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.)

Voice-assisted Artificial Intelligence-enabled Screening for Severe Acute Respiratory Syndrome Coronavirus 2 Exposure in Cardiovascular Clinics: Primary Results of the VOICE-COVID-19-II Randomized Trial.

BACKGROUND: Voice-assisted artificial intelligence-based systems may streamline clinical care among patients with heart failure (HF) and caregivers; however, randomized clinical trials are needed. We evaluated the potential for Amazon Alexa (Alexa), a voice-assisted artificial intelligence-based system, to conduct screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a HF clinic. METHODS AND RESULTS: We enrolled 52 participants (patients and caregivers) from a HF clinic who were randomly assigned with a subsequent cross-over to receive a SARS-CoV-2 screening questionnaire via Alexa or health care personnel. The primary outcome was overall response concordance, as measured by the percentage of agreement and unweighted kappa scores between groups. A postscreening survey evaluated comfort with using the artificial intelligence-based device. In total, 36 participants (69%) were male, the median age was 51 years (range 34-65 years) years and 36 (69%) were English speaking. Twenty-one participants (40%) were patients with HF. For the primary outcome, there were no statistical differences between the groups: Alexa-research coordinator group 96.9% agreement and unweighted kappa score of 0.92 (95% confidence interval 0.84-1.00) vs research coordinator-Alexa group 98.5% agreement and unweighted kappa score of 0.95 (95% confidence interval 0.88-1.00) (P value for all comparisons > .05). Overall, 87% of participants rated their screening experience as good or outstanding. CONCLUSIONS: Alexa demonstrated comparable performance to a health care professional for SARS-CoV-2 screening in a group of patients with HF and caregivers and may represent an attractive approach to symptom screening in this population. Future studies evaluating such technologies for other uses among patients with HF and caregivers are warranted. NCT04508972.

Assessing the Impact of COVID-19 on Indigenous Peoples in Latin America: Towards Effective Post-Pandemic Policies

[...]a broad and inclusive approach to post-pandemic policy-making—one that considers Indigenous forms of knowledge whilst fostering appreciation for their cultures and lives—is needed to adequately assist Indigenous peoples in repairing the harm they have suffered as a result of COVID-19.3 COVID-19 and its deadly impact on Indigenous communities There are no less than eight hundred distinct Indigenous communities across Latin America, each with its own unique identity, culture, and [End Page 169] history. In Bolivia, for example, where Indigenous groups comprise a significant portion of the electorate (between 41 and 62 percent of the population), Latin America's first Indigenous political executive was elected in 2006.4 In most instances, however, Indigenous peoples make up only a small proportion of Latin American country populations (generally ranging from 0.5–15 percent), one factor ensuring limited political influence and the widespread marginalization of their interests.5 As a consequence, Indigenous peoples across the region entered the pandemic whilst already suffering from a range of serious economic and socio-cultural inequalities.6 Inadequate access to medical care, chronic poverty and economic marginalization, racism and prejudice, and inadequate access to education are common issues that exacerbated the impact of the pandemic.7 The World Health Organization confirmed the arrival of the pandemic in the region on February 26, 2020. [...]Indigenous mortality rates were 4.03 percent in Brazil and 19.9 percent in Mexico—significantly higher than 2.2 percent and 5.7 percent overall mortality rates in each country respectively.9 Unfortunately, the lack of regional data on, and deliberate under-reporting of, Indigenous mortality rates across much of Latin America has problematized many of the available datasets.10 In Brazil, for example, organizations such as The Articulation of Indigenous Peoples (APIB), have shown that the total number of recognized Indigenous deaths (902 persons as of April 7, 2022), undercounts the actual figure by at least 31 percent.11 Other sources, such as the Special Secretariat for Indigenous Health (SESAI), which is responsible for Indigenous medical care, also provides incomplete data on Brazilian Indigenous mortality by failing to count Indigenous urban dwellers or those who live outside of recognized government-controlled territories in their data sets.12 Such groups are among some of the most vulnerable Indigenous communities in the country, receiving little, if any, support from government agencies charged with supporting Indigenous communities.13 As a result, the scale and scope of COVID-19's impact on Indigenous Brazilians is, and for the foreseeable future will likely remain, unknowable.14 Despite a lack of adequate data across much of Latin America, a growing body of evidence indicates that Indigenous peoples were particularly vulnerable to COVID-19, and that they likely died or suffered long-term health issues in disproportionate numbers.15 In a study of Indigenous peoples in Chile, for instance, regions with larger Indigenous populations recorded a noticeable increase in overall mortality.16 Where direct data do not exist, emerging studies suggest that the medical impact of COVID-19 was likely compounded by a range of structural inequalities and environmental factors.17 Many Indigenous peoples lack access to adequate medical care. [...]disproportionate exposure to pesticides—used extensively in agricultural industries in which many Indigenous people find employment, as well as exposure to smoke inhalation—caused by out-of-control forest fires across Latin America—likely exacerbated the repertory symptoms caused by COVID-19.18 As a consequence, Indigenous peoples had to face COVID-19 not only with fewer resources, but with greater exposure to the types of pre-existing conditions known to aggravate the impact of the disease.19 Particularly high mortality rates among Indigenous elders, who act as stores of traditional knowledge, affected cultural continuity and community cohesion.20 To better understand this we spoke with a representative of the Indigenous Kaingang people, Duko Vãgfy, who explained that "[t]he worst losses [we suffered] were the elders, because they held so much knowledge about [our] people.

