had AKI. Underlying CKD, diabetes, steroid use and illness severity were independently associated with AKI. Follow-up is needed to determine the long-term impact on kidney function and recovery.