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Background: Zotatifin (eFT226) is a potent and selective inhibitor of eukaryotic initiation factor 4A (eIF4A), a host RNA helicase required for SARS-CoV-2 replication. In vitro, zotatifin demonstrates broad spectrum antiviral activity against all human coronaviruses tested. Zotatifin has physicochemical and pharmacokinetic (PK) properties suitable for convenient, single subcutaneous (sc) injection. This study assessed the safety, antiviral activity, and PK of zotatifin in non-hospitalized patients (pts) with mild/moderate COVID. Method(s): PROPEL is a randomized, placebo-controlled, double-blind study in non-hospitalized pts with mild/moderate COVID. At randomization, pts must have had a SARS-CoV-2 positive test within 7 days and at least 1 COVID symptom. Pts were randomized (3:1) to zotatifin or placebo sc in 3 cohorts of 12 pts each. Cohort 1, 2 and 3 received a single dose (SD) of zotatifin of 0.01. 0.02 and 0.035 mg/kg or matching placebo. Safety (adverse event (AE) and laboratory tests), antiviral activity (mid-turbinate nasal swabs and saliva), and plasma PK were collected over 30 days. The primary endpoint was safety;key secondary endpoints included SARS-CoV-2 viral load (VL) and PK. The study was not powered for statistical inferential testing. Result(s): 36 pts were enrolled across all three cohorts and completed a 30-day follow up. Data is currently available for pts in cohorts 1 and 2, 18 and 6 of whom received zotatifin and placebo, respectively. Baseline characteristics were comparable between groups. The most common AE was erythema at injection site in cohort 1 (44%) and cohort 2 (89%), vs. 0% in the zotatifin and pooled placebo groups, respectively. Other AE frequencies were comparable between zotatifin and placebo and no serious AEs were reported. The concentrationtime profile of zotatifin from cohorts 1 and 2 following sc administration was similar to that reported previously following IV administration, demonstrated a terminal elimination half-life (t1/2) of ~ 4 days, high steady-state volume of distribution (Vss) of 31 L/kg, and low plasma clearance (Cl) of 3.9 mL/min/kg. A faster time to viral RNA undetectability was observed with zotatifin vs. placebo (see Fig 1. Not statistically significant). Conclusion(s): Zotatifin was safe, well tolerated and demonstrated a trend in clinical antiviral activity in patients with mild to moderate COVID which supports further clinical development. Zotatifin sc route of administration supports a point of care treatment for COVID.
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Blockchain technology (BCT) as a disruptive innovation has chains (SCs) to effectively deal with severe disruptions, such as those accompanied by COVID-19. To this end, this study explores BCT's role in minimizing the negative impact of such SC disruptions and improving SC resilience. Our study employs semistructured interviews interwoven with thematic analysis to identify the capabilities deployable by BCT at each stage of disruption. Our study reveals key issues associated with contemporary SC networks and the capabilities that can be enhanced by blockchain-enabled SCs to mitigate such issues. Our study further proposes a conceptual framework highlighting the relationships among various phases of disruption, blockchain capabilities, and SC resilience capabilities through the theoretical lens of the dynamic capabilities view. The proposed framework underscores that for a firm operating in a dynamic and rapidly changing environment, BCT can enhance the ability to sense, ability to seize, and ability to maintain. IEEE
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Background The global health community has emphasized the importance of reporting epidemiological data by age and sex groups in the COVID-19 pandemic. However, age and sex disaggregated data of COVID-19 cases and deaths are rarely reported. Such data are very crucial for public to make truly informed choices about their own diseases risk and also for governments for public policy response. Objective To assess age and gender difference among COVID-19 cases and deaths in Nepal. Method This is a retrospective study which uses public data on COVID-19 cases and deaths released by Ministry of Health and Population, Government of Nepal from January to November, 2020. The data analysis was carried out using SPPS software version 26. Result Nepal reported 233,452 confirmed cases and 1,566 deaths of COVID-19 from 23 January 2020 to 30 November 2020. We found statistically significant differences on COVID-19 cases by age and gender in Nepal with higher number of cases among males of economically active age groups (20-60 years). Similarly, we found significant difference in COVID-19 mortality with more death occurred among male group compared to female group and with highest number of deaths among the people of above 60 years. Furthermore, we found differences in cases and deaths among provinces. Conclusion The age and gender differences in COVID cases and deaths in Nepal indicates needs of considering age and sex groups seriously while planning for testing, case management and vaccination against COVID-19 infections in Nepal. Copyright © 2020, Kathmandu University. All rights reserved.
