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This conceptual paper examines voluntary versus mandatory cloud-based training, generating recommendations to harmonise the complementarity of face-to-face and online media in future careers. Technological change was already accelerating when the COVID-19 pandemic response turbocharged transformations of knowledge dissemination in training, thus impacting learning and competency development for the future. The methodology applies comprehensive, structured literature review following PRISMA guidelines with development of a novel conceptual framework illuminating facets of knowledge dissemination. Exploring the context of workplace training and the future of careers with aid of NVivo it was found that altered social cues in cloud training are generating changes in learner attention span, engagement, and peer-to-peer interaction, potentially increasing contract cheating. It is hence recommended that stakeholders demarcate theoretical and practical learning outcomes to develop hybrid cloud media and face-to-face knowledge dissemination to accentuate professional accreditation requirements, engagement and etiquette in virtual spaces, and improve understanding of work-home balance.
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Purpose: Emerging technologies have the capacity to transform industries offering substantial benefits to users. Given the increasing demand for advanced logistics services, third-party logistic service providers (LSPs) face greater pressure to deploy and realise these technologies, especially given the demands and operational challenges created during the COVID-19 crisis. Drawing upon the diffusion of innovation (DOI) theory and technology–organisation–environment (TOE) framework, this paper goes beyond just identifying drivers and barriers to technology adoption to understanding how LSPs and industry experts perceive these drivers and barriers and simultaneously confront and undertake actions to implement them. Design/methodology/approach: An exploratory study was conducted in three phases: (1) in-depth interviews with twelve stakeholders in the Australian logistics industry;(2) five in-depth interviews conducted with stakeholders during the COVID-19 crisis and (3) a focus group discussion session. All interviews were analysed using content analysis and revealed several drivers for the deployment of emerging technologies, including internal organisational factors that drive supply chain (SC) network optimisation. Findings: The analysis of the three phases identified several drivers for the deployment of emerging technologies in logistics, including internal organisational factors that drive SC network optimisation. Also identified were external drivers including the impact of the COVID-19 crisis, along with barriers and specific actions that were considered and implemented by LSPs for sustainable operations, particularly in a post-COVID-19 environment. Originality/value: This study explores organisational and industry drivers for the implementation of emerging technologies. Explicitly, it extends the extant research by highlighting organisational and industry drivers and enablers that influence adoption and deployment of emerging technologies. Second, it advances the existing perspectives on LSPs in the Australian context on the development and implementation of technology strategies. The paper offers insights around implementation of technologies, directly obtained from industrial application for managers and practitioners. © 2023, Emerald Publishing Limited.
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Introduction COVID-19 has been shown to disproportionately affect patients with metabolic syndrome-associated conditions. Although a few small studies have reported an increased frequency of severe COVID-19 infection in patients with NAFLD, little is known regarding the factors portending adverse outcomes in this group. Given the high and rising prevalence of NAFLD, it is important to identify the predictors of adverse outcomes in this diverse group of patients which was the aim of our study. Study Design We retrospectively studied patients with NAFLD diagnosed with COVID-19 at Community Medical Centers in Fresno, California between March 1 and September 30, 2020. Baseline demographics, medications, laboratory values during COVID-19, and baseline liver fibrosis scores prior to admission along with measured outcomes of severity were collected. Scores studied were NAFLD Fibrosis Score (NFS), AST to Platelet Ratio Index (APRI), fibrosis-4 (FIB-4), and MELD-Na. To assess correlations and associations, Chi-square tests, Independent sample t-tests and Pearson correlation testing were used. Results Patients over 18 years of age with NAFLD and PCR-confirmed COVID-19 were included in the study (n=298). Demographics: 71% Hispanic, 52% male, 72% government insurance, mean age 55 years. Outcomes: 83% hospitalized, 74% required supplemental oxygen, 30% required non-invasive positive pressure ventilation (NIPPV), 25% admitted to the intensive care unit (ICU), 15% required intubation and 13% required vasopressors. COVID-19 related mortality rate was 14%. Risk factors for adverse outcomes: Peak AST, ALT, and total bilirubin levels during COVID-19 had statistically significant positive correlations with ICU admission, intubation, and death. Albumin and platelet levels had statistically significant negative correlations with ICU admission, intubation, and death. Albumin had the strongest correlation of-0.431 to -0.497. Chronic proton pump inhibitor (PPI) use had a statistically significant positive correlation with intubation and ICU admission and chronic ACE-inhibitor use with the outcome of death. (Figure 1). Increasing baseline liver fibrosis scores (NFS, APRI, FIB-4) were associated with worse outcomes for hospitalization, oxygen requirement, NIPPV, ICU admission, intubation and death (Figure 2). Discussion Based on our study, patients with NAFLD with elevated baseline liver fibrosis scores, elevated ALT, AST, total bilirubin, and decreased albumin and platelets during COVID-19 are at a significantly elevated risk for adverse outcomes. NFS, APRI, and FIB-4 scores appeared superior to MELD-Na in predicting outcomes. Chronic PPI and ACEinhibitor use are associated with adverse outcomes, and thus should be used with caution in patients with NAFLD during COVID-19 pandemic. Clinicians should be aware of these risk factors while evaluating patients with COVID-19 and NAFLD. $Φgure
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Background: The third leading preventable cause of death in the United States is excessive alcohol use. Our study sought to assess the impact COVID-19 has had on hospitalizations for alcohol-related hepatitis at a community hospital system. We hypothesized an increase in cases of alcohol-related hepatitis requiring inpatient management in parallel with the economic strain imposed by the COVID-19 pandemic. Methods: The third leading preventable cause of death in the United States is excessive alcohol consumption. Our study sought to assess the impact of the COVID-19 on hospitalizations for alcohol-related hepatitis at a community hospital system. We hypothesized an increase in cases of alcohol-related hepatitis requiring inpatient management in parallel with the strain on the economic and societal norms imposed by the COVID-19 pandemic. Results: There was a 51% increase in the overall incidence of alcohol-related hepatitis requiring hospitalization between 2019 and 2020 (p=0.003), and 69% increase(p<0.001) after implementation of the stay-at-home orders. Additionally, 94%(p=0.028) increase in re-hospitalizations was noted in 2020 (p=0.028), a 100% increase in patients under the age of 40 (p=0.0028) as well as a trend towards a 125% increase (p=0.06) of female patients admitted with this diagnosis during the COVID-19 . Conclusion: Our study revealed drastic increases in severe alcohol-related hepatitis requiring inpatient management specifically in patients under the age of 40 and in females during the COVID-19 pandemic. Given the high morbidity and mortality associated with severe alcohol-related hepatitis, these findings have far reaching and lasting implications for our already strained healthcare system extending beyond the COVID-19 pandemic timeframe. Urgent public health interventions are needed to combat the rising misuse of alcohol and its consequences.