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Purpose: The Covid-19 pandemic has exacerbated social risks around the world, highlighting inequalities and eroding social cohesion in and between nations. The challenges posed by this global crisis to world governments can be overcome with cooperation between the public and private sectors. Several studies support the importance of external corporate social responsibility (CSR) activities in sharing knowledge with citizens and external stakeholders, with benefits for the company and for society. Few studies have investigated the relationship between knowledge management (KM) and sustainability. This work aims to investigate the influence of the gender variable in the sharing of CSR knowledge, focusing on the area of human rights. Design/methodology/approach: The panel regression analysis was performed on a sample of 660 European companies listed over the years 2017–2020. The hypotheses tested in panel regression were then corroborated by a further test. Findings: The results show a positive influence of women directors in the external disclosure of human rights. Evidence would assign a positive role to gender in sharing knowledge. Practical implications: The findings offer new insights into the role of gender on KM and sharing. The results show that gender can be a factor that stimulates CSR knowledge. The presence of women directors can be a useful tool to increase the relational capital of the companies and to share knowledge outside the company. Originality/value: The study contributes to the poor literature between knowledge sharing and sustainability. Evidence would assign a positive role to gender in sharing knowledge. © 2023, Emerald Publishing Limited.
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This paper presents the structured literature review of the big data and artificial intelligence in relation to the epidemic disasters among which the current SAR-COV-2. Providing a deep understanding of the state of the art, the paper drafts implications and valuable insights to manage and prevent epidemic disasters by public and private organisations drafting the research agenda. Interestingly, a two-decade study of the connection between big data, artificial intelligence and pandemic or epidemic issues is undertaken for the first time. This paper adopted a longitudinal study of the literature from the relevant databases Scopus as a leading source to get access to the articles. The diffusion of epidemic disasters among which SARS-COV-2 needs to be managed investigating several aspects such as the prevention and tracking of the epidemia or pandemia. The role of smart technologies and particularly big data and artificial intelligence is useful in tracking, preventing and managing the emergency by organisations, institutions and policymakers. This study provides for the first time the connection among big data, artificial intelligence and epidemic disasters, providing valuable implications, insights and emerging issues among which the relevance of decision-making processes and risks definition and assessment. Copyright © 2022 Inderscience Enterprises Ltd.
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Introduction:Although quarantine measures have been effective in preventing the spread of SARS-COV2 infection, they have limited physical activity and changed dietary habits, factors known to predispose the progression of nonalcoholic fatty liver disease (NAFLD). A role of PNPLA3 in weight gain has been recently reported. Aim: to evaluate changes on metabolic and hepatic profile in NAFLD patients during COVID-19 pandemic and to investigate the impact of PNPLA3 on the effect of lifestyle. Matherials and Methods and Results: 357 NAFLD patients who had a medical checkup no more than 6 months before COVID-19 blockade were included. Anthropometric, clinical and laboratory data and ultrasound grading of steatosis were collected before and after the blockade. Adherence to the Mediterranean Diet (MD) and physical activity (PA) was assessed at each visit. Genotyping for PNPLA3 was available in 188.After lockdown 48% patients gained weight and 16% worsened steatosis grade. Weight gain was associated with bad adherence to MD (p=0.005) and PA (p=0.03) and to PNPLA3 GG genotype (p=0.04). Interestingly, at multivariate analysis adjusted for sex, age, PA, MD and PNPLA3 GG, only PNPLA3 GG remained associated with weight gain (p=0.04). A higher glycemia (112±32 vs 106±25, p=0.002) and prevalence of increased transaminases (ALT 30% vs 21%, p= 0.02) were observed after lockdown only in patients who gained weight. Analyzing patients who gained weight according to age (i.e < or >67 ys), both older and younger patients showed less adherence to MD, but only younger patients had a significantly reduced PA during lockdown (23% vs 40%, p=0.002). Conclusions: During lockdown nearly half of NAFLD patients gained weight with consequent worsening of metabolic and liver features, highlighting, independently of the pandemic, the beneficial role of correct lifestyle.More interestingly, PNPLA3 GG genotype emerged as an independent risk factor for weight gain, opening new perspectives in NAFLD patients care.
