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Using insights from the changes made to a workshop developed before, but occurring after the pandemic, I describe the usefulness of design thinking activities and approaches to education in the post-COVID teaching era. I argue that design thinking techniques help build awareness around tolerance for ambiguity as an opportunity to inspire creative teaching solutions. This transferable skill is important for our students as soon-to-be graduates, and for faculty looking to build resilience in this uncertain time. Using Boyer's framework for scholarship, I explore opportunities to connect the teaching and learning goals of students and faculty. © Springer Nature Switzerland AG 2021. All rights reserved.
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Objective: COVID-19 leads to highly variable clinical outcomes among older people with psychiatric and medical co-morbidities. Evidence guiding management of future outbreaks among this vulnerable population in in-patient psychiatry settings are sparse. Hence, we aimed to investigate the correlates of poor clinical outcomes related to COVID-19 and to explore the perspectives of COVID-19 survivors in in-patient psychiatry settings. Method: We investigated the correlates of poor clinical outcomes related to COVID-19 using retrospective chart review of 81 older people in in-patient psychiatry settings. Correlates of clinical outcomes related to COVID-19 were assessed by multiple logistic regression models. Moreover, we explored the perspectives of 10 of those COVID-19 survivors by qualitative interviews. We analysed the qualitative data using thematic analysis. Results: Although 25.9% (n = 21) participants were asymptomatic, there was high COVID-19 related mortality rate (14.8%;n = 12). Vitamin-D deficiency, anticholinergic burden, and isolation policies within psychiatric wards were significantly (P < 0.05) associated with COVID-19 related deaths. Participants emphasised the importance of strengthening local support networks and making vaccination centres more accessible. Conclusions: Reducing anticholinergic prescriptions and improving isolation policies may mitigate poor clinical outcomes. Future research investigating the impact of vitamin-D supplementation on COVID-19 related outcomes are warranted. © The Author(s) 2023.
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Background: Airway stenosis is a known complication of prolonged intubation in hospitalized patients. With the high rate of intubations in patients with COVID-19 pneumonia, laryngotracheal stenosis (LTS) is a complication of COVID-19 that drastically reduces quality of life for patients who may remain tracheostomy-dependent. Methods: Patient medical history, laryngoscopy, and CT imaging were obtained from medical records. Results: We report four cases of complicated LTS following intubation after COVID-19 pneumonia and explore the current literature in a narrative review. Four patients developed LTS following intubation from COVID-19 pneumonia. Three patients remain tracheostomy-dependent, and the fourth required a heroic operative schedule to avoid tracheostomy. Conclusion: Intubation for COVID-19 pneumonia can result in severe LTS, which may persist despite endoscopic intervention. © 2022 by the authors.
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To describe the safety and efficacy of lung transplantation for COVID-19 related acute respiratory distress syndrome (ARDS) or pulmonary fibrosis (PF). The transplanted patient's characteristics, the donor's characteristics and the outcomes following the transplantation were extracted from the UNOS database. The overall survival (OS) was calculated using the Kaplan-Meier method and the cox proportional regression models were utilized to examine the association of the baseline characteristics with the OS. A total of 204 and 191 patients received lung transplantation due to COVID-19 related ARDS and PF respectively through August 2022. The majority were males (76.2%) and were identified as caucasian (55.7%). The median age and allocation score for the ARDS cohort was 47 [37, 55] and 88.3 [81.0, 91.1] wherea the PF cohort was 54 [45, 62] and 79.3 [47.7, 88.3]. There were 18 and 15 acute rejections in the ARDS and PF groups respectively during a median follow-up of 186 [63, 359] and 181 [40, 348] day. The 1-, 6- and 12- month OS was 98.4%, 95.1% and 88.3% for the ARDS arm and 96.3%, 92.2% and 83.8% for the PF arm. Receiving a graft from a smoker donor was associated with worse OS in the ARDS cohort, whereas female gender was associated with worse OS in the PF cohort. Lung transplantation is beneficial in patients with irreversible respiratory failure due to COVID-19 with survival similar to other pre-transplant etiologies. [ABSTRACT FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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Rationale: Asthma remains a significant comorbidity among children with food allergy (FA). Longitudinal data on the course of asthma in this population, particularly during the COVID-19 pandemic, is lacking. This study aims to describe asthma management and control among children with FA during the COVID-19 pandemic. Methods: Children with FA (≤12 years old at enrollment) were enrolled into FORWARD, a prospective, observational cohort study. Data from participants with FA and asthma who completed a 12-month and 24-month post-enrollment asthma therapy assessment were included (n=125). Surveys were administered between January 2019 - July 2022, which includes the onset and duration of COVID-19. Responses to the same questions at the two time points were analyzed using tests of exact symmetry. Results: Compared to the 12-month survey, caregivers at the 24-month survey more frequently reported that their children were not using their inhaler for quick relief (1.6% vs. 9.4%, p = 0.008) and were using their medication incorrectly (3.2% vs. 8.7%, p = 0.003). They less frequently reported that they were unsure whether their medications were useful (3.2% vs. 0.0%, p = 0.016). A similar distribution was observed when non-Hispanic Black and non-Hispanic White participants were compared. No significant differences were evident when comparing symptoms. Conclusions: The symptom burden of asthma remained stable even during the pandemic. However, during this time, children with asthma were less likely to need a rescue inhaler and to be adherent to their maintenance regimen. Further longitudinal research on asthma management is necessary to better understand the potential impact of COVID-19.
