Advancements in the Treatment of Diuretic Resistance in Congestive Heart Failure.

This narrative evaluates the dynamic developments that have significantly transformed treatment strategies in the constantly evolving domain of diuretic resistance (DR) management in congestive heart failure (CHF). The discourse explores historical challenges and the current state of therapeutic approaches as it investigates the crucial matter of DR in patients with CHF. An introduction provides a synopsis of the pivotal function diuretics performed in the management of fluid excess and the intricacies associated with CHF. The narrative explores the progressive exposure of the constraints that traditional treatments face, thus underscoring the persistent issue of DR and the imperative for innovative methodologies. The text underscores advancements in pharmacotherapy that demonstrate efficacy in surmounting resistance, including innovative diuretics and combination therapies. Furthermore, it outlines the pivotal shift towards personalized medicine, an approach that transforms the results of treatments through the integration of genetic knowledge and individualized strategies. Furthermore, the text delves into nonpharmacological strategies, including ultrafiltration and renal denervation, that enhance the overall comprehension of the intricate battle against diuretic resistance. In summary, this narrative exemplifies resolute perseverance in the pursuit of solutions, presenting a promising future wherein various developments converge to restore hope in regard to the control of DR and the improvement of the health status of chronic heart failure patients.

A thorough overview of the literature on waste recycling in the circular economy: current practices and future perspectives.

To develop a circular economy (CE) and protect the environment, waste recycling (WR) is crucial. This study examines WR research conducted over the past two decades to identify the most significant advancements and promising areas for future research. The following challenges were handled through text mining, content, and bibliometrics analysis: How has CE influenced the evolution of WR research? What are the CE's most important WR research trends and themes? What directions could future research on WR take regarding the CE transition? Using 1118 articles from the Scopus database journal, bibliometric networks were made and analyzed. Hence, five critical CE-related problems needing further research were recognized: waste recycling is the first cluster, followed by technology, the CE transformation, plastic waste, and waste management (WM). Examining WM and inclusive waste reduction practices and their distinct highlight patterns may impact future research fields and serve as a transitional tool to CE (which aims to minimize waste generation). Forthcoming research targets contain waste reduction and incorporation of WR into the CE framework.

Sustainable performance in SMEs using big data analytics for closed-loop supply chains and reverse omnichannel.

The study aims to examine the advantages of utilizing big data analytics (BDA) on circular economy (CE) dual systems, which are closed-loop supply chain (CLSC) and the reverse omnichannel (ROC), aiming to enhance sustainable firm performance (SFP) of the small and medium based enterprises (SMEs). The product return knowledge (PRK) can reinforce the proposed network of relationships and facilitate the approach of active returns in CE. Using the structural equation model (SEM) in AMOS v24, the researchers examined the hypotheses using data from a simple random sample of 232 SMEs in Pakistan. Though ROC solutions provide rare performance-related benefits, however, BDA makes the CE system more efficient. CLSC gets strengthened when the PRK is developed. The improved PRK facilitates the CLSC network and enhances its performance. This study adopts a novel approach to studying CE by considering the dual system of CE in the forms of CLSC and ROC. The research investigates whether the BDA facilitates improved product return processes by improving CLSC operations and achieving service capabilities using ROC. Finally, the proposed framework is the first to investigate the benefits evolving from the PRK, which enhance the capability to sense, seize, and reconfigure the process and facilitate the approach of active return in CE. The findings suggest that firms must decide carefully between CLSC and ROC. Choosing CLSC requires higher operational capabilities, whereas deciding on ROC requires higher service capabilities. Lastly, PRK is necessary for achieving the firm's performance objectives.

Comparison of long-term clinical outcomes of bioabsorbable polymer versus durable polymer drug-eluting stents: a systematic review and meta-analysis.

