Clinical characteristics and risk factors of patients with COVID-19 developing barotrauma

Background: At our hospital, people with COVID-19 (coronavirus disease 2019) had a high rate of pulmonary barotrauma. Therefore, the current study looked at barotrauma in COVID-19 patients getting invasive and non-invasive positive pressure ventilation to assess its prevalence, clinical results, and features. Methodology: Our retrospective cohort study comprised of adult COVID-19 pneumonia patients who visited our tertiary care hospital between April 2020 and September 2021 and developed barotrauma. Result(s): Sixty-eight patients were included in this study. Subcutaneous emphysema was the most frequent type of barotrauma, reported at 67.6%;pneumomediastinum, reported at 61.8%;pneumothorax, reported at 47.1%. The most frequent device associated with barotrauma was CPAP (51.5%). Among the 68 patients, 27.9% were discharged without supplemental oxygen, while 4.4% were discharged on oxygen. 76.5% of the patients expired because of COVID pneumonia and its complications. In addition, 38.2% of the patients required invasive mechanical breathing, and 77.9% of the patients were admitted to the ICU. Conclusion(s): Barotrauma in COVID-19 can pose a serious risk factor leading to mortality. Also, using CPAP was linked to a higher risk of barotrauma.Copyright © 2021 Muslim OT et al.

Students' employability confidence in COVID-19 pandemic: role of career anxiety and perceived distress

Purpose: The present research aims to investigate the impact of "COVID-19 phobia” factors (psychological, social, economic and psychosomatic) on career anxiety and perceived distress. Further, this research assesses whether career anxiety and perceived distress foster or diminish students' employability confidence. Design/methodology/approach: "Partial Least Squares Structural Equation Modeling (PLS-SEM)” has been used to analyze the data. Findings: The results depict that factors (psychological, economic and psychosomatic) are positively and significantly associated with career anxiety and perceived distress. However, social factors indicate an adverse impact on perceived distress. Further, career anxiety and perceived distress positively influence employability confidence, but the associations are not highly impactful. Originality/value: This research elucidates an unexplored phenomenon in the context of a developing country that coronavirus disease 2019 (COVID-19) phobia scale (i.e. psychological, social, economic and psychosomatic) result in career anxiety and distress. Moreover, no studies highlighted the direct impact of career anxiety and perceived distress on employability confidence. © 2023, Emerald Publishing Limited.

Performance of sectoral Islamic indices during COVID-19

This study examines the impact of oil prices, world uncertainty and pandemic uncertainty on sectoral Islamic stocks (financial, healthcare, industrial, oil and gas, the technology sector, the telecommunications sector and the utility sector). This study employs quantile-on-quantile regression and wavelet-based Granger causality ranging from 1996Q1 to 2020Q4. The findings of the study confirm the overall negative effect of world oil prices, world uncertainty and the world pandemic uncertainty index on all the sectoral Islamic indices except the technology and telecommunication sectors. We find that world oil prices, world uncertainty and the world pandemic uncertainty index positively affect the technology and telecommunications sectors. However, the relationship between the proposed variables varies over the quantiles, depicting the heterogeneous response of financial markets due to various states of the economy. This study has policy implications related to sectoral Islamic indices;policies should be based on the sectoral performance of Islamic indices rather than the overall index because of the heterogeneous performance of various sectors. Copyright © 2022 Inderscience Enterprises Ltd.

The impact of sudden public events and fiscal policy relief on the financing constraints of small and medium enterprises: a quasi-natural experiment during COVID-19

Using data on Chinese GEM-listed companies from the first quarter of 2018 to the second quarter of 2022, we examine the impact of COVID-19 on SMEs' financing constraints and the moderating effect of fiscal and tax incentives using the difference-in-differences method (DID). The results indicate that the COVID-19 shock severely affected SMEs' financing constraints, and this effect is more pronounced among firms in industries particularly sensitive to COVID-19, such as transportation, catering, accommodation, culture, and entertainment. A further analysis shows that tax incentives and fiscal subsidies have differing moderating effects, with the former alleviating SMEs' financing constraints and the latter having only a relatively limited effect. This finding provides direct micro-level evidence for understanding the impact of COVID-19 on financing constraints and provides insights for promoting the optimization of fiscal support policies for SMEs. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Forecasting the volatility of precious metals prices with global economic policy uncertainty in pre and during the COVID-19 period: Novel evidence from the GARCH-MIDAS approach

Economic policy is a major determinant of investment and financial decisions;Moreover, prices of precious metals are highly influenced by any uncertainty recorded in the global economic policy. Therefore, the prime consideration of the authors is to assess how global economic policy uncertainty influences the volatility of precious metals prices;particularly "gold, palladium, platinum, and silver” in the pre and during the COVID-19 pandemic. This research analyzed the full sample period (the 1997–2022), pre-COVID period (1997–2019), and during the COVID period (2020−2022) to evaluate the impact during different sample periods. Therefore, the GARCH-MIDAS approach is employed at the data set of different frequencies, i.e., monthly data of GEPU and daily data of precious metals. The results reveal a significant nexus between global GEPU and precious metals price volatility. The findings infer that any uncertainty recorded in global economic policy escalate the price volatility of gold, palladium, platinum, and silver prices. The present study increments the existing literature and provides insights for future scholars, investors, and policymakers. © 2023 Elsevier B.V.