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mRNA-based therapy has emerged as the most promising nucleic acid therapy in the fight against COVID-19. However, a safe and efficacious systemic delivery remains a challenge for mRNA therapy. Lipid nanoparticles (LNPs) are currently widely used in mRNA delivery vehicles. Here, series of ionizable LNPs are rationally designed. YK009-LNP is an optimal delivery platform to carry mRNA. YK009-LNP exhibited higher mRNA delivery efficiency, a more favorable biodistribution pattern, and better safety than the approved MC3-LNP. In addition, mRNA encoding SARS-CoV-2 Omicron receptor binding domain protein was synthesized, and intramuscular administration of mice with YK009-LNP-Omicron mRNA induced a robust immune response and immune protective effect. Our study provides a novel mRNA delivery vehicle with more powerful delivery efficiency and better safety than the approved LNPs. This article is protected by copyright. All rights reserved.
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Purpose: How to improve the resilience of service firms in the crisis, such as the COVID-19 epidemic, to maintain a sustainable competitive advantage becomes a growing concern worldwide. Digital platform capability (DPC) provides a series of opportunities and advantages for service firms to shape resilience in the crisis. This study aims to clarify the effect and mechanism of DPC on service firms' resilience, and provides a new mediator (strategic learning [SL]), as well as two boundary conditions (legal inefficiency [LIE] and legal incompleteness [LIC]). Design/methodology/approach: Questionnaires were used to obtain firm data, and executives answered these key questions. Data from 293 service firms during the COVID-19 period were used for hypothesis testing. Findings: DPC was positively related to the adaptive capacity (AC) and planning capacity (PC) of service firms. SL mediated the positive effect of DPC on the AC and PC of service firms. The positive effect between DPC and SL was weakened when LIE and LIC were high. Practical implications: This study suggests that it is a very desirable measure to improve DPC to gain organizational resilience (OR) in the crisis. In addition, a SL process in the crisis is crucial, because service firms need to absorb key strategic information from digital platforms to cope with uncertainty. The services firms need to realize that the benefits of DPC will be weakened in the dysfunctional institutional environment of LIE and LIC. Originality/value: To the best of the authors' knowledge, this study is the first to link the DPC with the resilience of service firms, and provides a new explanation mechanism and some boundary conditions for this important relationship. Furthermore, this study takes a step forward, because these efforts respond to the widespread call of the literature on digitalization and OR, and provide new insights for understanding digital resilience. © 2022, Emerald Publishing Limited.
