Hospital administrators play an essential role in the implementation of Antibiotic Stewardship Programs, which is instrumental in the fight against antimicrobial resistance. The foundation and sustenance of such programs has been made possible through leadership; this is through interdisciplinary collaboration that is done with policy formulation and stewardship inclusion into the institutional systems. Indeed, it is immense strength where ID physicians and clinical pharmacists with special training proactively involve themselves in the program. Beyond that, the accreditation standards that incorporate ASPs (...) really enhance compliance and institutional commitment. Obstacles to movement include an absence of resources, unwilling prescriber, and other competing health conditions for priority. To achieve such success, the hospital administrators must ensure adequate staffing, proper utilization of advanced technologies, and instillation of accountability through focused education and participation. Besides the reduction of resistance, ASPs contribute to such improvements in patient outcomes, efficient consumption of resources, and significant reductions in costs. As this narrative review indicates, leadership at the hospital level plays an important role in augmenting antibiotic stewardship. Addressing major barriers, along with strategic implementation, means that administrators may play an important role in further maximizing effectiveness while truly adding to the world-wide effort against antimicrobial resistance. (shrink)

OBJECTIVES: To compare the practices of local research ethics committees and the time they take to obtain ethical approval for a multi-centre study. DESIGN: A retrospective analysis of outcome of applications for a multi-centre study to local research ethics committees. SETTING: Thirty-six local research ethics committees covering 38 district health authorities in England. MAIN MEASURES: Response of chairmen and women, the time required to obtain approval, and questions asked in application forms. RESULTS: We received replies from all 36 chairmen contacted: (...) four (11%) granted their approval, and 32 (89%) required our proposal to be considered by their local research ethics committee. Three committees asked us to attend their meetings. The application was approved by all 36 local research ethics committees but the time to obtain ethical approval varied between six to 208 days. One third of the committees did not approve the project within three months, and three took longer than six months. There was considerable variation in the issues raised by local research ethics committees and none conformed exactly to the Royal College of Physicians' guidelines. CONCLUSION: Obtaining ethical approval for a multi-centre study is time-consuming. There is much diversity in the practice of local research ethics committees. Our data support the recommendation for a central or regional review body of multi-centre studies which will be acceptable to all local research ethics committees. (shrink)

According to Minstrumentalize” this framework to propose an evolutionary basis for the existence of a biological resilience to drug addiction in people.

The problem of addiction is one of the major challenges and controversies confronting medicine and society. It also poses important and complex philosophical and scientific problems. What is addiction? Why does it occur? And how should we respond to it, as individuals and as a society? The Routledge Handbook of Philosophy and Science of Addiction is an outstanding reference source to the key topics, problems and debates in this exciting subject. It spans several disciplines and is the first collection of (...) its kind. Organised into three clear parts, forty-five chapters by a team of international contributors examine key areas, including: the meaning of addiction to individuals conceptions of addiction varieties and taxonomies of addiction methods and models of addiction evolution and addiction history, sociology and anthropology population distribution and epidemiology developmental processes vulnerabilities and resilience psychological and neural mechanisms prevention, treatment and spontaneous recovery public health and the ethics of care social justice, law and policy. Essential reading for students and researchers in addiction research and in philosophy, particularly philosophy of mind and psychology and ethics, The Routledge Handbook of Philosophy and Science of Addiction will also be of great interest to those in related fields, such as medicine, mental health, social work, and social policy. (shrink)

The unified framework for addiction (UFA) formulated by Redish et al. is a tour de force. It uniquely predicts that there should be multiple addiction syndromes and pathways – a diversity that would reflect the complexity of the mammalian brain decision system. Here I explore some of the evolutionary and developmental ramifications of UFA and derive several new avenues for research.

The question posed is whether the optimization methods of calculus that are often used in social and scientific analyses offer an appropriate analytical approach to analyze problems that are immersed in systemic complexity and its consequences. This paper refers to the portfolio of such complex problems belonging to social and scientific forces. We refer to such a complex combination by the term ‘socio-scientific’. In the study of socio-scientific complexity, dynamic preferences, intricate decisions, and uncertain behavior, endogenous relations and systemic perturbations (...) abound. The arguments presented in this paper establish that the methodological approach of optimization and steady-state equilibrium turns out to be nicety rather than objectivity in the presence of complexity. Complex situations of the socio-scientific universe cause perturbations in the variables; there explaining complexity formed by the social embedding of variables. Indeed, human individuals, institutions and governments, and society at large are complex interrelated entities. Therefore, complex interrelations caused by social embedding remain submerged in social perturbations. However, interactions arising from social embedding also generate endogenous and complex relations. The contribution of this paper is in the area of endogenous learning in the wellbeing objective criterion function. The interrelationships between the emergent cognitive variables now cause interactive embedding, complexity, and social perturbations. Yet such perturbations are not altogether uncontrollable. They can be and need to be controlled for the purposes of social explanation—hence demanding predictability—even as the complex nature of evolutionary systemic learning proceeds. The controllability problem of extreme perturbations leads us to formalize a mathematical methodology to study controllable perturbations while avoiding extreme forms of perturbations in socio-scientific theory. (shrink)