BACKGROUND: One million individuals in the USA die from acute myocardial infarction (MI), which currently affects 3 million people globally. The available data about the early and late outcomes of both biodegradable polymer drug-eluting stents (BP-DES) and durable polymer drug-eluting stents exhibit inconsistency. We performed a meta-analysis comparing the safety and efficacy of BP-DES with DP-DES. METHODS: PubMed, Google Scholar, EMBASE, Cochrane, Ovid Medline, and Clinical Trials.gov databases were used to find out studies comparing BP-DES to DP-DES. All the analyses used the random-effects model. RESULTS: A total of 18 studies were incorporated in this meta-analysis that involved 28,874 patients, out of which 11,997 received the BP Stent, and the rest of 16,578 received the DP stent. Thorough analyses revealed that the risk of all-cause death was significantly higher in the BP-DES group (5.4% vs 2.7%) (RR 1.22, p 0.02) for two years or less than two-year follow-up. For studies with more than two years of follow-up, all-cause death was 9.07% (599/6603) in BP-DES and 9.47% (531/5602) in the DP-DES group but failed to achieve statistically significant levels (RR 0.97, p 0.58). CONCLUSIONS: The study revealed no clinically significant (P value was > 0.05) differences in all-cause death, cardiac death, target lesion revascularization (TLR), late stent thrombosis, device-oriented composite endpoint/target lesion failure (DOCE/TLF), myocardial infarction (MI), target vessel MI, target vessel revascularization (TVR), target vessel infarction (TVI) between BP-DES and DP-DES for more than two years of follow-up. Additionally, all-cause death was only outcomes which found to have a statistically significant difference for less than two years of follow-up, while remaining were statistically non-significant.

Assessing the efficacy of celecoxib after tonsillectomy and/or adenoidectomy: A systematic review and meta-analysis of randomised control trials.

OBJECTIVES: Tonsillectomy and adenoidectomy are common surgical procedures that cause persistent pain, bleeding, and functional limitations. We aimed to investigate the efficacy of celecoxib compared with a placebo for managing post-tonsillectomy or adenoidectomy pain and other adverse events. DESIGN: Systematic review and meta-analysis. METHODS: We conducted a systematic literature search in the PubMed, Cochrane, and Google Scholar databases from inception until July 2023. Dichotomous outcomes have been reported as risk ratios (RR) while continuous outcomes were reported using mean differences (MD). A funnel plot was drawn to investigate publication bias. RESULTS: From 1394 records identified, 6 randomised double-blind trials comprising 591 participants undergoing tonsillectomy and/or adenoidectomy were eligible for inclusion. A high dose (400 mg) of celecoxib was effective in decreasing the pain score for 'worst pain' after the procedure (MD: -10.98, [95% CI: -11.53, -10.42], p < .01, I2 = 0%) while a low dose (200 mg) was not significantly effective (p = 0.31). For managing other outcomes such as vomiting (RR: 1.37 [95% CI: 0.69, 2.68], p = 0.37, I2 = 67%), diarrhoea (RR: 1.41, [95% CI: 0.75, 2.64], p = .29, I2 = 42%), dizziness/drowsiness (RR: 0.90, [95% CI: 0.71, 1.15], p = .48, I2 = 0%), functional recovery time (p = .74), and headache (p = .91), there was no significant difference between the group on celecoxib and the placebo group regardless of dosage. Finally, there was no significant difference (RR: 1.02, [95% CI: 0.91, 1.15], p = .69, I2 = 0%) in the effect of the intervention on minimum bleeding, moderate bleeding, and profuse bleeding. CONCLUSION: This meta-analysis provides robust evidence pooled from high-quality trials and raises questions about the efficacy of celecoxib for tonsillectomy and/or adenoidectomy, challenging existing perceptions.

A Comprehensive Analysis of Conventional Acupuncture and Pharmacological Approaches for Cardiac Arrhythmias: An Umbrella Review.

