scholarly journals E-commerce now Big Commerce: E-commerce Industry and Consumer Internet Sector & its Effect on the World Today

2021 ◽  
Vol 9 (9) ◽  
pp. 1144-1151
Author(s):  
Dr. Anita Kumari
Keyword(s):  
Fold Increase ◽  
Tier 2 ◽  
Online Activity ◽  
Digital Platforms ◽  
Internet Economy ◽  
Huge Impact ◽  
Negative Impacts ◽  
Medium Businesses ◽  
Tier 3 ◽  
Start Ups

Abstract: The Covid19 pandemic has made a huge impact on the ecommerce industry. The industry has experienced some benefits and problems during the pandemic. People tend to buy more items online as it can be more secure when it comes to the spread of disease. The repocommerce industry is having an increased sales growth. Many methods and techniques are being used by the e rts are saying that overall ecommerce industry to make Covid19 pandemic. This sup the negative impacts that happened to online business during the study is done to deeply analyse the problems and factors that are affecting the Online businesses and to know about the situations of ecommerce business in different parts of the world.The COVID-19 pandemic has had a significant impact on the Indian economy, which saw one of the largest lockdowns globally. The Indian internet economy, which was one of the most attractive markets worldwide, saw a 90% decline in April 2020, crippled by the shutdowns.1The decline was a result of steep falls in business for e-commerce and travel, the largest sectors in the internet ecosystem. However, the pandemic helped accelerate growth for segments such as hyperlocal delivery, edtech, healthtechand online payments as Indian consumers moved online to fulfil their daily needs. Despite a steep GMV fall in the initial months of the lockdown, India’s internet economy is likely to be a net beneficiary in longer run, driven by multi-fold increase in digital interactions and adoption of digital platforms. The number of first time online users has witnessed an increase across segments, along with an increase in online activity from tier 2 and tier 3 cities, which indicates a strong opportunity for enterprises and start-ups to cater to these cohorts digitally as the new normal. What is also expected to drive growth for digitally native start-ups is rising adoption by small and medium businesses in the country. Small merchants across cities are now adopting mobile channels, implementing online payments and exploring collaborations with technologydriven start-ups. Keywords: Ecommerce, Eshops, Covid19, Lockdowns, etc.

scholarly journals The effectiveness of the three-tier system of local restrictions for control of COVID-19

2020 ◽  
Author(s):  
Paul R Hunter ◽  
Julii Brainard ◽  
Alastair Grant
Keyword(s):  
Exponential Growth ◽  
Rapid Identification ◽  
Reproductive Rate ◽  
Tier 2 ◽  
Time Points ◽  
Tier System ◽  
Tier 1 ◽  
R Value ◽  
Negative Impacts ◽  
Tier 3

Despite it being over 10 months since COVID-19 was first reported to the world and it having caused over 1.3 million deaths it is still uncertain how the virus can be controlled whilst minimising the negative impacts on society and the economy. On the 14th October, England introduced a three-tier system of regional restrictions in an attempt to control the epidemic. This lasted until the 5th November when a new national lockdown was imposed. Tier 1 was the least and Tier 3 the most restrictive tiers. We used publicly available data of daily cases by local authority (local government areas) and estimated the reproductive rate (R value) of the epidemic over the previous 14 days at various time points after the imposition of the tier system or where local authorities were moved into higher tiers at time points after reallocation. At day 0 there vas very little difference in the R value between authorities in the different groups but by day 14 the R value in Tier 3 authorities had fallen to about 0.9, in Tier 2 to about 1.0 and in Tier 1 the R value was about 1.5. The restrictions in Tier 1 had little impact on transmission and allowed exponential growth in the large majority of authorities. By contrast the epidemic was declining in most Tier 3 authorities. In Tier 2, exponential growth was being seen in about half of authorities but declining in half. We concluded that the existing three tier system would have been sufficient to control the epidemic if all authorities had been moved out of Tier 1 into tier 2 and there had been more rapid identification and transfer of those authorities where the epidemic was increasing out of Tier 2 into Tier 3. A more restrictive tier than Tier 3 may be needed but only by a small number of authorities.

