Several intuitionistic fuzzy hamy mean operators with complex interval values and their application in assessing the quality of tourism services.

In order to assess the quality of senior tourism services in vacation destinations, we examine complex interval valued intuitionistic Fuzzy Dombi Hamy Mean (CIVIFDHM) operators. These operators successfully manage imprecision and uncertainty in the preferences of senior tourists. However, the Hamy mean (HM) operator can identify the connections between various input data sets and produce excellent outcomes when combining and evaluating information. We illustrate their usefulness and efficacy through a case study, providing a strong instrument for improving service quality for senior citizens and promoting an inclusive and fulfilling travel experience. In this work, we develop the HM operator and Dombi operations with Complex interval valued intuitionistic fuzzy numbers (CIVIFNs). We recommend the CIVIFDHM operator, complex interval valued intuitionistic fuzzy weighted Dombi Hamy mean (CIVIFWDHM), complex interval valued intuitionistic fuzzy dual Dombi Hamy mean (CIVIFDDHM), and complex interval valued intuitionistic fuzzy weighted dual Dombi Hamy mean (CIVIFWDD) operators. Next, multiple attribute decision making (MADM) models are constructed with the help of CIVIFWDHM and CIVIFWDDHM operators. We provided an evaluation of an older tourism operator in a tourist area as an example to show the suggested models.

Synthesis, mol-ecular and crystal structure of [(NH2)2CSSC(NH2)2]2[RuBr6]Br2·3H2O.

The title compound, bis-[di-thio-bis-(formamidinium)] hexa-bromido-ruthenium dibromide trihydrate, [(NH2)2CSSC(NH2)2]2[RuBr6]Br2·3H2O, crystallizes in the ortho-rhom-bic system, space group Cmcm, Z = 4. The [RuBr6]2- anionic complex has an octa-hedral structure. The Ru-Br distances fall in the range 2.4779 (4)-2.4890 (4) Å. The S-S and C-S distances are 2.0282 (12) and 1.783 (2) Å, respectively. The H2O mol-ecules, Br- ions, and NH2 groups of the cation are linked by hydrogen bonds. The conformation of the cation is consolidated by intra-molecular O-H⋯Br, O-H⋯O, N-H⋯Br and N-H⋯O hydrogen bonds. The [(NH2)2CSSC(NH2)2]2+ cations form a hydrogen-bonded system involving the Br - ions and the water mol-ecules. Two Br - anions form four hydrogen bonds, each with the NH2 groups of two cations, thus linking the cations into a ring. The rings are connected by water mol-ecules, forming N-H⋯O-H⋯Br hydrogen bonds.

Role of age and sex in the incidence of adverse effects among diabetic patients treated with glipizide.

Glipizide is an antidiabetic drug that belongs to a class of medication known as sulfonylureas. It is considered one of the highly prescribed antidiabetic drugs for the treatment of type II diabetes in patients following a kidney transplant. It lowers blood glucose levels by causing the release of insulin from ß-cells in the pancreas. Its main metabolizing pathway is through the liver. It has several adverse effects, which range from an upset stomach to glipizide-induced haemolytic anaemia and hypoglycaemia. These adverse effects may be spontaneous, or they could have a genetic cause. The present study aimed to assess and document the incidence of glipizide-induced adverse reactions among patients prescribed the drug. The present retrospective case-control study used the electronic medical records of patients prescribed glipizide for the past 3 years. These records were reviewed to extract and document cases and/or signs of glipizide-induced adverse reactions. The results revealed that the incidence of adverse effects was higher among female patients (odds ratio, 2.40, P<0.001). Moreover, the results revealed that the likelihood of developing adverse drug reactions among patients <40 years of age was higher than in older patients (P>0.05). The outcomes of the present study are expected to prompt future studies to take sex and age into consideration, in an aim to improve treatment outcomes, reduce adverse events and decrease the burden of unnecessary costs for healthcare systems. Recommendations also include genetic screening prior to administering the medication, educating the patients and caregivers on the possibility of adverse drug reactions, and routine follow-up. This issue is of utmost importance to achieve the optimal outcomes with the minimal detrimental effects.

A method to assess the quality of additive manufacturing metal powders using the triboelectric charging concept.