Deaths by COVID-19 in a hospital from a city from Legal Amazon region: what lessons could be learned?

Objective: Describe the epidemiology of COVID-19 deaths within a hospital in the Amazon region in a period of 64 days, which corresponds to the growth curve of the COVID-19 first-wave pandemic in 2020. Method(s): The data were obtained from medical records of 152 deaths registered for adults and elderly hospitalized. The data were also compared with the number of deaths in previous years during the same period studied to assess the impact of the pandemic on this hospital. The study also assesses the impact of intra-hospital transfers, accounting for the number of times patients who died performed transfers between sectors of the hospital. Result(s): During the period analyzed, there was an increase in deaths compared to the previous years. The majority of dead patients were male, aged between 34 and 96 years. The deaths were associated comorbidities such as arterial hypertension, diabetes mellitus, and kidney disease. The SARS-CoV-2 infection was confirmed in 91 cases. Among them, 15 individuals were admitted without conditions related to SARS-CoV-2 infection;they had a three-fold higher number of hospital transfers than those admitted with SARS-CoV-2 infection symptoms. Sixteen patients with SARS-CoV-2 infection developed respiratory symptoms just after hospitalization. The diagnostic exam for SARS-CoV-2 infection was performed on average 4 (+/- 6) days after the onset of symptoms and 6 (+/- 6) days after admission, and the average time from the onset of respiratory symptoms to death was 4 (+/- 6) days. Conclusion(s): These data suggest the high presence of hospital infection by SARS-CoV-2 in the Brazilian Amazon region, which may be related to the number of sectorial transfers, delay in confirming the diagnosis, and lack of management. We report a serious public health problem, as it demonstrates the fragility of healthcare institutions in the hospital environment.Copyright © 2023 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.

Brazil's Amazon Oxygen Crisis: How Lives and Health Were Sacrificed During the Peak of COVID-19 to Promote an Agenda with Long-Term Consequences for the Environment, Indigenous Peoples, and Health.

In January 2021, oxygen supplies in the Amazon region's largest city were allowed to run out at the peak of the second wave of the COVID-19 epidemic, shocking the world as hospital patients expired for lack of this basic medical resource in Manaus, which during the first COVID-19 wave had become the world's first city to bury its dead in mass graves. Brazil's authorities used this tragedy to further a political agenda that implies enormous environmental and human-rights consequences. Transport of oxygen was used to promote building a road that, together with its planned side roads, would give deforesters access to much of what remains of Brazil's Amazon Forest. Here, we demonstrate that the logistical strategy adopted by the Jair Bolsonaro administration's Ministries of Health and Infrastructure to bring oxygen to Manaus was the worst possible choice, and the foreseeable delay in the arrival of oxygen cost hundreds of lives. Rather than sending trucks to carry oxygen on the nearly impassible Highway BR-319 during the rainy season, the most appropriate transport option was barges on the Madeira River. As oxygen supplies dwindled in Manaus, the families of wealthier COVID-19 victims scrambled to buy the few remaining cylinders at prices out of reach for those in poorer (and often ethnically distinct) economic strata. Ethnic health disparities are aggravated by both the direct consequences of the oxygen crisis and, on the longer term, by the consequences of the highway project that political use of the crisis materially advanced.

