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PurposeThis sudden disruption of work in the world due to the coronavirus disease 2019 (COVID-19) pandemic has led to unravelling situations hitherto unknown to researchers and therefore requires careful and thorough investigation. The aim of the study was to investigate the relationship between work from home (WFH) isolation, WFH loss of task identity and job insecurity amid COVID-19 pandemic WFH arrangements by focusing on information technology/information technology-enabled services (IT/ITES) sector employees in India. The study also investigated the mediating role of work alienation.Design/methodology/approachData were collected from IT/ITES sector employees who were working from home. The sample size was 312, with 71.8% males and 28.2% females. The study used a descriptive research design. Analysis of the data was carried out using partial least square structural equation modeling. All constructs–independent and dependent–were reflectively measured. The evaluated quality parameters (discriminant validity, reliability, collinearity, common method bias) for all the constructs were found to be within acceptable limits.FindingsFindings from the study indicate that WFH-related isolation and loss of task identity have a significant direct impact on job insecurity. These, along with the mediating construct of work alienation, predicted a 35.8% variance in job insecurity. The study found that work alienation provided complementary mediation between the independent constructs evaluated.Originality/valueThis study attempts to scrape the surface and gain insight into the problems that may arise in the new world of work. This paper presents an attempt to explain some of the psychological pitfalls associated with WFH during the COVID-19 pandemic and to understand their impact on job insecurity.

Food delivery applications (FDAs) represent a category of mobile applications that are used by consumers to order food online. The popularity of these FDAs has been growing exponentially recently, yet not much research has been carried out the topic. This study investigates consumers’ acceptance of FDAs using the theory of consumption values as its theoretical basis. The model explores the association between consumption values (functional, social, emotional, conditional, and epistemic), visibility, and usage intention of FDAs. Data were collected from 440 Indian consumers and the model was tested using structural equation modeling. Except for emotional value, the results indicated a significant association between functional, social, conditional, and epistemic values and usage intention. Furthermore, visibility mediated the relationship between consumption values and usage intention. This study’s theoretical and practical contributions are relevant to researchers and practitioners working in areas related to FDAs.

The popularity of e-tailers has distorted the retail industry in India. Websites are becoming an important means through which customers get product information and purchase items for their needs. This research paper focuses on four dimensions, i.e. user interface, convenience, personalized recommendations, and perceived security of the website, to assess their impact on online customer satisfaction with and loyalty towards E-tailers. The study questionnaire used established measures. The data was collected from four large cities in India, namely Chennai, Mumbai, Kolkata and Delhi. Analysis of the survey results suggests that perceived website security is the most important dimension for customer loyalty. E-tailers have to ensure adequate security provisions in their websites to build up consumer perceptions of trust and so repeat business loyalty.

High mortality has been observed in the cancer population affected with COVID-19 during this pandemic. We undertook this study to determine the characteristics and outcomes of cancer patients with COVID-19 and assessed the factors predicting outcome.Patients of all age groups with a proven history of malignancy and a recent diagnosis of SARS-CoV-2 infection based on nasal/nasopharyngeal reverse transcriptase (RT)-PCR tests were included. Demographic, clinical and laboratory variables were compared between survivors and non-survivors groups, with respect to observed mortality.Between May 11 and August 10, 2020, 134 patients were included from the three centres and observed mortality was 17.1 per cent. The median age was 53 yr (interquartile range 39-61 yr) and thirty four patients (25%) were asymptomatic. Solid tumours accounted for 69.1 per cent and breast cancer was the most common tumour type (20%). One hundred and five patients (70.5%) had received chemotherapy within the past four weeks and 25 patients (19.3%) had neutropenia at presentation. On multivariate analysis, age [odds ratio (OR) 7.99 (95% confidence interval [CI] 1.18-54.00); P=0.033], haemoglobin [OR 6.28 (95% CI 1.07-37.04); P=0.042] neutrophil-lymphocyte ratio [OR 12.02 (95% CI 2.08-69.51); P=0.005] and baseline serum albumin [OR 18.52 (95% CI 2.80-122.27); P=0.002], were associated with higher mortality. Recent chemotherapy, haematological tumours type and baseline neutropenia did not affect the outcome.Higher mortality in moderate and severe infections was associated with baseline organ dysfunction and elderly age. Significant proportion of patients were asymptomatic and might remain undetected.