A new method to assess the quality of additive manufacturing (AM) metal powders using the triboelectric charging concept is demonstrated using CpTi, Ti6Al4V, AlSi10Mg, IN 738, and SS 316L powders. For each powder tested, the surface chemical composition was first analyzed using X-ray photoelectron spectroscopy (XPS) to determine the composition of the passivation layer. Some modifications to the current GranuCharge™ setup, developed by GranuTools™, were then performed by incorporating a flow rate measuring tool to assess how tribocharging is affected as a function of flow rate. Variations in the tribocharging response have been found with the flow rate of CpTi, AlSi10Mg and SS 316L powders. Moreover, results suggest that the tribocharging behavior might not be the same even with powders fabricated with the same passivation process. Finally, the compressed exponential model of Trachenko and Zaccone was used to reproduce the tribocharging behavior of the powders. The models were found to work best when the stretch constant ß = 1.5, which is identical to the value found in other systems such as structural glasses, colloidal gels, entangled polymers, and supercooled liquids, which experience jamming when motion of individual particles become restricted, causing their motion to slow down.

Applications of magnesium iodide structure via modified-polynomials.

A relatively recent approach in molecular graph theory for analyzing chemical networks and structures is called a modified polynomial. It emphasizes the characteristics of molecules through the use of a polynomial-based procedure and presents numerical descriptors in algebraic form. The Quantitative Structure-Property Relationship study makes use of Modified Polynomials (M-Polynomials) as a mathematical tool. M-Polynomials used to create connections between a material's various properties and its structural characteristics. In this study, we calculated several modified polynomials and gave a polynomial description of the magnesium iodide structure. Particularly, we computed first, second and modified Zagreb indices based M-polynomials. Randic index, and inverse Randic indices based M-polynomials are also computed in this work.

Delayed Inflammatory Reaction to Hyaluronic Acid Dermal Filler Following Zoledronic Acid Administration: A Case Report.

Zoledronic acid is a bisphosphonate that can be administered intravenously and used to treat several bone disorders. It decreases bone resorption, thereby improving bone mineral density (BMD) and reducing fractures. The Food and Drug Administration (FDA) has approved zoledronic acid for the prevention and treatment of osteoporosis in postmenopausal females and males and for other conditions. Zoledronic acid is generally well tolerated, with most side effects being musculoskeletal or gastrointestinal. Cutaneous side effects include maculopapular rash and other mild skin reactions. Rare severe skin rashes, such as toxic epidermal necrolysis, have been reported. Here, we report the case of a 64-year-old female with a medical history of breast cancer status post-radical mastectomy and chemotherapy presenting with delayed hypersensitivity reaction to a hyaluronic acid dermal filler two days after receiving zoledronic acid intravenously given to maintain bone density, symptoms completely resolved with oral prednisolone 20 mg once daily and cetirizine 10 mg. Cases of delayed inflammatory reaction to hyaluronic acid soft tissue filler have previously been reported in patients who have received vaccination or those with viral infections. However, to our knowledge, there have been no reports of delayed inflammatory reactions to facial hyaluronic acid injections after zoledronic acid administration.

Crystal structure and Hirshfeld surface analysis of dimethyl 2-oxo-4-(pyridin-2-yl)-6-(thio-phen-2-yl)cyclo-hex-3-ene-1,3-di-carboxyl-ate.

In the title compound, C19H17NO5S, the cyclo-hexene ring adopts nearly an envelope conformation. In the crystal, mol-ecules are linked by C-H⋯O hydrogen bonds, forming a three-dimensional network. In addition, C-H⋯π inter-actions connect the mol-ecules by forming layers parallel to the (010) plane. According to the Hirshfeld surface analysis, H⋯H (36.9%), O⋯H/H⋯O (31.0%), C⋯H/H⋯C (18.9%) and S⋯H/H⋯S (7.9%) inter-actions are the most significant contributors to the crystal packing.

Study of some graph theoretical parameters for the structures of anticancer drugs.

Eigenvalues have great importance in the field of mathematics, and their relevance extends beyond this area to include several other disciplines such as economics, chemistry, and numerous fields. According to our study, eigenvalues are utilized in chemistry to express a chemical compound's numerous physical properties as well as its energy form. It is important to get a comprehensive understanding of the interrelationship underlying mathematics and chemistry. The anti-bonding phase is correlated with positive eigenvalues, whereas the bonding level is connected with negative eigenvalues. Additionally, the non-bonded level corresponds to eigenvalues of zero. This study focuses on the analysis of various structures of anticancer drugs, specifically examining their characteristic polynomials, eigenvalues of the adjacency matrix, matching number and nullity. Consequently, the selected structures of the aforementioned anticancer drugs exhibit stability since they are composed of closed-shell molecules, characterized by a nullity value of zero.