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Background: Quarantine measures during Corona Virus Disease 2019 (COVID-19) pandemic changed lifestyle habits. In Nonalcoholic fatty liver disease (NAFLD) weight gain and unhealthy diet, along with PNPLA3 gene, impact on metabolic and hepatic disease. Aim: to evaluate prevalence and predictors of weight gain and steatosis progression in NAFLD outpatients during COVID-19 lockdown. Methods: 357 NAFLD outpatients were evaluated before COVID-19 lockdown and 6 months apart. Anthropometric, metabolic (i.e. presence and therapy of type 2 diabetes-T2DM, hypertension, dyslipidemia), laboratory data (glycemia, lipids, transaminases) as well as ultrasound (US) grading of steatosis were collected pre and post lockdown. Worsening of metabolic alterations was assessed post lockdown as newonset comorbidity or introduction of new therapies. Patients were questioned about diet and physical activity at each visit. In 222 patients genotyping for PNPLA3 was available. Results: Mean age was 61 ±12 ys, with 67% male. After lockdown 28% of the cohort worsened US steatosis grade from mild to moderate or severe. Patients who worsened steatosis had a higher prevalence of T2DM (34% vs 12%, p=0.006) and higher BMI (28.6 ±3.9 vs 26.8 ±3.6 kg/m2, p=0.01) pre lockdown compared to those who did not. No impact of diet or physical activity was observed on steatosis progression. An increase in body weight was registered in 170 (48%) patients with a mean increase of 3.2 ±2.4 Kg. As expected, patients with weight gain compared to those without it had a significantly lower adherence to diet (45% vs 61%, p=0.005) and decreased physical activity (28% vs 45%, p=0.001) at post lockdown visit. However, deterioration of lifestyle was not significant in subjects with PNPLA3 homozygosity for the risk allele. In addition, no impact on weight gain of pre lockdown lifestyle (diet adhesion 60% vs 52%, p=0.15;physical activity 48% vs 40%, p=0.16) or metabolic comorbidities was found. In patients who gained weight a worse glycemic control was observed (7% vs 2%, p=0.04) with increase in glycemia (106 ± 25 vs 111 ± 30 mg/dl p<0.001) compared to pre lockdown. Conclusion: Lockdown led to a dramatic change in lifestyle with consequent weight gain in almost half of our cohort of NAFLD patients. Indeed, genetic factors seem to modulate this impact. Therefore, during pandemic emergencies should be highly important to monitor patients' lifestyle at home, possibly by new technologies such as telemedicine.
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The COVID-19 pandemic situation has had unprecedented negative consequences in the tourism sector, especially in the hotel industry, which has implied negative shocks directly and indirectly in city revenues, employment and economy. Recent research has indicated that technology is becoming central in finding solutions for tourism recovery through the development of new or improved ICT-enabled tourism services, which could help to achieving a higher attraction of tourists and other sources of foreign investments to cities. This paper therefore seeks to analyse the impact of blockchain technologies (BCT) on the tourism business for attracting new customers to cities with the aim at gaining insights regarding public policies to be taken by local governments for improving tourism business in their city. To achieve this aim, this paper provides an empirical research on the impact of BCT on both lowering prices and improving service quality of lodging accommodations by a sample of lodging accommodations in different Italian cities, providing insights to know if the implementation of BCT on hospitality business, can help city governments to improve smart living into the urban space, deriving some recommendations for city government to take public policies to favour the implementation of these technologies into the hospitality industry. © 2021, IFIP International Federation for Information Processing.