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PurposeCoronavirus disease (COVID-19) was declared as a pandemic since COVID-19's widespread outbreak and the hospitality industry has been the hardest hit due to lockdown. Consequently, hospitality workers are suffering from the negative aspects of mental health. In the event of such a crisis, this study aims to explore the link between unemployment and home isolation to the willingness to choose electronic consultation (e-consultation) by exploiting psychological ill-being and behavioural intention (BI) with marital status as a moderator.Design/methodology/approachA quantitative methodology is applied to primary data collected from 310 workers from the hospitality industry through an online survey.FindingsFindings of this study suggest that the usage of the e-consultation service can be adopted using three levels. There are valid reasons to conclude unemployment and home isolation are linked to higher rates of psychological health behaviours, which can result in stigma, loss of self-worth and increased mortality. The adverse effect is higher for single individuals than for married people.Originality/valueThe study focussed on e-consultation, BI coupled with the Fishbein scale and a classification model for the prediction of willingness to choose e-consultation with the extension of Theory of Planned Behaviour (TPB).
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Purpose The Internet is used as a tool to seek health information by individuals. Mental health concerns are the high prevalence of the novel coronavirus disease 2019 (COVID-19) and preventive steps are required to curb the illness. Therefore, to gain more insight into health concerns, it is now a common practice to seek health information on the Internet. This study propose an integrated theoretical model to explore the relationship between COVID-19 protocols and perceived online trust with online health information seeking intention (OHISI) and a moderating effect of perceived severity and perceived urgency. Design/methodology/approach Data are collected from 325 athletes in the category of individual and team sports through an online survey in a Likert-scale questionnaire. The analysis is performed with a quantitative methodology. Findings The study reveals the bright side of online health information (OHI), which brings athletes together and has played out with virtual happy hours, meetings and events. The bright side of OHI reflects social, cultural, technological and economic benefits. An OHI chatbot offers bright personalised side information to the individual seeker, which is more convenient and efficient than human capabilities. Originality/value The pivotal contribution is the integrated theoretical framework that is derived from multidisciplinary literature to capture the complexity of OHI. Also, it conceptualises the constructs in the context of OHI and COVID-19.
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Purpose Mobile-based payment is increasing exponentially but in the developing country like India, consumers' perception is highly positive in daily cash transaction. The purpose of this research is to identify and examine the important challenges for mobile wallet (m-wallet) implementation in India. In the wake of COVID-19, one of the transmission mechanisms of this virus has been the coins and paper money passed between a buyer and a seller. As such m-wallet considered as a convenience of payment has become a necessity in light of the pandemic. Design/methodology/approach The authors explored 19 unique sets of challenges selected from the literature and collected data from 14 experts from private sector, multinational corporations and mixed private and public partnership who have significant knowledge and experience of mobile payment implementation and use in their respective organisations. Also, the authors have used Interpretive Structural Modelling (ISM) methodology in developing a hierarchal model for the identified challenges. The authors implemented Cross-Impact Matrix Multiplication Applied to Classification (MICMAC) analysis to classify the identified challenges. Findings The ISM-based framework is divided into nine different hierarchical levels. "Lack of strong regulatory compliance (Ch6)" has been recognised as the most important challenge, which inhibited the mobile wallet implementation, whereas "Perception of customers about the value of using mobile wallets (Ch11)" is the most dependent critical challenge. There are seven hierarchical layers in between the top and the bottom level with the varied number of challenges based on their driving and dependence power. Originality/value This is the first research to the best of our knowledge that has not only comprehensively reviewed the m-wallet literature but also employed a unique ISM-MICMAC-based approach to develop a framework of challenges for the m-wallet implementation.