We provide the South Asian Declaration, containing the consensus guidelines for coronavirus disease 2019 (COVID-19) vaccination in cancer patients.

Purpose Prolonged closure of educational institutions prompted authorities to adopt online teaching as an alternative method to impart education. The purpose of this study is to investigate the readiness on the part of teachers to switch/adopt online teaching as a part of their pedagogy. Also, this study analyses relationship between perceived stress (PS) and readiness to change (RTC)/adopt. Design/methodology/approach All the constructs were adapted from established scales, exploratory factor analysis confirmed item loadings on the appropriate constructs. Convenience sampling was used for data collection; owing to COVID-19 this appeared to be the only viable method. Partial least square structural equation modelling was used for analysis of data. Findings Results from this study indicate that 32.2% variance in RTC is accounted for by exogenous constructs perceived usefulness, perceived ease of use and autonomy (AUT). Although f2 effect size pointed towards non-significance of AUT in predicting RTC (path coefficients were found to be significant for all the exogenous constructs). Also, RTC accounted for 32.6% variance in PS. To assess the predictive relevance of the model, blindfolding procedure was used to obtain Q2 values (Q2PS = 0.231; Q2RTC = 0.243). Positive Q2 values provide support for the model’s predictive relevance. Research limitations/implications Data were collected from teachers employed in urban public schools. A complete picture can be obtained by involving teachers from rural public and state-run schools. Practical implications Teachers’ readiness to adopt online teaching as a part of their pedagogy may act as a starting point for the policymakers to design properly structured training programs for teachers that minimise stress levels. Social implications If not handled properly, the society may end with either loss of learning to one generation or a major chunk of stressed-out teaching populations or both. Originality/value To the best of the author’s knowledge, this study is probably the first one focusing on sudden shift to online teaching and PS.

Transition to e-learning has become crucial in the last two years, partially forced by the current pandemic. Therefore, the main objective of this study is to examine an integrated and comprehensive moderation-cum-mediation model that focuses on user intention to adopt e-learning. Self-efficacy, interaction, and e-learning contents were taken as the independent constructs. User satisfaction and user intention were taken as dependent constructs. Enjoyment and choice were taken as moderators. “Choice” was explicitly used in this study as a moderator to test whether the transition was by force or choice. Five hundred and sixty-two teachers and students from two countries, India and Saudi Arabia, were considered for this study. The findings indicate that self-efficacy and interaction augment user satisfaction and user intention. User satisfaction enhances user intention. It also mediates the relationship between self-efficacy, interaction, and user intention. Choice moderates the relationship between interaction and user intention. Enjoyment moderates the relationship between e-learning contents and user intention. This study is unique as it provides a multi-group analysis that compares nationality, gender, and the type of respondents in a multi-national context. All the stakeholders of e-learning, the teachers, the students, the policymakers, and the platforms, may find the results of this study particularly useful.

Introduction Our objective was to document the incidence of COVID-19 in vaccinated health care professionals and related personnel. Method We conducted an online survey to ascertain the incidence of COVID-19 symptoms, reverse transcriptase polymerase chain reaction (RT-PCR) positivity, effect on normal activity, need for anti-COVID-19 medication, hospitalization, and death among individuals who had completed both doses of COVID vaccination at least 2 weeks earlier. Results A total of 351 unique valid responses were received. Among the 340 people who had been vaccinated in India, 5% (17/340) had COVID-19 symptoms, 4.7% (16) became COVID-19 RT-PCR positive, 12 (3.5%) had sickness preventing normal daily activity, 2.65% (9) required anti-COVID-19 medication, and 1.18% (4) required hospitalization. Among family members living with the survey responders, the corresponding incidence was even lower. There was one death in this group. Discussion Being health care professionals, the responders would be at higher risk of daily exposure to COVID-19. Even in this high risk group, the vaccine efficacy is good. Vulture journalists should stop spreading fake news and misinformation that makes people hesitate taking the vaccine or be afflicted analysis paralysis. Every person who chooses to remain unvaccinated increases the risk for our entire community. We also need to follow universal precautions (wearing mask, physical distancing, handwashing) diligently without letting down our guard.

