Frequency of Nucleated Red Blood Cells in the Peripheral Blood of ICU-Admitted Patients.

Background Nucleated red blood cells (NRBCs) are not normally found in the peripheral blood of normal healthy individuals. The presence of NRBCs on an adult peripheral blood smear indicates that there is an extremely high demand for the bone marrow to manufacture RBCs and that immature red blood cells are being released into the bloodstream. Anemia, myelofibrosis, thalassemia, miliary tuberculosis, malignancies of the bone marrow (myelomas, leukemias, lymphomas), and prolonged hypoxemia are a few possible pathogenic reasons. Critically ill patients who have NRBCs have a high mortality rate and a worse prognosis. OBJECTIVE: To evaluate the clinical significance of NRBCs in the peripheral blood of critically ill patients admitted to the ICU to find a cut-off to predict mortality. MATERIALS AND METHODS: A cross-sectional study was carried out over a period of six months September 1, 2020, to March 31, 2021, in Lahore, Pakistan. A total of 800 critically ill patients of both sexes in the age group of 18-70 years were included. Patients younger than 18 years and patients who underwent surgery were excluded. A quantity of 3 ml of whole blood sample in an ethylenediamine tetraacetic acid (EDTA) vial from each patient was run on SYSMEX XN-9000 (Sysmex Corporation, Kobe, Hyogo, Japan) and the results were reviewed on peripheral smears. RESULTS: The incidence of NRBCs in ICU-admitted patients was 62.5% (500/800). The total number of NRBC-positive patients recovering after the treatment was 364 (72.8%). The overall mortality of NRBC-positive patients was 30% (150/500). It was significantly higher (p<0.001) than that of NRBC-negative patients (14%; 44/300). During treatment, the highest mortality rate was seen in patients due to malignancy (100%), followed by sepsis (58.8%). It was observed that the disease pattern and number of NRBCs were significantly different (p<0.001) among all disease groups. However, there was no statistically significant difference in NRBCs on the basis of gender (p >0.05). In our study, a cutoff of NRBCs of 2.50 showed a high risk of mortality with a sensitivity of 91%. CONCLUSION: The presence of NRBCs may predict mortality in critically ill ICU-admitted patients. Their presence in the blood may be regarded as a marker of severity suggesting a high risk of ICU death.

Downside risk-return volatilities during Covid 19 outbreak: a comparison across developed and emerging markets.

This research study evaluates the impact of the Covid 19 pandemics on the downside risk-return volatilities across the four stock markets of the USA, UK, China, and Pakistan. The pandemic results in severe economic and financial consequences both at micro and macro levels as well as across the stock markets of various countries. The selected stock markets of the USA, UK, Pakistan, and China are significantly affected in terms of both investor risk and return during the pandemic time. The entire period distribution of the risk exhibited the downside risk behavior of both markets and investors' serious concern regarding their investment strategies. Using high-frequency data from January 2020 to April 2021, the findings of the study reveal more of the downside abnormal returns across both markets. The impact is larger and high in developed markets of USA and UK compared to the emerging markets of China and Pakistan. The outcomes of the various value-at-risk models disclose the higher downside risk implications for all markets, larger for developed countries. Similarly, the three stock markets of the USA, UK, and China were found to be significantly connected during a pandemic. Investors' reactions were positive and high in case of positive news outbreaks and dwindling in case of negative news and downside impact. The outcomes of the study are useful for investors, portfolio managers, investment advisors, and others to understand the dynamics of the pandemic situation and devise effective strategies to overcome the severities of downside risk.

Revitalization of tourism and hospitality sector: preempting pandemics through lessons learned.

The devastating effects of the COVID-19 pandemic have left many repercussions for the tourism industry to preempt any future catastrophe of this nature. The research aims to propose recommendations for the post-COVID-19 business world to revitalize and reclaim their market space and win back their volumes without any fear of indefinite closures and continued lockdowns in the industry. Drawing from the literature, the study assumed revitalization through responsiveness, use of advanced technology, customers' and employees' willingness, enhanced skills, adherence to standard operating procedures and protective measures, and restructuring via a public-private partnership. For the purpose, survey method was employed to collect data from the industry. After confirmation of the reliability and validity, the regression analyses supported effective revitalization through government responsiveness, use of digital technology, psychological recouping of customers' willingness, enhancing technical skills through training, strict adherence to protective measures, and destination restructuring and reorganization through a public-private partnership. The study proclaimed that Pakistan's tourism and hospitality sector development has evolved through the COVID-19 situation, and is likely to revamp and revitalize into a sustainable business. Once achieving sustainability, the revamped industry will likely to increase revenue, generate employment, and alleviate poverty through thriving public-private partnerships, community involvement, and community well-being without compromising people's health.

The Impact of Social Entrepreneurship, Corporate Social Responsibilities, and Working Capital Management Practices on the Performance of Tourism Small-Medium Enterprises (SMEs) During COVID-19: Moderating Role of Employee Behavior.