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Background:COVID-19 is a respiratory disease caused by novel coronavirus SARS CoV -2 and has been declared as pan- demic by WHO. The timely detection of cases and their contacts is crucial to help curtail the pandemic. Introduction of antigen based RDT has been able to bridge the time gap of detection and tracing as these tests are timely and easy to perform. However the real world performance of these assays is uncertain and the sensitivity of the test is claimed to be between 50% to 87%. This study was conducted to evaluate the currently used antigen -based RDT for the detection of SARS CoV-2 virus in respiratory specimens. Methods:This prospective study included patients who were seeking healthcare in Ophthalmology department for eye ailments and were subjected to SARS CoV-2 antigen based RDT. Regardless of results of RDT, nasopharyngeal swabs were collected from these patients and were tested for SARS CoV-2 RNA by real-time RT PCR using commercial assay (SD Biosensor). The evaluation of antigen-based RDT for the detection of SARS CoV-2 virus was performed with real time RT-PCR as gold standard. Results:A total of 564 patients were tested by both antigen based RDT and real time RT -PCR. The antigen based RDT exhibited analytical sensitivity and specificity of 37.5% and 99.79% respectively. Positive predictive value and negative predictive value of RDT were 96.4% and 91.6% respectively. Negative correlation was found between antigens based RDT’s positivity and Ct values of E and RdRp genes. Conclusions:Overall poor sensitivity of RDT does not allow adopting it as point of care test in screening for COVID -19 and it only serves as an additional test to RT-PCR because of potential false negative results.
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The global COVID-19 outbreak and consequent lockdown pushed consumers to engage in more e-shopping, which could lead to e-impulse purchases (e-IB). The purpose of this study is to investigate the interrelationships between e-impulse buying tendencies (e-IBT), e-impulse buying (e-IB), and customer satisfaction empirically (CS). The customers' intent to continue e-shopping is also investigated. Data was collected from 580 consumers in India's Union Territory of Delhi using a standardized instrument. The psychometric features of the research survey instrument were first verified using the LISREL Structural Equation Modeling Package. Hayes (2018) PROCESS was used to evaluate the moderated mediation model and hypotheses. The association between e-IBT and CS was empirically demonstrated to be mediated by e-IB. Furthermore, e-IBT is associated to e-IB in a good way. Furthermore, e-IB is positively connected to CS, indicating that consumers intend to continue shopping online. The findings also show that the e-IBT interacts with the website (first moderator) and stimulants and promotions (second moderator) to significantly influence the e-IB. Further, hedonic motives modify the e-IB-CS relationship. © 2021 Elsevier Inc.
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Purpose Several industries including banking are booming because of COVID-19. However, it is still unknown whether this growth is momentary or permanent in nature. Hence, this study aims to identify the role of health-related concerns and trust as stimuli on M-payment loyalty. Design/methodology/approach Data were collected through Google Forms from 431 participants. Subjects were M-payment users. The hypothesized model was tested using structural equational modeling. Findings Results of the study indicate that perceived severity and trust act as stimuli for M-payment loyalty. Further, trust not only influences loyalty directly but also through intimacy. Additionally, no linear relationship was found between perceived usefulness and M-payment loyalty. Originality/value This work is an early attempt to consider health-related concerns and trust as stimuli to predict M-payment loyalty. Further, this study focused on three new constructs, namely perceived severity, perceived susceptibility and intimacy, that are underexplored in digital banking literature.