Optimal Timing for Launching Installation of Tier 2 and 3 Systems of School-Wide Positive Behavioral Interventions and Supports

2021 ◽  
pp. 109830072199608
Author(s):  
Angus Kittelman ◽  
Sterett H. Mercer ◽  
Kent McIntosh ◽  
Robert Hoselton
Keyword(s):  
Longitudinal Study ◽  
Behavioral Interventions ◽  
Structural Equation ◽  
Equation Modeling ◽  
Optimal Timing ◽  
First Year ◽  
Tier 2 ◽  
Positive Behavioral Interventions ◽  
Tier 1 ◽  
Tier 3

The purpose of this longitudinal study was to examine patterns in implementation of Tier 2 and 3 school-wide positive behavioral interventions and supports (SWPBIS) systems to identify timings of installation that led to higher implementation of advanced tiers. Extant data from 776 schools in 27 states reporting on the first 3 years of Tier 2 implementation and 359 schools in 23 states reporting on the first year of Tier 3 implementation were analyzed. Using structural equation modeling, we found that higher Tier 1 implementation predicted subsequent Tier 2 and Tier 3 implementation. In addition, waiting 2 or 3 years after initial Tier 1 implementation to launch Tier 2 systems predicted higher initial Tier 2 implementation (compared with implementing the next year). Finally, we found that launching Tier 3 systems after Tier 2 systems, compared with launching both tiers simultaneously, predicted higher Tier 2 implementation in the second and third year, so long as Tier 3 systems were launched within 3 years of Tier 2 systems. These findings provide empirical guidance for when to launch Tier 2 and 3 systems; however, we emphasize that delays in launching advanced systems should not equate to delays in more intensive supports for students.

scholarly journals Global Inland Capture and Culture Finfisheries Follow Different Trends When Evaluated by the Human Development Index

2021 ◽  
Vol 13 (15) ◽  
pp. 8420
Author(s):  
Peter W. Sorensen ◽  
Maria Lourdes D. Palomares
Keyword(s):  
Socioeconomic Factors ◽  
Human Development ◽  
Human Development Index ◽  
Developed Countries ◽  
Global Scale ◽  
Tier 2 ◽  
Development Index ◽  
Tier 1 ◽  
Catch Reconstruction ◽  
Tier 3

To assess whether and how socioeconomic factors might be influencing global freshwater finfisheries, inland fishery data reported to the FAO between 1950 and 2015 were grouped by capture and culture, country human development index, plotted, and compared. We found that while capture inland finfishes have greatly increased on a global scale, this trend is being driven almost entirely by poorly developed (Tier-3) countries which also identify only 17% of their catch. In contrast, capture finfisheries have recently plateaued in moderately-developed (Tier-2) countries which are also identifying 16% of their catch but are dominated by a single country, China. In contrast, reported capture finfisheries are declining in well-developed (Tier-1) countries which identify nearly all (78%) of their fishes. Simultaneously, aquacultural activity has been increasing rapidly in both Tier-2 and Tier-3 countries, but only slowly in Tier-1 countries; remarkably, nearly all cultured species are being identified by all tier groups. These distinctly different trends suggest that socioeconomic factors influence how countries report and conduct capture finfisheries. Reported rapid increases in capture fisheries are worrisome in poorly developed countries because they cannot be explained and thus these fisheries cannot be managed meaningfully even though they depend on them for food. Our descriptive, proof-of-concept study suggests that socioeconomic factors should be considered in future, more sophisticated efforts to understand global freshwater fisheries which might include catch reconstruction.

scholarly journals 23. Regional Variation in Outpatient Antibiotic Prescribing in a Commercially-insured Population, United States, 2017

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S12-S12
Author(s):  
Destani J Bizune ◽  
Danielle Palms ◽  
Laura M King ◽  
Monina Bartoces ◽  
Ruth Link-Gelles ◽  
...  
Keyword(s):  
United States ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Urgent Care ◽  
Antibiotic Prescribing ◽  
Tier 2 ◽  
Regional Variability ◽  
Patient Age ◽  
Patient Âgé ◽  
Tier 3