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Background. Epetraborole (EBO) - an orally available bacterial leucyl transfer RNA synthetase inhibitor with potent activity against nontuberculous mycobacteria - is under clinical development for treatment of MAC lung disease. We conducted a Phase 1b dose-ranging study of EBO tablets in healthy adult volunteers, to inform dose selection in the treatment of MAC lung disease. Methods. In this double-blind, placebo-controlled trial, EBO or placebo tablets were administered (n=8/cohort, 3:1 randomization) at dosages of 250-1000 mg q24h or 500 mg or 1000 mg q48h for up to 28 days. Standard Ph1 clinical and laboratory evaluations and treatment-emergent adverse events (TEAEs) were assessed. Based on prior human studies using significantly higher EBO daily doses, gastrointestinal (GI) events and anemia were predetermined AEs of special interest (AESIs). Plasma concentrations of EBO were measured by validated LC-MS/MS methods. Plasma PK parameters were determined using non-compartmental methods. Results. A total of 43 subjects were enrolled;the 1000 mg q24h cohort was terminated early due to local COVID restrictions. Overall, 80.6% EBO subjects and 83.3% placebo subjects experienced >=1 TEAE, none of which was serious or severe (Table). Most TEAEs were mild in severity (90%), and the remainder were moderate (10%). No TEAE leading to withdrawal from study was reported. The most frequent types of TEAEs were GI events (48.4% EBO, 41.7% placebo subjects), the most common being mild nausea. Two subjects had premature discontinuation of EBO due to a TEAE (asymptomatic liver enzyme elevations in a 250 mg q24h subject and mild nausea in a 1000 mg q48h subject). One 1000mg q24h subject had a TEAE of anemia. No clinically significant findings or TEAEs were observed for physical examinations, ECGs, or urine laboratory tests. Plasma Cmax and AUC0- of EBO increased in a linear, dose-proportional manner across cohorts. Tmax was observed at ~1 h post dose;mean t1/2 ranged from 7.63 to 11.1 h. Conclusion. * Oral EBO administered for 28-day dosing was generally well tolerated at the predicted therapeutic dose (500mg q24h) * Predictable PK characteristics facilitate its use in MAC lung disease * Further evaluation in a Phase 2/3 treatment-refractory MAC lung disease study is planned.
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This perspective article argues that anticipatory research into possible "emergency" response measures such as solar geoengineering will increase knowledge, and thus confidence, in any future decisions to either deploy or reject these technologies. Similarities between COVID and climate can reveal some perspective on the benefits of anticipatory vaccine research for anticipatory for solar geoengineering research. Although we deeply hope governments will aggressively reduce emissions and scale up adaptation efforts in time to avoid the worst climate impacts, we argue that the benefits of anticipatory solar geoengineer research currently outweigh the risks of not moving research forward.
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Background/Case Studies: On December 17th 2021 the U.S Food and Drug Administration published a letter to clinical laboratory staff and health care providers detailing a risk of false Rapid Plasma Reagin (RPR) when using the Bio-Rad Laboratories BioPlex 2200 Syphilis Total & RPR kit in people who had received a COVID-19 vaccination. Specifically, this notice stated that Treponema pallidum particle agglutination (TP-PA) assays did not appear to be impacted by this issue. At our institution it has been observed that since 2018, the positivity rate of syphilis screening with negative confirmatory testing has been dramatically increased from previous years. Curiously a striking number of these positives occurred at the end of the year, mainly October through December. Study Design/Methods: All whole blood (WB) donations from 2011-2021 which demonstrated positive syphilis screening with negative confirmatory testing were evaluated. Screening for syphilis was performed using the Beckman Coulter PK TP Microhemagglutination assay with confirmatory testing using CAPTIA Syphilis (T. pallidum)-G. Results/Findings: There were 77 whole blood donations from 59 unique donors screened positive for syphilis with negative confirmatory testing from 2011-2021 (summarized in table 1). A dramatic increase in the unconfirmed syphilis positivity rate was observed in 2018-2021 (mean: 0.439%) compared to 2011-2017 (mean: 0.024%, unpaired t-test p-value: 0.0010), representing an 18-fold increase in positive screens. Of these 77 donations, 8 donors contributed 26 units (median: 3, range: 2-5) between 2018-2021. Three of these 8 donors made several (6, 31, and 85) WB donations with negative syphilis screening prior to becoming positive. The 5 remaining donors switched back and forth between negative and positive over the course their donation history. Conclusion(s): There has been a statistically significant increase in unconfirmed syphilis positivity rate among whole blood donors at our institute since 2018 when compared to the 7 years prior. Additionally, the positivity rate doubled from 2020 to 2021. No changes were made to the testing assay used during this time period that could explain these results. There appears to be an autumnal peak in unconfirmed positives suggesting a possible environmental trigger such as viral infection or influenza/COVID-19 (for the 2021 increase) vaccination. Further investigation would be needed to confirm such a hypothesis. (Table Presented).