Clinical outcomes of patients treated with dexamethasone vs. methylprednisolone for severe COVID-19 pneumonia

BACKGROUND: Coronavirus Disease 19 (COVID-19) damages the lungs and may potentially culminate in acute respiratory distress syndrome (ARDS). Several therapy strategies, including corticosteroids, have been attempted across the world with favorable results. However, the most suitable corticosteroid type and dose for COVID-19 treatment remain undefined. Therefore, we performed a study to retrospectively compare the efficacy of two popular corticosteroid therapies: dexamethasone and methylprednisolone, in treating severe COVID-19 pneumonia. METHODS: This observational retrospective cohort analysis comprised 1001 patients diagnosed with an established diagnosis of severe COVID-19 pneumonia who were hospitalized to a tertiary care hospital, Dr. Ziauddin Hospital North Nazimabad, Karachi, Pakistan, from April 2020 through February 2021. RESULTS: Between the two study groups, no significant difference was reported in patient mortality. A significantly higher percentage of MTP patients required admission to the ICU (194 (33.0%) vs. 89 (21.5%);P- < 0.001). Patients in the DXM group had significantly lower chances of being admitted to the ICU (OR: 0.419, 95% CI: 0.273-0.642;P- < 0.001), supported by a significantly lower risk of the need of ICU admission (HR 0.538, 95% CI: 0.383-0.755;P- < 0.001). Additionally, on Kaplan-Meier analysis, the DXM group patients received discharge from the hospital significantly earlier (6.83 vs. 8.20 days;Log Rank P-0.003) and required ICU admission much later (5.01 vs. 2.40 days;Log Rank P- < 0.001). CONCLUSION: Dexamethasone was found to have a significant reduction in the need for intensive care unit admission as well as early hospital discharge.

Association of Chest X- ray findings with SARS-CoV-2 severity

Background: The COVID-19 first surfaced when cluster of pneumonia patients arose in Wuhan, Hubei Province, China. Although the current gold standard for COVID-19 diagnosis is reverse transcriptase-polymerase chain reaction (RT-PCR), chest x-ray (CXR) and computed tomography (CT) play a vital role in sickness diagnosis due to their limited sensitivity and availability. Aim: To evaluate retrospectively the role of CXR, the main radiological findings in it and its diagnostic accuracy in COVID-19 pneumonia. Methods: This is a cross sectional study involving 264 PCR positive COVID-19 patients with their clinical-epidemiological findings admitted at Ziauddin Hospital from May-July 2020. CXRs were taken as digital radiographs in our emergency department's isolation wards using the same portable X-ray device, according to local norms. CXRs were taken in two directions: antero-posterior (AP) and postero-anterior (PA). The hospitals' database had all of the images. To determine the number of radiological findings, multiple radiologists on duty completed an independent and retrospective examination of each CXR. In the event of disagreement, a mutual agreement was reached. SPSS version 20 was used for statistical analysis. Results: We were able to find 264 patients who met our criteria. With a mean age of 56.4214.89, the majority of individuals were determined to be males 189(71.6%) and females 75(28.4%). (Range of 16 to 87 years). 127 patients (48.1%) had severe illness symptoms and were admitted to the ICU, while the remaining 102(38.6%) had mild to moderate disease 35(13.3%). Diffuse (29.2%) and middle and lower co-existing distribution (25.8%) whereas just lower lobe (13.3%) were the most common predominance in severity. Peripheral involvement was also seen in (8.7%) cases. Conclusion: Both lungs are equally affected with the disease having the consolidation and opacifications while the effusion is the major complication in the severe cases. Diffuse involvement of the lung lobes is seen in the study followed by the middle and lower lobe involvement.