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Disruptions induced by the COVID-19 pandemic have wreaked havoc in supply chain networks. To gain an understanding of the dynamics that had been at play, we construct a real supply chain network (scale-free) based on a seed firm (Apple), its customers, and its first- and second-tier suppliers, yielding a network of a total of 883 firms. We then use visualization to derive insight into various network characteristics and develop an agent-based model to capture the disruption of the network over a period of 400 days from the onset of the pandemic. The disruptions experienced by firms depend on the stringency of measures taken to curb the pandemic in their respective countries and the severity of disruptions experienced by suppliers in a specific region. We specifically find that spatial complexity, degree centrality, betweenness centrality, and closeness centrality have changed significantly throughout our observation period. We thus subsequently theorize on the influence of some of these characteristics on supply chain resilience (SCRes), and through our empirical tests, we find that, at the network level, Average degree and spatial complexity significantly influence SCRes. At the firm-level, we find that powerful firms within the network influence SCRes based on their betweenness centrality and closeness Centrality. Implications for managerial practice and academic research are discussed. IEEE
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Background: The global health community has emphasized the importance of reporting epidemiological data by age and sex groups in the COVID-19 pandemic. However, age and sex disaggregated data of COVID-19 cases and deaths are rarely reported. Such data are very crucial for public to make truly informed choices about their own diseases risk and also for governments for public policy response. Objective To assess age and gender difference among COVID-19 cases and deaths in Nepal. Method This is a retrospective study which uses public data on COVID-19 cases and deaths released by Ministry of Health and Population, Government of Nepal from January to November, 2020. The data analysis was carried out using SPPS software version 26. Result Nepal reported 233,452 confirmed cases and 1,566 deaths of COVID-19 from 23 January 2020 to 30 November 2020. We found statistically significant differences on COVID-19 cases by age and gender in Nepal with higher number of cases among males of economically active age groups (20-60 years). Similarly, we found significant difference in COVID-19 mortality with more death occurred among male group compared to female group and with highest number of deaths among the people of above 60 years. Furthermore, we found differences in cases and deaths among provinces. Conclusion The age and gender differences in COVID cases and deaths in Nepal indicates needs of considering age and sex groups seriously while planning for testing, case management and vaccination against COVID-19 infections in Nepal.
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Objective: To determine the spectrum of clinical presentation, multisystem involvement and treatment outcome in children with MIS-C. Study Design: A descriptive cohort study Place and Duration of Study: Conducted at The Children's Hospital and Institute of Child Health, Lahore from May 15, 2020 to November 22, 2020. Material and Methods: Children (aged 0-16 years) with features of this new inflammatory syndrome who fulfilled the WHO criteria for MIS-C and required admission to hospital were prospectively identified. Demographic and clinical data were collected from patient records and entered on a predesigned proforma and results were analyzed on SPSS 20. Results: A total of 24 patients were enrolled in the study. Majority were males (17/24, 70%). Mean age of presentation was 7.3 years. Six patients (25%) had a positive PCR for SARS CoV-2 but none of the patients had been symptomatic with classic COVID-19 respiratory symptoms in the 6 weeks prior to admission. Comorbid conditions were present in only 2 patients (8%). SARS-CoV-2 antibodies were positive for 23/24 patients (96%). Despite being clinically unwell, with laboratory evidence of elevated C-reactive protein, ferritin, and D-dimers, no pathological organism was isolated in any of the 24 children. There were two major presentations: one as atypical or typical Kawasaki disease (18 of 24, 75%) and a more severe second one with shock or low cardiac output (6 of 24, 25%). Common presenting features were fever, body aches, and abdominal pain. Four out of 24 (16%) patients had sufficient criteria for typical Kawasaki disease, whereas 18 children (75%) presented more sub acutely with presentation resembling Kawasaki disease;all had at least two features of classic Kawasaki. Myocardial dysfunction seen in 3 patients (12%) and pericardial effusion was observed in 5 patients (20%). Coronary artery dilatation was seen in 12 (50%) patients. All 6 children with shock-like presentation had coronary artery involvement. Twenty children (83%) received intravenous immunoglobulin within the first 2 days of their stay. Thirteen (54%) patients received therapeutic anticoagulation (enoxaparin) on the basis of the high risk of thromboembolism and number of D-dimers. There was one death (4%). Conclusion: The SARS-COV 19 pandemic led to the identification of a new and potentially life-threating childhood disease, referred to as MIS-C. Prompt diagnosis and early treatment with IVIGs has shown a good early outcome. .