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We present a status update for MagAO-X, a 2000 actuator, 3.6 kHz adaptive optics and coronagraph system for the Magellan Clay 6.5 m telescope. MagAO-X is optimized for high contrast imaging at visible wavelengths. Our primary science goals are detection and characterization of Solar System-like exoplanets, ranging from very young, still-accreting planets detected at H-alpha, to older temperate planets which will be characterized using reflected starlight. First light was in Dec, 2019, but subsequent commissioning runs were canceled due to COVID-19. In the interim, MagAO-X has served as a lab testbed. Highlights include implementation of several focal plane and low-order wavefront sensing algorithms, development of a new predictive control algorithm, and the addition of an IFU module. MagAO-X also serves as the AO system for the Giant Magellan Telescope High Contrast Adaptive Optics Testbed. We will provide an overview of these projects, and report the results of our commissioning and science run in April, 2022. Finally, we will present the status of a comprehensive upgrade to MagAO-X to enable extreme-contrast characterization of exoplanets in reflected light. These upgrades include a new post-AO 1000-actuator deformable mirror inside the coronagraph, latest generation sCMOS detectors for wavefront sensing, optimized PIAACMC coronagraphs, and computing system upgrades. When these Phase II upgrades are complete we plan to conduct a survey of nearby exoplanets in reflected light.
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Background: Surufatinib (a small-molecule inhibitor of VEGFR1-3, FGFR1, and CSF-1R) has exhibited encouraging antitumor activity for the treatment of advanced neuroendocrine tumors (including NEN and NEC) in multiple registration studies. Here, we report the preliminary results of advanced neuroendocrine tumors of an ongoing, multicenter, real-world study of surufatinib + MDT (ChiCTR2100049999). Challenges in tumor clinical trials management in the face of the COVID-19 resurgence period in Shanghai. Methods: In this multicenter, single-arm real-world study, adults (18-80) with advanced neuroendocrine tumors (including NEN and NEC) were eligible and received surufatinib (300mg orally, QD) with MDT（multidisciplinary collaborative diagnosis and treatment). The primary endpoint was progression-free survival (PFS) per RECIST 1.1. We minimized the interruptions caused by the pandemic using telemedicine platforms for all patients. This included online consultations, follow-up drug distributions, and health management services. Results: Twenty-three pts were enrolled, with 20 NEN and 3 NEC. At the data cutoff date (April 10, 2022), 15 pts had at least one post-baseline tumor assessment;of them, the confirmed ORR (95%CI) was 20% (4.3-48.1), and DCR (95%CI) was 93.33% (68.1-99.8). Median PFS (mPFS) (95%CI): 10.640 mo (3.796-17.484);median OS: not reached and median duration of follow up was 6.870 mo (6.797-6.943). A pNET patient (NO. 010007) was interrupted by asymptomatic COVID-19 infection 9 mo after enrollment. There are no interruptions caused by COVID-19 for other patients. An NEC patient treated with single agent had a 5.85 mo PFS, evaluated as NE, in whom target lesion resected after baseline. In overall pts (n=23), most commonly (≥3 pts) with hemorrhage, anemia, hypertension, proteinuria, and abdominal pain. Three pts had TRAEs that led to treatment discontinuation. Conclusions: Surufatinib + MDT exhibited promising efficacy and manageable toxicity in pts with advanced neuroendocrine tumors. Now and in the future, it is necessary to design regulatory changes in telehealth adoption for clinical trial design in the pandemic era. Clinical trial identification: ChiCTR2100049999. Legal entity responsible for the study: The authors. Funding: Hutchison MediPharma Limited. Disclosure: All authors have declared no conflicts of interest.
