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Although low-carbon economic growth has been emphasized in both the Paris Agreement and the Sustainable Development Goals, this is the first study to examine the interplay between oil consumption, urbanization, and economic growth in India's GHG emissions from 1965 to 2021. A quantile regression analysis found that a one percent rise in greenhouse gas emissions is linked to a 0.34 percent rise in economic growth, a 0.599 percent rise in oil consumption, and a 0.28 percent drop in urbanization. Using the Granger causality technique, researchers found that CO2 emissions cause economic development and urbanization in only one direction. On the other hand, oil consumption only has a one-way influence on carbon emissions and urbanization, and economic expansion only has a one-way effect on urbanization.

Oil is among the enormously vital and most traded commodities globally, involving many forex transactions in the face of various types of shocks attributable to geopolitics, supply, demand, market crisis, etc. This study uses a systematic literature review approach to explore the Literature from the SCOPUS database considering the relationship between oil prices and exchange rates by analyzing the papers from 1998 to 2022 and includes the final 123 papers. This study emphasizes three objectives; Literature developed so far, standard methodologies and findings, and the research gaps which can be pursued in further studies. Findings show that vast literature is developed around these variables and sub-topics in various dimensions, such as the stock market, gold prices, economic growth, etc. Research around the variables has increased in the recent past, indicating the continued relevancy of the relationship. However, it can be due to increased access to higher education and research. This study also finds the gap in the literature and has implications for the policymakers in monetary and fiscal policy planning, as well as investors across the globe in making portfolio management strategies.

Background: pertussis vaccination in pregnancy is recommended in many countries to provide protection to young infants. The best timing for this vaccination is uncertain. In the UK, vaccination is recommended between 16 weeks and 32 weeks of gestation. In this trial we aimed to investigate the equivalence of three time periods for pertussis vaccination in pregnancy.Methods: in this open-label, equivalence, randomised controlled trial to investigate equivalence of different time windows for pertussis vaccination in pregnancy, participants were randomly assigned (1:1:1 ratio) to receive a pertussis-containing vaccine (Boostrix-inactivated poliovirus vaccine) in one of three gestational age groups, comprising group 1 (≤23 weeks + 6 days), group 2 (24-27 weeks + 6 days), and group 3 (28-31 weeks + 6 days) using a computer-generated randomisation list. The primary outcome was concentration of pertussis-specific antibodies in the infant born at term at birth. Maternal blood sampling was done before and 2 weeks after vaccination and at delivery, together with a cord sample, and an infant sample was collected at least 4 weeks after primary vaccination. Reactogenicity was assessed for 7 days after vaccination. This trial was registered with ClinicalTrials.gov (NCT03908164).Findings: between May 7, 2019, and Feb 13, 2020, of 1010 women assessed for eligibility, 364 women were recruited and 351 received the intervention (120 in group 1, 119 in group 2, and 112 in group 3). Equivalence of time periods was demonstrated for anti-pertussis toxin and anti-pertactin IgG concentrations. The cord blood geometric mean concentrations of anti-filamentous haemagglutinin IgG were higher with increasing gestational age at vaccination, such that for infants in group 1 (≤23 weeks + 6 days), equivalence to group 3 (28-31 weeks + 6 days) was not shown. Reported rates of fever were similar between study groups.Interpretation: pertussis vaccination at three different time intervals in pregnancy resulted in equivalent concentrations of IgG antibodies in infants against two of the three pertussis antigens assessed. Overall, these findings support recommendations to vaccinate any time between 16 weeks and 32 weeks of gestation.Funding: the Thrasher Research Fund and the National Immunisation Schedule Evaluation Consortium through the National Institute for Health and Care Research policy research programme.

