Decision Factors behind Cisco Networking Hardware Acceptance in Business Environments

Networking hardware might be considered a relatively unexposed enabler of the enormous success of the modern digital economy, and information technology of a global reach. The COVID-19 traffic spike across e-commerce portals puts further pressure on computer network component vendors and raises the bar regarding both performance and reliability. Therefore, the authors undertake a challenge of identifying factors influencing the level of Cisco switches acceptance among network administrators in business environments. To achieve that, Structural Equation Modelling is introduced. The feedback gathered from 205 study contributors enabled the authors to evaluate the significance of two domain-specific factors-Technological Innovation (TI) and Availability of Professional Training (APT). The APT was confirmed to have a significant impact on networking hardware acceptance. The study contributes to extending the decision-making rationale regarding the procurement of networking switches and shows the added value of technology-oriented professional training for job satisfaction and working efficiency.

Patterns of sedation and narcotic utilization for critically ill patients with COVID-19

INTRODUCTION: The COVID-19 pandemic has proliferated since the start of this year and has strained ICU resources globally. Far from an isolated respiratory illness, COVID-19 has multisystem effects, including pronounced neurological effects. Very little is known about critically ill patients and their sedation/analgesia requirements. We sought to quantify the sedation requirements for critically ill patients with COVID-19. METHODS: A prospective registry from 03/2020 to 06/2020 with COVID-19 at an urban tertiary care hospital was analyzed for intubated COVID-19 patients. Sedation data was abstracted for days 1,3,5,7,10,13,16,19,22,25, and 28 from the EMR, and infusion information was recorded as weighted average doses over a 24-hour period. Narcotics were reported as oral morphine equivalents (OMEs) and benzodiazepine doses were reported as midazolam equivalents (ME). A comparison was made to the placebo group of patients from the MIND-USA study as the median of the means. RESULTS: A total of 62 patients were analyzed with 55% African American, 33% Hispanic, 65% male, mean age of 58.5 years old, BMI of 33, and APACHE II score on ICU admission of 18.6. The median duration of mechanical ventilation was 9.5 days and an in-hospital mortality of 80.6%. Compared to the control arm of the MIND-USA study, the COVID-19 cohort had 2.89x higher propofol dose (TDD 4032 mg vs. 1391 mg), 5.5x higher precedex dose (TDD 3400mcg vs. 617mcg), 8.8x higher benzodiazepine dose (35 mg ME vs. 4 mg ME) and 1.79x higher OME dose (363 mg vs. 203 mg). The average infusions per patients was 2.42 and the most used infusions used were propofol (30% of patients per day) and precedex (25.8%). Approximately 17.6% of patients per day were receiving a paralytic infusion;however, a considerably greater share of patients (46.6% per day) were demonstrating quadriplegic paralysis. CONCLUSIONS: Critically ill patients with COVID-19 infection have significantly higher sedation/narcotic requirements than patients without COVID-19. This may be related to the underlying neurological effects of the virus and a potentially synergistic effect with sedation causing a high rate of quadriplegic paralysis. Further prospective trials are required to evaluate this hypothesis.