With a global incidence of approximately 3.4% and an annual mortality rate of 3.7 million, cardiac arrhythmias (CAs) are a pressing global health issue. Their increasing prevalence, especially among older people, is intensifying the challenge for health care systems worldwide. This study aims to compare the safety and effectiveness of acupuncture and pharmacological treatments for CAs, addressing critical gaps in understanding optimal therapeutic approaches. A search of PubMed, EMBASE, and the Cochrane database of systematic reviews was performed to identify data compiled through September 2023 for this umbrella review. Randomized controlled trials (RCTs) as the foundation for meta-analyses and peer-reviewed systematic reviews were the primary focus of the literature search. The Grading of Recommendations Assessment, Development, and Evaluation method was used to assess the overall certainty of the evidence, whereas AMSTAR 2 and the Cochrane Collaboration tool were used to evaluate the quality of the included reviews. Following a comprehensive review, three systematic analyses of 27 RCTs were integrated. Acupuncture led to a slightly greater reduction in the recurrence rate of paroxysmal supraventricular tachycardia (SVT) compared to standard pharmaceutical therapy (risk ratio [RR], 1.06; 95% confidence interval [CI], 0.88-1.27; I2 = 56%; P = .55), although the difference was not statistically significant. In contrast, acupuncture significantly outperformed pharmacological treatment in the context of ventricular premature beats (VPBs) (RR, 1.16; 95 CI, 1.08-1.25; I2 = 0%; P < .0001). The reduction in paroxysmal atrial fibrillation (AF)/atrial flutter was increased with acupuncture, albeit without statistical significance (RR, 1.12; 95% CI, 0.88-1.42; I2 = 0%; P = .36). Acupuncture also led to a greater reduction in heart rate (HR) compared to pharmaceutical treatment despite notable heterogeneity and a lack of statistical significance (mean difference, -1.55; 95% CI, -41.37 to 38.28; I2 = 99%; P = .94). Adverse events were effectively managed, affirming the favorable safety profile of acupuncture. Our study suggests that acupuncture leads to a greater reduction in the recurrence rates of VPBs, AF, and atrial flutter but not significantly so in paroxysmal SVT or post-treatment HR. While promising for specific arrhythmias, the varying effectiveness of acupuncture underscores the need for further research and clinical assessment to determine its precise role and suitability in managing particular cardiac conditions.

Predictors of radioiodine (RAI)-avidity restoration for NTRK fusion-positive RAI-resistant metastatic thyroid cancers.

Context: Two-thirds of metastatic differentiated thyroid cancer (DTC) patients have radioiodine (RAI)-resistant disease, resulting in poor prognosis and high mortality. For rare NTRK and RET fusion-positive metastatic, RAI-resistant thyroid cancers, variable success of re-induction of RAI avidity during treatment with NTRK or RET inhibitors has been reported. Case presentation and results: We report two cases with RAI-resistant lung metastases treated with larotrectinib: an 83-year-old male presenting with an ETV6::NTRK3 fusion-positive tumor with the TERT promoter mutation c.-124C>T, and a 31-year-old female presenting with a TPR::NTRK1 fusion-positive tumor (and negative for TERT promoter mutation). Post larotrectinib treatment, diagnostic I-123 whole body scan revealed unsuccessful RAI-uptake re-induction in the TERT-positive tumor, with a thyroid differentiation score (TDS) of -0.287. In contrast, the TERT-negative tumor exhibited successful I-131 reuptake with a TDS of -0.060. Conclusion: As observed for RAI-resistance associated with concurrent TERT and BRAF mutations, the co-occurrence of TERT mutations and NTRK fusions may also contribute to re-sensitization failure.

Efficacy and safety of ciprofol versus propofol for induction and maintenance of general anesthesia: a systematic review and meta-analysis.