Applying the World-System theory in the conservation sciences to understand COVID-19 pandemic as a socio-environmental synergy

The pandemic of COVID-19 caused a global epidemiological, economic and social crisis. In the con-servation sciences, several studies have focused efforts on understanding the effects of declining human activities on biodiversity, understanding the pandemic as an anthropogenic "pause"of global scale. But the impact of the pandemic was not the same for everyone. Different impacts are consequences of politi-cal and ethical questions about who and what can pause or be paused, according to what authority and under what conditions. Therefore, the historical asymmetrical relations of power in the World System are crucial to understanding environmental impacts and thinking about solutions in the post-pandemic world. This article discusses why historical local-global inequalities should be an indispensable reference variable for examining the different experiences caused by the pandemic in biodiversity, aiming at ad-vancing the discussion about the society-nature relationship that the pandemic has spurred. To do so, we use the World-System Theory, initially proposed by Wallerstein, whose analytical categories allow us to situate nature conservation within broader economic, historical, and contemporary contexts. We argue for the understanding of biodiversity conservation in the context of the historical-sociological and global-local relations of the World-System. Finally, we discuss that the COVID-19 pandemic should be understood as an emergent phenomenon of the society-nature dynamic of the world-system.

Evaluation of AI Techniques for Detecting Deceptive Reviews in Cyberspace: A Study of Pre- and Post-COVID-19 Trends

With cyberspace's continuous evolution, online reviews play a crucial role in determining business success in various sectors, ranging from restaurants and hotels to e-commerce applications. Typically, a favorable review for a specific product draws in more consumers and results in a significant boost in sales. Unfortunately, a few businesses are using deceptive methods to improve their online reputation by using fake reviews of competitors. As a result, detecting fake reviews has become a difficult and ever-changing research field. Verbal characteristics extracted from review text, as well as nonverbal features such as the reviewer's engagement metrics, the IP address of the device, and so on, play an important role in detecting fake reviews. This article examines and compares various machine learning techniques for detecting deceptive reviews on various online platforms such as e-commerce websites such as Amazon and online review websites such as Yelp, among others. © 2023 IEEE.

Evaluation of an online human-robot interaction competition platform based on virtual reality – case study in RCAP2021

Due to the COVID-19 pandemic, many robot competitions have been canceled in the past years. To address this problem, we proposed a cloud-based VR platform for the crowdsourcing of embodied human-robot interactions. However, this system only suggested the feasibility of the competition application, and actual competitions had not yet been held and implemented. Therefore, through demonstration experiments in the RoboCup Asia Pacific (RCAP) conducted in a hybrid format with on-site and remote participation, we evaluated the usefulness of using cloud computing on AWS from whether the latency time causes problems in human-robot interaction in a virtual reality environment. [ FROM AUTHOR] Copyright of Advanced Robotics is the property of Taylor & Francis Ltd 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.)

(Re)shaping Amazon labour struggles on both sides of the Atlantic: the power dynamics in Germany and the US amidst the pandemic.

With the initial context of COVID-19 fuelling Amazon's exponential growth, this article investigates how the pandemic (re)defined labour struggles, i.e., cultivating labour's structural, associational and institutional powers in two case study countries, Germany and the US. By analysing these power resources in its two largest markets, I argue that Amazon's structural conditions by which it organises its warehouse labour, which predate the pandemic, have continued to act as obstacles to collective labour action. While in Germany, ver.di continues to mobilise its workplace power but has been unable to get Amazon to sign a collective agreement, the pandemic triggered unprecedented workplace mobilisations and the pursuit of associational power in the US, albeit with varying outcomes. Despite their different industrial relations systems and labour struggles, these two cases highlight the key role of shop-floor organising to put pressure on Amazon, while Amazon's continued rejection of unions as negotiating partners further underlines the importance of regulating Amazon's union-busting tactics.