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Objectives: To describe the epidemiological characteristics, clinical presentation, severity of the disease, and early outcomes of children with COVID-19 in Pakistan with special reference to underlying comorbid conditions. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The Children’s Hospital and The Institute of Child Health, Lahore, from March 15 to July 31, 2020. Material and Methods: We analyzed data on all laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARC-COV-2) infection in children admitted to a single tertiary care center including patient characteristics, clinical course and hospital outcomes with special reference to underlying comorbidity. Results: Of 42 symptomatic children, 19 (45%) had a pre-existing comorbidity, the most common of which was chronic kidney disease (7/19-37%). The median age was 7.75 years (IQR: 1.3–11.2) with a slight female preponderance (55%). Fever (79%), respiratory symptoms (52%), and gastrointestinal symptoms (14%) were the most common symptoms. No direct or indirect contact with COVID-19 positive person was identified in 12 patients (29%). Patients with pre-existing comorbidity required mechanical ventilation and prolonged intensive care monitoring than those without. There were three fatalities in the groups of 42 (7%) patients, and underlying comorbid conditions were significantly associated with a fatal outcome (p=0.032). Conclusion: COVID-19 in children is generally mild with good outcome. Chronic kidney disease was the commonest co-morbidity and the presence of an underlying co-morbid condition is a risk factor for prolonged hospital stay and a poor outcome. © 2020, Pakistan Pediatric Journal. All rights reserved.
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We report a 10-year-old girl who presented with fever, unilateral redness of eye, strawberry tongue, cheilitis, acralmaculopapularrash and erythematous swelling of hands and feet followed by desquamation. Her father had COVID-19 almost a month back and her SARS-CoV-2 antibodies were raised. She had normal inflammatory markers, normal echocardiogram and a benign self-resolving rash. Though skin and mucosal lesions resembled Kawasaki disease like syndrome, these were isolated cutaneous manifestation most likely immune mediated and temporally related to SARS-CoV-2 infection. © 2020, Pakistan Pediatric Journal. All rights reserved.
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Introduction: COVID-19 has spread all around the world with huge toll of human lives and suffering since it evolved in China. Nepal had slow rise in morbidity due to COVID 19 in early days but has been gripped by the pandemic's exponential growth lately. This study was conducted with the aim to describe the clinical and epidemiological features of Nepali children in early phase of the pandemic. Methods: This was an observational study conducted at 11 COVID care centres designated by the Government of Nepal with availability of supervision by paediatricians between January and August 2020 in children under 18 years of age diagnosed with COVID 19. Data was collected based on definitions outlined in data collection resources available at WHO-ISARIC Global COVID-19 clinical resources platform and analysed. Results: One hundred and twenty one children diagnosed with COVID 19 who presented to the designated centres were enrolled. Majority of children (83.4%) were identified as a part of contact tracing, 28.1% had an identified contact to a person with COVID 19 prior to their diagnosis and 20.7% had another household member diagnosed with COVID 19. The mean age of admitted children was 8.8 years (SD 5.6 years) with the largest proportion being adolescents (40.5%). Male (58.7%) children were more commonly affected. There were 15 (12.4%) infants and 8 (6%) of them were under two months of age. Most children (87, 71.9%) were asymptomatic, 21 (22.3%) had mild symptoms and six (4.9%) had moderately severe symptoms. Fever (18.2%) was the most commonly reported symptom. All children were discharged after a median of 14 days of hospitalisation. Conclusions: Nepali children of all ages are affected by COVID 19 and present with asymptomatic or mildly symptomatic infection. Fever and respiratory symptoms are the most commonly reported symptoms. Most children do not develop complications. Continued surveillance in larger population of children as the pandemic unfolds will generate more stringent observations.
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The immune response developed in Indians through the vaccination program may affect the much needed capability to fight for our lives against the war with COVID-19. This study aimed to support the utility of vaccines to fight against various diseases, and to explore why there is a possibility that Indians may have genetic and regional advantages against this pandemic disease. Books like Essential pediatrics by DR.Ghai and various articles, WHO(World Health Organization) website, etc were referred for this review article. Some more information was obtained using keywords such as vaccination in India, immunity, research articles, COVID-19, WHO etc. The result is based on the various studies done regarding the utility of different vaccines on respiratory disorders, non-specific effects of these vaccines in neonates and in elders. It can be concluded that a background of an essential and compulsory vaccination programs in India may have been providing and may provide in the near future, the much needed immunity to tackle and eradicate coronavirus and the need of a thorough research for an authentic basis. © International Journal of Research in Pharmaceutical Sciences.