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Background: Coronavirus Disease (COVID-19) could be considered as a human model of marked inflammation combined with severe hypoxia. In this setting, both erythropoiesis and iron metabolism appear to be profoundly affected by inflammatory and hypoxic stimuli, which act in the opposite direction. In patients with SARS-CoV-2 infection, Hb levels tend to be relatively high even in the context of severe disease and marked inflammation. A better understanding of erythropoiesis and iron metabolism in COVID-19 could contribute to elucidate the relationship between hypoxia and inflammation on erythropoietic control. Aims: To investigate the prevalence of anemia, the alterations of iron homeostasis,and the relationship between inflammation,hypoxia and erythropoiesis in a cohort of COVID-19 patients admitted both to medical wards and intensive care unit (ICU). Methods: We retrospectively analyzed data of 303 patients with COVID- 19 (178 subjects admitted to medical wards and 125 subjects admitted to the ICU). Biochemical parameters were collected on admission (T0), after 7 days of hospitalization (T1) and at discharge/death (T2). Results: The median age of the patients was 62 years (53-71) and 72% were males. ICU patients had lower mean Hb levels compared to non- ICU patients (11.3±1.8 vs 12.8±1.8 g/dL at T0, 10.2±1.6 vs 12.2±1.9 g/ dL at T1, 10±1.4 vs 12±1.7 g/dL at T2;p<0.001). Mean Hb concentration did not fall under 12 g/dl in the non-ICU group and under 10 g/ dl in the ICU group during hospitalization. Hb decreased by approximately 1 g/dl in both cohorts during the first 7 days of hospitalization, then remained stable until discharge. ICU patients also showed increased inflammatory markers and ferritin levels (1401 vs 839 mcg/l at T0, p<0.001;913 vs 832 mcg/L at T1, p ns;764 vs 651 mcg/L at T2, p ns). There were no significant differences in other iron parameters between groups. Hypoxia was a prominent feature of ICU patients (P/F ratio 91 vs 224, p<0.001). Patients who were anemic on admission maintained relatively constant Hb concentrations from T0 to T2 (10.8 g/dL at T0, 10.2 g/dL at T1 and 10.4 g/dL at T2), thus remaining in a range of mild to moderate anemia. Conversely, the non-anemic group displayed a greater reduction of Hb levels (13.7 g/dl at T0, 12.7 g/dl at T1, 12 g/dl at T2). Anemic subjects were more hypoxic than non-anemic patients (P/F 151 vs 292 at T0, p<0.001) and showed significantly higher levels of CRP (10.8 vs 6.6 mg/dL), IL-6 (60.3 vs 47.7 ng/L) and leukocyte count (7290 vs 6130 x109/L). Ferritin was higher in anemic patients at T0 and T1 (1220 vs 926 mcg/L and 852 vs 896 mcg/L, p ns), decreasing more at T2 (655 vs 763 mcg/L, p ns). Median hepcidin levels, which were available for a limited subset of non- ICU patients, were elevated during the whole period: 233 ng/mL at T0, 95 ng/mL at T1 and 60 ng/mL at T2. Summary/Conclusion: In patients with SARS-CoV-2 infection, two main factors influence erythropoiesis and iron homeostasis: systemic inflammation and profound hypoxia. Markedly high ferritin and hepcidin levels reflect a strong inflammatory response. However, COVID-19 patients tend to have disproportionately high Hb levels in the contest of the inflammatory milieu. The absolute reduction in Hb levels is more prominent in patients who displayed normal Hb on admission. Conversely, anemic and profoundly hypoxic subjects show constant mean Hb levels over time. Thus, we can hypothesize that the erythropoietic drive provided by hypoxia could counterbalance the effect of inflammation on hepcidin regulation, preventing Hb levels from falling dramatically during hospitalization.
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Introduction: Acute kidney injury (AKI) and urinary sediment alterations are frequently associated to COVID-19, adding severity and high mortality risk. Knowledge of patient characteristics, risk factors, adverse outcomes, and regional peculiarities are key in the fight against this new disease. In order to describe the clinical characteristics of COVID-19 kidney involvement in Latin America (LA), the Latin American Society of Nephrology and Hypertension presents preliminary results of an ongoing Registry. Method(s): Repository of patients (Pts) by open invitation to nephrologists in LA. We included pts with confirmed SARS-CoV-2 infection by RT-PCR who developed proteinuria and/or, hematuria and/or AKI. Pts with CKD stage 5, on chronic dialysis or transplanted were excluded. Surveymonkey platform was used for data entry, and the SPSS v22 was used for the analysis. The study was approved by the Institutional Review Board of Clinica Los Olivos (Cochabamba, Bolivia) and a waiver of written consent was granted. Demographic variables, comorbidities, lab, characteristics