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The purpose of this research is to study the effects of neoclassical trade liberalization policies enacted in India in 1991 to determine the effect on levels of poverty and income inequality. This research predicts that poverty and economic inequality will be reduced due to implementation of economic liberalization policies. The research uses empirical data from the National Sample Survey Organization (NSSO), in India and develops a regression model to determine the effects of economic liberalization on income inequality and absolute poverty. The results of the regression model suggest that income inequality and poverty decreased during the year liberalization policies were enacted, but is not statistically proven with enough confidence that liberalization is strongly correlated with a reduction in inequality and poverty. There is a weak statistical correlation that suggests inequality increased in the Indian urban sector, and decreased in the rural sector due to liberalization. In conjunction with a literature review where more robust data and econometric models are applied, the empirical analysis by complimented with the fact that in general income inequality decreased due to economic liberalization policies alone, holding all exogenous factors that affect income inequality constant. The literature review also confirms that poverty levels decreased with economic liberalization, holding all other exogenous factors that affect poverty constant. The implication of this research is that liberalization polices have been successful for overall development in India, and suggests that implementation of liberalization policies may be desirable in nations under similar circumstances as India in the era before its liberalization. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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This research hypothesizes that greater availability of healthcare services, and greater choice in healthcare facilities results in better health when controlling for a variety of socio-economic factors within the Canadian context. This research will model access to healthcare services using density of general and specialist physicians relative to population size, and the geographic density of healthcare facilities. Choice in healthcare is modeled by the number of healthcare facilities in each health region, when normalized by the population in that health region. Various health outcomes will be used as benchmarks to test this hypothesis, including self-reported general health, self-reported mental health, influenza immunization rates, body mass index (BMI), and incidence of diabetes, cardiovascular disease and hypertension. From the empirical results, choice in the healthcare system does not have an impact on the selected health outcomes. Increased availability of healthcare generally improves health outcomes, but this is dependent on the health outcome in question, and the provincial region being analyzed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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The study analyses the contribution of the tourism, banking, property fund and real estate, and finance and securities industries to the systemic risk of Thailand. Using quantile regression, the study estimates the measures of systemic risk (conditional Value-at-Risk (CoVaR) and delta conditional Value-at-Risk ( increment CoVaR)) and examines the relevance of various industries in increasing the systemic risk of Thailand using Kolmogorov - Smirnov test. The findings support the relevance of the tourism industry in significantly contributing to the systemic risk in Thailand. The study also highlights the systemic relevance of the tourism industry during the COVID-19 period in Thailand, when the industry was severely impacted, which adversely affected its systemic risk.
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Recent studies have proven that the shape of the stenosis greatly affects the flow characteristics. The 2D rigid wall model examined in this research is analyzed mathematically using various principles and results of functional analysis for the existence and uniqueness of the solution. The model taken into consideration for the current study has also been used to examine the consequences of hyperviscosity in COVID-19 cases. The results of the investigation surmise that the maximum peak velocity of 3.155m/s and the minimum trough pressure of 7041.538Pa were manifested in the high slope geometry. Also, the number of spots over the upper wall of high slope geometry bearing the least wall shear stress was considerably high when compared to the other geometries. The study deduced that the arterial segment bearing dual high slope stenosis was more susceptible to new plaques, plaque ruptures, and hyper viscous syndrome. © 2023 THE AUTHORS
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Attendance is an important part of the academic environment. The manual method of marking student attendance is time-consuming and also not accurate. So, the use of biometric attendance is a better alternative to the manual method. There are many biometric techniques that can be considered to design an automated system to mark attendance. Facial recognition is one such biometric technique that can be used. In this paper, we propose the implementation of facial recognition where the attendance is marked by recognizing the faces detected in the video feed from the classroom. We are in the midst of the once in a century crisis, ever since the COVID-19 pandemic broke out it has become imperative to accommodate certain behavioral changes in our day to day lives, one such major change which is essential to curb the spread of COVID-19 is to wear a face mask, and thus, the facial recognition-based attendance adds another advantage by recognizing the faces even though students would be wearing the masks. Another important measure that needs to be followed to contain the spread of COVID-19 is to ensure social distancing in all public spaces;hence, there is a need to ensure that social distancing norms are followed by the students. So, we propose implementation of a system to monitor the social distancing among the students. Further, we propose to implement a COVID-19 vaccination status monitoring system using which we can monitor the vaccination status of the individuals through the video feed from the classroom. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
The study investigates the systemic risk transmission from the US banking sector and the US market to the five most economically impacted Asian nations (Thailand, Malaysia, the Philippines, India, and Singapore) during the COVID-19 period of 2020. We consider the conditional value-at-risk (CoVaR) approach to estimate the systemic risk of the given economies at 5% quantile (for severe downturn risk) and 20% quantile (for moderate downturn risk). Our findings demonstrate a rise in systemic risk for these Asian countries in 2020, particularly in the first half of the year. The findings also provide evidence of the significant systemic risk transmission from the US banking sector and the US stock market to the majority of the given Asian economies at both quantiles. The study further highlights the significant contribution of the US financial market in increasing the systemic risk of the given Asian economies in 2020. We find similar results for systemic risk transmission from the UK, the European Union, and Japan to the given Asian economies. The findings have implications for market participants, risk managers, and regulators who are concerned with risk diversification and tracking the routes of risk shock transmission. JEL Codes: G10;G18;G20. © 2023 Institute of Financial Management and Research.
