Inflammatory biomarkers and cardiac injury in COVID-19 patients.

Introduction: Cardiac injury has received considerable attention due to the higher risk of morbidity and mortality associated with coronavirus disease. However, in a developing country, there is a scarcity of data on cardiac injury in COVID-19 patients related to inflammatory biomarkers. Methods: Therefore, the present research retrospectively analyzes data from three territorial hospitals in Pakistan's Punjab province to investigate the potential impact of the cardiac injury on the mortality and severity of COVID-19-infected patients. We evaluated 2,051 patients between January 16 and April 18, 2022, with confirmed COVID-19. The in-hospital mortality recorded for the selected sample size was about 16.28%. Results: The majority of the participants were identified as male (64%) with a median age of 65 years. Also, fever, fatigue, and dyspnea were reported as common symptoms. An aggregate of 623 patients (30.38%) had a cardiac injury, and when these patients are compared to those without cardiac injury, the participants were significantly older and had more comorbidities with higher leukocyte counts, elevated levels of C-reactive protein, interleukin-6, procalcitonin, myohemoglobin, creatinine kinase-myocardial band, serum creatinine, high-sensitivity troponin-I, N-terminal pro-B-type natriuretic peptide had a significant amount of multiple ground-glass opacity and bilateral pulmonary infiltration in radiographic results. Participants with heart injury required more non-invasive or invasive mechanical respiration than those who did not have a cardiac injury. Individuals with cardiac injury had higher rates of sepsis, acute respiratory distress syndrome (ARDS), d-dimer concentration, and respiratory failure than those without cardiac injury. Patients who had had a cardiac injury died at a higher rate than those who had not suffered cardiac damage. In the multivariable logistic regression analysis, participants with cardiac injury showed greater odds of COVID-19 mortality and were found associated with older age (OR = 1.99, 95% CI = 0.04-3.19), elevated cardiac troponin I (OR = 18.64, 95% CI = 13.16-23.01), the complication of sepsis (OR = 10.39, 95% CI = 7.41-13.39) and ARDS (OR = 6.65, 95% CI = 4.04-8.91). Conclusion: Cardiac injury is a frequent complication among patients with coronavirus-induced infection in Punjab, Pakistan, and it is significantly linked to a greater risk of in-hospital mortality.

Research Methods in a Multinational Business Environment and Implications for Capital Formation: Application of Cross-Sectional Autoregressive Distributed Lag Methods.

We explore whether foreign direct investment outflows augment or obstruct public or private capital in developing countries by decomposing domestic capital into private and public capital. While developed countries are the primary source of foreign direct investment outflows (FDIOs), developing economies have become the primary source of FDIO over the past 30 years. We apply cross-sectional autoregressive distributed lag (CS-ARDL) methods to overcome the issue of endogeneity and cross-sectional dependency in our dataset. This study analyzes the interaction effects of foreign direct investment and institutional quality (IQ) in promoting aggregate domestic capital formation in developing countries. Our empirical results show that FDI outflows augment private capital formation and additionally, IQ also upsurges private capital formation. Conversely, as per results, FDI outflows obstruct public capital formation, and IQ crowds out public capital formation significantly while private capital crowds out FDI inflows. As per result estimations, we notice that FDIO crowds in private capital formation, thus we conclude that the private sector controls the majority of the sectors for developing countries and the role of the public sector is quite minimal. We conclude that private and public capital possess different attributes; thus clubbing them together might result in aggregation bias. Our result estimations provide several useful policy implications.

Modeling COVID-19 Impact on Consumption and Mobility in Europe: A Legacy Toward Sustainable Business Performance.

This article has explored the impact of coronavirus disease 2019 (COVID-19)-induced decline in consumer durables and mobility on nitrogen dioxide (NO2) emission in Europe by providing empirical and graphical justifications based on consumer price index (CPI) and gross domestic product (GDP) deflator indexes. The empirical estimations show that carbon dioxide (CO2) and NOx emission along with other greenhouse gases drastically decreased in the wake of COVID-19-induced lockdowns and decrease in the demand of consumer goods in Europe. This means that COVID-19 improved environment in the European region. However, high cost (e.g., unemployment, loss of life, and social segregation) makes COVID-19 an unstable solution to environmental woes where positive impact of COVID-19 on environment achieved in short run cannot be guaranteed in the long run. Besides environment, COVID-19 drastically curtailed economic activities and exposed them to the risk of economic crisis particularly in case of Europe.