Dans un contexte où la COVID-19 a alimenté la croissance exponentielle d'Amazon, cet article examine comment la pandémie a (re)défini les luttes syndicales, en soulignant son impact sur les pouvoirs structurels, associatifs et institutionnels des travailleurs dans les deux pays étudiés, à savoir l'Allemagne et les États-Unis. En analysant ces ressources de pouvoir sur les deux plus importants marchés d'Amazon, l'auteur fait valoir que les modalités structurelles de l'organisation de sa main-d'œuvre par Amazon dans les entrepôts d'Amazon, qui sont antérieures à la pandémie, ont continué à faire obstacle à l'action collective des travailleurs. En Allemagne, le syndicat unifié des services (ver.di) continue de mobiliser ses forces sur le lieu de travail sans parvenir à faire signer une convention collective à Amazon. Aux États-Unis, la pandémie a entraîné des mouvements de mobilisation sans précédent sur les lieux de travail, à la recherche d'un pouvoir associatif, mais avec des résultats inégaux. Malgré leurs différences en termes de systèmes de relations industrielles et de luttes syndicales, ces deux cas mettent en évidence le rôle clé de la mobilisation des travailleurs à la base pour faire pression sur Amazon ; quant au fait qu'Amazon continue de récuser les syndicats en tant que partenaires de négociation, il souligne l'importance de réglementer les tactiques antisyndicales de cette entreprise.

Misinformation Caused Increased Urban Mobility and the End of Social Confinement Before the Second Wave of COVID-19 in Amazonia.

Tendentious projections about COVID-19 in Brazil provided an appealing excuse for individuals and decision-makers to justify poor choices during a critical phase of the pandemic. The erroneous results likely contributed to premature resumption of in-person school classes and easing of restrictions on social contact, favoring the resurgence of COVID-19. In Manaus, the largest city in the Amazon region, the COVID-19 pandemic did not end in 2020 of its own accord, but rather rebounded in a disastrous second wave of the disease.

Panorama of Peruvian Secondary Education Teachers Trained in ICT Use Before COVID-19 Pandemic

In order to determine the panorama of secondary education teachers who received training in ICT use before the transition to e-teaching due to the COVID-19 pandemic in Peru, this study is presented with a quantitative, descriptive and trending approach. For this, three Surveys to Peruvian Teachers (ENDO) carried out by Ministerio de Educación del Perú before the pandemic, in 2014, 2016 and 2018 were analyzed. The total of secondary education teachers who participated in each year, respectively, were 3710 (78.5% = urban, 21.5% = rural), 3986 (81.9% = urban, 18.1% = rural) and 6118 (85.3% = urban, 14.7% = rural). After the analysis, it can be concluded that number of teachers trained in 2014 decreased in 2018 that classroom-based modality was the predominant one in these trainings, and Amazon region is the one that presents the most worrying figures. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

PLANTS AND ANIMALS USED TO COMBAT THE COVID-19 PANDEMIC IN TWO INDIGENOUS TICUNA COMMUNITIES IN THE DEPARTMENT OF LORETO, PERU

COVID-19 has impacted the Indigenous Amazonian communities of Peru for two consecutive years, compelling them to recover traditional knowledge, practices and strategies to combat it. We present the plant and animal species used by two Ticuna communities in the Peruvian Amazon during the COVID-19 pandemic, describing the preparation and administration of the preparations. The information was obtained through semi-structured interviews with men and women from the communities during the first two waves of the pandemic, from May 2020 to June 2021. The interviews were conducted face-to-face, during fieldwork carried out in the communities, and virtual, using the telephone and messaging applications available in the communities or in the nearby major population centers. During fieldwork in Nueva Galilea, visits were made to the collection points of the plant species. Fourteen plant species and three animal species used in the pandemic were identified. The most commonly used parts of the plant species, in order of importance, were the leaves, roots, bulbs and fruits, prepared fresh, and in the form of infusions, baths, and steam inhalations. It is evident how traditional knowledge in the use of plants and animals that heal, in an integrated manner with the appropriation of external knowledge, is still vital in Ticuna communities. Knowledge about the healing properties of fourteen plant species and three identified animal species has made it possible to combat the symptoms of a very aggressive disease. © Association for Jewish Studies 2021.