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Cardiac disease is now a major cause of death for people affected by COVID-19. For the past five years, the death rate of people affected by the cardiac disease has increased a lot. In recent years, many deep learning models have provided prominent results for predicting it from different UCI heart disease data and other ECG data. Cardiac disease can be predicted from medical diagnosis and electrocardiogram data. Even though many types of detection for cardiac disease are available, ECG plays a major role in identifying it accurately. However, still, there is some gap in identifying the correct data, cleaning the unwanted features with popular methods, and optimizing it for better accuracy. In this paper, we propose a deep learning model, such as an Extreme Learning Machine (ELM), for predicting cardiac disease from the benchmark dataset, such as the MIT-BIH Arrhythmia dataset available in the PhysioNet database. The Principal Component Analysis is used to extract and identify the best features. Transfer learning is additionally used with kernel ELM for the improvement of the classification performance of ELM. Finally, the proposed Extreme Learning Machine model classifies cardiac disease with a promising result of 98.50% accuracy. In future research, it can be predicted in various datasets for performance improvement by selecting all other ensemble models. © 2022 Seventh Sense Research Group.
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Mathematical modeling and computational studies about the spread of covid 19 is the present trending research topic. Even though some of the countries around the globe are witnessing a great rise in the recovered population, a certain class of recovered people is facing serious side effects, as explored by various surveys and studies. A system of ordinary differential equations (ODE) is formulated by considering the vulnerable, hospitalized, and recovered population. An equation designed to govern various long-term side effects experienced by the recovered population is coupled with the ODE system. The resulting system is solved numerically and the possible optimization methods are discussed. © 2022 American Institute of Physics Inc.. All rights reserved.
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COVID-19 is symptomized with a great downfall in the proper functioning of the respiratory system of an affected human. The present work revolves around the research made to study the number of people infected with time under several circumstances. These circumstances include the lockdown introduced by the ruling governments. Additionally, we have shown a pattern for the infected people when the disease can be transmitted through airborne mode. In the present work, we intend to consider a transmission rate that is imparted, to the existing rate, by the airborne nature of the coronavirus. This adds novelty to our present work. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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India's National Rural Employment Guarantee Act (NREGA), in the last 15 years, has evolved as the world's largest employer of the last resort. This social protection, specifically designed as a demand-driven automatic employment stabiliser to enable households to cope with livelihood shocks, offers 100 days of guaranteed wage employment in a financial year to all rural households. The budget for this unique legislative entitlement in a developing country was nearly doubled from US$8 billion in 2019-20 to $15 billion in 2020-21 to partially offset the impact of the COVID-19 pandemic lockdowns. After the first pandemic wave, NREGA provided employment to 76 million households - more than a third of all rural Indian families. Even though women have consistently worked more than half the NREGA person-days annually, in the midst of the pandemic women's share of employment declined by 2 per cent in 2020-21. However, this may have been a temporary decrease due to the unprecedented mass reverse exodus of urban migrants to their rural villages. Still, state-level analysis in this research highlights the persistent under-utilisation of NREGA by women in the poorer states of the Indo-Gangetic plain. On the other hand, the southern states have higher participation of women due to a combination of factors including better human development outcomes, higher wages, and sometimes better child-care facilities at worksites, which are necessary nationwide remedies. In particular, in the state of Kerala the novel integration of the government-initiated Kudumbashree community self-help women's groups with NREGA has led to the feminisation of the programme. This convergence provides important insights on the significance of women's participation in the decentralised management of NREGA to dilute both gender-intensive and gender-exclusive barriers, which could be fruitfully replicated nationwide.