Objective: To determine the clinical characteristics, management and outcomes of patients presenting with chlorine gas exposure in an emergency setting. Method: The single-centre, retrospective cross-sectional study was conducted at the emergency department of Aga Khan University Hospital, Karachi, and comprised data of all patients who presented on March 06, 2020, due to acute chlorine gas exposure after a specific industrial accident. Demographic and clinical data was recorded from the medical record files. The association between risk factors and complications was explored. Data was analysed using SPSS 20. Results: There were 51 male patients with a mean age of 33.10+8.37 years. The most commonly affected organ system was respiratory 49(96%), with 43(84.3) having shortness of breath. Eye irritation was found in 44(86.3%) cases and the central nervous system was involved in 14(27.4%). Most of the patients were admitted from the emergency department 36(70%). Regarding treatment, 1(1.9%) patient each required invasive and non-invasive mechanical ventilation. Complications included toxic pneumonitis 3(5.9%) and pneumomediastinum 1(1.7%). No correlation was found between smoking and complications (p>0.05). Conclusion: Most patients showed complete resolution of symptoms after receiving supportive treatment, while complications was rare and there was no mortality. Key Words: Chlorine gas, HAZMAT incident, Emergency department.

A 31-year-old Caucasian woman underwent a standard workup as a potential kidney transplant donor. Kidney donor protocol CT showed a left para-aortic hypervascular mass suspicious for a paraganglioma. Biochemical workup revealed elevated urinary catecholamines, supporting this suspicion. The patient underwent surgical resection with histopathological evaluation that confirmed the diagnosis. Endocrine evaluation 2 years later revealed a family history of a cousin with a history of pheochromocytoma as a teenager. A genetic panel identified a missense mutation in succinate dehydrogenase C (c.202T>C; p.Ser68Pro), which was described as a variant of unknown significance. In silico analysis suggested that it may be a deleterious mutation. We concluded that this mutation may be pathogenic, considering these supporting pieces of evidence and her early-onset paraganglioma. This report highlights the importance of genetic screening in patients with paragangliomas/pheochromocytomas, since many cases are familial. Additionally, it underscores the importance of evaluating and documenting cases of variants of unknown significance.

As the world’s largest oil exporter, Saudi Arabia faces the same pressures as any other government to expand its economy. Saudi Vision 2030 is to reduce the country’s reliance on oil exports and revenues. One of the main goals of Saudi Vision 2030 is to increase the share of GDP that does not come from oil. Dynamic autoregressive distributed lag (ARDL) cointegration is used to look at how oil exports and exports of goods other than oil affect GDP growth. The results of the dynamic ARDL simulation show that there is both long-term and short-term cointegration between the variables. The dynamic ARDL simulation tests rely on the presence of cointegration to show that a 1% increase in oil exports will boost Saudi Arabia’s economic growth by about 0.48% in the long run and 0.18% in the short run, depending on the type of time frame. In the same way, the results about non-oil exports showed that an increase in non-oil exports would boost Saudi Arabia’s economic growth by 0.26 percentage points in the long run and by 0.16 percentage points in the short run. This is a good sign of Saudi Arabia’s efforts to diversify its economy away from oil exports and make room for international investors to help the country reach its Vision 2030 goals. AcknowledgmentThis study is supported via funding from Prince Sattam bin Abdulaziz University project number (PSAU/2023/R/1444).

This research measures Saudis' environmental awareness. A survey questionnaire that was sent out electronically across the Kingdom has 21 Likert scale questions, ranging from "strongly disagree" to "strongly agree," and nine "yes" or "no" questions about activities that are good for the environment. The first part of the questionnaire used binary logistic regression, demographics, and component analysis to test possible hypotheses. All nine statements utilized for Structural Equation Modelling (SEM) in the last section were significant. The factor analysis found three. One of these characteristics revealed a significant gender response, showing that women are more open to and responsive to environmental awareness activities than men. Those who took an environmental course were 1.304 times more ecologically aware than those who did not (factor 2). Participating in campus activities makes 1.449 people more environmentally conscious. This study shows the importance of teaching males about the environment to make it more sustainable.

This study determines Oman’s most important macroeconomic factors between 1990 and 2019. The ARDL bound test findings for co-integration show that both long and short runs exist. The error-correcting mechanism further states that when the divergence from long-run equilibrium is rectified at an adaptation speed of 78.9%, it signals an inversion to a long-run stable state. In response to a change in the previous year’s economic growth, the final consumption expenditure indicates a rise of 0.472; the gross fixed capital formation and export indicate hikes of 0.149 and 0.358 at a 1% significance level. Additionally, the findings of co-integration regression using fully modified ordinary least square (FMOLS), dynamic ordinary least square (DOLS), and canonical co-integration regression (CCR) were used to strengthen and validate the results that export ranks first in Oman, followed by final consumption spending. Therefore, export, gross fixed capital formation, and final consumption expenditure are vital macroeconomic elements supporting Oman’s economic development.

