Global [formula omitted]-Commerce (G[formula omitted]C) theory by intuitionistic fuzzy [formula omitted]-submodule

Intuitionistic fuzzy set (IFS) theory can be applied for multi-aspect systems due to its capability to address uncertainty and incomplete information in terms of membership and non-membership degrees. Unfortunately, classical Γ -structures cannot handle fuzzy and imprecise information in real problems. In fact, there is no rigorous base to practically express the effectiveness of multi-attribute systems in IFS environment. Here, we develop a generalized IFS with the notion of Γ -module called intuitionistic fuzzy Γ -submodule (IF Γ M) to establish a novel " Global electronic (e)-Commerce (GeC) Theory ". To simplify the analysis of parameters, (α , β) -cut representation is proposed in terms of comprehensive distribution of fuzzy number for the classification of components. On the other hand, Cartesian product is implemented to correspond the elements. Substantial properties of IF Γ M including (α , β) -cut, Cartesian product and t -intuitionistic fuzzy Γ -submodule (t -IF Γ M) are characterized with illustrative examples to extend the framework of IF Γ M, where (α , β) -cut and support t -IF Γ M are verified to be Γ -submodules based on the properties of IF Γ M. Through Γ -module homomorphism, image and inverse image, the parametric connections between (α , β) -cuts are systematically investigated. In addition, a mathematical relationship between the Cartesian product and (α , β) -cut is determined. The overlapping intersection of a collection of t -IF Γ M is proved to be t -IF Γ M, and the image and inverse image are preserved under Γ -module homomorphism. As global e -trades are increasingly expanding after the recent coronavirus disease 2019 (COVID-19) hit, with the growth of 26.7-trillion dollars, businesses are required to transform their traditional functional natures to online (or blended) strategies for cost efficiency and self-survival in the present competitive environment. Therefore, compared to recent studies on IFS in the context of Γ -structures, the main contribution of this study is to provide a theoretical basis for the establishment of a new GeC Theory through the developed IF Γ M method and Γ -module M which targets the purchasing rate of customers through e -commerce companies. In the end, the performance of the proposed method in terms of upper and lower cut, t -intuitionistic fuzzy set, support and IF Γ M model, is analyzed in the developed GeC Theory. The proposed GeC Theory is validated using real datasets of e -commerce mega companies, i.e., Amazon, Alibaba, eBay, Shopify. They are characterized based on the amount of online shopping by samples (individuals). Compared to the existing methods, the GeC approach is an effective IFS-based method for complex systems with uncertainty. [ FROM AUTHOR] Copyright of Engineering Applications of Artificial Intelligence is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

In-Hospital Delays for Acute Stroke Treatment Delivery During the COVID-19 Pandemic.

BACKGROUND: We investigated the impact of regionally imposed social and healthcare restrictions due to coronavirus disease 2019 (COVID-19) to the time metrics in the management of acute ischemic stroke patients admitted at the regional stroke referral site for Central South Ontario, Canada. METHODS: We compared relevant time metrics between patients with acute ischemic stroke receiving intravenous tissue plasminogen activator (tPA) and/or endovascular thrombectomy (EVT) before and after the declared restrictions and state of emergency imposed in our region (March 17, 2020). RESULTS: We identified a significant increase in the median door-to-CT times for patients receiving intravenous tPA (19 min, interquartile range (IQR): 14-27 min vs. 13 min, IQR: 9-17 min, p = 0.008) and/or EVT (20 min, IQR: 15-33 min vs. 11 min, IQR: 5-20 min, p = 0.035) after the start of social and healthcare restrictions in our region compared to the previous 12 months. For patients receiving intravenous tPA treatment, we also found a significant increase (p = 0.005) in the median door-to-needle time (61 min, IQR: 46-72 min vs. 37 min, IQR: 30-50 min). No delays in the time from symptom onset to hospital presentation were uncovered for patients receiving tPA and/or endovascular reperfusion treatments in the first 1.5 months after the establishment of regional and institutional restrictions due to the COVID-19 pandemic. CONCLUSION: We detected an increase in our institutional time to treatment metrics for acute ischemic stroke patients receiving tPA and/or endovascular reperfusion therapies, related to delays from hospital presentation to the acquisition of cranial CT imaging for both tPA- and EVT-treated patients, and an added delay to treatment with tPA.