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Background: Off-level medicines do not provide adequate health outcomes since there is insufficient efficacy and/or toxicity evidence. Off-level medicines are more vulnerable to adverse drug reactions (ADRs), which are a prominent cause of morbidity and mortality. Objective of the study is to determine the relationship between the medication complexity and severity of COVID-19 and its impact on pharmacotherapy evaluation. Materials and Methods: A prospective, cross-sectional study was conducted in the COVID ward where medication complexity was assessed for all prescriptions on admission using the Medical Regimen Complexity Index's guidelines and subjected to pharmacotherapy evaluation. Results: Overall, the patients spent an average of 7.55 +/- 3.60 days in the hospital. Each prescription contained an average of 6.54 +/- 2.51 drugs. Polypharmacy was found in 82.70% (263) of the prescriptions, while medication duplication was found in 17.29% (55), severe drug interactions accounted for 83.01% (264), and drug dosage adjustment was performed in 10.06% (32). The mean medication complexity was 26.86 +/- 7. 58. When comparing medication complexity concerning the severity of COVID-19, we found that the average medication complexity score for mild was 24.62 +/- 6.04, moderate was 31.65 +/- 8.39, severe was 35.19 +/- 6.81, and critical was 28.59 +/- 8.60. we found a statistically significant positive correlation between the medical complexity and the hospital stay (P-value, 0.000), and there was an association between the medication complexity and the Covid-19 severity (p <0.001). Conclusion: The assessment of the medication complexity in routine pharmacotherapy evaluations could be beneficial in alerting potential risks, suggesting additional focus wherever required, and decreasing the financial burden by reducing hospital stay. It demonstrated an association between medication complexity and the severity of COVID-19.
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Background: Appropriate and timely administration of anti-D immunoglobulin (Ig) post-sensitizing events (PSE) and routine antenatal anti-D prophylaxis (RAADP) reduces the risk of developing immune anti-D resulting from pregnancy. Serious Hazards of Transfusion (SHOT), the UK haemovigilance scheme collects and analyses reports relating to failures in the management of anti-D Ig and RAADP. Delayed administration is defined as failure to give RAADP before 34 weeks gestation or anti-D Ig within 72 h for both (PSE), including delivery. COVID-19 pandemic has continued to affect the provision of safe and timely healthcare, including providing the optimal comprehensive care for pregnant women. Annual SHOT Reports have identified system failures resulting in omission/delays, administration errors, and other events involving anti-D Ig. This review looks at the impact of the COVID-19 pandemic on the provision of antenatal and postnatal care for patients requiring RAADP or anti-D Ig. Aims: To identify failures in the management of anti-D Ig and RAADP relating to the COVID-19 pandemic based on reports submitted to SHOT. Methods: The SHOT database was reviewed, reports relating to anti-D Ig and RAADP for 2021 were identified using the search terms' COVID' 'COVID-19' and 'pandemic'. Data were analysed for trends in errors relating to the COVID-19 pandemic. Results: A total of 341 reports were analysed by SHOT for 2021, the majority relating to omission or late administration (228/341, 66.9%). Twenty cases were identified where the COVID-19 pandemic was reported to be implicated;18 occurred in 2021, and two occurred in 2020. 16/20 involved omission or late administration of anti-D Ig or RAADP. In 1 case, anti-D Ig was given to a mother with a D-negative infant post-delivery, and in one case, RAADP was administered where the infant was predicted to be D-negative by cell-free fetal DNA analysis. One woman was given the wrong dose of anti-D Ig following a PSE, and in one case, a D-positive woman was inappropriately given anti-D Ig. The reported contribution of the pandemic to errors was variable. It included pregnant women being unable to attend clinics because they had COVID-19 or were self-isolating, clinics being cancelled to reduce attendances, changes to patient mixes in wards, misunderstanding of changes to policies relating to the use of anti-D Ig, cancellation of training and educational activities, staff redeployment and early discharge of patients to reduce the potential risk of exposure. Summary/Conclusions: Management of anti-D Ig and RAADP is a complex process involving many healthcare staff. Previous SHOT recommendations have included improvements to policies and processes, the introduction of checklists, and the administration of the product prior to discharge. The COVID-19 pandemic introduced new challenges for healthcare provision, with many changes being made to meet rapidly evolving situations. This review demonstrates that the effect of the pandemic contributed to errors involving anti-D Ig and RAADPmanagement, resulting in the potential for the development of immune anti-D and serious sequelae for subsequent pregnancies. The impact of change on safe practices must not be underestimated, and all measures must be taken to ensure patients are not adversely affected. Organizations should ensure that lessons learned from the pandemic are used to inform future practice and improve patient safety.