Cardiovascular Disease Mortality and Potential Risk Factor in China: A Multi-Dimensional Assessment by a Grey Relational Approach.

Objectives: This study aims to investigate the impact of hypertension, diabetes, and high blood cholesterol on increased mortality from cardiovascular diseases such as coronary heart disease, stroke, and pulmonary heart disease in a multi-dimensional way. Methods: The grey relational analysis methodology is adopted to assess the connection between cardiac risk factors and related mortality. The Hurwicz and the Conservative (Min-Max) criterion approach are also utilized to identify the prospective risk factor that contributes the most to increased cardiac mortality. Results: The findings reveal that hypertension has a more grounded relationship with stroke and pulmonary heart disease mortality, whereas high blood cholesterol appears to be the leading contributor to deaths from coronary heart disease. The results based on the Hurwicz and the Min-Max criterion show a robust connection between dyslipidemia, coronary heart disease, and cardiovascular disease mortality. Conclusion: Combating uncontrolled blood cholesterol and blood pressure levels would necessitate a multi-pronged strategy at both the national and local levels. Besides, the suggested methodologies provide a valuable tool and additional practical knowledge for public health policymakers and decision-makers in drawing rational decisions to combat China's rising CVD burden.

Prioritizing and Overcoming Barriers to e-Health Use among Elderly People: Implementation of the Analytical Hierarchical Process (AHP).

Rise in the aging population brings new challenges to modern societies. Old age is associated with several morbidities and usual issues related to health. Therefore, the provision of healthy and timely care has become the dire need to maintain their quality of life and wellbeing. The evolution of the e-health care system put pressure on societies to implement it successfully to ensure a safe and prompt provision of care services to the most vulnerable population successfully. Therefore, the provision and implementation of the e-health care system is a challenge for the health industry in terms of multi-objective decision-making. Multicriteria decision-making is a generalizable approach to making decisions with dependence and feedback and is known as an effective tool in decision-making processes, particularly in the healthcare sector. The present study aims to present an e-healthcare framework by identifying and prioritizing potential barriers towards the use of e-health by the elderly population. The analytical hierarchy process approach is adopted to calculate weights of identified potential barriers, respectively, and then rank them based on their degree of significance. The findings show that health and the ability-related barrier is ranked highest, followed by socio-environmental and attitudinal barriers. This research contributes to healthcare decision-making regarding e-health usage by implementing MCDA techniques. Our study will assist the public health practitioners and policymakers in drawing decisions on the best strategy to minimize the risks in using the e-healthcare system by the aging population, which significantly contributes to the smart healthcare system.

Application of Grey-Based SWARA and COPRAS Techniques in Disease Mortality Risk Assessment.

The health industry is amongst the most affected systems in terms of multiobjective decision-making, rendering the final solution, vulnerable to errors; however, multicriteria decision analysis (MDCA) emerges as a supportive tool for the process of decision-making. Therefore, the present study seeks to offer an MCDA framework for assessing and identifying the potential influence of socioeconomic risk factors on noncommunicable disease mortality. We adopted a subjective approach of grey-based Step-wise Weight Assessment Ratio Analysis (SWARA) and COmplex PRoportional Assessment (COPRAS) approach to calculate weights of parameters and criteria, respectively, and then rank them based on their degree of significance. The findings reveal that CRD mortality is potentially affected by the selected socioeconomic risk variables followed by IHD and cancer. Implementing MCDA techniques in the present study will assist the public health practitioners and policymakers in drawing decisions on the best strategy to reduce CRD mortality, which contributes significantly to raising overall mortality.

Corrigendum: Social Quarantine and Its Four Modes: Conceptional Exploration and the Theoretical Construction of the Policies Against COVID-19.

[This corrects the article DOI: 10.3389/fpubh.2021.614476.].

Association of Mortality-Related Risk Factors in Patients with COVID-19: A Retrospective Cohort Study.

