Evaluation with Roc Analysis, Logistics Regression Analysis and Other Statistical Tests Analysis of Retrospective Results of Biochemistry Laboratory Results, Analysised in Covid-19 Infected Serum or Plasma (Crp, Procalcitonin, Ferritin, D-Dimer, Fibrinogen, Ast, Alt, Ldh)

Objectives: A new type of coronavirus that emerged in Wuhan, China at the end of 2019, caused the Covid-19 (SARS-COV2) pandemic. Common cold symptoms are seen, but in more severe cases, pneumonia, Acute Respiratory Distress Syndrome (ARDS), coagulopathy, multi-organ failure are seen, and it causes death in the course of time. In this study, among the laboratory parameters followed in cases diagnosed with Covid-19 and followed in home isolation, service and intensive care unit;It is aimed to retrospectively evaluate CRP, procalcitonin, ferritin, D-Dimer, fibrinogen AST, ALT and LDH levels with ROC and other statistical analyzes in terms of predicting mortality in the treatment and follow-up of the disease. Materials-Methods: Between 01.04.2020 and 01.10.2020, the patients who applied to Necmettin Erbakan University Meram Medical Faculty Hospital with cold symptoms and were diagnosed with Covid-19 with RT-PCR positivity, were analyzed from Covid-19 infected serum and plasma. The results of the biomarkers were examined. Demographic data, vital signs and laboratory findings of the cases were compared. The results were statistically evaluated with the SPSS 22.0 package program. Result(s): 300 cases who received home isolation, service and supportive treatment in the intensive care unit were included in the study. Crp, Pct, D-dimer, ferritin, fibrinogen, LDH, AST and ALT values were found to be statistically significant. According to the results of ROC (Receiver Operating Characteristic) analysis performed to determine the predictive values of laboratory parameters that were significant as a result of univariate statistical analysis, Crp (0.890775), Pct (0.86795), D-dimer (0.856975), ferritin (0.836975), LDH (0.7829), fibrinogen (0.773925), AST (0.685925) and ALT (0.594025) were found. Conclusion(s): The high mutation ability of SARS-CoV-2 makes it difficult to control the pandemic. Therefore, early diagnosis of the disease has gained importance for the treatment of patients with high mortality risk. According to the ROC results we obtained in this study, it supports that CRP, Procalcitonin, Ferritin, D-dimer and LDH levels can be used as effective parameters in determining the prognosis and mortality risk in Covid-19 patients.

Role of knowledge management in healthcare systems to combat the COVID-19 pandemic

Knowledge management is a process by which knowledge is created, shared and used. If knowledge and information were shared timely and used globally, it could have prevented the loss of so many lives and economy downturn caused by COVID-19. This is where knowledge management comes into play, by delivering accurate and real-time information to safeguard against future pandemics and healthcare crises. The United Nations has identified 17 Sustainable Development Goals, whereby goal 3 (SDG3) pertains to general health and well-being. In the current pandemic, SDG3 has come under severe onslaught and would require concerted efforts on the part of the healthcare community to overcome the crisis and strive towards the goal of sustainable health. This paper identifies the need for knowledge management (KM) and how knowledge management technologies which have provided great benefits to other businesses can be utilised to mitigate the pandemic impacts. The content analysis method was adopted as part of the research methodology since data pertaining to knowledge management in healthcare, especially in combating COVID-19, is very limited and requires verification for authenticity. Key terms such as "knowledge management in healthcare", "knowledge management tools", "knowledge management in COVID-19" were used to identify the level of knowledge management currently being applied in healthcare systems and how various knowledge management tools can be effectively utilised by healthcare professionals. The findings of the study suggest that there is a lack of knowledge management in the global healthcare system and discuss the resulting implications in managing the COVID-19 pandemic to some extent.

A rapid review and meta-analysis of the laboratory phenotype of multisystem inflammatory syndrome in children

