Academic-Practice Partnership Pivot During COVID-19 Pandemic Surge.

During the COVID-19 surge months of March and April 2020, our New York multicenter health system experienced an influx of cases with COVID-19. We sought to study the impact of the surge period on patients with cancer prescribed radiation treatment (RT). We reviewed our secure departmental quality assurance database for all patients who underwent RT planning simulations from March 6, 2020, through April 30, 2020. A priority level between 1 and 3 was prospectively assigned to each case based on faculty consensus to determine which patients required immediate RT. In May 2020, each faculty physician again retrospectively reviewed their patients from the database and provided additional commentary on how the COVID-19 pandemic had affected each patient's care. All statistics are descriptive. A total of 412 RT courses in 406 unique patients were simulated for linear accelerator-based external beam RT. The median age was 66 years. Treatment intent was curative in 70.6% and palliative in 29.4%. Of the 412 cases, 66.7% were priority 1, 25% priority 2, and 7.8% priority 3. Two hundred thirty-nine cases (58%) underwent standard-of-care diagnosis, workup, and treatment plan. Seventeen patients (4.1%) electively canceled their RT, and 17 others (4.1%) electively delayed RT start. Thirty-four (8.3%) were prescribed hypofractionation to shorten their RT course, and 22 (5.3%) had a change in modality. Incomplete or delayed workup was identified in 19 cases (4.6%). The COVID-19 pandemic surge resulted in 42% of our patients having a non-standard-of-care pathway. This outcome demonstrates a significant impact of the COVID-19 crisis on routine cancer care.

Purpose This study aims to analyze the board characteristics–financial sustainability relationship in the largest US nonfinancial listed firms and the impact of the COVID-19 pandemic on this relationship. Design/methodology/approach Board characteristics such as attendance, cultural diversity, size, experience and gender diversity were assessed in relation to financial sustainability through various regression models, using 2007–2023 panel data of nonfinancial S&P 500 firms. Findings The examined board characteristics are positively associated with financial sustainability. The COVID-19 pandemic accentuated this association, which emphasizes the importance of effective board oversight during crises. Practical implications The findings provide guidance to shareholders, managers and regulators seeking to enhance corporate governance and financial sustainability. The adoption of effective supervisory and monitoring mechanisms can improve financial sustainability and reporting practices. Social implications Enhanced financial sustainability practices can lead to a more stable and secure financial future for companies, thus benefiting employees, shareholders and communities. This study offers insights for promoting the overall social and economic well-being of the US market. Originality/value This study enhances knowledge on how board characteristics influence financial sustainability, particularly during crises such as the COVID-19 pandemic. It provides insights into safeguarding stakeholder interests and improving financial sustainability in the US market.

BackgroundAntibiotic overutilization during the COVID-19 pandemic has been reported, despite relatively infrequent bacterial co-infection. We explored antibiotic utilization before, during and after the COVID-19 surge in Michigan.MethodsCross-sectional study at an 877-bed hospital in Detroit, Michigan from January 2019 through May 2020. Measures: Count of COVID-19 hospital admissions by day. Monthly antibiotic utilization for formulary agents used to treat pneumonia were measured using monthly days of therapy (DOT) per 1000 patient days present and the National Health Care Safety Network Standardized Antimicrobial Administration Ratio (SAAR). Descriptive analysis was utilized.ResultsThe first COVID-19 case was detected March 11, 2020 and peaked in early April (Figure 1). Antibiotic utilization is demonstrated in Figure 2. The COVID-19 peak was associated with increased use of multiple antibiotics; notably, DOT per 1000 days present for ceftriaxone, cefepime and doxycycline were 85.43, 79.42 and 71.56, respectively in April. The institutional all-antibacterial SAAR was significantly reduced in May at 0.96, p=0.0022, after the COVID-19 surge.Figure 1Figure 2ConclusionWe observed increased utilization of multiple antibiotics during the COVID-19 surge, and reduction in the all-antibacterial SAAR after the surge. More robust information is needed to promote optimal antibiotic use for patients with COVID-19 infections.DisclosuresAll Authors: No reported disclosures