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Blood transfusions are an essential part of supportive care for certain patient cohorts, particularly those on palliative care. Most transfusions occur in the hospital setting, including community hospitals. Transfusion in the patient's home supports individualised care, reduces demand on acute services and inconvenience for patient travel to hospital. Decision to undertake home transfusions requires assessment of risks and benefits, with regular review. Risk of acute transfusion reaction in any setting is rare but can result in major morbidity or death. This review looks at adverse events and reactions reported to Serious Hazards of Transfusion (SHOT), the UK haemovigilance scheme, where the transfusion was performed in the patient's home. SHOT cases submitted 2010-2020 were identified using the terms 'home', 'home transfusion' and 'patient's home'. Data were manipulated in MS Excel identifying reactions (febrile, allergic and hypotensive [FAHR], transfusion-associated circulatory overload [TACO]) and events (right blood right patient (RBRP), avoidable, delayed and over/under-transfusion [ADU], incorrect blood component transfused-specific requirements not met [IBCT-SRNM]). 20 cases of home transfusion were identified. FAHR accounted for 10/20 cases, IBCT-SRNM (3/20), HSE (3/20), RBRP (2/20), TACO (1/20) and ADU (1/20). Where patient sex was recorded, 12/19 were male. Age range 3-90 years (median 66, SD 24.9). Red cell components were implicated in 12/20 cases, platelet concentrates in 7/20 cases and one fresh frozen plasma. Patient underlying condition was haematological in 12/20 cases, others included pancytopaenia, angiodysplasia, metastatic cancer and anaemia. Chronic anaemia was the indication in 8/12 red cell transfusion cases and prophylaxis for 4/7 of platelet transfusions. Reactions ( n -11) were febrile (5/11), allergic reactions (3/11), TACO (1/11), 1 anaphylaxis and 1 unclassified. 7/11 patients (6 FAHR and 1 TACO) required hospital admission as a result of the reaction. Four patients were identified as not suitable for home transfusion after the event, SHOT expert review noted one patient should have been ineligible in the first place due to risk of TACO. Adverse events ( n = 9) included cold chain failures (2/9), one failure to inform the laboratory of home transfusion, failure to provide irradiated red cells (2/9), errors in labelling (2/9), incorrect administration rate, failure to provide antigen-negative blood and delay due to an incorrect Hb result. There are no data regarding the number of home transfusions in the UK, therefore it remains unclear whether reactions and errors are over-represented in these cases. Careful consideration should be given to the eligibility of patients to receive home transfusion, particularly the risk of TACO and previous transfusion reactions, before this regime is implemented. No data were available regarding staff performing the transfusions, nurses administering home transfusions must be transfusion trained and competent in identification and management of reactions. There must be robust processes for urgent transfer to hospital. There are no national guidelines for safe practice for home transfusions, including informed consent. Home transfusion is an increasingly important component of patient care, particularly during the COVID-19 pandemic to minimise risk for vulnerable patients, the infrastructure supporting this must have patient safety at its core.
