The Effect of Increased Coverage on U.S. Medical Expenditures

The purpose of this research paper is to examine the effect of the health reform bill, known as the Patient Protection and Affordable Care Act (PPACA), on total medical expenditures in the United States. Since the PPACA will provide health insurance to an additional 32 million Americans, medical expenditures can be expected to increase since the government will have to insure individuals who presently have no health insurance. This paper will outline the present healthcare system in the United States and explain why there was a growing call for healthcare reform in the country. A regression analysis was performed using data from the 2006 Medical Expenditure Panel Survey (MEPS), a comprehensive survey of over 34 thousand civilian, non-institutionalized United States respondents designed to measure respondents’ medical history and how they utilized medical treatments and care. The result of the regression analysis estimated that medical expenditures can be expected to increase by 7.44%, or roughly $17 billion, after full implementation of the PPACA in 2019

Consumers Increasing Confidence towards Social Commerce: The Role of Social Media Marketing, Trust and Social Media Engagement

Recent research shows peoples are spending more time on digital online platforms like Facebook, and others. Of which business organization sees as an opportunity for expanding businesses. This study aims to investigate the driving factors behind the increasing confidence of social commerce consumers to social media engagement, social media marketing effectiveness, and social/self-identities, along with their increasing confidence level for social commerce. With the help of structure, online survey data were collected from 200 respondents and were analyzed using Smart PlS3 software. Results revealed that social media engagement levels significantly affect the trust level, which consequently results in increased confidence level for social commerce. Furthermore, it was also found that social media marketing activities and social presence positively affect the trust of social media community members.&nbsp

The impact of Covid-19 on E-business practices and consumer buying behavior in a developing country

Online trade has shown a sharp increase since the outbreak of pandemic Coronavirus. The COVID-19 has affected almost all financial and business activities around the world, even in Pakistan. It has changed the way consumers used to shop before the pandemic outbreak. Many companies until recently have developed and created their online stores and making up the most of their sales using internet channel. Consumer have no other choice but shop from home. In this research study, we discuss the impact of COVID-19 on e-business practices and consumer behavior in Pakistan. The theory of acceptance model has been applied where consumer behavior, e-business, and COVID-19, and posted as a key construct of the proposed research model. Structural Equation Modelling approach has been used to examine the interrelationship of variables of research. We applied two-step recommended Structural Equation Modelling approach, first, validate the constructs by using Confirmatory Factor Analysis, and then conducted Structural Equation Modelling path analysis and report the results, which indicated that in the present scenario COVID-19 has significantly impacted both e-businesses and consumer buying behavior in the context of Pakistan. This research briefly highlights the e-commerce trends and discusses the rapidly growing scope for online businesses and makes several future research suggestions, especially in the context of cultural and other barriers such as digital payment adoption in developing economies. This study limitation is the study sample and context-specific to Pakistan

Improvement of Serum Biochemical Parameters and Hematological Indices Through α-Tocopherol Administration in Dietary Oxidized Olive Oil Induced Toxicity in Rats

Dietary oxidized olive oil, alone or in combination with different doses of α-tocopherol, were given to Swiss albino rats for 30 days; in order to determine its role in oxidative stress and fatty liver, induced by the oxidized olive oils. Serum biochemical parameters and hematological indices of blood were analyzed. The liver was analyzed for histopathological changes, lipid peroxidation, and polar triacylglycerols composition. Results revealed that there was a significant decline in the serum total cholesterol, triglycerides, LDL, glucose and ALT; while a significant increase occurred in the serum HDL levels through the supplementation of α-tocopherol in male and female rats. Hematological parameters were almost in the normal reference range in the groups that were fed α-tocopherol, alone or in combination with oxidized oil, while being significantly altered by the oxidized olive oil. There were acute hepatitis and necrosis in the liver with no fatty changes after feeding with oxidized olive oil, along with varying doses of α-tocopherol. Higher amounts of polar compounds were present in female rats (15.2–93.1 μg/g) compared to male rats (12.2–82.3%) that correspond to the supplementation of α-tocopherol in combination with oxidized oil. Lipid oxidation in liver was minimized by tocopherol, while an increase occurred in the accumulation of oxidized lipids in the liver. These findings revealed that tocopherol is beneficial against the oxidized oil induced biochemical and hematological changes and lipid peroxidation but causes fatty accumulation in the liver. Therefore, the role of tocopherol in patients with fatty liver disease may be considered, as tocopherol may increase the chance of survival