Introduction: Laboratory features are included in the current case definitions of the multisystem inflammatory syndrome in children (MIS-C) associated with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2). Objectives: We reviewed the clinical laboratory test values reported in MIS-C, to better characterise the laboratory phenotype. Methods: A comprehensive search of the WHO COVID-19 database was conducted from January to November 2020. The median test values reported in children 0-19 years with MIS-C, were extracted for each laboratory variable reviewed. Random effects meta-analyses were performed and the quantile estimation method used to determine estimates of the pooled median for each variable. The risk of bias was assessed using the QUADAS-2 tool. Results: Twenty-two observational studies were included in the analyses N=831 children. The overall risk of bias was considered moderate with varying heterogeneity between the studies reviewed for each variable (I2 52.4 - 96.63%). The estimated pooled median values which were abnormal included CRP 188.12 mg/L (95% CI 158.54, 217.70), ESR 60.07 mm/hr (95% CI 49.88, 70.26), ferritin (587.63 ng/ml;95% CI (476.29, 698.97), pro-BNP 6927ng/ml (95% CI 794.52, 13061.13), D-dimer 3.03 ng/L (95% CI 2.41, 3.65), absolute neutrophil count 9.61x109L (95% CI 7.72, 11.50), absolute lymphocyte count 0.92 x109/L (95% CI 0.74, 1.10), platelet count 150.82 x109/L (95% CI 135.09, 145.07), albumin 28.89g/L (95% CI 25.56, 32.22) and sodium 132.67mmol/L (95% CI 131.44, 133.89). Limitations The analyses were limited by varying reporting methods and the use of different normal reference ranges across studies. Conclusion: Markers of inflammation, coagulopathy and cardiac dysfunction, were confirmed as important features of the laboratory phenotype of MIS-C. It is necessary however, to further compare the laboratory values of MIS-C to those with COVID-19 and other hyperinflammatory syndromes in children, to develop evidence-based diagnostic criteria.

Coupling of cryptocurrency trading with the sustainable environmental goals: Is it on the cards?

Following the systematic review and bibliometric analysis of current literature, this paper attempts to investigate whether the wealth generated through cryptocurrency trading can assist in attaining the United Nations' (UN) sustainable development goal (SDG) 7, affordable and clean energy and UN SDG 13 related to climate action. The critical analysis of literature indicates a growing interest in cryptocurrency, the UN's SDGs and the negative effect that crypto mining has on the use of enormous energy. However, there is a clear gap in the literature that focuses on the possibility of using the wealth generated through cryptocurrency trading in financing environmentally friendly projects and attaining the UN's SDG 7 and SDG 13. The findings and the future research direction of this study aim to firstly expand the academic literature related to SDG 7 and SDG 13 and secondly to examine the relationship between cryptocurrency and sustainability even during an uncertain period. This study provides evidence pertaining to the theoretical models that can be applied within discussion of the complex relationship between cryptocurrency, clean energy and climate action. Our findings will provide policymakers with information regarding actions that need to be taken in order to convert cryptocurrency generated wealth and consequently attaining sustainable socio-economic goals in the future.

Online Teaching in an Un-prepared Country during COVID-19: An Interview Study on Final Year Medical and Dental Students

Aims: To assess medical students' perception of online teaching to suggest transforming the future curriculum in low-economic countries. Study Design: Cross-sectional online interview study. Place and Duration of Study: A team of collaborators interviewed final year medical and dental students of Pakistan from 07/08/2020 till 17/09/2020. Methodology: A questionnaire was developed based on open and close-ended questions in Google forms;focusing on institutional preparedness, views on online education, the institute's closure and COVID-19, and long-term effects of closure of the institute. Independent fellow researchers systematically analyzed the unaltered transcripts of the responses, and themes were then identified and coded to conclude the results. SPSS version 23 used for analysis. As this study was based on final year students. Results: In response to an invitation email, 2442/2661 (91.77%) students voluntarily participate in this qualitative study. Most participants were females (1614, 66.10%). Closing down institutes was directly linked to a lack of motivation and feel of helplessness. As most showed dissatisfaction with online teaching compounded by psychological effects, students feared losing clinical skills and life during the pandemic. Conclusion: The psychological impact of the crisis led to resistance to accepting the change for a better outcome. Incorporating telemedicine, different interactive learning style to online teaching, and resilience training would result in fruitful outcomes. Developed countries may also guide build infrastructure in developing countries to develop a more robust online teaching methodology in the long-run.

Service Innovation Readiness of Health Institutions during COVID-19: A Perspective from the Kingdom of Saudi Arabia

The purpose of the research was to explore the factors which affect service innovation in organizations and how the utilization of resources can improve organizational performance, and gain a competitive advantage by adopting numerous innovative practices. This study hypothesizes Service Innovation Readiness (SIR) to consist of Strategic Alignment favoring Service Innovation (SASI) and Empowering Structure for Service Innovation (ESSI), which regulate the organization's preparedness to adopt service innovation changes. Six dimensions were identified and analyzed to understand their effects on SASI and ESSI. A structured questionnaire on a 5-point Likert scale was used to collect data from the selected hospitals of Saudi Arabia. The research results contribute considerably to the subject matter by theorizing SIR and the complex variable settings essential for embracing SI. This research also provides some understanding of the service innovation management dimension through a complete assessment that measures the organization's readiness and attempts to direct organizations' efforts to achieve and sustain competitive advantage. The study conducted is unique in the current geographic limits and has explored numerous SI areas of an organization's readiness to adopt service innovation.