and causes of AKI, need for kidney replacement therapy (KRT), ICU admission, mechanical ventilation (MV), complications and in-hospital mortality were collected Results: N= 632 pts. Brazil, Mexico, Colombia, Argentina, Peru and Bolivia were the main providers of pts. Median age 63 yrs (IQR, 53-73). Most pts were male (67.2%). One or more comorbidities were present in 86.9% of cases, mainly hypertension, diabetes and obesity. AKI was hospital-acquired in 59.7% and non-oliguric in 58.5%. Other causes of kidney involvement associated to COVID-19 were volume depletion (38.6%), nephrotoxicity (26.7%), and sepsis (23.4%). KRT was implemented in 47.2% but 32 pts (5.1%) needing dialysis were not dialyzed. Non-recovery of renal function was observed in 65.3%. Sixty-six percent of pts were in ICU and 67.2% underwent MV. However, 3.3% and 2.5% pts needing ICU and MV respectively did not receive it. Proteinuria (PU) at admission was present in 62.5% of 280 evaluable pts. which had more CKD, severity of AKI and the underlying condition and higher mortality rate. In those pts without PU at admission, onset of PU during hospital stay was observed in 15.4% (29/188) which had more hypertension, COVID-19 MODS as cause of AKI, more severe AKI as well as organ dysfunction. Complications in the general population occurred in 79.7%, mainly sepsis (44.9%). All-cause mortality was 57.4%. Variables independently associated to mortality were age (RR 0.95), COVID-19 DOMS (RR 2.46), nephrotoxicity (RR 2.07), oliguria (RR 2.28), non-recovery of AKI (1.97), ICU admisssion (RR 25.6) and MV (2.51). Conclusion(s): This regional cohort of COVID-19 patients showed that kidney involvement is usually found in elderly males patients with associated comorbidities. AKI was predominantly hospital-acquired and non-oliguric. COVID-19 multi-organ dysfunction syndrome (MODS), volume depletion, nephrotoxicity and sepsis were main causes of AKI. Almost half patients required KRT. Of note, a number of pts needing KRT, ICU admission or MV were not treated for not recorded reasons. PU at admission was frequent and associated to CKD, severe clinical condition, worse renal outcomes and increased mortality. In-hospital onset of PU was linked to hypertension, COVID-19 MODS as cause of AKI, and severity of kidney, respiratory and hemodynamic failure. No conflict of interestCopyright © 2021
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Background: SARS-COV2 is a threatful viral disease which can evolve into respiratory failure but identification of risk factors for progression towards severe forms is still ongoing During infection impairment of liver function tests has been frequently reported and evidence of the negative impact of metabolic alterations on the clinical course are emerging, mainly evaluated in Asiatic populations Aim: to define the prognostic role of metabolic disease and liver damage on SARS-COV2 severity in a cohort of Italian patients Methods: All patients with confirmed COVID-19 infection admitted to low-intensity care COVID Units between March and April 2020 were enrolled Severe SARS-COV2 infection was defined according to International consensus requiring intensive respiratory support (CPAP/orotracheal intubation) All data were collected at admission Results: 382 patients were enrolled, mean age was 65±17 ys and 60% were male Mean BMI was 27±5 kg/m2 (61% overweight and 25% obese), prevalence of T2DM 17%, hypertension 44%, dyslipidemia 29% At admission 39% and 40% of patients had increased ALT and GGT levels, respectively Median hospitalization stay was 14 days (IQR 8-24), with 30% of patients experiencing severe SARS-COV2 infection and mortality in 14% of overall cases Subjects with severe infection presented higher prevalence of male sex (68% vs 56%, p=0 03), T2DM (25% vs 14%, p=0 01), dyslipidemia (36% vs 26%, p=0 05) and increased ALT (53% vs 32%, p<0 001) and GGT (53% vs 34%, p=0 01) levels at admission In multivariate analysis (adjusted for age, sex, T2DM, dyslipidemia, increased ALT and GGT at admission and SARS-COV2 therapy), T2DM (OR 3 1, 95%CI 1 6-6 0;p=0 001), dyslipidemia (OR 1 9, 95%CI 1 1-3 3;p=0 03), and increased ALT (OR 4 7, 95%CI 2 5- 9 0;p<0 001) and GGT (OR 2 0, 95%CI 1 2-3-3;p=0 009), resulted associated with high risk of more severe SARSCOV2 disease Interestingly, in patients with both T2DM and dyslipidemia, this risk was further increased (OR 5 2, 95%CI 2 1-12 6;p<0 001) Conclusion: We confirm that liver involvement is common during SARS-COV2 infection and it is a negative prognostic factor although it is not clear whether it precedes or follows, the severity of clinical course In addition, the risk of severe form of respiratory distress is increased by metabolic alterations, and the more numerous the alterations, the higher the risk.