Understanding the distribution of organ failure before and during the COVID-19 pandemic surge can provide a deeper understanding of how the pandemic strained health care systems and affected outcomes. To assess the distribution of organ failure in 3 New York City hospitals during the COVID-19 pandemic. A retrospective cohort study of adult admissions across hospitals from February 1, 2020, through May 31, 2020, was conducted. The cohort was stratified into those admitted before March 17, 2020 (prepandemic) and those admitted on or after that date (SARS-CoV-2-positive and non-SARS-CoV-2). Sequential Organ Failure Assessment scores were computed every 2 hours for each admission. A total of 1 794 975 scores were computed for 20 704 admissions. Before and during the pandemic, renal failure was the most common type of organ failure at admission and respiratory failure was the most common type of hospital-onset organ failure. The SARS-CoV-2-positive group showed a 231% increase in respiratory failure compared with the prepandemic group. More than 65% of hospital-onset organ failure in the prepandemic group and 83% of hospital-onset respiratory failure in the SARS-CoV-2-positive group occurred outside intensive care units. The SARS-CoV-2-positive group showed a 341% increase in multiorgan failure compared with the prepandemic group. Compared with the prepandemic and non-SARS-CoV-2 patients, SARS-CoV-2-positive patients had significantly higher mortality for the same admission and maximum organ failure score. Most hospital-onset organ failure began outside intensive care units, with a marked increase in multiorgan failure during pandemic surge conditions and greater hospital mortality for the severity of organ failure.

The COVID-19 pandemic altered access to healthcare by decreasing the number of patients able to receive preventative care and cancer screening. We hypothesized that, given these changes in access to care, radiologic screening for breast and lung cancer would be decreased, and patients with these cancers would consequently present at later stages of their disease. This is a retrospective cross-sectional study of 2017 to September 2021 UMass Memorial Tumor Registry data for adult breast and lung cancer patients. Changes in stage at presentation of breast and lung cancer during the COVID-19 pandemic were measured, defined as before and during COVID-19. There were no statistically significant changes in the overall stage of presentation before or during the COVID-19 pandemic for either breast or lung cancer patients. Analysis of case presentation and stage during periods of COVID-19 surges that occurred during the time of this study compared with prepandemic data demonstrated a statistically significant decrease in overall presentation of breast cancer patients in the first surge, with no other statistically significant changes in breast cancer presentation. A nonstatistically significant decrease in lung cancer presentation was seen during the initial surge of COVID-19. There was also a statistically significant increase in early-stage presentation of lung cancer during the second and third COVID-19 surges. In the 2 years after the COVID-19 pandemic, we were not able to demonstrate stage migration at presentation of breast and lung cancer patients to later stages despite decreases in overall presentation during the initial 2 years of the COVID pandemic. An increase in early-stage lung cancer during the second and third surges is interesting and could be related to increased chest imaging for COVID pneumonia.

Projet Rosace : robot sécurisé d’assistance à la chirurgie endoscopique

Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.