BACKGROUND: Propofol has been the gold standard for anesthesia induction and maintenance due to its rapid onset and favorable pharmacokinetic properties. However, the search for alternative agents with improved safety and efficacy has led to the emergence of ciprofol (HSK3486), a structural analog of propofol. This systematic review and meta-analysis aim to comprehensively assess the safety and efficacy of ciprofol compared to propofol for anesthesia induction and maintenance in adult patients undergoing surgical procedures. METHODS: This study included only double-arm RCTs in which participants were aged eighteen or older undergoing surgery. For the statistical analysis of the extracted data, we employed RevMan 5.4.1. RESULTS: Ciprofol demonstrated a promising trend of higher anesthesiologists' satisfaction during the induction phase (MD 0.14, 95%, CI - 0.28 to 0.56, p = 0.51), whereas Propofol was favored during maintenance. Propofol also exhibited advantages with a shorter time to successful anesthesia induction (MD 0.08 min, 95% CI 0.00 to 0.15, p = 0.04), and quicker attainment of full alertness (MD 0.11 min, 95% CI - 1.29 to 1.52, p = 0.87), suggesting its efficiency in clinical practice. Importantly, there were no significant disparities in the success rate of anesthesia. CONCLUSION: Both ciprofol and propofol demonstrate comparable efficacy and safety for anesthesia induction and maintenance in adult patients undergoing surgery. While propofol provides a faster onset of induction, ciprofol exhibits advantages in terms of pain management. Clinicians should consider these findings when selecting anesthetic agents, and tailoring choices to individual patient needs and clinical scenarios.

Dual-chamber versus single chamber pacemakers, a systemic review and meta-analysis on sick sinus syndrome and atrioventricular block patients.

Aims: The atrioventricular block (AVB) is a conduction system problem that results from the impairment in the transmission of an impulse from the atria to the ventricle, the disease has many etiologies. This article aimed to evaluate the efficacy and safety of dual and single-chamber pacemakers in patients with SSS and AVB. Methods: An electronic search of PubMed (Medline), EMBASE, and Google Scholar was performed from 2000 till August 15th, 2022. Retrieved articles were exported to Endnote Reference Library Software, where duplicate studies were removed from the list, and only articles meeting the eligibility criteria of this study were selected. RevMan 5.4 and STATA 16 software were used for the analysis. The modified Cochrane Collaboration's risk of bias and New-castle Ottawa scale were used for quality assessment of RCTs and observational studies respectively. Results: This study is composed of 8953 patients with sick-sinus syndrome and atrioventricular block. A total of thirteen outcomes are included in this meta-analysis, out of which atrial fibrillation significantly favored dual chamber [OR = 1.29; 95 % CI = 1.05-1.59; P = 0.01 I2 = 29 %] and overall complications [OR = 0.48; 95 % CI = 0.29-0.77; p = 0.03 I2 = 0 %] and pneumothorax [OR = 0.31; 95 % CI = 0.10-0.93; p = 0.04, I2 = 0 %] were satisfied by single-chamber pacing. Conclusion: This study concluded that neither single-chamber nor dual-chamber pacemakers are superior to each other, but they are unique in their own ways as the results of this study manifest remarkable reduction in atrial fibrillation rates and pneumothorax using dual-chamber and single-chamber pacemakers respectively.

Corporate social responsibility-an antidote for sustainable business performance: interconnecting role of digital technologies, employee eco-behavior, and tax avoidance.

Small- and medium-sized enterprises (SMEs) have consistently contributed significantly to the economy's gross domestic product (GDP). Organizations are motivated to achieve sustainable performance by mitigating the adverse impacts of company operations by improving productivity and optimizing resource utilization. In order to achieve this objective, the businesses are making all their efforts and developing the systems to ensure sustainable performance. Based on the prevailing research gaps, the current study examines the role of a portfolio of responsible digital technologies (DT), which provides a competitive advantage and helps achieve sustainable firm performance (SFP). Using a simple random sampling technique, data from 294 textile manufacturing SMEs is collected and analyzed using the structural equation model (SEM) in AMOS v.24. The results indicated that digital technologies, tax avoidance, green employee behavior, and corporate social responsibility facilitated improving the SFP of SMEs. Furthermore, it is worth noting that the link connecting TA and SFP is unaffected by CSR activities aimed at the environment. This finding, however, should not lessen the importance of TA, which deserves significant attention and thought from management.