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The COVID-19 pandemic disrupted medical care and reduced access to elective procedures. While prior claims-based research has shown that patients received more conservative care, little is known about how radiation therapy (RT) ordering behavior changed during the pandemic. This study examines whether the rate at which orders for lumpectomy were followed by orders for RT changed from 2019 to 2020, and whether there were changes in the percentage of RT orders that were for hypofractionated (HF) RT, rather than conventional (CF) RT. Prior authorization order data pertaining to patients from one national organization's commercial and Medicare Advantage health plans were used to perform the analysis. Included patients were females, aged 18 to 89, who had an order for a lumpectomy in 2019 or 2020. Patients were excluded if they were not continuously enrolled in their health plan for 90 days following lumpectomy. Orders were reviewed to determine whether patients had an order for RT in the 90 days following lumpectomy. Orders were classified as HF if they were for 5 to 21 fractions, CF if they were for 28 or more fractions, and as neither if they were for other numbers of fractions. Univariate analyses were conducted using Chi-square tests, and adjusted analyses were conducted using multivariate logistic regression, controlling for patient age, urbanicity, local median income (<$40,000, $40,000-$80,000, or >$80,000), region (top four CMS regions by enrollment versus all other regions), if the designated lumpectomy facility's name implied an academic affiliation, and if the designated lumpectomy facility was a hospital. There were 4,689 patients meeting inclusion criteria in 2019 and 4,383 in 2020, for a total of 9,072. In 2019, 47.1% (2,208/4,689) of patients had an RT order following lumpectomy, versus 44.6% (1,953/4,383) in 2020, a significant difference (P=0.02). Of the patients receiving RT orders meeting the definition of HF or CF, 76.3% (1,475/1,933) of orders in 2019 were for HF, and 80.5% (1,383/1,719) of orders in 2020 were for HF, a significant difference (P<0.01). Adjusted analysis found that patients in 2020 were at significantly reduced odds (OR: 0.91;95% CI: 0.83-0.99) of receiving an order for RT following lumpectomy, and among orders meeting the definition of HF or CF, there were significantly increased odds that the order was for HF (OR: 1.29;95% CI: 1.10-1.52). Patient age, region, and receipt of an order for treatment at an academic facility were significantly associated with receipt of an order for RT. Patient age, local median income, and region were all significantly associated with whether CF versus HF RT was ordered. In the population examined, physicians were less likely to order RT following lumpectomy in 2020 than in 2019, and if they did, were more likely to order HF in 2020 than in 2019. This suggests that physician ordering became more conservative in response to the pandemic. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: In the 1990s, it was demonstrated that Black patients were less likely to receive timely treatment for Stage 3 lung cancer than White patients. While contemporary work has found racial disparities in accessing insurance, diagnostics, and treatments, we wished to explore whether patients faced disparities once in treatment. To do this, we examined whether racial disparities were observable in a 2019 cohort of Medicare Advantage beneficiaries receiving treatment for lung cancer. Methods: This retrospective, observational study used health plan claims data to identify Black and White patients aged 18 to 89 years with a Medicare Advantage health plan in calendar year 2019 who received diagnostic imaging (computed tomography or positron emission tomography) followed by lung cancer treatment (radiation therapy [RT] or surgery claims mentioning a diagnosis of lung cancer) within 90 days. Only patients treated in 2019 were considered so that the findings would reflect the state of care immediately preceding the COVID-19 pandemic. Patients were excluded if they had a history of RT or lung surgery in the year prior to the diagnostic imaging date. Other databases were used to determine cancer stage, patient demographics, comorbidities, the urbanicity and median income of patients' home ZIP code, and whether treatment was ordered by a hospital-based physician. A multivariate logistic model was used to examine the association between race and surgery, and a multivariate negative binomial model was used to examine the association between race and days to treatment (surgery or RT). Results: We identified 823 patients, 83.8% White (690), and 16.2% (133) Black. Surgery was received by 3.1% [4/133] of Black patients and 9.7% [61/690]) of White patients. Black patients received treatment on average 36.9 days after diagnosis, versus 35.1 days for White patients. Adjusted analysis did not find a significant association between race and receipt of surgery (P = 0.07) or race and days to treatment (P = 0.77). No covariate was significantly associated with receipt of surgery. Residence in a state with a higher obesity rate was associated with fewer days to treatment (P = 0.02). Conclusions: In a uniformly insured population that successfully received treatment, adjusted analysis found no evidence of a Black / White racial disparity in use of lung surgery for Stage 3 lung cancer or in timeliness of treatment. Given the directionality of the findings, they could potentially have been significant if the sample size had been increased by extending the enrollment period. The implication of these findings is that it may be most fruitful to address racial disparities at the frontend of the care process;working to ensure that patients have access to insurance, diagnostics, and treatments, as disparities were not observed in a population that had accessed treatment. Further research is needed to assess whether racial disparities in lung cancer treatment have dissipated over time.