CODA-19: Using a non-expert crowd to annotate research aspects on 10,000+ abstracts in the COVID-19 open research dataset

This paper introduces CODA-19, a human-annotated dataset that codes the Background, Purpose, Method, Finding/Contribution, and Other sections of 10,966 English s in the COVID-19 Open Research Dataset. CODA-19 was created by 248 crowd workers from Amazon Mechanical Turk within 10 days, and achieved labeling quality comparable to that of experts. Each was annotated by nine different workers, and the final labels were acquired by majority vote. The inter-annotator agreement (Cohen's kappa) between the crowd and the biomedical expert (0.741) is comparable to inter-expert agreement (0.788). CODA-19's labels have an accuracy of 82.2% when compared to the biomedical expert's labels, while the accuracy between experts was 85.0%. Reliable human annotations help scientists access and integrate the rapidly accelerating coronavirus literature, and also serve as the battery of AI/NLP research, but obtaining expert annotations can be slow. We demonstrated that a non-expert crowd can be rapidly employed at scale to join the fight against COVID-19. © ACL 2020.All right reserved.

Global Human Threat: The Potential Synergism between Mercury Intoxication and COVID-19.

The COVID-19 pandemic affected billions of people worldwide, and exposure to toxic metals has emerged as an important risk factor for COVID-19 severity. Mercury is currently ranked as the third toxic substance of global concern for human health, and its emissions to the atmosphere have increased globally. Both COVID-19 and mercury exposure present a high prevalence in similar regions: East and Southeast Asia, South America and Sub-Saharan Africa. Since both factors represent a multiorgan threat, a possible synergism could be exacerbating health injuries. Here, we discuss key aspects in mercury intoxication and SARS-CoV-2 infection, describing the similarities shared in clinical manifestations (especially neurological and cardiovascular outcomes), molecular mechanisms (with a hypothesis in the renin-angiotensin system) and genetic susceptibility (mainly by apolipoprotein E, paraoxonase 1 and glutathione family genes). Literature gaps on epidemiological data are also highlighted, considering the coincident prevalence. Furthermore, based on the most recent evidence, we justify and propose a case study of the vulnerable populations of the Brazilian Amazon. An understanding of the possible adverse synergism between these two factors is crucial and urgent for developing future strategies for reducing disparities between developed and underdeveloped/developing countries and the proper management of their vulnerable populations, particularly considering the long-term sequelae of COVID-19.

The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era.

BACKGROUND: Neglected tropical diseases (NTDs) disproportionately affect populations living in resource-limited settings. In the Amazon basin, substantial numbers of NTDs are zoonotic, transmitted by vertebrate (dogs, bats, snakes) and invertebrate species (sand flies and triatomine insects). However, no dedicated consortia exist to find commonalities in the risk factors for or mitigations against bite-associated NTDs such as rabies, snake envenoming, Chagas disease and leishmaniasis in the region. The rapid expansion of COVID-19 has further reduced resources for NTDs, exacerbated health inequality and reiterated the need to raise awareness of NTDs related to bites. METHODS: The nine countries that make up the Amazon basin have been considered (Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Surinam and Venezuela) in the formation of a new network. RESULTS: The Amazonian Tropical Bites Research Initiative (ATBRI) has been created, with the aim of creating transdisciplinary solutions to the problem of animal bites leading to disease in Amazonian communities. The ATBRI seeks to unify the currently disjointed approach to the control of bite-related neglected zoonoses across Latin America. CONCLUSIONS: The coordination of different sectors and inclusion of all stakeholders will advance this field and generate evidence for policy-making, promoting governance and linkage across a One Health arena.

JUX - A Cloud Hosted Learning Management System Based on OpenedX

Higher education across the world during the COVID pandemic changes its knowledge delivery mode from on-campus studies to off-campus studies, i.e. E-Learning. The e-education provider must be competent in order to create a robust learning environment that can handle the difficulties facing teachers, students, and system administrators at this rapid pace of change. The system administrator needs to improve the network connectivity, bandwidth etc. for providing seamless connectivity for E-Learning alongside their campus network services. The challenge of providing smooth services for e-learning is sometimes hurdled the other network services for the campus and therefore the management and administrator suggest deploying the e-learning services on the cloud and setting apart the campus network services. This will solve the problem of available network limits can face by the institute due to the limited amount of hardware and bandwidth issues. Furthermore, the cloud deployment reduces the capital as well as the recurring cost of running the services. This paper will focus to address the problem defined above and providing Amazon Web Services (AWS) based cost-effective cloud architecture for OpenedX based learning solutions. This study is expected to demonstrate a technological solution for the process of implementing a cloud-based LMS. © 2022 IEEE.