To examine general risk propensity in relation to perceptions of noise, risk behaviour, and hearing loss in the general population.Participants completed an online survey using the Amazon Mechanical Turk crowdsourcing platform.The sample comprised 1274 adults from the United States.Higher general risk propensity was associated with an increased likelihood to engage in noise-risk behaviours. Lower general risk propensity was associated with increased knowledge of noise risks and an increased perception of noise as risky. The frequency of self-reported exposures to hazardous noise resulted in estimated annual noise doses exceeding standard hazard limits in 40% of the surveyed population.Results revealed limited knowledge of the risks and associated health consequences of noise exposure in the general population Results of this study suggest a high rate of self-exposure to hazardous noise by the general population. Those with higher general risk propensity are more likely to engage in risky noise behaviour. Risky noise behaviour is associated with age, gender, race, ethnicity, and general risk propensity. Intervention programs to modify risky noise behaviour in the general population should focus on both increasing knowledge and establishing accurate perceptions of risk.

Background Helicobacter pylori is a key agent for causing gastric complications linked with gastric disorders. In response to infection, host cells stimulate autophagy to maintain cellular homeostasis. However, H. pylori have evolved the ability to usurp the host’s autophagic machinery. High mobility group box1 (HMGB1), an alarmin molecule is a regulator of autophagy and its expression is augmented during infection and gastric cancer. Therefore, this study aims to explore the role of glycyrrhizin (a known inhibitor of HMGB1) in autophagy during H. pylori infection. Main methods Human gastric cancer (AGS) cells were infected with the H. pylori SS1 strain and further treatment was done with glycyrrhizin. Western blot was used to examine the expression of autophagy proteins. Autophagy and lysosomal activity were monitored by fluorescence assays. A knockdown of HMGB1 was performed to verify the effect of glycyrrhizin. H. pylori infection in in vivo mice model was established and the effect of glycyrrhizin treatment was studied. Results The autophagy-lysosomal pathway was impaired due to an increase in lysosomal membrane permeabilization during H. pylori infection in AGS cells. Subsequently, glycyrrhizin treatment restored the lysosomal membrane integrity. The recovered lysosomal function enhanced autolysosome formation and concomitantly attenuated the intracellular H. pylori growth by eliminating the pathogenic niche. Additionally, glycyrrhizin treatment inhibited inflammation and improved gastric tissue damage in mice. Conclusion This study showed that inhibiting HMGB1 restored lysosomal activity to ameliorate H. pylori infection. It also demonstrated the potential of glycyrrhizin as an antibacterial agent to address the problem of antimicrobial resistance.

Abstract An important managerial challenge is understanding consumers’ reactions to stockouts of a desired product―will they stay brand loyal or switch to competing brands? We posit that consumers are more likely to prefer substitutes from the same brand when a stockout is unexpected (vs. expected). This tendency arises as consumers feel greater negative affect upon encountering an unexpected stockout, which leads them to choose alternatives that provide greater affective value to ameliorate their negative feelings. Since the brand is a relatively affect-rich attribute compared to common non-brand attributes (e.g., price and quantity), consumers facing an unexpected stockout are more likely to choose a same-brand substitute. Five studies illustrate the effect and support the process by demonstrating that unexpected stockouts do not result in brand loyalty when non-brand attributes offer greater affective value than the brand. We further show that managers systematically mispredict how consumers’ expectations of stockouts relate to brand loyalty.

To examine the causation between consumption, export, import, and economic growth for the Sultanate of Oman using yearly time series data collected from the World Bank for 2000-2018. Further, it was tested by basic statistics, the Bound test with the ARDL model, and the Granger-causality tests. The findings of the Bound test analysis indicate the presence of both long-run and short-run associations among competing variables. The ARDL Model result reflects that imports have both short-run and long-run effects, supported by the Granger Causality tests by indicating the presence of unidirectional causality import to economic growth and import to consumption. The outcome of the study revealed that import is essential for economic growth as imports can absorb foreign technology in the domestic economy that can boost the export and further act as an engine of growth. How to Cite: Khan, U., Khan, A. M., Alam, M. D., & Alkatheery,N. (2022). Causation Between Consumption, Export, Import & Economic Growth of Oman. Etikonomi, 21(1), 67-78. https://doi.org/10.15408/etk.v21i1.20034.