Aims and Objectives: The ongoing COVID-19 pandemic is having a profound impact on the current clinical trials. We wanted to document the extent of the disruption amongst Indian clinical trial sites. Materials and Methods: We conducted an online survey among oncologists in India with active trials to document their experience with challenges and novel solutions. Results: A total of 60 oncologists replied of which 40 had ongoing trials with open recruitment. Majority of them had stopped screening (55%) and recruitment (62.5%). Almost half of the sites did not have adequate infrastructure (47.5%). Almost all the sites had enrolled patients worried about the impact of COVID-19 on their health outcome (up to 87.5%). The majority of sites had problems with adherence to study schedule of events (87.5%) and administration of study medication (42.5%). A total of 55% of the sites had provided the option of virtual visits. Both investigators (75%) and sponsors/contract research organizations (67.5%) had reached out to each other to maintain study integrity. More than half the centers had difficulty related to adverse events and serious adverse events (documentation and reporting; up to 75%). Discussion: Regulatory authorities in several countries have announced guidelines on the conduct of clinical trials during the COVID-19 pandemic. Whether the disruption lasts for a short or long time, its impact on clinical trials is going to be irreparable.

Objective: We are presently going through a historic and unprecedented crisis for humanity with SARS-CoV-2 causing immense damage to life and world economics. It has been 3 months, since we had the first cluster in China and we felt the need to look into certain regional patterns of transmission of the virus with respect to some distinctive living conditions, incidence of malaria, the genomics of different strains, and its impact on severity. Material and Methods: Data for 107 countries was compiled and correlation analysis was done between incidence of malaria and number of SARS-CoV-2 cases. Possibility of genetic similarity between SARS-CoV-2 and reported zoonotic RNA viruses found associated previously with some Plasmodium species was explored by utilizing NCBI database. Results: We found a significant inverse correlation between SARS-CoV-2 disease burden and incidence of Malaria. Our analysis also showed that a 12 base pair region encoding a part of surface glycoprotein of SARS- CoV-2 aligned with the Plasmodium associated zoonotic viral genome. Conclusion: Our analysis suggests a significantly lower SARS-CoV-2 disease burden in Malaria endemic regions and an inverse correlation with incidence of Malaria. The possibility of a pre-existing immunological memory for SARS-CoV-2 in Indians is possible and needs to be explored further

The management of patients with colorectal cancer during the current SARS-CoV2 pandemic opens a Pandora's Box. While the world is facing an unprecedented crisis of fighting a life-threatening infectious disease, patients with colorectal cancer are facing the dual challenge to fight cancer while protecting them from infection. We attempted to critically examine the existing evidence for chemotherapy in colorectal cancer in different stages of disease and suggest treatment options in these vulnerable patients. Treatment options which do not overburden existing health-care resources can be provided for patients with colorectal cancer patients requiring chemotherapy without significant compromise in efficacy or increase the risk of hospital acquired SAR-CoV-2 infection.

There has been a paradigm shift in the management of cancer, with the immense progress in cancer genomics. More and more targeted therapies are becoming available by the day and personalized medicine is becoming popular with specific drugs being designed for selected subgroups of patients. One such new class of targeted drugs in the armamentarium is Poly ADP Ribose Polymerase (PARP) inhibitors (PARPi), which inhibit the enzyme PARP, thus interfering with DNA repair. This strategy utilizes a pre-existing genomic lesion in tumors with homologous recombination repair defects (including BRCA mutations), weakening tumor cells further by blocking the alternate pathway of DNA repair. In this review, we discuss in detail, the evolution, genetics, mechanism of action, mechanism of resistance, indications of use of PARP inhibitors, as well as combination with other agents and future directions.

Incidence of mucormycosis suddenly surged in India after the second wave of COVID-19. This is a crippling disease and needs to be studied in detail to understand the disease, its course, and the outcomes.Between 1st March and 15th July 2021, our network of hospitals in North India received a total of 155 cases of COVID-associated mucormycosis cases as all of them reported affliction by COVID-19 earlier or concurrent. Their records were retrieved from the Electronic Health Records system of the hospitals and their demographics, clinical features, treatments, and outcomes were studied. More than 80% (125 cases) had proven disease and the remaining 30 were categorized as ‘possible’ mucormycosis as per the EORTC criteria.More than two-thirds (69.0%) of the cases were males and the mean age was 53 years for either sex. Nearly two-thirds (64.5%) had symptoms of nose and jaws and 42.6% had eye involvement. Some had multiple symptoms. As many as 78.7% had diabetes and 91.6% gave history of use of steroids during COVID-19 treatment. The primary surgery was functional endoscopic sinus surgery (FESS) (83.9%). Overall mortality was 16.8%, which is one-and-a-half times the mortality in hospitalized COVID-19 patients in the corresponding population. Occurrence of mucormycosis was associated with diabetes and use of steroids, but mortality was not associated with either of them. Cases undergoing surgery and on antifungal had steeply lower mortality (11.9% vs. 50.0%, P < 0.001) than those who were exclusively on antifungal drugs. Treatment by different drugs did not make much of a difference in mortality.