To help ensure the ethical conduct of research, many have recommended educational efforts in research ethics to investigators and members of research ethics committees (RECs). One type of education activity involves multi-day workshops in research ethics. To be effective, such workshops should contain the appropriate content and teaching techniques geared towards the learning styles of the targeted audiences. To ensure consistency in content and quality, we describe the development of a curriculum guide, core competencies and associated learning objectives and activities (...) to help educators organize research ethics workshops in their respective institutions. The curriculum guide is divided into modular units to enable planners to develop workshops of different lengths and choose content materials that match the needs, abilities, and prior experiences of the target audiences. The content material in the curriculum guide is relevant for audiences in the Middle East, because individuals from the Middle East who participated in a Certificate Program in research ethics selected and developed the training materials (e.g., articles, powerpoint slides, case studies, protocols). Also, many of the activities incorporate active-learning methods, consisting of group work activities analyzing case studies and reviewing protocols. The development of such a workshop training curriculum guide represents a sustainable educational resource to enhance research ethics capacity in the Middle East. (shrink)

The United Nations has been holding the High-Level Political Forum (HLPF) annually since 2015, where countries meet to discuss the progress, they have made in achieving the sustainable development goals of the 2030 Vision, and to identify the challenges they face, their areas of focus in the future, and to evaluate their efforts in achieving and submitting voluntary reports on this. The research seeks to analyze Arabic translation of the speech of the Kingdom of Saudi Arabia; as a special type (...) of political communication to reveal the most prominent strategies that have formed it, and to identify the mechanisms that have been achieved; which has given the speech its uniqueness and efficacy, as each speech carries with it its strategies and mechanisms that lead to its success or failure. The study adopted the pragmatic approach imposed by the nature of this work. It came up with a set of results, the most prominent of which is that the solidarity strategy is the most effective in achieving the goals of the Kingdom’s speech, and thus this strategy was an introduction to other strategies, especially the persuasive and directive strategies. (shrink)

The proposed work describes an approach for segmentation of activated sludge flocs from the microscopic images for monitoring wastewater treatment. The morphological features of flocs and filaments are related to the state of an activated sludge wastewater treatment plant and must be monitored for proper functioning. Hence, image processing and analysis could be a time-saving monitoring tool. To address this challenge, we propose a novel framework involving a multiphase edge detection algorithm based on information theory. The proposed framework is evaluated (...) and scrutinized critically considering the artifacts found in the photographs tested. To evaluate the segmentations, gold approximation of estimated truth images is created. In addition, the performance was subjectively evaluated for its potential for segmenting activated sludge images. Experimental results show that the proposed framework exhibits the good results and demonstrates its effectiveness. (shrink)

ABSTRACTThe rapid expansion of primary education in Ethiopia has enabled most children to attend primary education—or at least to start schooling. This expansion, however, is largely “symbolic” rat...

Biobanking is a relatively new concept in Egypt. Building a good relationship with different stakeholders is essential for the social sustainability of biobanks. To establish this relationship, it is necessary to assess the attitude of different groups towards this concept. The objective of this work is to assess the knowledge, attitude, and opinions of Egyptian patients towards biobanking issues. We designed a structured survey to be administered to patients coming to the outpatient clinics in 3 university hospitals in Egypt. The (...) survey included questions estimating the level of knowledge about the term “Biobank”, together with questions about the attitudes and opinions about related issues. Two hundred and fifty-nine patients participated in the survey. Eighty-one percent of participants reported that they never heard about the term before. About 85% expressed that they would be willing to donate their samples for research and about 87% thought that sample donation did not contradict their religious beliefs. Fifty eight percent were willing to participate in a genetic research project, 27.8% supported sharing their sample with pharmaceutical companies, and 32.4% agreed to share their samples with institutions abroad. Although there is limited knowledge about biobanking among Egyptian patients, many had a positive attitude towards sample donation and didn’t show religious concerns against it. However, they showed concerns regarding participation in genetic research and with sharing their samples across borders or with pharmaceutical companies. Public education about biobanking is possible, taking into consideration the specific cultural and legal framework in Egypt. (shrink)