Délais dans le traitement en milieu hospitalier des AVC aigus dans le contexte de la pandémie de COVID-19. CONTEXTE: Nous nous sommes penchés, dans le contexte de la pandémie de COVID-19, sur l'impact de restrictions régionales imposées dans le domaine social et dans les soins de santé sur les délais de prise en charge de patients victimes d'un AVC aigu. À noter que ces patients ont été admis dans un centre régional de traitement des AVC situé dans le centre-ouest de l'Ontario (Canada). MÉTHODES: Nous avons comparé entre eux les délais de prise en charge de patients ayant bénéficié d'activateurs tissulaires du plasminogène par intraveineuse (tPA) et/ou d'une procédure de thrombectomie endovasculaire (TE) avant et après la mise sur pied de restrictions et l'imposition d'un état d'urgence sanitaire dans notre région (17 mars 2020). RÉSULTATS: Après la mise sur pied de ces restrictions, nous avons identifié, par rapport aux 12 mois précédent, une augmentation notable des délais médians entre l'arrivée à l'hôpital et un examen de tomodensitométrie dans le cas de patients bénéficiant de tPA (19 minutes, EI : 14­27 minutes contre 13 minutes, EI : 9­17 minutes ; p = 0,008) et/ou d'une procédure de TE (20 minutes, EI : 15­33 minutes contre 11 minutes, EI : 5­20 minutes ; p = 0,035). Pour ce qui est des patients bénéficiant de tPA, nous avons également observé une augmentation importante (p = 0,005) des délais médians entre leur arrivée à l'hôpital et l'injection d'un traitement (61 minutes, EI : 46­72 minutes contre 37 minutes, EI : 30­50 minutes). Enfin, dans le premier mois et demi suivant la mise sur pied des restrictions régionales et institutionnelles attribuables à la pandémie de COVID-19, aucun délai supplémentaire entre l'apparition des premiers symptômes d'un AVC et l'arrivée à l'hôpital n'a été remarqué pour des patients bénéficiant de tPA et/ou d'une procédure de TE. CONCLUSION: En somme, nous avons détecté une augmentation de nos délais de traitement dans le cas de patients victimes d'un AVC aigu ayant bénéficié de tPA et/ou d'une procédure de TE. Cela peut être attribué à une augmentation des délais de présentation à l'hôpital mais aussi à des délais dans l'obtention d'images de tomodensitométrie pour des patients traités avec des tPA et une procédure de TE, sans compter des délais accrus pour bénéficier d'un traitement de tPA.

Comparison of vaccine-induced antibody neutralization against SARS-CoV-2 variants of concern following primary and booster doses of COVID-19 vaccines.

The SARS-CoV-2 pandemic has, as of July 2022, infected more than 550 million people and caused over 6 million deaths across the world. COVID-19 vaccines were quickly developed to protect against severe disease, hospitalization and death. In the present study, we performed a direct comparative analysis of four COVID-19 vaccines: BNT162b2 (Pfizer/BioNTech), mRNA-1273 (Moderna), ChAdOx1 (Oxford/AstraZeneca) and Ad26.COV2.S (Johnson & Johnson/Janssen), following primary and booster vaccination. We focused on the vaccine-induced antibody-mediated immune response against multiple SARS-CoV-2 variants: wildtype, B.1.1.7 (Alpha), B.1.351 (Beta), B.1.617.2 (Delta) and B.1.1.529 (Omicron). The analysis included the quantification of total IgG levels against SARS-CoV-2 Spike, as well as the quantification of antibody neutralization titers. Furthermore, the study assessed the high-throughput ACE2 competition assay as a surrogate for the traditional pseudovirus neutralization assay. The results demonstrated marked differences in antibody-mediated immune responses. The lowest Spike-specific IgG levels and antibody neutralization titers were induced by one dose of the Ad26.COV2.S vaccine, intermediate levels by two doses of the BNT162b2 vaccine, and the highest levels by two doses of the mRNA-1273 vaccine or heterologous vaccination of one dose of the ChAdOx1 vaccine and a subsequent mRNA vaccine. The study also demonstrated that accumulation of SARS-CoV-2 Spike protein mutations was accompanied by a marked decline in antibody neutralization capacity, especially for B.1.1.529. Administration of a booster dose was shown to significantly increase Spike-specific IgG levels and antibody neutralization titers, erasing the differences between the vaccine-induced antibody-mediated immune response between the four vaccines. The findings of this study highlight the importance of booster vaccines and the potential inclusion of future heterologous vaccination strategies for broad protection against current and emerging SARS-CoV-2 variants.