Introduction The COVID-19 pandemic has overwhelmingly affected healthcare systems, particularly in the area of antibiotic management. The surge in antimicrobial use to address secondary bacterial infections in COVID-19 patients has heightened concerns about overuse and antimicrobial resistance (AMR). This study examined the pandemic's effect on the antibiotic stewardship program (ASP) at two general hospitals in Abu Dhabi, focusing on changes in prescribing practices, adherence to stewardship guidelines, resistance trends, and overall health system impact. The present retrospective study evaluated shifts in antibiotic consumption, compliance with stewardship practices, and broader healthcare implications. The aim is to assess the pandemic's impact, identify improvement areas, and provide insights to enhance the ASP in addressing the global AMR crisis. Methods This retrospective review assessed electronic medical records from two general hospitals in Abu Dhabi over a 24-month period, from January 2019 to December 2020. It included pre-COVID-19 data from 2019 and data from 2020 during the COVID-19 surge. The study focused on patients aged 25 to 40 years with respiratory tract infections, urinary tract infections, ventilator-associated pneumonia, and nosocomial infections, identified using predefined ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes. Patients with COVID-19 diagnoses and those undergoing surgical procedures were excluded. Key metrics compared data from 2019 and 2020 to assess changes in clinicians' prescribing practices, antibiotic usage, ASP interventions, and their impact on the healthcare system. Results The COVID-19 pandemic influenced antibiotic use and resistance trends, leading to longer hospital stays (3.86 days in 2019 vs. 4.29 days in 2020) and increased use of duplicate anaerobic therapy (4.58% in 2019 vs. 5.71%in 2020). From 2019 to 2020, the average duration of antibiotic therapy decreased from 6.23 days to 5.24 days, but empirical therapy without sufficient evidence rose. The average length of treatment increased (2.87 days in 2019 vs. 3.28 days in 2020), and there was a rise in the use of antibiotics for viral and fungal infections, with cases growing from 17.08%in 2019 to 22.38%in 2020. Despite modest improvements in stewardship practices in 2020, AMR challenges persisted. These results underscore the need for enhanced stewardship programs and continued research to address the ongoing impacton antibiotic prescribing and resistance. Conclusion The COVID-19 pandemic increased antibiotic use and altered resistance patterns. Although stewardship practices improved, AMR challenges remained. Enhanced stewardship programs and ongoing research are essential to mitigate these effects and improve antibiotic management. Recommendation To address changes in antibiotic use and resistance during the COVID-19 pandemic, it is recommended to strengthen ASPs to adapt to new prescribing trends, ensure adherence to evidence-based practices, provide ongoing education for clinicians, invest in research on long-term resistance impacts, and enhance data tracking and monitoring systems.

Carbon dioxide emissions have emerged as a major concern due to the rapid expansion of industries in economies that are developing. From 2000 to 2021, this study looks at the BRICS+ countries' CO 2 emissions and how they relate to energy, technology, and finances. Examining how renewable energy, sustainable finance, technological innovation, fintech, and financial institutions affect emissions is the goal. This study contributes to the literature from its use of MMQR, AMG, and FE‐DKSE to deal with endogeneity. In the beginning, emissions from renewable energy sources are higher than expected because of transitional losses, but as technology advances, CO 2 emissions are steadily falling. Although the expansion of fintech makes green finance more accessible, the increased demand for digital infrastructure it necessitates actually increases emissions, in contrast to the beneficial effect of financial institutions and sustainable finance on emissions. This study emphasizes the importance of policies that support environmentally conscious investments and energy efficiency measures, all while tackling the temporary obstacles to integrating renewable energy sources, helping to achieve global climate objectives. In the context of the BRICS+, the results highlight the significance of sustainable development and the mitigation of climate change, which is relevant to SDGs 7, 9, 12, and 13.

One of the key challenges for businesses during the Covid-19 pandemic has been to maintain financial sustainability despite the public crisis and consumer demand shocks. While some companies have managed to digitize and cope with the new realities, others have not. This will determine the future of companies and the direction of anti-crisis tools in management strategies. The purpose of this study is to analyze the use of digitalization as an anti-crisis tool among Azerbaijani businesses during the Covid-19 outbreak. The data set is based on voluntary survey data gathered from key businesses of the Azerbaijan economy. Our analysis applied k-means clustering, the related-samples Wilcoxon Signed Rank test and the independent-samples Mann-Whitney U test to learn whether there was any connection between digitalization and financial sustainability. Our findings indicate that 42% of the businesses that participated in the study obtained benefits by using digitalization as a crisis management tool during the Covid-19 pandemic period, but 38% of the respondents did not report any significant changes in their businesses despite increased digitalization efforts. Moreover, 20% of the businesses examined experienced negative changes after digitalization. The results of the independent-samples Mann-Whitney U test indicated that those businesses that had high scores before and after the increased digitalization efforts during the Covid-19 pandemic, achieved higher median profits, while the businesses with lower scores experienced a financial loss. As can be seen from the results, the chances of benefiting from digitalization are rather uncertain for local businesses. The main policy conclusion from this study is that businesses in Azerbaijan need to address the digitization challenge comprehensively to increase benefits and reduce costs. The results of our study are useful for business owners, policy makers, and top managers when developing strategies for enterprise-level digitization, especially during and after viral outbreaks.