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The COVID-19 outbreak was initially reported in Wuhan, China, and it has been declared a Public Health Emergency of International Concern (PHEIC) on January 30, 2020 by WHO. It has now spread to over 180 countries and has gradually evolved into a world-wide pandemic, endangering the state of global public health and becoming a serious threat to the global community. To combat and prevent the spread of the disease, all individuals should be well-informed of the rapidly changing state of COVID-19. To accomplish this objective, I have built a website to analyze and deliver the latest state of the disease and relevant analytical insights. The website is designed to cater to the general audience and aims to communicate insights through various straightforward and concise data visualizations that are supported by sound statistical methods, accurate data modeling, state-of-the-art natural language processing techniques, and reliable data sources. This paper discusses the major methodologies, which are utilized to generate the insights displayed on the website, which include an automatic data ingestion pipeline, normalization techniques, moving average computation, ARIMA time-series forecasting, and logistic regression models. In addition, the paper highlights key discoveries that have been derived with regard to COVID-19 using the methodologies. © Authors.
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While different crowdsourcing platforms promote remote data collection, experiments in the immersive Virtual Reality (iVR) research community are predominantly performed in person. The COVID-19 pandemic, however, has forced researchers in different disciplines, including iVR, to seriously consider remote studies. In this paper, we present a remote study using the Immersive Virtual Alimentation and Nutrition (IVAN) application, designed to educate users about food-energy density and portion size control. We report on the results of a remote experiment with 45 users using the IVAN app. In IVAN, users actively construct knowledge about energy density by manipulating virtual food items, and explore the concept of portion size control through hypothesis testing and assembling virtual meals in iVR. To explore the feasibility of conducting remote iVR studies using an interactive health-related application for nutrition education, two conditions were devised (interactive vs. passive). The results demonstrate the feasibility of conducting remote iVR studies using health-related applications. Furthermore, the results also indicate that regardless of level of interactivity learners significantly improved their knowledge about portion size control after using the IVAN (p < 0.0001). Adding interactivity, however, suggests that the perceived learning experience of users could be partially affected. Learners reported significantly higher scores for immediacy of control in the interactive condition compared to those in the passive condition (p < 0.05). This study demonstrates the feasibility of conducting an unsupervised remote iVR experiment using a complex and interactive health-related iVR app. Copyright © 2022 Sajjadi, Edwards, Zhao, Fatemi, Long, Klippel and Masterson.
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The urban epidemics of the late nineteenth century shaped housing policies into the 1970‘s and provided better housing outcomes for many. Recent decades, with different policy settings prevailing, have seen rising levels of homelessness, burgeoning queues for social housing and a pervasive crisis of housing affordability for younger people. Tax and other policies that encouraged investment in housing for capital gain have diverted national savings into higher housing costs and debts. Major shifts in wealth have been driven by gains from ‘rentier’ rather than ‘entrepreneurial’ behaviours. Rising house prices and rents have had significant, negative, productivity effects and induced housing outcomes that have reduced labour productivity. Productivity and wellbeing, for the majority, have been eroded by high, and rising, housing and land costs. Covid-19 has revealed the cracks in advanced economy housing systems that policies ignored after the GFC. The housing consequences of Covid-19 have already needed urgent actions for homeless and poorer, overcrowded households. The role of housing in recovery stimulus investment programmes urgently needs a new analytical lens recognising the productivity effects identified in PIN research. The consequences of working at home and the future pandemic risks of present structures of dwellings and cities and the ‘scarring’ effects of economic effects of Covid-19 in poorer communities and neighbourhoods raise new challenges. At the same time metropolitan and national governments need to construct housing policy missions for change that will refocus housing on promoting wellbeing and raising labour productivity over the decade ahead. © Philip McCann and Tim Vorley 2021.
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Emerging economies are striving to realize their potential for sustainable production in achieving zero-carbon agenda. Due to natural resource constraints, businesses must focus on green production resources to develop the circular economy. Therefore, this study aims to identify the key role of green financing and logistics in adopting sustainable production and circular economy. We have collected the data from 240 respondents from the Chinese manufacturing sector following the COVID-19 peak in late 2020 and analyzed using structural equation modeling. As per research findings, green financing and green logistics have a significant and positive effect on sustainable production and the circular economy. Second, sustainable production has a significant positive influence on the circular economy. Manifestly, sustainable production was discovered to play an important mediating role among these variables. Besides, the novel Importance-performance map analysis shows each constructs performance and importance value towards the circular economy. This paper contributed to the literature and highlighted the importance of each construct. Moreover, the study findings implied that green financing and green logistics should be integrated into organizational procuring and financing strategies for manufacturing green and sustainable goods, and advancing the circular economy goals.