Numerical study of time-fractional fourth-order differential equations with variable coefficients

AbstractIn this article, we study numerical solutions of time-fractional fourth-order partial differential equations with variable coefficients by introducing the fractional derivative in the sense of Caputo. We implement reliable series solution techniques namely Adomian decomposition method (ADM) and He’s variational iteration method (HVIM). Some applications are presented to highlight the significant features of these techniques. The comparison shows that the solutions obtained are in good agreement with each other and with their respective exact solutions. Some of these types of differential equations arise practically in the theory of transverse vibrations

Design and Development of an effective DDoS Shield to implement a well secured Defense System against vulnerable attacks

ABSTRACT: Denial of Service and the Distributed Denial of Service Attacks have recently merged as one of the most newsworthy, if not the greatest, weaknesses of the Internet. This research paper attempts to explain how they work, why they are hard to combat today, and what will need to happen if they are to be brought under control. It is divided into parts for the purpose of easy analysis and understanding. The first is an overview of the current situation and also brief explanatory of the rest of the chapters being covered. The second is a detailed description of exactly how this attack works, and why it is hard to cope with today; of necessity it includes a description of how the Internet works today. The third section is totally about the different attacks in recent years and how they affected the people or the big organizations. The fourth section describes the short-term prospects, the tools which are used to rectify these attacks. The fifth is problems being faced with an explanatory of the percentage of attack in recent years and comparing the problems. The sixth is what can be done today to help alleviate this problem. The seventh section describes the legal actions and also legal actions that can be followed against the attack by the victim; and the eighth section describes the long-term picture, what will change to bring this class of problem under control, if not eliminate it entirely

Molecular epidemiology of hcv among health care workers of khyber pakhtunkhwa

<p>Abstract</p> <p>Background</p> <p>Studies of the molecular epidemiology and risk factors for hepatitis C virus (HCV) in health care workers (HCWs) of Peshawar, Khyber Pakhtunkhwa region are scarce. Lack of awareness about the transmission of HCV and regular blood screening is contributing a great deal towards the spread of hepatitis C. This study is an attempt to investigate the prevalence of HCV and its possible association with both occupational and non-occupational risk factors among the HCWs of Peshawar.</p> <p>Results</p> <p>Blood samples of 824 HCWs, aged between 20-59 years were analysed for anti-HCV antibodies, HCV RNA and HCV genotypes by Immunochromatographic tests and PCR. All relevant information was obtained from the HCWs with the help of a questionnaire. The study revealed that 4.13% of the HCWs were positive for HCV antibodies, while HCV RNA was detected in 2.79% of the individuals. The most predominant HCV genotype was 3a and 2a.</p> <p>Conclusion</p> <p>A program for education about occupational risk factors and regular blood screening must be implemented in all healthcare setups of Khyber Pakhtunkhwa province in order to help reduce the burden of HCV infection.</p

Identification and characterization of antibacterial compound(s) of cockroaches (Periplaneta americana)

Infectious diseases remain a significant threat to human health, contributing to more than 17 million deaths, annually. With the worsening trends of drug resistance, there is a need for newer and more powerful antimicrobial agents. We hypothesized that animals living in polluted environments are potential source of antimicrobials. Under polluted milieus, organisms such as cockroaches encounter different types of microbes, including superbugs. Such creatures survive the onslaught of superbugs and are able to ward off disease by producing antimicrobial substances. Here, we characterized antibacterial properties in extracts of various body organs of cockroaches (Periplaneta americana) and showed potent antibacterial activity in crude brain extract against methicillin-resistant Staphylococcus aureus and neuropathogenic E. coli K1. The size-exclusion spin columns revealed that the active compound(s) are less than 10 kDa in molecular mass. Using cytotoxicity assays, it was observed that pre-treatment of bacteria with lysates inhibited bacteria-mediated host cell cytotoxicity. Using spectra obtained with LC-MS on Agilent 1290 infinity liquid chromatograph, coupled with an Agilent 6460 triple quadruple mass spectrometer, tissues lysates were analyzed. Among hundreds of compounds, only a few homologous compounds were identified that contained isoquinoline group, chromene derivatives, thiazine groups, imidazoles, pyrrole containing analogs, sulfonamides, furanones, flavanones, and known to possess broad-spectrum antimicrobial properties, and possess anti-inflammatory, anti-tumour, and analgesic properties. Further identification, characterization and functional studies using individual compounds can act as a breakthrough in developing novel therapeutics against various pathogens including superbugs

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research