Google Trends and cryptocurrencies: a nonparametric causality-in-quantiles analysis

Purpose: This article aims to uncover the impact of Google Trends on cryptocurrency markets beyond Bitcoin during the time of increased attention to altcoins, especially during the COVID-19 pandemic. Design/methodology/approach: This paper analyses the nexus among the Google Trends and six cryptocurrencies, namely Bitcoin, New Economy Movement (NEM), Dash, Ethereum, Ripple and Litecoin by utilizing the causality-in-quantiles technique on data comprised of the years January 2016–March 2021. Findings: The findings show that Google Trends cause the Litecoin, Bitcoin, Ripple, Ethereum and NEM prices at majority of the quantiles except for Dash. Originality/value: The findings will help investors to develop more in-depth understanding of impact of Google Trends on cryptocurrency prices and build successful trading strategies in a more matured digital assets ecosystem. © 2022, Emerald Publishing Limited.

E-learning in higher education during COVID-19: evidence from blackboard learning system

Purpose: The blackboard learning system is an online platform designed for e-learning employed by higher education institutes like universities that facilities students to continue learning and educational activities. This study explores the determinants that affect students' acceptance and use of Blackboard learning system (BLS) in Pakistan utilizing the modified UTAUT framework with social isolation as an additional variable. Design/methodology/approach: A questionnaire survey was conducted, and the study gathered 494 university students' responses in Pakistan as participants. The collected data were interpreted applying PLS-SEM version 3.2.3 software. Findings: The study's findings exhibited that PE, EE, FC and SI are the prime determinants influencing the intention and use of BLS in Pakistani universities. Hedonic motivation and social isolation interact differently between UTAUT variables and use intention. The results verify the suitability of the applied theory in the background of the study. Research limitations/implications: However, the findings highlight the present understanding of BLS use from the learners' aspect, but the study's limitation cannot be evaded. The study respondents belonged to a specific region of Pakistan (Karachi) that might influence the usefulness of the outcomes. Other factors categorized as the environmental, system and organizational elements were not part of the study that may also differentiate the BLS acceptance. The model was extended by including the social isolation, but the effect is insignificant yet positive;therefore, it is required to evaluate the model differently, such as the organizational aspect, for future research. Moreover, the ethnic factors that vary in emerging and developed economies may provide different explanations;therefore, they can be incorporated in future studies. Likewise, the variables such as hedonic motivation need to be emphasized more by examining and evaluating its effect on students' education performance in the future. Practical implications: The outcome of the study suggests some implications. At first, being the modified framework UTAUT2 application makes the collaboration appropriate according to the current phenomena of the COVID-19 pandemic and its contribution to the higher education region to analyze the acceptance of e-learning systems. Educational institutions within Pakistan would emphasize enhancing students' accomplishment by improving the interface and the blackboard learning system workability. Hence, learners' effectiveness in learning would be escalated;they would be encouraged to accomplish study objectives using BLS, particularly when they consider it easy to use and a useful platform for e-learning during the pandemic. Furthermore, enhancing the e-learning system in the context of the effort demands to be required to utilize BLS should be the foremost objective as learners would be motivated to accept the technology if they consider it simple, convenient, and user-friendly to adopt. Thus, the benefits of using BLS during this situation when universities are not operational will make students adaptable to change in the prospect. Learners will accept the model of online education, even if the universities become operational. However, it can increase the rate of earnings and revenue for universities as they can enroll in online and regular classes. Therefore, it is suggested that higher education management should create a resilient online platform by which facilitators can communicate with learners without any obstacles. Social implications: Hence, it is recommended to introduce the online short course, qualification, certified courses and integrated coursework with international ventures and ongoing classes. Numerous learners continue their studies along with the job. Therefore, it is suggested to introduce online programs for those learners. Another benefit would be that it offers an integrated platform for sharing knowledge. BLS offers to maintain the complete information in one place, and learners can see them as per hei convenience based on their availability. This reduces the burden on administration related to keeping the educational material and resource in various files. Thus, it also reduces the expense of universities. It is suggested to emphasize encouraging the use of BLS through an effective plan that can assist in execution and help learners identify the technology features rather than to face difficultly to accept the change. Moreover, the acceptance of BLS for educational purposes verifies that other learning events can occur on the online platform. Thus, it is recommended to promote the origin of the online atmosphere and the initiation of other events. Globally, dynamics are changing frequently and continuously and are moving towards artificial intelligence systems;the circumstances are suitable for promoting online educational platforms' acceptance by incorporating it with the current educational arrangement. Originality/value: The study provides recommendations for the research to be conducted to explore the modified framework in different regions and boundaries to evaluate the effect of other factors on adopting e-learning platforms. © 2021, Emerald Publishing Limited.