Introduction: We present data from a systematic survey on conflict of interest (COI) disclosure and its interpretation by the doctors participating in continuing medical education (CME). Methods: A brief 12 question online Google survey with multiple choice options (read, select, and click) was done among Indian practicing doctors using links shared through WhatsApp through the internet over a 72 h period. Results: Of the 386 replies, 373 unique replies were eligible for evaluation. The majority found CME activities beneficial. About 73% of participants would watch out for bias, even if the speaker shows COI disclosure slide. The use of brand/trade names was considered as a flag for bias by the majority. About 99% wanted the speaker to show a final take home message slide. Cross verification of the data presented by comparing to published data was done in more than 75% of instances by only 25% of the participating doctors. A significantly higher number of doctors found bias when CME activities were being organized by the health-care industry as compared to programs of medical bodies/societies/organizations. Discussion: COI considerations are given due to the importance of medical professionals. However, doctors are smart enough to understand the limitations of such disclosures and remain alert to ensure they are not influenced by any bias. Take home message slide gives the presenters opportunity to share their insights and allows the audience to make their own judgment on the impartiality of the data presented. The doctors are aware that bias could be more when CME activities are organized by healthcare industry and take appropriate precautions. Conclusion: COI is is given due importance by the medical professionals. COI disclosures are often incomplete. Doctors remain alert to ensure they are not influenced by biased presentations. Concluding take home message slide is unanimously recommended. Presentation bias is more when healthcare industry is directly organizing educational and promotional activities.

e18018 Background: Oral cavity squamous cell carcinoma (OCSCC) is the third most common malignancies in India with an estimated 72,000 deaths annually. The incidence is increasing owing to rising alcohol and tobacco consumption in last 2 decades. Methods: We performed a retrospective cohort study in patients with OCSCC to identify risk factors for local and metastatic recurrences following definitive treatment including surgery and/or radiation therapy or chemotherapy or both at our institute. Patient records were screened from 2016 till 2021. Eligible patients were followed up for disease status and outcome. Data included sociodemographic details, substance use, tumor differentiation, stage at diagnosis, LVI, PNI, margin status, treatment details and site of recurrence. All statistical analysis was performed on Microsoft excel 2016 and Jamovi version 1.6.23.0. Results: Out of 195 patients files screened, 90 were available for analysis. Demographic details, substance use pattern and tumor profile are highlighted in table. Tongue was the most frequent site involved and most of the tumors were well to moderately differentiated. Majority of the patients presented as locally advanced disease (Stage IVa). LVI and PNI were identified in 5.75% and 29.89% patients respectively while one of the patients had a positive margin after resection. Surgery followed by adjuvant chemo-radiation was the most frequently prescribed treatment (n = 46; 52.8%) whereas 27.59% patients (n = 24) underwent surgery alone. Fifty six (63.3%) patients experienced recurrence out of which 50% were local and 35% were metastatic recurrences. On multivariate analysis, the predictors of disease recurrence were male gender (OR- 3.2; 95% CI- 1.02-10.05; p-0.05), tobacco and alcohol use (OR- 1.93; 95% CI- 0.8-4.6; p- 0.14 and OR- 2.16; 95% CI- 0.82-5.65; p- 0.12 respectively), Stage IVb disease (OR- > 10; 95% CI- 0-10; p-1.0), presence of PNI (OR- 1.39 ; 95% CI- 0.55-3.70; p-0.497) and presence of LVI (OR- 2.54; 95% CI- 0.36-50.8; p- 0.414). Median disease free survival and overall survival of the cohort was 11.3 months and 15 months respectively. Advanced stage, tobacco consumption, presence of LVI and PNI negatively affected overall survival in our cohort. Conclusions: Oral cavity squamous cell carcinoma is among the most preventable malignancies and they contribute to significant morbidity and mortality. This study highlights the role of early detection and management of such patients. Patients may still experience disease recurrence after initial management which may be difficult to treat. Such patients should be encouraged to participate in a clinical trial as treatment options for recurrent disease are limited.[Table: see text]