A Recent Digitalization in Recycling Industry Attaining Ecological Sustainability: A Comprehensive Outlook and Future Trend.

The management of waste through dual way of recycling (i-e offline and online) is assumed to have a key role in attaining ecological sustainability and enabling circular practices. The research on online recycling is gaining evolution in recent age. Prior literature on the current research theme has failed to provide a comprehensive outlook and future trend. Therefore, the current research intends to elaborate the current research scenario linked with online recycling by critically scrutinizing the prior research over the last 41 years. A comprehensive analysis was conducted using the Scopus database, retrieving a total of 866 articles. These articles were selected to provide a conceptual overview and understanding of the fundamental research conducted in the field. By employing bibliometric analysis this research provides comprehensive detail about evolution, mapping of publications and prominent trends from the year 1981 to 2022 to understand the practices and future trends of online recycling research. The outcomes elucidated that there is exponential increase in research publications relating to online recycling over the last five years. The most influential producer of online recycling research are China, United Kingdom and United States. Chinese Universities has the highest number of publications among all the countries across globe. Moreover, the current research trend is focused on technology based circular economy, industrial ecology, bio-based waste management, dual channel recycling, municipal waste, waste from electrical and electronic equipment (WEEE), environmental impact and lifecycle assessment. Hence, the prominent research perspective and highlighted features could offer recommendation for upcoming studies to contribute in literature and help practitioners, policymakers and professionals move towards circular practices.

Innovative Approaches and Therapies to Enhance Neuroplasticity and Promote Recovery in Patients With Neurological Disorders: A Narrative Review.

Brain rehabilitation and recovery for people with neurological disorders, such as stroke, traumatic brain injury (TBI), and neurodegenerative diseases, depend mainly on neuroplasticity, the brain's capacity to restructure and adapt. This literature review aims to look into cutting-edge methods and treatments that support neuroplasticity and recovery in these groups. A thorough search of electronic databases revealed a wide range of research and papers investigating several neuroplasticity-targeting methods, such as cognitive training, physical activity, non-invasive brain stimulation, and pharmaceutical interventions. The results indicate that these therapies can control neuroplasticity and improve motor, mental, and sensory function. In addition, cutting-edge approaches, such as virtual reality (VR) and brain-computer interfaces (BCIs), promise to increase neuroplasticity and foster rehabilitation. However, many issues and restrictions still need to be resolved, including the demand for individualized treatments and the absence of defined standards. In conclusion, this review emphasizes the significance of neuroplasticity in brain rehabilitation. It identifies novel strategies and treatments that promise to enhance recovery in patients with neurological illnesses. Future studies should concentrate on improving these therapies and developing evidence-based standards to direct clinical practice and enhance outcomes for this vulnerable population.

Frequency and Factors of Sleep Paralysis Among Medical Students of Karachi.

INTRODUCTION: Sleep paralysis is a prevalent phenomenon characterized by suffocation, immobility, and hallucinations. Its causes remain unknown, although the neurotransmitter imbalance is suggested as a potential factor. This condition is closely associated with hallucinations and a sense of intrusion, often observed in patients with narcolepsy, hypertension, and seizures. METHODS: A cross-sectional study was conducted in various medical colleges in Karachi, involving 297 participants aged 18 to 30 years. The participants were divided into groups based on gender and year of study. They were surveyed about the frequency of sleep paralysis episodes, their beliefs about the phenomenon, sleep routines, and academic impacts. RESULTS: Among the respondents, a significant number of females (n=209, 70.3%) reported experiencing sleep paralysis. The overall mean age was 20±2.0 years. Correlation analysis revealed an insignificant relationship between depression and mental anxiety (p=0.147). Similarly, no significant association was found when comparing the occurrence of sleep paralysis (p=0.16). However, a notable finding was the significant link between sleep paralysis and its impact on academics (p=0.043). CONCLUSION: This study highlighted the frequency of sleep paralysis among medical students, particularly among females. Furthermore, it emphasizes the diverse beliefs held by individuals regarding these frightening episodes. To address this neglected issue, it is essential to conduct awareness sessions aimed at understanding and alleviating sleep paralysis in individuals' lives.