Background Safety of treatment for multidrug-resistant tuberculosis (MDR/RR-TB) can be an obstacle to treatment completion. Evaluate safety of longer MDR/RR-TB regimens containing bedaquiline and/or delamanid. Methods Multicentre (16 countries), prospective, observational study reporting incidence and frequency of clinically relevant adverse events of special interest (AESIs) among patients who received MDR/RR-TB treatment containing bedaquiline and/or delamanid. The AESIs were defined a priori as important events caused by bedaquiline, delamanid, linezolid, injectables, and other commonly used drugs. Occurrence of these events was also reported by exposure to the likely causative agent. Results Among 2296 patients, the most common clinically relevant AESIs were peripheral neuropathy (26.4%), electrolyte depletion (26.0%), and hearing loss (13.2%) with an incidence per 1000 person months of treatment, 1000 person-months of treatment 21.5 (95% confidence interval [CI]: 19.8–23.2), 20.7 (95% CI: 19.1–22.4), and 9.7 (95% CI: 8.6–10.8), respectively. QT interval was prolonged in 2.7% or 1.8 (95% CI: 1.4–2.3)/1000 person-months of treatment. Patients receiving injectables (N = 925) and linezolid (N = 1826) were most likely to experience events during exposure. Hearing loss, acute renal failure, or electrolyte depletion occurred in 36.8% or 72.8 (95% CI: 66.0–80.0) times/1000 person-months of injectable drug exposure. Peripheral neuropathy, optic neuritis, and/or myelosuppression occurred in 27.8% or 22.8 (95% CI: 20.9–24.8) times/1000 patient-months of linezolid exposure. Conclusions AEs often related to linezolid and injectable drugs were more common than those frequently attributed to bedaquiline and delamanid. MDR-TB treatment monitoring and drug durations should reflect expected safety profiles of drug combinations. Clinical Trials Registration NCT03259269.

Diabetic kidney disease is one of the most common microvascular complications of diabetes mellitus with consequences of diabetic nephropathy. Here we amined to evaluate the nephroprotective potential of methanolic Mentha longifolia (MML) against serotonin-induced hypoglycemia allied toxicity in the rat model of diabetes. Diabetes was induced in rats via alloxan administration and validated by blood glucose level measurement. After that, the animals were treated with serotonin and methanolic extract of Mentha longifolia. Surprisingly, serotonin treatment significantly reduced the glucose levels to hypoglycemic conditions, accompanied by impaired redox defense system, abnormal kidney histopathology, dyslipidemia, and altered level of liver toxicity markers. Interestingly these changes were rescued by the methanolic extract of M. longifolia. The present study suggests that impaired serotonin levels during diabetic conditions may accelerate hypoglycemic allied free radical-dependent abnormalities; however, medicinal plants like M. longifolia can reduce these deleterious effects by scavenging free radicals and their associated toxicity.

Recently, conversation on diversity and inclusion has been at the forefront in the media as well as the workplace. Though research has examined how diversity impacts organizational culture and decision-making, little attention has been given to how corporate diversity impacts consumers’ responses to the firm. This article establishes a link between diversity and the perceived morality of market actors. A series of studies demonstrate that greater diversity (racial, gender, or national) in a corporate team leads to perceptions of greater morality of the firm and its representatives and, as a consequence, results in more favorable consumer attitudes and behavior toward the firm. This positive effect arises because consumers perceive diverse teams as possessing higher perspective-taking abilities. Since marketplace morality is concerned with the greater good, we argue that higher perceptions of perspective-taking signal that the team will safeguard the broad interests of the community rather than serve narrow interest groups. The findings have broad implications since consumers are increasingly concerned with moral consumption. Our research suggests that diversity in the workforce is not only important for team performance and social equity but can shape consumers’ sentiments and behavior toward the firm.