The failure or success of an enterprise depends upon its working capital management practices (WCMP) along with effective corporate social responsibilities (CSR) and social entrepreneurship (SE). These factors ensure not only the soundness of financial indicators but also the profitability of an enterprise. Therefore, the objective of this study was to determine the impact of CSR, SE, and WCMP on the performance of small-medium enterprises (SMEs) of tourism sector, during the lockdown period in Malaysia. The goals also include the investigation of moderating role of employee behavior (EB) among the nexus of CSR, SE, WCMP, and performance of SMEs. The survey was performed to find out the practices adopted by the SMEs during corona days. A quantitative research method has been adopted to get data with convenient sampling technique, and PLS-SEM has been exploited to find out the significant nexus among CSR, SE, WCMP, and the performance of SMEs. The results indicate that CSR, SE, and WCMP have a positive association with the performance of SMEs in Malaysia. The results also indicate that EB positively moderates among the nexus of CSR, SE, WCMP, and the performance of SMEs in Malaysia. Stock review strategies by the SMEs during the corona days also exhibit significant differences except for no stock review. Significant differences between the enterprises show a lack of adaptation of the financial indicators that determine enterprise soundness. The study not only provides guidelines for entrepreneurs of SMEs but also helps in maintaining standards for the evaluation of the enterprises.

The Impact of Social Entrepreneurship, Corporate Social Responsibilities, and Working Capital Management Practices on the Performance of Tourism Small–Medium Enterprises (SMEs) During COVID-19: Moderating Role of Employee Behavior

The failure or success of an enterprise depends upon its working capital management practices (WCMP) along with effective corporate social responsibilities (CSR) and social entrepreneurship (SE). These factors ensure not only the soundness of financial indicators but also the profitability of an enterprise. Therefore, the objective of this study was to determine the impact of CSR, SE, and WCMP on the performance of small–medium enterprises (SMEs) of tourism sector, during the lockdown period in Malaysia. The goals also include the investigation of moderating role of employee behavior (EB) among the nexus of CSR, SE, WCMP, and performance of SMEs. The survey was performed to find out the practices adopted by the SMEs during corona days. A quantitative research method has been adopted to get data with convenient sampling technique, and PLS-SEM has been exploited to find out the significant nexus among CSR, SE, WCMP, and the performance of SMEs. The results indicate that CSR, SE, and WCMP have a positive association with the performance of SMEs in Malaysia. The results also indicate that EB positively moderates among the nexus of CSR, SE, WCMP, and the performance of SMEs in Malaysia. Stock review strategies by the SMEs during the corona days also exhibit significant differences except for no stock review. Significant differences between the enterprises show a lack of adaptation of the financial indicators that determine enterprise soundness. The study not only provides guidelines for entrepreneurs of SMEs but also helps in maintaining standards for the evaluation of the enterprises.

Mental health crisis in pregnant women during current COVID-19 pandemic

Even though for majority of women pregnancy period is a blessed period of their life but a few expecting women encountered a range of negative emotions in those ninth months which lead to depression and anxiety. Maternal mental health issues are interlinked with both short- and long-term health risks for the affected female parent and as well as for the child. The entire health and functional performance of the mother along with the children's mental, physiological and cognitive development is affected by the disrupting mental health situation of the mother. The risks of morbidities which are caused by the psychological problems such as intense stress, natural disasters and accidents and conflict situation could be increased among the perinatal mothers. As a result, it is possible that obstetric women are more exposed to mental health related issues during the pandemic of COVID-19. It is concluded that development of appropriate strategies is important to reduce stress by diagnosing and managing mental health diseases in new mothers without delay at the time of pandemic. Screening techniques based on internet, online counseling and web-related psychological assistance and therapeutic interventions might produce a significant role in this regard. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Molecular epidemiology of SARS-CoV-2 in Faisalabad, Pakistan: A real-world clinical experience.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-2019 is a new global health challenge which causes severe respiratory complications. As of May 17th, 2020, SARS-CoV-2 has infected 4.6 million people and caused 310,000 deaths, worldwide. In order to study potential impact of infection, complete epidemiological information should be reported on regular basis however, data from Pakistan has not yet been published. This retrospective study is the first report of epidemiological trends of COVID-19 in Faisalabad, Pakistan. On April 4th, 2020, 128 nasopharyngeal swabs collected from city Faisalabad were transported to Postgraduate Research Institute, Lahore for further processing. RNA was extracted using QIAsymphony DSP Virus/Pathogen Midi Kit and real-time PCR was performed to quantify COVID-19. Our finding showed that overall prevalence of COVID-19 in Faisalabad on April 4th was 17.18% (22 of 128). Prevalence was higher in males (n = 17; 77.2%) as compared to females (n = 5; 22.8%) but this gender-wise difference was not statistically significant. Patients belonging to age group 37-47 years were found to be most (45.5%) infected with COVID-19.