Psychological distress among students of higher education due to e-learning crackup: moderating role of university support

Purpose: The emergence of electronic learning during the COVID-19 outbreak has been the way by which higher education has attempted to save the situation. However, e-learning still causes psychological distress because of its crackups and fear. Hence, the authors aim to study the impact of e-learning crackup on fear of academic year loss and psychological distress by incorporating university support as a moderator. Design/methodology/approach: Partial least squares structural equation modeling (PLS-SEM) has been used to analyze data. Findings: The results depict that e-learning crackup fosters students' fear of academic year loss, but e-learning crackup has an insignificant impact on psychological distress. However, psychological distress is driven by fear of an academic year loss. Lastly, university support moderates the relationship between e-learning crackup and psychological distress, but no moderating role exists between fear of academic year loss and psychological distress. Originality/value: The recent pandemic has severely affected the mental health of students. Therefore, it is crucial to study the reasons that foster distress among them. But, unfortunately, there is a prominent absence of research for inspecting students' psychological distress because of the e-learning crisis, especially in the wake of COVID-19. © 2021, Emerald Publishing Limited.

Corona fear and e-commerce adoption in an emerging economy: paradigm shift of consumer intention

Purpose: The lockdown in the spring of 2020 significantly disrupted businesses. Unquestionably, countless dealers who had to shut their shops for weeks were hit hardest by the crisis. Similarly, consumers also face many difficulties, especially in emerging economies. At this time, e-commerce is the only available option that people can use to fulfill their needs. In developing states, people prefer to buy things from shops. Hence, it raises a concern about whether people will adopt e-commerce in the COVID-19 pandemic. The study aims to examine the consumers’ intention to adopt e-commerce by incorporating corona fear as a moderator. Design/methodology/approach: The statistical techniques applied to the data set were confirmatory factor analysis and partial least square structural equation modeling. Findings: The findings depict that perceived usefulness, perceived ease of use, subjective norms, perceived lack of alternatives are positively and significantly connected with the intention to adopt e-commerce. However, perceived risk, perceived behavioral control and attitude have a positive but insignificant effect. Additionally, moderating analysis results depict that corona fear moderates the associations between perceived risk, perceived usefulness, subjective norms and attitude. However, no moderating effect is found in perceived ease of use and perceived behavioral control. Originality/value: The present research is the initial attempt that analyzes consumers’ intention to accept e-commerce during the corona pandemic in a country like Pakistan, where the trend of physical shopping is more favorable among consumers. Also, it includes the moderating role of corona fear to understand how this fear has shaped the consumers’ intention to shop online? Additionally, the technology acceptance model framework is expanded by including perceived risk and perceived lack of alternatives in the research model. © 2021, Emerald Publishing Limited.

Exploring the implications of the first COVID-19 lockdown on patients with melanoma: a national survey.

The impact of the COVID-19 pandemic upon care of malignant melanoma (MM) remains as yet poorly understood. We undertook a UK-wide national survey, in conjunction with a patient support group (Melanoma UK), to explore patient perceptions of the impact of the pandemic upon treatment and outpatient care of their MM. Our findings suggest that following the onset of COVID-19, a significant minority of treatments and appointments have been delayed, there has been a shift from face-to-face to virtual outpatient consultations and there may be a rise in psychological comorbidities in patients with MM. We would urge clinicians to consider mental health interventions as part of a holistic care package.

Individual-Level Determinants of Lifestyle Behavioral Changes during COVID-19 Lockdown in the United States: Results of an Online Survey

This study examined individual-level determinants of self-reported changes in healthy (diet and physical activity) and addictive (alcohol use, smoking, and vaping) lifestyle behaviors during the initial COVID-19 lockdown period in the USA. A national online survey was administered between May and June 2020 that targeted a representative U.S. sample and yielded data from 1276 respondents, including 58% male and 50% racial/ethnic minorities. We used univariate and multivariable linear regression models to examine the associations of sociodemographic, mental health, and behavioral determinants with self-reported changes in lifestyle behaviors. Some study participants reported increases in healthy lifestyle behaviors since the pandemic (i.e., 36% increased healthy eating behaviors, and 33% increased physical activity). However, they also reported increases in addictive lifestyle behaviors including alcohol use (40%), tobacco use (41%), and vaping (46%). With regard to individual-level determinants, individuals who reported adhering to social distancing guidelines were also more likely to report increases in healthy lifestyle behaviors (beta = 0.12, 95% CI 0.04 to 0.21). Conversely, women (beta = -0.37, 95% CI -0.62 to -0.12), and unemployed individuals (beta = -0.33, 95% CI -0.64 to -0.02) were less likely to report increases in healthy lifestyle behaviors. In addition, individuals reporting anxiety were more likely to report increases in addictive behaviors (beta = 0.26, 95% CI 0.09 to 0.43). Taken together, these findings suggest that women and unemployed individuals may benefit from interventions targeting diet and physical activity, and that individuals reporting anxiety may benefit from interventions targeting smoking and alcohol cessation to address lifestyle changes during the pandemic.