OBJECTIVE/PURPOSE The aim of the study was to determine the level of interest in human papillomavirus (HPV) self-sampling as a method of cervical cancer screening in a population of women affiliated with a primary care clinic. MATERIALS AND METHODS A survey was given to women (N = 182) between the ages of 25 and 69 years attending a family medicine clinic in Edmonton, Canada. Primary outcome measures include (1) the percentage of women who feel that HPV self-sampling should be available and (2) the percentage of women who would prefer HPV self-sampling to the Pap test. Secondary outcomes include the percentage of women aware of HPV self-sampling and factors associated with a preference for HPV self-sampling using logistic regression. RESULTS Most women (84%) were up-to-date on Pap testing, and most (85%) had had postsecondary education (either completed or in progress). The percentage of the women who moderately or strongly felt that HPV self-sampling should be available was 60%; the percentage of the women who would prefer HPV self-sampling was 24%. Only 7% of the women reported being previously aware of HPV self-sampling. The factor associated with a preference for HPV self-sampling was the Pap comfort score, with an odds ratio of 1.51 (95% CI = 1.05-2.16, p = .026). CONCLUSIONS In this population of well-educated women who were mostly up-to-date on cervical screening, there was a clear interest to have the option of HPV self-sampling. It is important for cancer screening programs to take this into account, given that women are the ultimate beneficiaries of these programs.

The full well capacity (FWC) and the pinned photodiode (PPD) capacitance of four-transistor pixel in a CMOS image sensor are reported to be dependent on the potential barrier offered by transfer gate (TG). The asymmetrical TG channel potential increases the effective potential barrier, thereby increasing the FWC and decreasing the feedforward charges. At the PPD-TG interface, a potential pocket can exist, the influence of which is minimized to lower the image lag. In the presence of a potential pocket, two charge transfer potential barriers (CTPBs) are present in the charge transfer path. The combined effect of the two potential barriers is higher than the single barrier reported in the literature. The CTPB depends on the number of integrated PPD charges and influences the FWC and PPD capacitance. The improved PPD capacitance model matches well with the measurement results when the influence of potential pocket on CTPB is considered.

Helicobacter pylori a key agent for causing gastric complications is linked with peptic ulcer, gastritis, and in severe cases gastric cancer. In response to infection, host cells stimulate autophagy to maintain cellular homeostasis. However, H. pylori have evolved the ability to usurp the host’s autophagic machinery. High mobility group box1 (HMGB1), an alarmin molecule is a regulator of autophagy and its expression is augmented in gastric cancer and many other cancers. Therefore, this study aims to explore the role of glycyrrhizin (a known inhibitor of HMGB1) in autophagy during H. pylori infection. Human gastric cancer (AGS) cells were infected with H. pylori SS1 strain and further treatment was done with glycyrrhizin. Western blot was used to examine the expression levels of autophagy proteins. Autophagy and lysosomal activity were monitored by immunofluorescence. We have performed knockdown of HMGB1 to verify the effect of glycyrrhizin by siRNA transfection method. H. pylori-infection in vivo C56BL/6 mice model was established and the effect of glycyrrhizin treatment was studied. We found that the autophagy-lysosomal pathway was impaired due to a significant increase in lysosomal membrane permeabilization during H. pylori infection in AGS cells. Subsequently, glycyrrhizin treatment restored the lysosomal membrane integrity, accompanied by an increase in cathepsin B activity and reduction of ROS and inflammatory cytokine IL-8. The recovered lysosomal function enhanced autolysosome formation and concomitantly attenuated the intracellular H. pylori growth by eliminating the pathogenic niche from gastric cells. Additionally, glycyrrhizin treatment inhibited inflammation and improved gastric tissue damages in mice.

The study investigates the asymmetric and long-run impact of political stability on consumption-based carbon dioxide (CCO

Travel and tourism have glimpsed a significant and promising implication for economic development. Despite the commendatory implication of tourism, it levies a stringent environmental cost such as environmental degeneration. Hence, this study will incorporate the 18 countries out of the top 20 travel and tourism contributors to economic growth to assess the progressive correlation between tourist arrival, economic growth, energy consumption, and oil consumption on carbon emission by applying panel ARDL spanning from 1995 to 2019. The outcome of the panel ARDL reveals that both periods have witnessed that the endogenous variables have a substantial and positive impact on environmental degradation except for tourism as it indicates −0.22 and −0.48% in the long and short run, having a rate of adjustment as −0.52 toward the equilibrium. The simultaneous quantile regression reveals that in the 50 and 75 percentiles, the effect of tourism has a negative impact, which contradicts the PMG findings. These determinations suggest that the policymakers look for more manageable and environmentally sound tourism and economic growth procedures to safeguard the sustainable environment in the studied countries.