Economic Anxiety and the Performance of SMEs during COVID-19: A Cross-National Study in Kuwait

The focal aim of the project was to assess the economic anxiety (EA) and the performance of small and medium enterprises (SMEs) during partial and full lockdowns in Kuwait. The challenges facing the SMEs during COVID-19 and the potential solutions were also explored. The call for this vital investigation was due to the global economic fallout and the shocking drop within the marketplace caused by the COVID-19 pandemic. A descriptive approach was used for online survey design to collect datasets from 147 SMEs spanning all governorates of Kuwait in the period between March and June 2021. It included sociodemographic data, economic anxiety perception, potential challenges and solutions to SMEs, and SMEs’performance. The data analysis using SPSS 25 showed that 78.2% of the SMEs were affected directly by the COVID-19 pandemic, and about 83% were affected negatively by the COVID-19 pandemic. In comparison, only 12.2% experienced a positive impact, mainly medical, technology, social media, food supplies, and delivery or logistics industries. With great concerns of SMEs for all dimensions related to economic anxiety (with an average of around 3.95), the greatest concerns were the financial and cash flow, followed by labor shortage (an average between 4.51 and 5.00). The results also showed that most of the performance indicators for the SMEs were low (with an average of less than or equal to 2.5), and more than 66% of them worked fewer hours during the pandemic;the number of operating hours was dropped dramatically. More than 74% of the SMEs used technology in more than 20% of their activities, representing an increase in using technologies of about 44%, and about 25.2% used social networks in more than 80% of their activities. The performance of SMEs is also found to be significantly and positively correlated with the economic anxiety levels, with a correlation coefficient of 0.186. The findings revealed significant and crucial outcomes for policymaking, decision-makers, and governmental agencies to build recovery plans and proper actions needed to manage the consequences caused by the disaster against the economic and other developments within the context of SMEs. Overall, there is a clear need to find ways and customize operations to adapt to the new work modes that require social distancing, online operations, and site management. In addition, new alternative modes of SMEs work follow to compensate for the lower working hours from the office and increased online working from home.

Effect of a combination of nitazoxanide, ribavirin, and ivermectin plus zinc supplement (MANS.NRIZ study) on the clearance of mild COVID-19.

This trial compared the rate and time of viral clearance in subjects receiving a combination of nitazoxanide, ribavirin, and ivermectin plus Zinc versus those receiving supportive treatment. This non-randomized controlled trial included 62 patients on the triple combination treatment versus 51 age- and sex-matched patients on routine supportive treatment. all of them confirmed cases by positive reverse-transcription polymerase chain reaction of a nasopharyngeal swab. Trial results showed that the clearance rates were 0% and 58.1% on the 7th day and 13.7% and 73.1% on the 15th day in the supportive treatment and combined antiviral groups, respectively. The cumulative clearance rates on the 15th day are 13.7% and 88.7% in the supportive treatment and combined antiviral groups, respectively. This trial concluded by stating that the combined use of nitazoxanide, ribavirin, and ivermectin plus zinc supplement effectively cleared the SARS-COV2 from the nasopharynx in a shorter time than symptomatic therapy.

Drug supply shortage in Nigeria during COVID-19: efforts and challenges.

The COVID-19 pandemic has resulted in massive disruptions in global supply chains. Nigeria is particularly vulnerable with respect to pharmaceuticals since there is reduced local production and about 70% of the drug supply is imported creating a huge supply-demand disparity particularly in times like COVID-19. Nigeria is in need of huge quantities of quality-assured health commodities to effectively respond to the pandemic. Significant shortages of other essential medicines and medical products across the country could be imminent. Drug scarcity in Nigeria during the COVID-19 pandemic period is because of several accumulated factors, majorly as a result of global lockdown, decreased manufacturing, unaddressed regulatory affairs, poor access to resources by the population, lack of buffer stocks, security instability, and poor funding of the healthcare system. This situation if left unattended, could cause serious drawbacks to the health of the populace as well as the quality of life of Nigerians amid the COVID-19 Pandemic. Appropriate measures should be directed to ensure ethical processes on drug production, importation, pricing, and distribution to avoid such events during unavoidable scenarios, like the COVID-19 pandemic and other public health emergencies.