Gig Work and the Pandemic: Looking for Good Pay from Bad Jobs During the COVID-19 Crisis

COVID-19 led to work hour reductions and layoffs for many Americans with wage/salary jobs. Some gig work, however, which is usually considered precarious, remained available. We examine whether people doing gig microtasks right before the pandemic increased their microtask hours during COVID-19 and whether those changes helped them financially. Using data from workers on Amazon's Mechanical Turk platform from February, March, and April of 2020, we find that roughly one third of existing workers increased their microtask hours. Increases were larger for people who lost household income or wage/salary hours. Spending more time on microtasks, however, did little to help workers financially. Furthermore, the people most reliant on microtasks before the pandemic had worse financial outcomes than others. In short, even though microtask work might seem like a good way for people to recoup lost income during the pandemic, it was of limited utility even for the experienced workers in our sample.

Attitudes About Artificially Intelligent Interactive Voice Response Systems Using Amazon Alexa in Cardiovascular Clinics: Insights from the VOICE-COVID-19 Study.

The acceptability of artificially intelligent interactive voice response (AI-IVR) systems in cardiovascular research settings is unclear. As a result, we evaluated peoples' attitudes regarding the Amazon Echo Show 8 device when used for electronic data capture in cardiovascular clinics. Participants were recruited following the Voice-Based Screening for SARS-CoV-2 Exposure in Cardiovascular clinics study. Overall, 215 people enrolled and underwent screening (mean age 46.1; 55% females) in the VOICE-COVID study and 58 people consented to participate in a post-screening survey. Following thematic analysis, four key themes affecting AI-IVR acceptability were identified. These were difficulties with communication (44.8%), limitations with available interaction modalities (41.4%), barriers with the development of therapeutic relationships (25.9%), and concerns with universality and accessibility (8.6%). While there are potential concerns with the use of AI-IVR technologies, these systems appeared to be well accepted in cardiovascular clinics. Increased development of these technologies could significantly improve healthcare access and efficiency.

Voice-Based Screening for SARS-CoV-2 Exposure in Cardiovascular Clinics (VOICE-COVID-19-II): Protocol for a Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic has disrupted the health care system, limiting health care resources such as the availability of health care professionals, patient monitoring, contact tracing, and continuous surveillance. As a result of this significant burden, digital tools have become an important asset in increasing the efficiency of patient care delivery. Digital tools can help support health care institutions by tracking transmission of the virus, aiding in the screening process, and providing telemedicine support. However, digital health tools face challenges associated with barriers to accessibility, efficiency, and privacy-related ethical issues. OBJECTIVE: This paper describes the study design of an open-label, noninterventional, crossover, randomized controlled trial aimed at assessing whether interactive voice response systems can screen for SARS-CoV-2 in patients as accurately as standard screening done by people. The study aims to assess the concordance and interrater reliability of symptom screening done by Amazon Alexa compared to manual screening done by research coordinators. The perceived level of comfort of patients when interacting with voice response systems and their personal experience will also be evaluated. METHODS: A total of 52 patients visiting the heart failure clinic at the Royal Victoria Hospital of the McGill University Health Center, in Montreal, Quebec, will be recruited. Patients will be randomly assigned to first be screened for symptoms of SARS-CoV-2 either digitally, by Amazon Alexa, or manually, by the research coordinator. Participants will subsequently be crossed over and screened either digitally or manually. The clinical setup includes an Amazon Echo Show, a tablet, and an uninterrupted power supply mounted on a mobile cart. The primary end point will be the interrater reliability on the accuracy of randomized screening data performed by Amazon Alexa versus research coordinators. The secondary end point will be the perceived level of comfort and app engagement of patients as assessed using 5-point Likert scales and binary mode responses. RESULTS: Data collection started in May 2021 and is expected to be completed in fall 2022. Data analysis is expected to be completed in early 2023. CONCLUSIONS: The use of voice-based assistants could improve the provision of health services and reduce the burden on health care personnel. Demonstrating a high interrater reliability between Amazon Alexa and health care coordinators may serve future digital tools to streamline the screening and delivery of care in the context of other conditions and clinical settings. The COVID-19 pandemic occurs during the first digital era using digital tools such as Amazon Alexa for disease screening, and it represents an opportunity to implement such technology in health care institutions in the long term. TRIAL REGISTRATION: ClinicalTrials.gov NCT04508972; https://clinicaltrials.gov/ct2/show/NCT04508972. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41209.