COVID-19 is a rapidly disseminating infectious disease conferred by the World Health Organization (WHO) as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics data have been identified for patients with COVID-19, but mortality-related risk factors and a comprehensive clinical course of disease in a developing country have not been specifically defined. This retrospective, single-center cohort study involved all successive inpatients having a positive COVID-19 polymerase chain reaction (PCR), with deceased or discharged clinical outcomes from 1 January to 10 May 2021. Data were extracted from electronic medical records on demographic, clinical, radiological, and laboratory findings as well as complications faced and treatment provided during follow-up, involving serial samples for viral RNA identification, and compared between the dead and survivors. To investigate the risk factors associated with in-hospital mortality, we employed the multivariate logistic regression model. In this study, 2048 patients were involved, 1458 of whom were discharged, and 590 died in hospital. More than half of patients were identified as male with old age being the potential risk factor of mortality. Exactly 94.8% of all patients presented with fever at the time of admission. Several comorbidities were present in the study population, with the most frequent comorbidity being cardiovascular diseases (1177 of 2048) and hypertension (975 of 2048) followed by cerebrovascular disease and diabetes mellitus. Mortality rates for infected patients were observed as higher in severe patients (46.3%) compared with non-severe cases (26.1%) during a follow-up. Multivariate regression analysis showed a significant association of in-hospital mortality of patients with older age, presence of hypertension and cardiovascular diseases as underlying comorbidities, increased level of cardiac troponin I and d-dimer concentration on admission, as well as septicemia and ARDS as a complication during illness. To minimize the risk of death in COVID19 patients, as well as the risk of severe complications, urgent public health measures should be properly planned and implemented on those vulnerable populations. To detect early manifestations of clinical problems, thorough and regular follow-up is warranted.

Social Quarantine and Its Four Modes: Conceptional Exploration and the Theoretical Construction of the Polices Against COVID-19.

Building on the studies of health quarantine from a social perspective, this article explores the complex contexts of social quarantine as a mode of public health, a mode of community action and a behavioural and psychological mode of social distancing. To establish a conceptual investigation of the "social quarantine" issue, this study investigates four approaches to quarantine: public health, social administration, behavioural norms, and psychological effects. The study identifies the features of these modes and discusses their relationships. In addition, this study constructs a preventive framework for quarantine that embraces social and health policies to enrich the understanding of policy measures for social distancing and lockdown measures. On this basis, the study evaluates the strategies of policy development in response to the COVID-19 pandemic. The study concludes that these modes can reconstruct social relations and provide some basis for theoretical analysis about the features of social quarantine, which is vital for policymakers when considering national and global prevention strategies for public health.

Unpacking the Mental Health of Nurses during COVID-19: Evidence from Pakistan.

The prime objective of the present study is to test the effect of COVID-19 fear on the mental condition of nurses in the public health sector of Pakistan. This study seeks to measure the psychological distress, anxiety, and psychological well-being of nurses due to fear of COVID-19 and exposure to COVID-19. This research further reveals the moderating role of "social support" in the link between COVID-19 fear, exposure and mental health. Through a convenient sampling technique, 250 sample contributors were chosen from 12 public hospitals. The results were obtained by applying multiple regression and moderation analysis by SPSS and the Hayes process. The outcomes indicated that fear of exposure to COVID-19 affects the mental health of nurses. The findings also discovered that social support is not very constructive in the pandemic. However, we suggested that social support is the best weapon to encourage nurses to relieve their fear and minimize negative emotions.

COVID-19 and Mental Health: A Study of Stress, Resilience, and Depression among the Older Population in Pakistan.

Extending studies of the adverse effects of SARS-2 coronavirus on general health consequences, this research explores complexities related to the mental health of the elderly as a result of pandemic-related stress. The study addresses this issue by using resilience theory to examine the effects of fear and exposure related to COVID-19 and depression. Besides, our study examines the moderating effects of self-efficacy in order to provide an understanding of how the coping abilities of the elderly may mitigate the effect of stress levels on mental health during pandemics. Our model is tested by analysing the survey data collected from Rawalpindi, a metropolitan city in Pakistan. The main results of the study confirm the positive association of pandemic-related fear and exposure virus with depression. However, self-efficacy shows a negative direct effect on depression, and the findings also confirm the moderation effect of self-efficacy on the fear of COVID-19 and depression, but the moderation effect of self-efficacy on COVID-19 exposure and depression is not supported. Based on the outcomes, some severe geriatric care policies that could weaken the pandemic-related fear, exposure to the virus, and depression are recommended.

Exploring the Relationships Between Four Aging Ideals: A Bibliometric Study.