Both developed and underdeveloped economies worldwide are now more concerned than ever in respect of achieving environmental sustainability. Accordingly, the majority of the global economies have ratified several environment-related pacts to facilitate the tackling of global environment-related problems. Although these problems are assumed to be addressed using diverse mechanisms, limiting the use of fossil fuels has often been recognized as the ultimate enabler of environmental sustainability. Against this backdrop, this study aims to assess the environmental impacts associated with higher renewable energy use, controlling for economic growth and population size, in the context of the G7 and E7 countries using data from 1997 to 2018. Moreover, instead of using the traditional environmental quality proxies, this study tries to proxy environmental degradation with the load capacity factor levels of the countries of concern. The long-run associations among the study's variables are confirmed by outcomes generated from the cointegration analysis. Besides, regression analysis highlighted that integrating renewable energy into the energy systems while withdrawing from the use of fossil fuels can help to improve environmental quality by increasing the load capacity factor levels. In contrast, economic growth and population size expansion are evidenced to impose environmental quality-dampening impacts by reducing the load capacity factor levels. However, the findings, in the majority of the cases, are seen to differ across the groups of the G7 and E7 countries, especially in terms of the variations in the magnitudes of marginal environmental effects over the short and long run. Lastly, the causality analysis confirms the directions of the causal relationships among the variables of concern. Based on these results, a couple of policy interventions are recommended for improving environmental quality in the G7 and E7 countries.

The pandemic has affected the world from many different perspectives, including environmental change. This research study aims to investigate the pandemic and its associated effect on the professional environment by measuring some of the parameters that are likely to disclose the impact of the pandemic. A structural questionnaire elicits design to capture the effect of COVID-19, where 284 respondents participated and present their views on a different statement based on the Likert scale. The factor analysis reveals five factors, which were further tested by hypothesis testing and binary logistic regression-and found factors 2, 3, and 5 to be significant in both tests.

Clarity about the role of delamanid in longer regimens for multidrug-resistant TB is needed after discordant Phase IIb and Phase III randomized controlled trial results. The Phase IIb trial found that the addition of delamanid to a background regimen hastened culture conversion; the results of the Phase III trial were equivocal. We evaluated the effect of adding delamanid for 24 weeks to three-drug MDR/RR-TB regimens on two- and six-month culture conversion in the endTB observational study. We used pooled logistic regression to estimate the observational analogue of the intention-to-treat effect (aITT) adjusting for baseline confounders and to estimate the observational analogue of the per-protocol effect (aPP) using inverse probability of censoring weighting to control for time-varying confounding. At treatment initiation, 362 patients received three likely effective drugs (delamanid-free) or three likely effective drugs plus delamanid (delamanid-containing). Over 80% of patients received two to three Group A drugs (bedaquiline, linezolid, moxifloxacin/levofloxacin) in their regimen. We found no evidence the addition of delamanid to a three-drug regimen increased two-month (aITT relative risk: 0.90 (95% CI: 0.73–1.11), aPP relative risk: 0.89 (95% CI: 0.66–1.21)) or six-month culture conversion (aITT relative risk: 0.94 (95% CI: 0.84, 1.02), aPP relative risk: 0.93 (95% CI: 0.83, 1.04)). In regimens containing combinations of three likely effective, highly active anti-TB drugs the addition of delamanid had no discernible effect on culture conversion at two or six months. As the standard of care for MDR/RR-TB treatment becomes more potent, it may become increasingly difficult to detect the benefit of adding a single agent to standard of care MDR/RR-TB regimens. Novel approaches like those implemented may help account for background regimens and establish effectiveness of new chemical entities.

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.

