Colchicine anti-inflammatory therapy for non-intensive care unit hospitalized COVID-19 patients: results from a pilot open-label, randomized controlled clinical trial.

Systemic inflammation is a hallmark of severe coronavirus disease-19 (COVID-19). Anti-inflammatory therapy is considered crucial to modulate the hyperinflammatory response (cytokine storm) in hospitalized COVID-19 patients. There is currently no specific, conclusively proven, cost-efficient, and worldwide available anti-inflammatory therapy available to treat COVID-19 patients with cytokine storm. The present study aimed to investigate the treatment benefit of oral colchicine for hospitalized COVID-19 patients with suspected cytokine storm. Colchicine is an approved drug and possesses multiple anti-inflammatory mechanisms. This was a pilot, open-label randomized controlled clinical trial comparing standard of care (SOC) plus oral colchicine (colchicine arm) vs. SOC alone (control arm) in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. Colchicine treatment was initiated within first 48 hours of admission delivered at 1.5 mg loading dose, followed by 0.5 mg b.i.d. for next 6 days and 0.5 mg q.d. for the second week. A total of 96 patients were randomly allocated to the colchicine (n=48) and control groups (n=48). Both colchicine and control group patients experienced similar clinical outcomes by day 14 of hospitalization. Treatment outcome by day 14 in colchicine vs control arm: recovered and discharged alive: 36 (75.0%) vs. 37 (77.1%), remain admitted after 14-days: 4 (8.3%) vs. 5 (10.4%), ICU transferred: 4 (8.3%) vs. 3 (6.3%), and mortality: 4 (8.3%) vs. 3 (6.3%). The speed of improvement of COVID-19 acute symptoms including shortness of breath, fever, cough, the need of supplementary oxygen, and oxygen saturation level, was almost identical in the two groups. Length of hospitalization was on average 1.5 day shorter in the colchicine group. There was no evidence for a difference between the two groups in the follow-up serum levels of inflammatory biomarkers including C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), high-sensitivity troponin T (hs-TnT) and N-terminal pro b-type natriuretic peptide (NT pro-BNP). According to the results of our study, oral colchicine does not appear to show clinical benefits in non-ICU hospitalized COVID-19 patients with suspected cytokine storm. It is possible that the anti-inflammatory pathways of colchicine are not crucially involved in the pathogenesis of COVID-19.

Profit, cash flow, and leverage: the case of ASEAN stock market performance during the COVID-19 pandemic

Purpose: The coronavirus disease 2019 (COVID-19) outbreak in the first quarter of 2020 has caused a severe decline in stock markets worldwide. While prior studies in developed markets found that workplace closure can negatively impact the capital market (e.g. Ozili and Arun, 2020), lesser is known about how it impacts emerging capital markets, which may have different characteristics and behaviour (Harjoto et al., 2021). Hence, this study seeks to uncover stock performance around workplace closure dates of firms incorporated in ASEAN countries and investigates the role of accounting fundamentals in mitigating workplace closure policy's effects on stock performances. Design/methodology/approach: Using an event study methodology, the authors measure the cumulative abnormal returns (CARs) around workplace closure dates. The authors then use cross-sectional analysis to analyse whether the accounting fundamentals, specifically profitability, cash flow, and leverage, are associated with the CAR. This cross-sectional study involves 1,720 firms that are incorporated in the ASEAN countries. Findings: This analysis indicates that, on average, ASEAN capital markets react negatively to workplace closure policies. The authors then find that the CARs around workplace closure dates are positively associated with the current ratios and are negatively associated with long-term debt ratios. This study’s results thus indicate that firms with a higher liquidity and a higher solvency experience a less adverse impact of the COVID-19 pandemic than other firms. The authors also find that the associations are more robust for (1) firms in industries more affected by COVID-19 and (2) firms located in countries with more severe cases. Additionally, contrary to this study’s expectation, the authors do not find meaningful associations between CARs around workplace closure dates and firms' cash flow from operation and profit respectively. This study’s results suggest that investors view prior performances related to firms' ability to generate operating cash flow and profit as less relevant to measure firm performance around the workplace closure event. Research limitations/implications: This study’s results contribute to studies examining fundamental accounting roles during the COVID-19 era, specifically in emerging economies. The findings are critical for investors in understanding the company fundamentals associated with stock price performance in emerging markets during the recent health-related crisis. Originality/value: Most studies analysing cross-sectional differences in stock returns during the COVID-19 era focus on industry-level differences and use observations from developed markets (Sinagl, 2020;Ramelli and Wagner, 2020). Studies using firm-level analysis in emerging markets are still limited. The authors expand prior studies by using firm-level analysis that spans six countries in ASEAN. © 2022, Emerald Publishing Limited.