Analysis and simulation study of the HIV/AIDS model using the real cases.

We construct a model to investigate HIV/AIDS dynamics in real cases and study its mathematical analysis. The study examines the qualitative outcomes and confirms the local and global asymptotic stability of both the endemic equilibrium and the disease-free equilibrium. The model's criteria for exhibiting both local and global asymptotically stable behavior are examined. We compute the endemic equilibria and obtain the existence of a unique positive endemic equilibrium. The data is fitted to the model using the idea of nonlinear least-squares fitting. Accurate parameter values are achieved by fitting the data to the model using a 95% confidence interval. The basic reproduction number is computed using parameters that have been fitted or estimated. Sensitivity analysis is performed to discover the influential parameters that impact the reproduction number and the eradication of the disease. The results show that implementing preventive measures can reduce HIV/AIDS cases.

Mass online training of health care workers during COVID-19: approach, impact, and outcomes for over 10,000 health care providers.

OBJECTIVES: COVID-19 revealed major shortfalls in healthcare workers (HCWs) trained in acute and critical care worldwide, especially in low-resource settings. We aimed to assess mass online courses' efficacy in preparing HCWs to manage COVID-19 patients and to determine whether rapidly deployed e-learning can enhance their knowledge and confidence during a pandemic. STUDY DESIGN: Retrospective cohort study. METHODS: This international retrospective cohort study, led by a large Academic Medical Centre (AMC), was conducted via YouTube and the AMC's online learning platform. From 2020 to 2021, multidisciplinary experts developed and deployed six online training courses based on the latest evidence-based management guidelines. Participants were selected through a voluntary sample following an electronic campaign. Training outcomes were assessed using pre-and post-test questionnaires, evaluation forms, and post-training assessment surveys. Kirkpatrick's Model guided training evaluation to measure self-reported knowledge, clinical skills, and confidence improvement. We also captured the number and type of COVID-19 patients managed by HCWs after the trainings. RESULTS: Every 22.8 reach/impression and every 1.2 engagements led to a course registration. The 10,425 registrants (56.8% female, 43.1% male) represented 584 medical facilities across 154 cities. The largest segments of participants were students/interns (20.6%) and medical officers (13.4%). Of the 2169 registered participants in courses with tests, 66.9% completed post-tests. Test scores from all courses increased from the initial baseline to subsequent improvement post-course. Participants completing post-training assessment surveys reported that the online courses improved their knowledge and clinical skills (83.5%) and confidence (89.4%). Respondents managed over 19,720 COVID-19 patients after attending the courses, with 47.7% patients being moderately/severely ill. CONCLUSIONS: Participants' confidence in handling COVID-19 patients is increased by rapidly deploying mass training to a substantial target population through digital tools. The findings present a virtual education and assessment model that can be leveraged for future global public health issues, and estimates for future electronic campaigns to target.

Crystal structure and Hirshfeld surface analysis of dimethyl 4'-bromo-3-oxo-5-(thio-phen-2-yl)-3,4,5,6-tetra-hydro-[1,1'-biphen-yl]-2,4-di-carboxyl-ate.

In the title compound, C20H17BrO5S, mol-ecules are connected by inter-molecular C-H⋯S hydrogen bonds with R 2 2(10) ring motifs, forming ribbons along the b-axis direction. C-H⋯π inter-actions consolidate the ribbon structure while van der Waals forces between the ribbons ensure the cohesion of the crystal structure. According to a Hirshfeld surface analysis, H⋯H (40.5%), O⋯H/H⋯O (27.0%), C⋯H/H⋯C (13.9%) and Br⋯H/H⋯Br (11.7%) inter-actions are the most significant contributors to the crystal packing. The thio-phene ring and its adjacent di-carboxyl-ate group and the three adjacent carbon atoms of the central hexene ring to which they are attached were refined as disordered over two sets of sites having occupancies of 0.8378 (15) and 0.1622 (15). The thio-phene group is disordered by a rotation of 180° around one bond.

Crystal structure and Hirshfeld surface analysis of 2,4-di-amino-6-[(1Z,3E)-1-cyano-2,4-di-phenyl-penta-1,3-dien-1-yl]pyridine-3,5-dicarbo-nitrile monohydrate.