Abstract Background Studies have shown that the Southern United States has higher rates of outpatient antibiotic prescribing compared to other regions in the country, but reasons for this variation are unclear. We aimed to determine whether the regional variability in outpatient antibiotic prescribing for respiratory diagnoses can be explained by differences in patient age, care setting, comorbidities, and diagnosis in a commercially-insured population. Methods We analyzed the 2017 IBM® MarketScan® Commercial Database of commercially-insured individuals aged < 65 years. We included visits with acute respiratory tract infection (ARTI) diagnoses from retail clinics, urgent care centers, emergency departments, and physician offices. ARTI diagnoses were categorized as: Tier 1, antibiotics are almost always indicated (pneumonia); Tier 2, antibiotics are sometimes indicated (sinusitis, acute otitis media, pharyngitis); and Tier 3, antibiotics are not indicated (asthma, allergy, bronchitis, bronchiolitis, influenza, nonsuppurative otitis media, viral upper respiratory infections, viral pneumonia). We calculated risk ratios and 95% confidence intervals (CI) stratified by US Census region and ARTI tier using log-binomial models controlling for patient age, comorbidities (Elixhauser and Complex Chronic Conditions for Children), and setting of care, with Tier 3 visits in the West, the strata with the lowest antibiotic prescription rate, as the reference for all strata. Results A total of 100,104,860 visits were analyzed. In multivariable modeling, ARTI visits in the South and Midwest were highly associated with receiving an antibiotic for Tier 2 conditions vs. patients in other regions (Figure 1). Figure 1. Multivariable model comparing risk of receiving an antibiotic for an ARTI by region and diagnostic tier in urgent care, retail health, emergency department, and office visits, MarketScan® 2017, United States Conclusion Regional variability in outpatient antibiotic prescribing for Tier 2 and 3 ARTIs remained even after controlling for patient age, comorbidities, and setting of care. It is likely that this variability is in part due to non-clinical factors such as regional differences in clinicians’ prescribing habits and patient expectations. Targeted and enhanced public health stewardship interventions are needed to address cultural factors that affect antibiotic prescribing in outpatient settings. Disclosures All Authors: No reported disclosures

Incorporation of plasma-based next-generation sequencing to improve guideline-concordant molecular testing in patients with newly diagnosed metastatic nonsquamous non-small cell lung cancer.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 14-14
Author(s):  
Charu Aggarwal ◽  
Melina Elpi Marmarelis ◽  
Wei-Ting Hwang ◽  
Dylan G. Scholes ◽  
Aditi Puri Singh ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Practice Change ◽  
Molecular Testing ◽  
Tier 2 ◽  
Newly Diagnosed ◽  
Next Generation ◽  
First Line ◽  
Tier 1 ◽  
Tier 3 ◽  
The Impact

14 Background: Current NCCN guidelines recommend comprehensive molecular profiling for all newly diagnosed patients with metastatic non-squamous NSCLC to enable the delivery of personalized medicine. We have previously demonstrated that incorporation of plasma based next-generation gene sequencing (NGS) improves detection of clinically actionable mutations in patients with advanced NSCLC (Aggarwal et al, JAMA Oncology, 2018). To increase rates of comprehensive molecular testing at our institution, we adapted our clinical practice to include concurrent use of plasma (P) and tissue (T) based NGS upon initial diagnosis. P NGS testing was performed using a commercial 74 gene assay. We analyzed the impact of this practice change on guideline concordant molecular testing at our institution. Methods: A retrospective cohort study of patients with newly diagnosed metastatic non-squamous NSCLC following the implementation of this practice change in 12/2018 was performed. Tiers of NCCN guideline concordant testing were defined, Tier 1: complete EGFR, ALK, BRAF, ROS1, MET, RET, NTRK testing, Tier 2: included above, but with incomplete NTRK testing, Tier 3: > 2 genes tested, Tier 4: single gene testing, Tier 5: no testing. Proportion of patients with comprehensive molecular testing by modality (T NGS vs. T+P NGS) were compared using one-sided Fisher’s exact test. Results: Between 01/2019, and 12/2019, 170 patients with newly diagnosed metastatic non-Sq NSCLC were treated at our institution. Overall, 98.2% (167/170) patients underwent molecular testing, Tier 1: n = 100 (59%), Tier 2: n = 39 (23%), Tier 3/4: n = 28 (16.5%), Tier 5: n = 3 (2%). Amongst these patients, 43.1% (72/167) were tested with T NGS alone, 8% (15/167) with P NGS alone, and 47.9% (80/167) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS: 95.7% (79/80) compared to T alone: 62.5% (45/72), p < 0.0005. Prior to the initiation of first line treatment, 72.4% (123/170) patients underwent molecular testing, Tier 1: n = 73 (59%), Tier 2: n = 27 (22%) and Tier 3/4: n = 23 (18%). Amongst these, 39% (48/123) were tested with T NGS alone, 7% (9/123) with P NGS alone and 53.6% (66/123) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS, 100% (66/66) compared to 52% (25/48) with T NGS alone (p < 0.0005). Conclusions: Incorporation of concurrent T+P NGS testing in treatment naïve metastatic non-Sq NSCLC significantly increased the proportion of patients undergoing guideline concordant molecular testing, including prior to initiation of first-line therapy at our institution. Concurrent T+P NGS should be adopted into institutional pathways and routine clinical practice.