Objective People with diabetes have a higher risk of suicidal behaviors than the general population. However, few studies have focused on understanding this relationship. We investigated risk factors and predicted suicide attempts in people with diabetes using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. Method Data was retrieved from Cerner Real-World Data™ and included over 3 million diabetes patients in the study. Least absolute shrinkage and selection operator regression was applied to identify associated factors. Gender-, diabetes-type-, and depression-specific LASSO regression models were analyzed. Results There were 7764 subjects diagnosed with suicide attempts with an average age of 45. We found risk factors for suicide attempts in diabetes patients, such as being an American Indian or Alaska Native ([Formula: see text] = 0.637), atypical agents ([Formula: see text] = 0.704), benzodiazepines ([Formula: see text] = 0.784), and antihistamines ([Formula: see text] = 0.528). Amyotrophy had a negative coefficient for suicide attempts in males with diabetes ([Formula: see text] = −2.025); in contrast, it had a positive coefficient in females with diabetes ([Formula: see text] = 3.339). Using MAOI had a negative coefficient for suicide attempts in T1DM patients ([Formula: see text] = −7.304). Aged less than 20 had a positive coefficient for suicide attempts in depressed ([Formula: see text] = 2.093) and non-depressed patients with diabetes ([Formula: see text] = 1.497). The LASSO model had 94.4% AUC and 87.4% F1 score. Conclusions To our knowledge, this is the first study using LASSO regression to identify risk factors for suicide attempts and diabetes. The shrinkage technique successfully reduced the number of variables in the model to improve overfitting. Further research is needed to study cause-and-effect relationships. The results may help providers identify high-risk groups of suicide attempters among diabetes patients.

There is no validated framework to evaluate health information technology (HIT) for diabetes self-management education and support (DSMES). AADE7 Self-Care Behaviors is a patient-centered DSMES designed by the American Association of Diabetes Educators (AADE). We developed a codebook based on the AADE7 Self-Care Behaviors principles as an evaluation framework. In this commentary, we demonstrate the real-life applications of this codebook through three diabetes research studies. The first study analyzed features of mobile diabetes applications. The second study evaluated provider documentation patterns in electronic health records (EHRs) to deliver ongoing patient-centered DSMES. The third study analyzed feedback messages from diabetes apps. We found that this codebook, based on AADE7, can be instrumental as a framework for research, as well as real-life use in HIT for DSMES principles.

To investigate the nexus between urban population, gross capital formation, and economic growth in the Kingdom of Saudi Arabia, yearly data was collected from the World Bank for the period 1974- 2018. Basic statistics test and correlation matrix was used to investigate the causal effect among the tested parameters, followed by Augmented Dickey-Fuller (ADF) stationary test, co-integration analysis by Johansen test after that Vector Auto-Correction Model for both short-run and long-run and finally the Granger-Causality tests. Result of unit root test analysis shows that the urban population became stationary at I (0) level while economic growth and gross capital formation became stationary at I (1). Johansen co-integration analysis indicates that there is presence of both long-run and short-run relationship between the three variables in the Kingdom of Saudi Arabia. The result of the VECM Model reflects that both economic growth and gross capital formation have a negative impact on urban population in the short run. According to the Granger-Causality tests, there is unidirectional causality with the urban population by both gross capital formation and economic growth. Also, the result of the Granger Causality tests show that there is unidirectional causality between economic growth and gross capital formations.

In the present E-healthcare industry, data breaches result in substantial economic losses due to cyber-attacks and hence create a trust deficit between the industry and users. The healthcare industry has rapidly adopted IoT frameworks but the trust deficit and privacy concerns limit its utilization among the masses. Along with privacy protection, content authentication is an important requirement in a number of critical applications and fragile watermarking provides an effective solution. However, existing fragile watermarking techniques lack the accuracy of tamper detection and hence are not reliable enough in terms of security and privacy of the data. This paper presents a novel low-complexity block-based fragile watermarking technique with high security against cyber-security attacks. This is achieved by embedding a fragile watermark in the host image using pixel domain blocking approach. The security of embedded watermark has been taken care of by using Cellular Automata and DNA based ENcryption (CADEN) framework to scramble the watermark bits using various secret keys. Experimental investigations show that besides being highly secure, the proposed technique is fragile to various signal processing and geometric attacks. The comparative analysis shows that the proposed scheme, despite having lower complexity, offers better efficiency in terms of imperceptibility, tamper detection and localization compared to other state-of-the-art techniques. Besides, the fragile watermark embedding makes the system capable to preserve the secret information in case of an attack with an average BER of 40%.