When examining research articles on the aging strategies, four ideals (i.e., successful aging, healthy aging, productive aging and active aging) could be explored by conducting bibliometric analyses. For the literature analysis, general information on the four aging ideals was understood through visualization analysis; the intellectual base and research hotspots were intuitively observed. CiteSpace was used as the method to conduct the co-occurrence analysis of keywords in order to obtain research trends and cutting-edge knowledge in the field of aging-related policies. Subsequently, the study revealed the nature of the link between these four aging ideals and disclosed the connection between their fundamental principles. The study ultimately enhanced the understanding of the diverse contexts that have impacted the way in which these ideals influence policy, which has caused dissimilar strategies for policy development. The study also extended the discussion of the definitions of and relationships between these four ideals with the goal of identifying new directions for aging-related practice and providing innovative insights and references for investigators.

Impact of Environmental Degradation on Human Health: An Assessment Using Multicriteria Decision Making.

Air pollution has emerged as a major global concern in recent decades as a result of rapid urbanization and industrialization, leading to a variety of adverse health outcomes. This research aims to investigate the influence of exposure to ambient and household particulate matter pollution (PM2.5), and ground-level ozone (O3) pollution on respiratory and cardiac mortality in Pakistan. We used grey incidence analysis (GIA) methodology to estimate the degree of proximity among selected variables and rank them based on mortality. Hurwicz's criterion is then adopted for further optimization by prioritizing the selected factors with the greatest influence on respiratory and cardiac mortality. The GIA findings revealed that asthma mortality is considerably impacted by exposure to ambient and household PM2.5 concentration while ischemic heart disease (IHD) mortality is potentially influenced by ground-level ozone exposure. Furthermore, results based on Hurwicz's analysis demonstrated that exposure to ambient PM2.5 concentration appeared as the most intensified factor of respiratory and cardiac mortality. This corroboration adds to the growing body of research demonstrating that exposure to ambient PM2.5 adversely leads to respiratory and cardiac risks, emphasizing the demand for further improvement of air quality in Pakistan. Besides, the suggested methodologies provide a valuable tool and additional practical knowledge for policymakers and decision-makers in drawing rational decisions.

Long-Term Air Pollution Exposure and Ischemic Heart Disease Mortality Among Elderly in High Aging Asian Economies.

In the epidemiological literature, the impact of environmental pollution on cardiac mortality has been well documented. There is, however, a paucity of evidence on the impact of air pollution exposure on ischemic heart disease (IHD) mortality among the Asian aged population. In response, this research seeks to investigate the degree of proximity between exposure to ambient PM2.5, household PM2.5, ground-level ozone (O3), and IHD mortality in the top seven Asian economies with the highest aging rates. This investigation is held in two phases. In the first phase, grey modeling is employed to assess the degree of proximity among the selected variables, and then rank them based on their estimated grey weights. In addition, a grey-based Technique for Order of Preference by Similarity to Ideal Solution (G-TOPSIS) is adopted to identify the key influencing factor that intensifies IHD mortality across the selected Asian economies. According to the estimated results, South Korea was the most afflicted nation in terms of IHD mortality owing to ambient PM2.5 and ground-level O3 exposure, whereas among the studied nations India was the biggest contributor to raising IHD mortality due to household PM2.5 exposure. Further, the outcomes of G-TOPSIS highlighted that exposure to household PM2.5 is a key influencing risk factor for increased IHD mortality in these regions, outweighing all other air pollutants. In conclusion, this grey assessment may enable policymakers to target more vulnerable individuals based on scientific facts and promote regional environmental justice. Stronger emission regulations will also be required to mitigate the adverse health outcomes associated with air pollution exposure, particularly in regions with a higher elderly population.

The Impact of Job Stress and State Anger on Turnover Intention Among Nurses During COVID-19: The Mediating Role of Emotional Exhaustion.