e14562 Background: Checkpoint inhibitors are approved in various solid malignancies in either first-line or following progression on chemotherapy. These have shown good efficacy with low toxicity. However, there are very few studies from Indian centers. The purpose of the study was to assess the real world efficacy and toxicity in patients treated with Immunotherapy (IO) in various solid malignancies. Methods: The present study is a retrospective single-center hospital-based registry study that included 94 patients treated with immune checkpoint inhibitors in various solid malignancies from January 1, 2017 to December 31, 2020. The investigator assessed response at 3-months post-initiation of treatment has been reported. Patients who received less than two months of Immunotherapy were excluded in response analysis. Adverse events during IO were documented and graded using CTCAE (Common terminology criteria for adverse events), v.5.0. All statistical analysis was performed using Microsoft Excel 2016 and R software (Rx 64 version 3.6.2). Results: Sixty-nine patients who received more than 2 months of IO were assessed. Baseline characteristics of patients are listed in table 1. Lung cancer 29% (n= 27) Head and neck cancer 22% (n=21) and metastatic renal cell carcinoma 10% (n=9) were the common cancers where IO was given. Overall response rate at 3 months was 55% (n=38). Progressive disease and stable disease were seen in 39% (n=27) and 6% (n=5) patients respectively. The reported severe adverse events were pneumonitis, colitis, and hepatitis, with Grade 3 or more toxicities were in 7% (5/69) patients. Conclusions: IO was associated with clinical benefit and fewer toxic effects; however, increased treatment cost remains a significant concern in developing countries like India.[Table: see text]

There has been a paradigm shift in the management of cancer, with the immense progress in cancer genomics. More and more targeted therapies are becoming available by the day and personalized medicine is becoming popular with specific drugs being designed for selected subgroups of patients. One such new class of targeted drugs in the armamentarium is Poly ADP Ribose Polymerase (PARP) inhibitors (PARPi), which inhibit the enzyme PARP, thus interfering with DNA repair. This strategy utilizes a pre-existing genomic lesion in tumors with homologous recombination repair defects (including BRCA mutations), weakening tumor cells further by blocking the alternate pathway of DNA repair. In this review, we discuss in detail, the evolution, genetics, mechanism of action, mechanism of resistance, indications of use of PARP inhibitors, as well as combination with other agents and future directions.

Prolonged lockdown as a part of the community mitigation steps to control the spread of the corona virus has led to massive work reorganization throughout the world. Companies as well as individuals are attempting to adjust to this new world of work. Organizations have shifted substantial parts of their work for certain sets of jobs to a "work from home (WFH)" format. The aim of this study is to investigate the relationship between WFH) work engagement and perceived employee happiness. WFH work engagement was hypothesized to be influenced by WFH autonomy, WFH convenience, and WFH psychosocial safety. All of the constructs were adapted from established scales. Convenience sampling was used for data collection as, under the circumstances, this was the only viable method. Partial least squares structural equation modelling was used for data analysis. Results from this study indicate that WFH work engagement was able to predict a 23.9% variance in perceived happiness, while exogenous constructs, such as WFH autonomy, WFH convenience, and WFH psychosocial safety, were able to predict a 25.2% variance in WFH work engagement. Further f 2 effect size (0.313) between WFH work engagement and happiness indicates high effect size. In order to assess the predictive relevance of the model, a blindfolding procedure was used to obtain Q 2 values. Q 2 values greater than zero indicate that the model has predictive relevance.

Clinico-pathological differences between adenocarcinoma in the right and left colo-rectum play a role in determining the prognosis and response to treatment. Studies suggest that primary tumor location is more relevant as the disease progresses and reflects a possible difference in biology and response to therapy. This review aims to explore the clinico-pathological features of right and left colo-rectum and the impact of primary tumor location on prognosis of CRC as well as discuss the available clinical data on tumor sidedness in metastatic colorectal cancer. In so far as the clinical data of tumor sidedness is concerned, very few reviews have discussed the clinical implications of sidedness in heavily pre-treated metastatic colorectal cancer (second and subsequent lines of therapy in metastatic disease). This review aims to fill the current gap in this setting.