ABSTRACT
With the unexpected rise of the COVID-19 pandemic, a vast majority of organizations and institutions have shifted to online modes of communication, especially educational institutions. Many hurdles popped up in due course of time, preventing the successful conduction of online examinations. Today, there is an application for each and everything and the number of users is steeply escalating. With such high rising demands and new necessities, it has become quite important to make sure the applications are easily available anytime and anywhere. Ensuring minimum downtime, frequent updates without any disruptions, and making it easily available for both developers and consumers are must-haves now. Satisfying these requirements over a monolithic architecture is not assured, hence, the microservices architecture is adopted, thus opening the door for new possibilities. This being the foundation of this project, an amalgam of how the web application we used is divided into microservices, containerization of each of them followed by pod deployment and finally using Kubernetes for service exposing and orchestration is presented in this paper. In short, an online exam monitoring system that can identify any abnormal behavior by test takers while being capable of tackling varying traffic loads is fault-tolerant and handles disaster recovery. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
With the unexpected rise of the COVID-19 pandemic, a vast majority of organizations and institutions have shifted to online modes of communication, especially educational institutions. Many hurdles popped up in due course of time, preventing the successful conduction of online examinations. Today, there is an application for each and everything and the number of users is steeply escalating. With such high rising demands and new necessities, it has become quite important to make sure the applications are easily available anytime and anywhere. Ensuring minimum downtime, frequent updates without any disruptions, and making it easily available for both developers and consumers are must-haves now. Satisfying these requirements over a monolithic architecture is not assured, hence, the microservices architecture is adopted, thus opening the door for new possibilities. This being the foundation of this project, an amalgam of how the web application we used is divided into microservices, containerization of each of them followed by pod deployment and finally using Kubernetes for service exposing and orchestration is presented in this paper. In short, an online exam monitoring system that can identify any abnormal behavior by test takers while being capable of tackling varying traffic loads is fault-tolerant and handles disaster recovery. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
The coronavirus disease 2019 has severely affected the financially constrained small and medium enterprises (SMEs). In response, various countries employed several policies to support SMEs. Using rich firm-level data from 34 countries, we study the impact of the pandemic-led crisis on cash-strapped SMEs and the role of governments in offsetting losses. Our results suggest that (i) government support programmes target mostly financially constrained firms;(ii) firms adjustments to the pandemic are associated with the likelihood of government support;(iii) financially constrained firms are more likely to lay off workers;and (iv) financially constrained firms layoff more male employees than female employees. © 2022 Banca Monte dei Paschi di Siena SpA.
ABSTRACT
Intravenous (IV) ascorbic acid (AA) improves organ function and reduces inflammation in sepsis, an inflammatory state similar to the post-hematopoietic cell transplant (HCT) milieu. This salutary effect is mediated by antioxidant activity as well transcriptional modulation by AA. HCT recipients are deficient in AA, therefore we evaluated the safety and efficacy of patients receiving parenteral AA after myeloablative conditioning for allogeneic HCT compared to similarly treated historical controls who did not receive AA. Methods: Patients with hematologic malignancies, AML (48% of patients), ALL (28%), and CML+MDS (25%) were enrolled in an IRB approved prospective phase 2 clinical trial (NCT03613727). IV AA 50 mg/kg/d divided in 3 doses was given on days 1-14 after HCT, followed by oral AA 500 mg bid from day 15 until 6 months post HCT (FDA-IND 138924). Conditioning regimens utilized included;fludarabine & melphalan (45%), cyclophosphamide with either busulfan (30%) or total body irradiation (25%). GVHD prophylaxis included calcineurin inhibitors and methotrexate or cellcept along with anti-thymocyte globulin (ATG). Primary endpoint was reduction in TRM at 1 year. Propensity score matching was used for matching study patients with similarly treated historical controls, matching for diagnosis, conditioning regimen, and CIBMTR disease risk category for comparison of clinical outcomes. Cox-proportional hazard models were used to estimate adjusted hazard ratios (AHR) between the time-to-event outcomes and study group, adjusted for patient age, donor type, stem cell source, diagnosis, conditioning regimen, and CIBMTR disease risk. Results of an interim analysis following a period of COVID 19 mandated suspension of study accrual are reported. Results: As of March 2020, 40 patients have received IV AA: these include HLA-matched related donor (MRD;n=11), and either 10/10 or 9/10 HLA- matched unrelated donor (MUD;n=22 & 7 respectively) recipients. Graft source was either peripheral blood (n=38) or bone marrow (n=2);88% patients had CIBMTR high risk disease. Median age was 55 years;males (19). All patients enrolled were deficient in AA at day 0, median AA level 0.3 mg/dL (range: 0.1-0.5);post AA infusion level was normal at 1.6 (1.2-5.7) on day 14. Median neutrophil and platelet recovery was by 12 days (range: 9-15 & 8-21 days respectively) with sustained donor engraftment. Median absolute CD3+ cell count at day 30 was 330 cells/microL. With a median follow up of 220 days in AA recipients, no statistically significant difference was observed in transplant related mortality between propensity matched historical controls and study patients (AHR 0.6, 95% CI: 0.2-1.5;p-value = 0.27);univariate survival analysis is depicted in Figure 1. Relapse was also similar (AHR 1.2, 95% CI: 0.3-4.5;p-value = 0.82), and despite a larger number of HLA mismatched unrelated donor recipients, acute GVHD (Grade II-IV) rates were similar in the two groups for both grade II-IV (AHR 0.8, 95% CI: 0.7-1.7;p-value = 0.65) and grade III-IV disease (AHR 0.6, 95% CI: 0.2-1.6;p-value = 0.32). Chronic GVHD rates were also similar (AHR 0.4, 95% CI: 0.1-2.7;p-value = 0.74). There are no attributable grade 3 - 4 toxicities from AA;CMV and EBV reactivation rates were not different in the two groups. Conclusions: In patients undergoing myeloablative allogeneic HCT the administration of IV ascorbic acid is safe and does not negatively impact myeloid engraftment or immune reconstitution. In this interim analysis, transplant related mortality, relapse and GVHD are not increased in IV AA recipients compared to historical controls. Thus, given its safety and tolerability, and possible salutary impact on survival and relapse in these high-risk patients, we posit the feasibility of a randomized phase 3 trial with IV AA in the post-transplant setting to determine its effect on relapse and TRM. [Formula presented] Disclosures: No relevant conflicts of interest to declare.