Based on the social exchange theory, the aim of this study is to identify the association between job stress state anger, emotional exhaustion and job turnover intention. This study postulates that job related stress and state anger among nurses during COVID-19 subsequently leads to their job turnover intentions. In addition, the study also aims to see the mediating role of emotional exhaustion between COVID-19-related job stress, state anger, and turnover intentions. The sample of this study is gathered from 335 registered nurses working in Pakistani hospitals dealing with COVID-19-related patients. The interrelationships between variables are checked by using structural equation modeling through AMOS. Key findings confirm that COVID-19-related job stress and state anger had a significant effect on nurses' turnover intentions. Furthermore, emotional exhaustion mediated the relationship between COVID-19-related job stress, state anger, and turnover intentions. There is a lack of research which has assessed the impact of Novel COVID-19-related job stress and state anger on nurses' turnover intentions in hospitals, providing empirical evidence from a developing country-Pakistan. This study offers managerial implications for hospital management and health policymakers. Moreover, nursing managers need to pay attention to nurses' turnover intentions who are facing the issue at the front line as patients receive their initial treatment from nurses in the COVID-19 outbreak.

Synthesis of some new N-(alkyl/aralkyl)-N-(2,3-dihydro-1,4-benzodioxan-6-yl)-4-chlorobenzenesulfonamides as possible therapeutic agents for Alzheimer's disease and Type-2 Diabetes.

In the current research work, a series of new N-(alkyl/aralkyl)-N-(2,3-dihydro-1,4-benzodioxan-6-yl)-4-chlorobenzenesulfonamides has been synthesized by reacting 1,4-benzozzdioxan-6-amine (1) with 4-chlorobenzenesulfonyl chloride (2) to yield N-(2,3-dihydro-1,4-benzodioxan-6-yl)-4-chlorobenzenesulfonamide (3) which was further reacted with different alkyl/aralkyl halides (4a-n) to afford the target compounds (5a-n). Structures of the synthesized compounds were confirmed by IR, 1H-NMR, EI-MS spectral techniques and CHN analysis data. The results of enzyme inhibition showed that the molecules, N-2-phenethyl-N-(2,3-dihydro-1,4-benzodioxin-6-yl)-4-chlorobenzenesulfonamide (5j) and N-(1-butyl)-N-(2,3-dihydro-1,4-benzodioxin-6-yl)-4-chlorobenzenesulfonamide (5d), exhibited moderate inhibitory potential against acetylcholinesterase with IC50 values 26.25±0.11 µM and 58.13±0.15 µM respectively, whereas, compounds N-benzyl-N-(2,3-dihydro-1,4-benzodioxin-6-yl)-4-chlorobenzenesulfonamide (5i) and N-(pentane-2-yl)-N-(2,3-dihydro-1,4-benzodioxin-6-yl)-4-chlorobenzenesulfonamide (5f) showed moderate inhibition against α-glucosidase enzyme as evident from IC50 values 74.52±0.07 and 83.52±0.08 µM respectively, relative to standards Eserine having IC50 value of 0.04±0.0001 µM for cholinesterases and Acarbose having IC50 value 38.25±0.12 µM for α-glucosidase, respectively.

Synthesis, Antioxidant and In-Silico Studies of Potent Urease Inhibitors: N-(4-{[(4-Methoxyphenethyl)-(substituted)amino]sulfonyl}phenyl)acetamides.

In this study, a new series of sulfonamides derivatives was synthesized and their inhibitory effects on DPPH and jack bean urease were evaluated. The in silico studies were also applied to ascertain the interactions of these molecules with active site of the enzyme. Synthesis was initiated by the nucleophilic substitution reaction of 2-(4-methoxyphenyl)-1-ethanamine (1: ) with 4-(acetylamino)benzenesulfonyl chloride (2): in aqueous sodium carbonate at pH 9. Precipitates collected were washed and dried to obtain the parent molecule, N-(4-{[(4-methoxyphenethyl)amino]sulfonyl}phenyl)acetamide (3): . Then, this parent was reacted with different alkyl/aralkyl halides, (4A-M: ), using dimethylformamide (DMF) as solvent and LiH as an activator to produce a series of new N-(4-{[(4-methoxyphenethyl)-(substituted)amino]sulfonyl}phenyl)acetamides (5A-M: ). All the synthesized compounds were characterized by IR, EI-MS, 1H-NMR, 13C-NMR and CHN analysis data. All of the synthesized compounds showed higher urease inhibitory activity than the standard thiourea. The compound 5 F: exhibited very excellent enzyme inhibitory activity with IC50 value of 0.0171±0.0070 µM relative to standard thiourea having IC50 value of 4.7455±0.0546 µM. Molecular docking studies suggested that ligands have good binding energy values and bind within the active region of taget protein. Chemo-informatics properties were evaluated by computational approaches and it was found that synthesized compounds mostly obeyed the Lipinski' rule.