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Convalescent plasma, donated by persons who have recently recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognise SARSCoV-2 virus. Safety and efficacy of COVID-19 Convalescent Plasma (CCP) was tested as part of two large randomised controlled trials (RCT) in UK (REMAP-CAP and RECOVERY). Serious Adverse Reactions (SAR) data relating to use of CCP reported to SHOT between April 2020 and Feb 2021 (inclusive) were reviewed. A total of 13 407 units of CCP were transfused under the two trials in the UK, with 11 477 (86%) of these given under RECOVERY. There were 14 confirmed SAR (one from REMAP-CAP and 13 relating to RECOVERY) equating to a risk of SAR of 1 in 958 units of CCP. The most common reactions seen in CCP recipients were pulmonary reactions (9/14, 64.3%). Transfusion-associated circulatory overload (TACO) was confirmed in 4 cases and transfusion associated dyspnoea (TAD) in the other 5. Moderate to severe febrile, allergic, hypotensive reactions were reported in 5 patients, all of whom recovered fully. Four patients with pulmonary reactions (3 with TACO and one with TAD) died with death possibly related to the transfusion complication. All reactions were reported in adult patients, with the average age being 65.6 years. TACO checklist was used in only 4/9 (44.4%) pulmonary reactions. One case of TAD was possibly preventable, all other cases were not. Significant co-morbidities were present in 9/14 (64.8%) cases, including COPD and cardiac disease (among many others). Imputablity assessment was challenging given the multisystem nature of severe COVID-19 illness-no reactions reported to SHOT have been noted by experts to be definitely related to CCP. The two large RCT from UK have helped establish the evidence that CCP does not improve survival or other clinical outcomes in patients hospitalised with COVID-19. A systematic review and meta-analysis published in February 2021 confirmed that treatment with CCP compared with placebo or standard of care was not significantly associated with a decrease in all-cause mortality or with any benefit for other clinical outcomes. Data from SHOT shows that the febrile, allergic hypotensive reactions and pulmonary complications were the most commonly reported reactions. Conclusion: The HFs day-to-day observation checklist was considered a useful tool for identifying behaviours that could lead to errors, waste in the system, staff injuries and lost time. The next step is to use the findings for change that will improve the process and lead to a better level of BMS engagement.
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Safety and efficacy of COVID-19 Convalescent Plasma (CCP) was tested as part of two large randomised controlled trials in UK (REMAP-CAP and RECOVERY). CCP collections by apheresis were started across NHSBT from early in the pandemic to support the trials. Data from CCP donors who had donated at least once in the period between April 2020 and March 2021 (inclusive) was reviewed. Of the 57 213 attendances during this period, 6908 (12.1%) resulted in at least one adverse event, reported within seven days of attendance. Donors experiencing an adverse event were more likely to be first-time donors than donors with no adverse event were. The risk of having any adverse event reduced from 14% for first-time donors to 7% for repeat donors. Bruising was seen in58%and vasovagal events were the second most commondonor adverse events accounting for 37% (2570/6908). Most (2373/2570, 92%) were mild with no loss of consciousness. CCP donors experienced lower rates of mild vasovagal events to new/returning whole blood donors overall but appear to be at higher risk after stratifying by sex and age. They are significantlymore likely to feel faint than new/returning apheresis donors. Differences between new/returning whole blood and CCP donors are statistically significant (p < 0.05) in both men and women in all age groups from 35 years upwards. In all cases where there is a significant difference, the rate was higher for CCP donors. When compared with new/returning apheresis donors, the rate in CCP donors was higher overall. One serious adverse event of donation was recorded in a new male CCP donor in his mid-40s who had severe immediate vasovagal reaction with hypotensive seizure requiring hospitalisation following his first CCP donation. He recovered subsequently and was withdrawn from donation. Donating CCP was largely safe but complications were seen following donation in 12% with vasovagal events, bruising and arm pain being the most reported donor adverse events. Vasovagal events could be multifactorial with increased anxiety, new/first time donors, vascular dysregulation or subclinical cardiac dysfunction secondary to recent COVID-19 infection possibly contributory. It is encouraging to see that the risk of having any adverse event halved with repeat donations.
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Fifty-one consecutive adult congenital heart disease (ACHD) patients attended a single site, day-case facility -in the midst of the Covid pandemic-for cardiac assessment tailored to their individual needs. All patients responded positively to our one to one invitation to attend, despite Covid restrictions, and to our anonymized questionnaire. The latter showed an overwhelming support for personalized care and for more patient education, support and empowerment. A subset of patients have since been enrolled in a pilot App with HUMA on an ACHD education, self-reporting and self-managing tool, with potential worldwide implications for ACHD care.
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Introduction: The COVID-19 pandemic has provided opportunity to the Armed Forces Medical Services (AFMS) healthcare institutions to plan and execute their surge capacity facilities and identify areas for improvements in planning in the future. Material and Methods: Available medical literature on the experiences of other countries in activating surge capacities in healthcare for the pandemic were examined in detail as were existing guidelines for establishing Intensive Care Units (ICU). Personal communications with peers to understand difficulties faced in activating surge capacities were also factored in. Results: Based on the findings from these sources, a plan to establish ten-bedded ICU units specifically for COVID-19 is evolved. The best practices and latest guidelines and experiences have been collated and modified suitably to suit the AFMS in this aspect. Conclusion: Planning ICUs in ten-bedded modular units will enable the AFMS to cater to surge capacities in the future for all situations where sudden increase in number of patients is anticipated.