Our research sought to describe barriers to mammography screening among a sample of predominantly Black women in metropolitan Atlanta, Georgia.The Pink Panel project convened community leaders from faith-based institutions to administer an offline survey to women via convenience sampling at fourteen churches in Atlanta in late 2019 and early 2020. With the COVID-19 pandemic, the research team switched to an online survey. The survey included seven questions about breast cancer awareness, barriers to breast cancer screening, and screening status. We used residence information to attain the 9-digit zip code to link to the Area Deprivation Index at the Census Block Group neighborhood level. We report results as descriptive statistics of the barriers to mammography screening.The 643 women represented 21 counties in Georgia, predominantly from metropolitan Atlanta, and 86% identified as Black. Among women aged 40 and older, 90% have ever had a mammogram. Among all women, 79% have ever had a mammogram, and 86% indicated that they would get a mammogram if offered in their neighborhood. The top barriers to mammography screening were lack of health insurance and high cost. Barriers to mammography screening did not differ substantially by Area Deprivation Index.Among metropolitan Atlanta women aged 40+ , nearly all reported ever having a mammogram. However, addressing the barriers, including lack of health insurance and high cost, that women reported may further improve mammography screening rates.

Antibiotic treatment plays an essential role in preventing

Purpose: Tourism plays a crucial role in enhancing the nation's welfare. Therefore, this study's core idea is to investigate tourist arrival, tourism growth, tourism expenditure, and its associated economic headway impact. Approach/Methodology/Design: Using an annual time series data from 1995-2018, capturing the effect of tourism growth, tourism expenditure on economic growth, and finally revealing the association amongst these endogenous and exogenous parameters. Findings: The unit root test analysis outcomes illustrate that all parameters become stationary when a first-order difference is considered as having a lag value of one. ADRL Bound test reveals the presence of short-run association among parameters. The outcomes of t-statistics and the Wald F-test reveal bidirectional and unidirectional causation among the parameters. Practical Implications: The study will contribute positively to the understanding of tourism and its associated effect to boost the economy. Originality/Valu

In 2015, the initiative Expand New Drug Markets for TB (endTB) began, with the objective of reducing barriers to access to the new and repurposed TB drugs. Here we describe the major implementation challenges encountered in 17 endTB countries. We provide insights on how national TB programmes and other stakeholders can scale-up the programmatic use of new and repurposed TB drugs, while building scientific evidence about their safety and efficacy. For any new drug or diagnostic, multiple market barriers can slow the pace of scale-up. During 2015–2019, endTB was successful in increasing the number of patients receiving new and repurposed TB drugs in 17 countries. The endTB experience has many lessons, which are relevant to country level introduction of new TB drugs, as well as non-TB drugs and diagnostics. For example: the importation of TB drugs is possible even in the absence of registration; emphasis on good clinical monitoring is more important than pharmacovigilance reporting; national guidelines and expert committees can both facilitate and hinder innovative practice; clinicians use new and repurposed TB drugs when they are available; data collection to generate scientific evidence requires financial and human resources; pilot projects can drive national scale-up.

The study attempts to assess the level of environmental sustainability awareness in the Kingdom of Saudi Arabia. In the process, the study tries to assess the impact of extracurricular activities in increasing awareness of environmental sustainability. A survey questionnaire was administered to the students of Prince Sattam University and other universities of Saudi Arabia. The questionnaire comprises statements on simple environmental conservation activities, which we come across on a daily basis. Hypothesis testing is used to identify significant differences across different categories of respondents. Further, the method of binary logistic regression is used to analyze the data. Though all the respondents agree that conserving the environment is important still there are significant differences across categories when it comes to believing in and practicing environmentally-responsible behavior. The results show that environmental awareness can be increased using awareness activities on sustainability issues in a University setting. The study concludes that increasing the number of extracurricular activities on environmental topics as only 38% of the respondents reported any activity related to the environment in the past year. The findings of this study suggest that increased awareness of environmental issues can boost the sustainability awareness, which will ultimately lead to a sustainable environment.