Exploring the impact of COVID-19 pandemic on women entrepreneurs in Pakistan

Purpose: The purpose of this paper is to explore the impact of COVID-19 lockdown on micro-businesses owned by women borrowers of microfinance institutions and to provide policy suggestions to assist women entrepreneurs in managing such an unexpected crisis from a qualitative perspective within developing countries such as Pakistan. Design/methodology/approach: The study adopts a qualitative research design to explore the impact of COVID-19 on women’s entrepreneurial activities. Seven women entrepreneurs were selected and semi-structured interviews with focused group discussion under case study research design are used. Thereby providing a contemporary view of the issues faced by women entrepreneurs in the period of huge social and economic upheaval. Findings: The results provide valuable insights about how the COVID-19 crisis affected women entrepreneurs by particularly considering household income, business sales, lifestyle and mental health. The liquidation of women-led businesses indicated the necessity to reconsider creativity and digitalization for business survival. Moreover, the results also revealed that the impact of the COVID-19 pandemic on the physical, mental and economic well-being of women highlights the need for considering gender gap issues in forming response policies for COVID-19 in developing countries. Originality/value: As the COVID-19 crisis is a recent and existing phenomenon, this study is among the first to explore particularly the impact of the COVID-19 outbreak on micro-enterprises mainly owned and managed by women. Thereby claiming that COVID-19 not only physically but also psychologically affected women entrepreneurs. Moreover, the study highlights a need of skill focused training programs for women entrepreneurs to make sure that they can protect their businesses during such difficult times. © 2021, Emerald Publishing Limited.

Factors influencing online learning of university students under the covid-19 pandemic

Online learning systems owing to their nature are free of restrictions of time or place and can prove to be a useful platform for students where they can continue their studies when it is not possible for them to go to a university in person owing to different reasons. Such systems have also been used in Pakistan, particularly in private sector, for university and school education. This paper attempts to highlight various issues that the students are facing and the factors that have a significant effect on their online learning experience. We collected data through online questionnaires distributed to 1200 students enrolled in six private universities in Pakistan. This study employed the Structure Equation Modelling (SEM) to examine factors that influenced online learning. The results showed that teaching and professional behaviour, course instructional planning and methodology and online connectivity were significantly positively associated with online learning. With the identification of key factors that affects online learning of students, it will be more helpful to provide improved services for effective student leaning. Other crucial implications and a way forward are also discussed in the paper.

Protecting asthmatics from covid-19

The coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome 2 virus (SARS-CoV-2). Infections were first detected in Wuhan, China in late 2019 and the infection has recently spread worldwide and been declared a pandemic by the World Health Organization. The disease presents with a spectrum of respiratory manifestations that range from asymptomatic cases, to patients with mild and severe symptoms, either with or without pneumonia. Symptoms include fever, upper respiratory tract coryza, cough and acute lower respiratory tract infection. Asthmatics have, thus far, only shown slightly higher risk for hospitalisation but not for mortality. However, this may change in South Africa. Asthmatics are advised to keep their asthma under control and to continue using controller medication. It is critical for all of us, especially asthmatics, to practice ‘social distancing’, wash hands frequently and practise sneeze and cough etiquette.

Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy.

COVID-19 severity appears to lie in its propensity to cause a hyperinflammatory response, attributed to the cytokine release syndrome (CRS) or 'cytokine storm', although the exact role of the CRS remains to be fully elucidated. Hyperinflammation triggers a hypercoagulable state, also thought to play a key role in COVID-19 pathogenesis. Disease severity is linked to age, sex and comorbid conditions, which in turn may be linked to oxidative stress and pre-existing depletion of nicotinamide adenine dinucleotide (NAD+). There is increasing evidence that the host genome may determine disease outcome. Since most information pertaining to COVID-19 has thus far been extrapolated from the 'global North', similar studies in African populations are warranted. Many studies are aimed at finding a therapeutic strategy based on scientific rationale. Some promising results have emerged, e.g. the use of corticosteroids in severe acute respiratory distress syndrome (ARDS).