The asymmetric unit of the title compound, C25H18N6·H2O, comproses two mol-ecules (I and II), together with a water mol-ecule. The terminal phenyl groups attached to the methyl groups of the mol-ecules I and II do not overlap completely, but are approximately perpendicular. In the crystal, the mol-ecules are connected by N-H⋯N, C-H⋯N, O-H⋯N and N-H⋯O hydrogen bonds with each other directly and through water mol-ecules, forming layers parallel to the (001) plane. C-H⋯π inter-actions between these layers ensure the cohesion of the crystal structure. A Hirshfeld surface analysis indicates that H⋯H (39.1% for mol-ecule I; 40.0% for mol-ecule II), C⋯H/H⋯C (26.6% for mol-ecule I and 25.8% for mol-ecule II) and N⋯H/H⋯N (24.3% for mol-ecules I and II) inter-actions are the most important contributors to the crystal packing.

Valency-based structural properties of gamma-sheet of boron clusters.

Boron cluster sheets are two-dimensional boron atom-based formations called borophene. They are similar to the two-dimensional sheet known as graphene, which is composed of carbon atoms arranged in a hexagonal lattice. The unique electrical, mechanical, and thermal properties of borophene make it a sought-after substance for a variety of uses, such as catalysis, energy storage, and electronics. There are two ways to manufacture borophene: chemical vapor deposition and molecular beam epitaxy. Vertex-edge valency-based topological descriptors are a great example of a molecular descriptor that provides information on the connection of atoms in a molecule. These descriptions are based on the notion that a node's value in a molecular network is the sum of the valency of those atoms that are directly connected to that node. In this article, we discussed some novel vertex-edge (ve) and edge-vertex (ev) topological descriptors and found their formulations for the boron cluster or borophene sheets. Also, we show the numerical and graphical comparison of these descriptors in this article.

Employers' perceptions of supports provided to their employees with disabilities.

The employment of individuals with disabilities is significantly low. Many factors are associated with this issue; however, support and accommodations that can be provided to such individuals can improve their employment rate and outcomes. This study aimed to examine the support provided to employees with disabilities in Saudi Arabia. The descriptive approach was utilized, and a survey was used to collect the data. The sample consisted of 86 employer participants to examine the support of their employees with disabilities. Findings revealed that the support provided was high, and the participants reported that such support facilitates finding and maintaining a job. In addition, the variables were all found to have no significant differences. Providing needed and necessary support is an effective strategy that leads to competitive employment for individuals with disabilities, especially for the long term. Implications and recommendations are also discussed.

Factors contributing to patency after aneurysmorrhaphy and outflow repair in arteriovenous fistula aneurysm treatment.

INTRODUCTION: Vascular access-related aneurysms (VARA) are a complication of arteriovenous fistulas. Repair techniques have been described in the literature with varied outcomes. MATERIALS AND METHODS: We conducted a prospective cohort study on patients who had VARA repair over 41 months. The indication for repair was an aneurysmal arteriovenous fistula (AVF) at risk of haemorrhage or difficulty in cannulation. Pseudoaneurysms, infected AVF and bleeding VARA were excluded. All patients underwent outflow stenosis treatment when present, followed by aneurysmorrhaphy. They were monitored periodically over 12 months, measuring functional primary and cumulative patency and access flow. We studied the patient demography, access flow and presence of outflow stenosis. Access flow was measured from the brachial artery (Qa) as a surrogate using ultrasonography. A Kaplan-Meier survival analysis was used to predict the primary and cumulative patency at 12 months and factors contributing to 12-month patency were analysed. RESULTS: A total of 64 patients were recruited for this study, of whom 58 completed the study. Most of the participants were male (67%) with a median age of 45 years. Forty-six patients (79.3%) had brachiocephalic fistula (BCF) aneurysms. Thirty-nine (67.2%) had preexisting outflow stenoses that required intervention. All patients underwent an aneurysmorrhaphy, of whom 12% had a cephalic arch vein transposition due to severe stenosis. Primary patency at 12 months was 86%, whereas the cumulative patency rate was 95%. Patency was significantly associated with younger age and showed a positive trend with higher preintervention Qa. Symptomatic recurrent stenosis developed in 17.2% of the cohort. CONCLUSION: Improving the patency of VARA entails the treatment of outflow stenosis and aneurysmorrhaphy. Surveillance is important to detect and treat recurrent outflow stenoses. The outcome is better among younger patients with pre-interventional access flow as measured in the brachial artery as a surrogate.