The COVID-19 pandemic is presently influencing the financial sustainability and the social adequacy of public pension schemes. In this paper, we measure the effects of COVID-19 on the Italian public pension system by introducing a deterministic shock due to the pandemic in the evolution of the variables mainly involved in the system’s evaluation. These variables, namely the unemployment rate, wage growth rate, inflation rate, and mortality rates, are modeled in a stochastic framework. Our results show that COVID-19 worsens the financial sustainability of the pension system in the short–medium term, while it does not appreciably affect social adequacy in the medium term. The Italian pension system already showed a social adequacy problem before 2020, which the pandemic does not further deteriorate essentially.

This study explores the short-term effects of COVID-19 on marriage and divorce rates in Korea. We document a 9.6–13.9% reduction in the provincial crude marriage rate in March-June 2020 after the surge in COVID-19 cases. On top of this overall decline, a one-unit increase in the number of confirmed cases per 1,000 people in a given province decreased the marriage rate by 3.8–6.2%. The crude divorce rate decreases by 3.2–7.1% after the surge of COVID-19. Our results imply that the decline in marriage rates due to COVID-19 can lead to a significant decrease in fertility rates in the near future.

<p><strong>Purpose:</strong> This present article offers insight into the impacts and implications of COVID-19 on the service delivery process for hotel customers. The objective also reflects on how technological innovations may mitigate those impacts and contribute to employee well-being. Keeping in mind the above, a conceptual framework has been developed that clearly and critically depicts the COVID-19 impact on technological innovation and its subsequent influence on hotel employees well-being. <strong>Design/methodology/approach:</strong> This research paper strongly outlines the current theoretical background on hotel services impacted by the COVID-19 pandemic. The author also investigated the current trends in hotel guest services influenced by technological innovations. The present data and industry report have been used to formulate the conceptual framework linked to employee well-being. <strong>Findings:</strong> This study proposes an underlying theory and research plan on technological innovation that facilitates hotel service delivery while keeping COVID-19 and social distance in mind and thereby contributes to comprehensive employee well-being. <strong>Originality/value:</strong> This article would be a pioneering study seriously investigating the impact of COVID-19 on hotel service delivery engulfed by the various technological innovations and contributing towards employee well-being at macro and micro levels.</p>

Innovation is a major economic growth contributor, which is often hindered by corruption. However, this relationship is not always supported. This study analyzes the interrelation between anti-corruption (AC) and technological innovation (TI) in China by applying the bootstrap rolling-window full-sample and subsample Granger causality test. The results confirm that the influence of AC on TI is two-fold. On the one hand, AC positively influences TI, indicating that it facilitates TI. This finding supports the “sanding-the-wheels” hypothesis, which postulates that corruption impedes innovation. On the other hand, there is a negative influence from AC to TI, which is mainly caused by the COVID-19 pandemic. Further, the results show that TI positively influences AC, implying that TI can affect government’s AC-related decisions. Based on these findings, governments should coordinate their efforts toward innovation and AC, while firms should adopt innovation-driven strategies for long-term growth.

This study assessed the impact of technological innovation on employee performance, especially during the COVID-19 pandemic situation. Data were gathered from private and government banks that applied technological innovations to the COVID-19 Pandemic. The author also elucidated more about the influence of technological innovation on employee performance, influenced by job satisfaction, work-life balance, and burnout. This study described technological innovation within the Jabodetabek Area’s banking industry by using variables that affect employee performance. The questionnaires were distributed through social media to 123 respondents under 40 years of work. The data were then analyzed using PLS-SEM through SmartPLS 3 software. Findings. The results of this study indicated the positive effect of technological innovation on the performance of bank employees. Utilizing technological innovation will increase employees’ satisfaction at work, balance employees' lives, reduce burnout, and improve employee performance eventually. This paper focused on the variables used in the banking industry, especially in COVID-19 Pandemic. Mediating variables used also have never been explored in the previous research.