Challenges of Emergency Medical Teams and Deploying a Field Hospital in the Aftermath of the Beirut Blast: A Qualitative Study.

OBJECTIVE: The huge explosion that occurred at Beirut Port led to a high number of casualties. Consequently, 7 field hospitals (FHs) were deployed in Lebanon. The purpose of this study is to explore the challenges that emergency medical teams (EMTs) faced and explain the gaps at the national level related to deploying a FH. METHODS: A qualitative study was conducted. To collect the data, semi-structured interviews were done with 8 key informants (5 from the FHs, 2 from Lebanese Army Forces, and 1 from Ministry of Public Health). In this study, purposive sampling was used and data were analyzed using Braun and Clarke (2006) thematic analysis and MAXQDA software. RESULTS: Three major themes (logistical challenges, staff challenges, and coronavirus disease [COVID-19] pandemic) and 10 subthemes emerged for the challenges that EMTs faced. The gaps at the national level were categorized into 2 themes (absence of needs-based response and limited effective coordination between the host country and donor countries) and 5 sub-themes. CONCLUSION: Lebanon focuses on response rather than preparedness for disasters. EMTs that arrived didn't meet the medical needs. Hence, there is a need to strengthen the national capacities and to ensure better communication and coordination between the disaster-affected country and the EMTs.

DETECTION OF COVID-19 (SARS-COV-2) AND THEIR VIRULENCE FACTOR ORF8 GENE AMONG PATIENTS IN THI-QAR PROVINCE, IRAQ

Covid-19 viral (SARS-CoV-2) infection evolved very rapidly to spreading geographically to become a global pandemic as declared by World Health Organization (WHO) within the first months of 2020. Viral respiratory infection such as severe acute coronavirus-2 disease (SARS-CoV-2), bacterial co-infections commonly are identified and are a major cause of morbidity and mortality requiring prompt and antibacterial diagnosis. Specimens were collected from 100 patients were included 68 male and 32 female with age ranged between 16 -85 years for the period from the beginning of October 2020 to the end of March 2021. Naso-oropharyngeal swabs were collected from each person with symptoms according to the WHO guideline for SARS Cov2. The results of the viral mutations showed the open reading frame 8 (ORF8) of SARS-CoV-2. The sequences were obtained from seven patients infected with SARS-CoV-2 by PCR using ORF8 specific primer. The amplified fragment of ORF8 was 366 bp. The nucleotide sequences of the seven open reading frames of ORF8 of SARS-CoV-2 were submitted in the GenBank under the accession numbers: MZ025969- MZ025975. The results of phylogenetic tree appeared that categorize of the seven ORF8 nucleotide sequences into three clades. SARS-CoV-2 ORF8 represents a major component in determining the viral pathogenicity and the outcome of the respiratory disease, and coding sequence analysis of this segment might help in track variants evolution in any location. General understanding of how SARS-CoV-2 mutations contribute to make disease progression is extremely critical not only for understanding of SARS-CoV-2 pathogenesis but also for SARS-CoV-2 vaccine development.

Ready, trainer horizontal ellipsis one*! discovering the entanglement of adaptive learning with virtual reality in industrial training: a case study

In response to the industrial world becoming more complex and the recent social distancing caused by the COVID-19 outbreak, emerging technologies such as Virtual Reality (VR) are gaining importance for industrial training. The novelty, however, does not lie in the sole use of VR-based technology but rather in its adaptive and flexible nature. This paper explores the synergy between VR environments and adaptive-based learning and tests the proposed approach in the railway sector. An iterative co-design approach is adopted to develop a VR-based training system for educating train conductors. The developed system is validated with ten conductors, where their learning preference, learning outcome, and learning performance were assessed. The results show an increase in individual motivation and perceived usefulness for the developed VR-based training system, demonstrating a higher learning preference, in comparison to the currently used physical simulator. Similarly, the results outline a knowledge gain in two out of six key knowledge subjects for conductor education and indicate that time improvements per exercise are needed to meet organizational performance goals. Consequently, this research presents an attractive alternative to costly and product-specific physical simulators and offers three strategic managerial implications opening new opportunities for using VR in developing learning training programmes.