scholarly journals Simultaneous Monitoring of the Middle Cerebral and Basilar Arteries to Detect Right-to-Left Shunts Using Transcranial Doppler by Agitated Saline Administration

2021 ◽  
Author(s):  
Min Kim ◽  
So Young Park ◽  
Ji Man Hong
Keyword(s):  
Transcranial Doppler ◽  
Valsalva Maneuver ◽  
Weighted Kappa ◽  
Tier 2 ◽  
Kappa Index ◽  
Evaluation Tool ◽  
Saline Administration ◽  
Basilar Arteries ◽  
Ischemic Attack ◽  
Tier 3

Abstract Transcranial Doppler (TCD) is an easy, non-invasive, and real-time monitoring device for detecting right-to-left shunts (RLS). Nonetheless, it has limited benefits in patients with poor temporal windows. Therefore, we aimed to investigate whether the basilar artery (BA) window was as effective as the middle cerebral artery (MCA) in detecting RLS during TCD monitoring. Overall, we enrolled 344 patients with stroke, transient ischemic attack, headache, or dizziness. MCA and BA were monitored using a modified headset. To investigate the feasibility of the suboccipital window in detecting RLS, we instituted an evaluation tool with three tiers to evaluate microembolic signals (MESs) during TCD monitoring. Tier 1: TCD monitoring of the MCA (bilaterally) in the resting state, tier 2: TCD monitoring of the MCA (bilaterally) while performing the Valsalva maneuver, and tier 3: TCD monitoring of the index MCA and BA while performing the Valsalva maneuver. In tiers 2 and 3, a high agreement rate of 0.8076 and 0.8068 (p<0.001), respectively, on the weighted kappa index, and a high intra-class correlation coefficient of 0.9822 and 0.9860 (p<0.001), respectively, were observed on detecting MESs. Our data suggests that the BA window is as effective as the MCA window for detecting RLS on TCD.

scholarly journals Initial Experience in Predicting the Risk of Hospitalization of 496 Outpatients with COVID-19 Using a Telemedicine Risk Assessment Tool

2020 ◽  
Author(s):  
James B O'Keefe ◽  
Elizabeth J Tong ◽  
Thomas H Taylor ◽  
Ghazala D Datoo O'Keefe ◽  
David C Tong
Keyword(s):  
Risk Assessment ◽  
Assessment Tool ◽  
Cox Regression ◽  
Risk Assessment Tool ◽  
Individual Risk ◽  
Tier 2 ◽  
Tier 1 ◽  
Risk Patients ◽  
Tier 3

Objective: To determine whether a risk prediction tool developed and implemented in March 2020 accurately predicts subsequent hospitalizations. Design: Retrospective cohort study, enrollment from March 24 to May 26, 2020 with follow-up calls until hospitalization or clinical improvement (final calls until June 19, 2020) Setting: Single center telemedicine program managing outpatients from a large medical system in Atlanta, Georgia Participants: 496 patients with laboratory-confirmed COVID-19 in isolation at home. Exclusion criteria included: (1) hospitalization prior to telemedicine program enrollment, (2) immediate discharge with no follow-up calls due to resolution. Exposure: Acute COVID-19 illness Main Outcome and Measures: Hospitalization was the outcome. Days to hospitalization was the metric. Survival analysis using Cox regression was used to determine factors associated with hospitalization. Results: The risk-assessment rubric assigned 496 outpatients to risk tiers as follows: Tier 1, 237 (47.8%); Tier 2, 185 (37.3%); Tier 3, 74 (14.9%). Subsequent hospitalizations numbered 3 (1%), 15 (7%), and 17 (23%) and for Tiers 1-3, respectively. From a Cox regression model with age ≥ 60, gender, and self-reported obesity as covariates, the adjusted hazard ratios using Tier 1 as reference were: Tier 2 HR=3.74 (95% CI, 1.06-13.27; P=0.041); Tier 3 HR=10.87 (95% CI, 3.09-38.27; P<0.001). Tier was the strongest predictor of time to hospitalization. Conclusions and Relevance: A telemedicine risk assessment tool prospectively applied to an outpatient population with COVID-19 identified both low-risk and high-risk patients with better performance than individual risk factors alone. This approach may be appropriate for optimum allocation of resources.