Interconnection between the role of blockchain technologies, supply chain integration, and circular economy: A case of small and medium-sized enterprises in Pakistan.

Increased industrialization has led to unprecedented resource depletion on a global scale. The current state of affairs has compelled practitioners and academics to investigate the role of sustainable technologies in greening the operations of businesses. Previous studies have attempted to examine the number of operational aspects for their role in making firms sustainable, yet the utility of blockchain technologies is in its infancy. The role of BT in enhancing integration across supply chains has been in the limelight in the recent past. At the same time, its ability to cause sustainable supply chain performance (SSCP) in sync with the circular economy (CE) and supply chain integration (SCI) has largely remained unexplored. Therefore, this study intends to examine the association between blockchain technologies (BTs) and SSCPs through integration to fill the empirical gaps. The study was pursued to investigate the moderating role of the CE on the relationship between multiple extents of SCI and SSCP. Based on dynamic capability theory (DCT), the study considered BT a dynamic resource. BTs are used to integrate and reenergize the relationships with upstream and downstream channel members in pursuit of sustainable performance outcomes. The study opted for a cross-sectional design, where data was collected through convenience sampling from 475 managers from SMEs operating across Pakistan. PLS-SEM was used to analyze the data and to generate the required empirical outcomes. Study results favored the significant association between BT and SSCP, followed by a significant mediating role of SCI dimensions and moderating role of the CE. The study's findings propagate the utility of BTs adoption for SMEs, which holds the potential for firms to achieve system-wide integration to achieve sustainable outcomes. The given empirical investigation holds valuable insights for practitioners and scholars intending to pursue research on the subject matter.

Unlocking sustainable supply chain performance through dynamic data analytics: a multiple mediation model of sustainable innovation and supply chain resilience.

This article provides a theoretical framework for comprehending the connections between dynamic data analytics capability (DDAC), innovation capabilities (IC), supply chain resilience (RES), and sustainable supply chain performance (SSCP). Since this is the first empirical investigation of the sequential mediation effect between DDAC and SSCP through IC and RES, it fills a critical need in the supply chain literature. A quantitative methodology was used, involving a survey questionnaire distributed to 259 large Pakistani manufacturing firms. We used PLS-SEM to test for the expected associations. Findings show that using DDAC has a beneficial effect on both innovative and resilient capabilities, which in turn leads to better SSCP. The research illuminates the sequential mediating roles of product, process, and resilience, underlining the need of combining data-driven innovation with resilience in order to achieve sustainable supply chain performance. These results provide useful guidance for businesses that want to boost their sustainability results by taking a more all-encompassing approach to data-driven innovation and resilience.

Does thiamine supplementation affect heart failure? A systematic review and meta-analysis of randomized control trials.

BACKGROUND: Heart failure is a pathophysiological condition where decreased cardiac output is observed subsequent to any structural deformity or cessation of normal function. Thiamine deficiency is one of the risk factors responsible for causing HF; other risk factors include hypertension, smoking, and obesity. OBJECTIVE: We conducted a systemic review and meta-analysis of RCTs to scrutinize whether the heart failure patients would benefit from thiamine supplementation or not when compared to placebo. METHODS: We selected only those double-arm randomized controlled trials (RCTs) which included participants presenting with symptomatic heart failure. We excluded all the articles published in languages other than English Language. Furthermore, all the studies other than RCTs were also omitted. Articles yielded from the electronic search were exported to EndNote Reference Library software to remove any duplicates. Analyses were done using the Review manager 5.4 tool. Mean values and standard deviations were retrieved for the continuous outcomes given as raw data. RESULTS: The 6 RCTs selected for the statistical analysis consisted of 298 participants (158 in the intervention group, 140 in the placebo group). The outcomes resulted to be non-significant with LVEF p-value= 0.08, NT-pro BNP p-value= 0.94, LVEDV p-value= 0.53, 6MWT p-value=0.59, mortality p-value= 0.61, hospitalization p-value= 0.53 and dyspnea p-value= 0.77. Heart rate is the only significant outcome with a p-value=0.04. CONCLUSION: To conclude, except for heart rate, thiamine supplementation had no effect on the outcomes of heart failure patients.