Topological Insights into Nanostar Dendrimers by Computing the Augmented Zagreb Index.

BACKGROUND: The field of nanobiotechnology uses precise nanofabrication techniques to advance our understanding and control of biological systems. Due to their remarkable properties, dendrimers, which are hyperbranched macromolecular structures with distinct and well-defined architectures, have emerged as pivotal entities within this field. They are gaining increasing attention for their potential to catalyze a paradigm shift in medical therapeutics, biotechnological applications, and advanced material sciences. OBJECTIVE: This paper focuses on a novel analytical expression and determines the precise value of the augmented Zagreb index, a topological descriptor, for eight classes of nanostar dendrimers. METHODS: The Zagreb index is a topological invariant to predict molecular behaviour and reactivity. In this paper, we have explored its application in characterizing the branching of nanostar dendrimers through computational modelling and mathematical rigor. RESULTS: Our research has measured the augmented Zagreb index for nanostar dendrimers, which fall into eight distinct classes. The results better explain the relationship between the dendrimers' topology and chemical properties. This correlation has implications for their structural stability and reactivity, potentially leading to new applications. CONCLUSION: Developing the augmented Zagreb index for nanostar dendrimers is a significant breakthrough in nanobiotechnology. Based on the correlation between the calculated topological index and the corresponding molecular attributes, our analytical approach has opened up new possibilities for designing and synthesizing dendrimers tailored to specific functions in medical and material science applications. This precise topological quantification could significantly enhance the utility and functionalization of dendrimers in cutting-edge nanotechnological applications.

Attitudes, Beliefs, and Behaviors of Topical Antibiotic Prescribing among Primary Care Providers in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: The World Health Organization (WHO) estimates that 20-50% of antibiotics are misused in society. In addition to the development of antimicrobial resistance, topical antibiotics have been associated with adverse effects such as allergic contact dermatitis (ACD) and inadequate wound healing. This study investigated the appropriateness of topical antibiotic prescriptions among primary care providers in Saudi Arabia. METHODS: A cross-sectional survey was conducted among Saudi Arabian primary care providers (physicians (general, family, and internal medicine)) employed in governmental and non-governmental healthcare facilities (primary care centers and outpatient clinics). RESULTS: In total, 222 participants were included in the analysis. A total of 73% agreed that inappropriate topical antibiotic use puts patients at risk, and 43% reported antibiotic resistance in daily practice. Many respondents lacked knowledge of the proper indications for topical antibiotics, and 66.2% attributed this to a lack of updated knowledge, while 45% blamed inadequate supervision. CONCLUSION: Antibiotic prescription patterns deviated from the standards recommended by WHO. This calls for continuous review at all levels of healthcare, providing more physician education and ensuring that antibiotic therapy guidelines are easily accessible and effectively used to avoid the negative consequences of inappropriate antibiotic prescription.

Crystal structure and Hirshfeld surface analysis of 6-imino-8-(4-methyl-phen-yl)-1,3,4,6-tetra-hydro-2H-pyrido[1,2-a]pyrimidine-7,9-dicarbo-nitrile.

In the ten-membered 1,3,4,6-tetra-hydro-2H-pyrido[1,2-a]pyrimidine ring system of the title compound, C17H15N5, the 1,2-di-hydro-pyridine ring is essentially planar (r.m.s. deviation = 0.001 Å), while the 1,3-diazinane ring has a distorted twist-boat conformation. In the crystal, mol-ecules are linked by N-H⋯N and C-H⋯N hydrogen bonds, forming a three-dimensional network. In addition, C-H⋯π inter-actions form layers parallel to the (100) plane. Thus, crystal-structure cohesion is ensured. According to a Hirshfeld surface study, H⋯H (40.4%), N⋯H/H⋯N (28.6%) and C⋯H/H⋯C (24.1%) inter-actions are the most important contributors to the crystal packing.

Edge based metric dimension of various coffee compounds.

An important dietary source of physiologically active compounds, coffee also contains phenolic acids, diterpenes, and caffeine. According to a certain study, some coffee secondary metabolites may advantageously modify a number of anti-cancer defense systems. This research looked at a few coffee chemical structures in terms of edge locating numbers or edge metric size to better understand the mechanics of coffee molecules. Additionally, this research includes graph theoretical properties of coffee chemical structures. The chemicals found in coffee, such as caffeine, diterpene or cafestol, kahweol, chlorogenic, caffeic, gallotannins, and ellagitannins, are especially examined in these publications.