scholarly journals Implementation of Grid Tier 2 and Tier 3 facilities on a Distributed OpenStack Cloud

2014 ◽  
Vol 513 (3) ◽  
pp. 032058 ◽  
Author(s):  
Antonio Limosani ◽  
Lucien Boland ◽  
Paul Coddington ◽  
Sean Crosby ◽  
Joanna Huang ◽  
...  
Keyword(s):  
Tier 2 ◽  
Tier 3

Legitimacy building of digital platforms in the informal economy: evidence from Indonesia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eko Heru Prasetyo
Keyword(s):  
Informal Economy ◽  
Chief Executive Officers ◽  
Business Models ◽  
Chief Executive ◽  
Sharing Economy ◽  
Bottom Of The Pyramid ◽  
Content Type ◽  
Digital Platforms ◽  
Executive Officers ◽  
Start Ups

Purpose This study aims to investigate how digital entrepreneurs develop platforms business models under an unregulated market and what approach they take to address informal economy (IE) activities. Design/methodology/approach The author used a qualitative method by interviewing sixteen respondents, including founders, Chief Executive Officers, and managers of digital-driven start-ups in Indonesia. I then analysed the interviews into several codes and themes for further discussion. Findings This study reveals distinctive approaches performed by startups within three-level institutions, namely, users, market and regulation. Each level represents digital entrepreneurs’ unique behaviour, which the author described as collective, narrative and compliant. Research limitations/implications This paper demonstrates that digital entrepreneurs leveraging informal sectors contribute to the process of formalisation. However, the author emphasise less on how it impacts informality and who receives incentives. Practical implications This study suggests appropriate strategies for entrepreneurs who build and develop a platform beyond immature setting and unveils different directions to comprehend their legitimacy building. Social implications This study also elucidates political implications such as how the dynamics between regulators’ response and entrepreneurs’ reaction shape the new regulative environment. An idea of self-regulate – entrepreneurs as actors instead of a subject of regulation – might be suitable to reflect how they overcome the bottom of the pyramid using technology innovation. Originality/value While previous studies focused primarily on sharing economy, this study provides a different array of discussion on the digitalisation of the informal economy in emerging markets.

HOSPITALITAS KRISTEN DALAM MENGHADAPI PANDEMI COVID-19 DI INDONESIA

2021 ◽  
Author(s):  
Dewi Yermawati Enjhela
Keyword(s):  
Qualitative Approach ◽  
Descriptive Research ◽  
Corona Virus ◽  
Huge Impact ◽  
The Government ◽  
Negative Impacts ◽  
The Impact ◽  
The City ◽  
Christian Hospitality ◽  
Research Type

AbstractIndonesia is one of the countries that has also been affected by the corona virus or covid-19 which originated from China, to be precise in the city of Wuhan. In early 2020 the corona virus or covid-19 began to enter the country of Indonesia. The corona virus has had a huge impact on the lives of Indonesian people, both positive and negative impacts. Communities affected by covid-19 are increasing day after day, but now to be precise in 2021 the increase in covid-19 infections is not as fast as 2020. And the impact is slowly being controlled by both the government and most Indonesians. The Indonesian people are now able to adjust to life in the midst of this Covid-19 pandemic, even the hospitality that faded at the beginning of Covid-19 entering Indonesia is now starting to slowly be shown by the Indonesian people. This paper aims to provide information about Covid-19 in Indonesia and the Christian hospitality that should be practiced by the Indonesian people, especially believers or Christians. This research uses a qualitative approach with theological research type and social descriptive research

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