Mapping and visualizing of research output on waste management and green technology: A bibliometric review of literature.

The transition to a circular economy (CE) and environmental protection highly depends on waste management (WM) and green technology (GT). The purpose of this study is to examine the past two decades of WM and GT research to identify the most significant advancements and potential future research areas. Bibliometrics content analysis and text mining were utilized to resolve the subsequent issues: Has WM and GT research developed over time in the CE industry? Does WM and GT research have a clearly defined purpose? How do you foresee the future of WM and GT research in the context of CE evolving? Consequently, 1149 journal articles from the Scopus database were used to create and evaluate bibliometric networks. Therefore, five significant CE-related issues requiring additional research were identified: The first category is bio-based WM, followed by CE transition, GT, ecological impacts, municipal solid WM and lifecycle assessment, and finally, bio-based WM. Future research topics and a tool for the CE transition may be impacted by the investigation of inclusive WM systems, GT practices and their defining highlight patterns (which aim to minimalize waste generation). Future research goals include reducing waste and implementing WM into the CE framework.

Investigating recycling decisions of internet recyclers: A step towards zero waste economy.

Online recycling has been recognized as an efficient method for waste recycling. This paper focuses on the information asymmetry between an internet recycler and consumers in the online transaction of used products. This paper is to find an optimal strategy for the internet recycler when the consumers would make an adverse selection in submitting the classification results (the used products would be classified into two kinds according to the quality: High quality and Low quality) of used products in online orders to avoid the loss because of internet recycler's moral hazard, which might bring the extra cost for internet recycler. Therefore, this study used game theory to establish a Stackelberg game model for analyzing an internet recycler and consumers' decision-making in the online transaction of used products. Based on the analysis of consumers' behaviors in an online transaction, internet recycler's strategies are divided into two kinds: A, high moral hazard strategy, and B, low moral hazard strategy. It is found that the strategy of low moral hazard is optimal for the internet recycler compared to the strategy of high moral hazard. Further, though strategy B is optimal, the internet recyclers is suggested to increase their moral hazard probability when the H used products are increasing (High-quality ones). Besides, for strategy B, the correction cost for wrong H orders and correction benefit from correction of wrong L orders would decrease the optimal moral hazard probability, and the impact of the correction benefit from correction of wrong L orders on the decision of moral hazard probability is more obvious.

Relationship between the ABO blood group and Rhesus factors with COVID-19 susceptibility.

INTRODUCTION: The molecular research has raised copious hypotheses about different molecular effects on the variable expression of the current virus on the human body. The present prospective study aims to determine clinically as well as statistically, the relation between ABO blood groups and Rhesus (Rh) factor and the severity of the Covid-19 virus. RESEARCH DESIGN AND METHODS: We conducted a prospective, single-centered study at The Combined Military Hospital Lahore, Pakistan. Details of only those patients who exhibit COVID-19 symptoms were included. The odds ratios with a 95% confidence interval and the chi-square test of blood groups and Rhesus factor was also conducted individually with the severity of disease, outcomes, and respiratory symptoms. P-values less than 0.05 was considered significant. RESULTS: The chi-square test and odd ratio yielded no significant results when the covid-19 status was compared with the Rhesus factor (p-value > 0.05). However, the results were found to be significant when associations were run between Covid-19 status and all the blood groups (p-value < 0.05). CONCLUSION: According to the analytical results of the present study, protective nature of all the blood antigens (A, B, AB, none) was observed in patients presenting with Covid-19 symptoms of varying severity.