Beyond the immediate impositions of dealing with COVID-19, this disease represents a severe and significant challenge confronting Pakistan’s economy. The study’s objective was to evaluate the coronavirus epidemic’s effect on Pakistan’s economy and measures devised to mitigate the damage done by this disease. The study research design used the elementary concept of Keynesian theory comprising of the mapping of systematic behavior of the COVID-19 pandemic. Issues were formally underpinned, described, and visualized through the Keynesian theory concept. The eruption of COVID-19 has jolted the national and international economy. Pakistan is included, causing millions of people to stay at home, lose their jobs, and suspend or end business operations. Unemployment in Pakistan has reached nearly 25 million people, driving many towards conditions of hunger and poverty as the major economic damage in several sectors is anticipated at around PKR 1.3 trillion. The hardest-affected sectors comprise industries such as tourism and travel, financial markets, entertainment, manufacturing, etc., having a devastating effect on gross domestic product (GDP). It is mainly daily-wage earners and people running small businesses that have been seriously exploited and subjected to a curfew-like situation. However, the Keynesian theory suggests that supportive macroeconomic policies must restore trust, demand recovery, and provide interest-free loans to overcome Pakistan’s currently upcoming crisis.

Background: Clinicians often utilize off-label dose escalation of ustekinumab (UST) in Crohn’s disease (CD) patients with disease refractory to standard dosing. Previous studies report mixed results with dose escalation of UST. Methods: A retrospective observational study of 143 adult patients with CD receiving UST over a 33-month time period was conducted. Patients receiving UST at standard dosage for a minimum of 16 weeks were included in the analysis. Primary outcomes collected were clinical response [Physician Global Assessment Score (PGA) by >1] and remission (PGA = 0). Changes in clinical parameters were calculated for dose-escalated patients beginning with the time of dose switch (~42 weeks) and compared with a group of patients who were classified as “failing” standard dosing at 42 weeks who were not dose escalated. Results: Dose escalation improved PGA by 0.47 ± 0.19 compared with patients remaining on every 8 weeks dosing (Q8 week), who worsened by 0.23 ± 0.23 ( p < 0.05). Dose escalation decreased CRP 0.33 ± 0.19 mg/L and increased serum albumin 0.23 ± 0.06 g/dL ( p < 0.05). Surprisingly, disease duration and prior CD surgeries inversely correlated with the need for dose escalation. Conclusion: Our results support UST Q4 week dose escalation for selected CD patients who fail to achieve remission on standard Q8 week dosing. Dose escalation improves clinical outcomes, prevents worsening disease severity, and positively impacts CRP and albumin levels. Together these data indicate that clinicians should attempt Q4 week UST dosing in refractory CD patients before switching to an alternative class of biologic therapy.

The main issue with this paper is to investigate the link between emotional intelligence and transformational leadership and the role of organizational culture as a moderator on that relationship by using two research methods: The covariance-based structural equation modeling (CB-SEM) and partial least squares (PLS-SEM). The study examined a complex model consisting of 60 indicators including moderator effects which used real data. This will help in understanding the respective differences of the two approaches in a setup comprising model specification and parameter estimation. The dual SEM approach represents an important contribution, permitting validation of the model's robustness, and, thanks to the CB-SEM method, to overcome the limitations of PLS-SEM. The findings show that both methods yield similar results with minor differences that may be attributed to their respective estimation requirements including model fit and complexity issues. After considering these results and findings from studies done in this line, the researcher concludes that future studies need to observe recommendations made to focus on the phenomenon and research design aspects and, not mere modeling. A study limitation is not testing SEM boundaries with non-normal data and small sample size. The study is first to apply SEM approaches to verify results of a complex leadership model that included moderator affects. A key implication is the insight gained about the application of standards and guidelines for clarifying the interpretation of the SEM theories and models for leadership and management research. This implies the equal use of the CB-SEM and PLS-SEM for future studies, without undue bias.

PurposeThis research aims to examine the role of green intellectual capital (GIC) dimensions in promoting sustainable healthcare as reflected by sustainable performance. The mediating effect of green absorptive capacity (GAC) and moderating role of environmental turbulence were also explored.Design/methodology/approachStructural equation modeling was utilized for hypotheses testing of a survey data set of 387 at healthcare organizations operating in Iraq. The data were collected using purposive sampling with expert judgment from senior managers and professionals.FindingsContrary to previous studies, the findings showed that only green human and relational capitals predict green performance and only green human capital predicted economic performance. GAC was related to green human capital, green structural capital and performance, and played a significant mediating role on the relationships.Research limitations/implicationsEven though the research was limited to one region of a single country, Iraq, GAC can be modified by managers to enhance GIC for sustainable healthcare performance. This action must be viewed in terms of the future timing of the impact while managers display strong conviction for sustainability commitment. Managers will find GRC least associated with performance, but that GIC dimensions work best in unison.Originality/valueThe examination of GIC with GAC as moderated by environmental turbulence contributes nascent theoretical insights in sustainable healthcare.

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