Yemen's triple emergency: Food crisis amid a civil war and COVID-19 pandemic.

Yemen has been termed as the world's worst humanitarian crisis by the United Nations. About 20.1 million (more than 50% of population) Yemenis are facing hunger and 10 million are severely food insecure according to reports by the World Food Programme. With the spread of COVID-19, the situation in Yemen has worsened and humanitarian aid from other countries has become the basis of life for hundreds of thousands of Yemenis after the threat of famine. Yemen is practically one of the poorest countries in the world. It has structural vulnerabilities that have developed over a protracted period of conflict and poor governance and more than 50% live in starving, they suffer for getting one meal a day. To prevent a total collapse of Yemen's food crises, the government and the international community should act now more decisively.

The Psychological Impact of the COVID-19 Pandemic on Health Professionals in Sudan 2020

Abstract: Background: The 2019 novel coronavirus (COVID-19) is highly contagious with pandemic transmission, and is therefore associated with severe  health problems and high public anxiety, with healthcare community speculation to be the most distressed because they are at the highest risk of infection. This study aimed to investigate the psychological impact on frontline medical staff in Khartoum state, Sudan, during the COVID-19 pandemic between January and March 2020.Materials and Methods: Patient Health Questionnaire-9 (PHQ-9) scale, Generalized Anxiety Disorders (GAD-7) scale, and the Revised Impact of  Event Scale (IES-R) were used to assess depression, anxiety, and Post-traumatic Stress Disorders (PTSD) on the participants, respectively, through an online questionnaire. The data were analyzed using the Statistical Package for Social Science (SPSS) version 24.Results: PHQ-9 depression scale showed that 285 (82%) staff members had some degree of depression, with mild depression being the most  frequent, seen in 96 (24.2%), whereas, severe depression was found to be more common among the age group between 45 and 65 years and was associated with working in the emergency room (ER) (P = 0.03). The PTSD among our participants was assessed by the IES-R that showed that 116 (29.3%) had subclinical PTSD, 124 (31.3%) had mild PTSD symptoms, 98 (24.7%) had moderate PTSD symptoms, and 58 (14.6%) had severe PTSD symptoms. Also, a statistical association was seen between the IES-R mean score and the age group between 25 and 34 years (P < 0.0001), having a friend or family member infected with the disease (P < 0.0001), and having a history of contact with a positive case of COVID-19 (P < 0.0001). We used GAD-7 anxiety score that showed mild anxiety in 32 (23.2%) participants, moderate anxiety in 53 (13.4%), and severe anxiety 66 (16.7%).Conclusion: This study aimed to explore the psychological impact of COVID-19 pandemic on medical staff’s perception and its determinants. Most of our participants were found to be suffering from anxiety and depression with combining personal variables and working conditions as predictors

The Hajj and COVID-19: How the Pandemic Shaped the World's Largest Religious Gathering.

The Hajj pilgrimage, one of the five pillars of Islam, is held in Saudi Arabia in the second week of Dhu'l-Hijjah, the last month of the Islamic calendar. It is one of the world's largest mass gatherings, constituting more than 2.5 million Muslim pilgrims from more than 180 countries. The COVID-19 pandemic posed a significant public health threat for such mass gatherings. Thus, a health risk assessment for the 2020 Hajj was held by the Saudi Arabia Ministry of Health and the WHO Collaborating Centre for Mass Gatherings Medicine, which concluded that foreign pilgrims should be excluded from the 2020 Hajj and that the number of pilgrims should be significantly reduced. Timely decisions allowed the Saudi government to conduct the Hajj, despite an initial postponement. However, the number of pilgrims was significantly downscaled, and extensive new protocols were set in place because of the pandemic. This article aims to shed light on the challenges faced and efforts made by Saudi Arabia to mitigate the spread of COVID-19 during the religious proceedings of the Hajj.