There is a growing interest in non-invasive stimulation interventions as treatment strategies to improve functional outcomes and recovery after spinal cord injury. Repetitive transcranial magnetic stimulation is a neuromodulatory intervention which has the potential to reinforce the residual spinal and supraspinal pathways and induce plasticity. Recent reviews have highlighted the therapeutic potential and the beneficial effects of rTMS on motor function, spasticity, and corticospinal excitability modulation in SCI individuals. For this scoping review, we focus on the stimulation parameters used in (...) 20 rTMS protocols. We extracted the rTMS parameters from 16 published rTMS studies involving SCI individuals and were able to infer preliminary associations between specific parameters and the effects observed. Future investigations will need to consider timing, intervention duration and dosage that may depend on the stage, the level, and the severity of the injury. There is a need for more real vs. sham rTMS studies, reporting similar designs with sufficient information for replication, to achieve a significant level of evidence regarding the use of rTMS in SCI. (shrink)

This paper examines the Bahāʾī philosophy with all its religious values and humanitarian practices to assess their relevance to the modern times. The rationale behind the choice of this subject was to find out whether the Bahāʾī philosophy could be yet another force and potential ideology to offer a solution to modern time challenges that are faced globally. Using a qualitative research design, the data was collected through a content analysis and close reading of Bahāʾī scriptures, tablets, letters and other (...) library sources. A close study of the Bahāʾī doctrines, values and faith revealed that the Bahāʾī philosophy extended the message of uniting the whole humanity by uniting all religions and sects, despite their apparent differences. All religions, according to the Bahāʾī faith, are manifestations of God and work towards an identical and universal divine plan to educate the human race. The social ethics of the Bahāʾīs emphasized upon the “oneness of humanity”, abolition of racial discrimination, class distinction, and religious prejudices, without any need of priesthood or rigid rituals of worshipping. If implemented and complied universally in principle, the Bahāʾī philosophy could be one of the potential ideologies to resolve the racial and religious conflicts. (shrink)

Despite the potential value of graduate-level research ethics training, most Middle East countries, including Jordan, do not routinely offer formal research ethics training. In students enrolled in Jordanian master’s level graduate program in pharmacy, the current study assessed: 1- differences in pre- and post-enrollment exposure to research ethics core themes, 2- whether this exposure was through a formal course or in an informal setting, and 3- student attitudes towards research ethics education and the need for integrating a dedicated research ethics (...) course into pharmacy graduate programs. A 12-item on-line survey was developed by the authors and disseminated to a convenience sample of current and former master-level pharmacy students in Jordan. A total of 61 eligible respondents completed the survey. A minority of respondents (38%) acknowledged receiving research ethics training prior to enrollment into a postgraduate pharmacy program with nearly half (16%) describing this training as informal. In comparison, a larger percentage of the total respondents (56%) had received research ethics training during their postgraduate program enrollment, with nearly half of those (25%) indicating that this training was informal. A majority of respondents reported a strong need for integrating a formal research ethics course into postgraduate pharmacy curriculum (90%) to support their research training and thesis writing (89%). Overall, the study revealed a notable lack of research ethics education for graduate-level pharmacy students in Jordan. (shrink)

ABSTRACTAdopting a temporally distant perspective on stressors reduces distress in adults. Here we investigate whether the extent to which individuals project themselves into the future influences distancing efficacy. We also examined modulating effects of age across adolescence and reactive aggression: factors associated with reduced future-thinking and poor emotion regulation. Participants read scenarios and rated negative affect when adopting a distant-future perspective, near-future perspective, or when reacting naturally. Self-report data revealed significant downregulation of negative affect during the distant-future condition, with a (...) similar though non-significant skin conductance pattern. Importantly, participants who projected further ahead showed the greatest distress reductions. While temporal distancing efficacy did not vary with age, participants reporting greater reactive aggression showed reduced distancing efficacy, and projected themselves less far into the future. Fi... (shrink)

Early executive function skills reliably predict school readiness and future academic success. While children’s skills undergo rapid development during the transition to formal schooling, it remains unclear the extent to which schooling exerts a unique influence on the accelerated development of EF and academic skills during the early years of schooling. In the present study, a quasi-experimental technique known as the school cutoff design was used to examine whether same-aged children who made vs. missed the age cutoff for school entry (...) significantly differed on EF, reading, and math outcomes. Data from 166 pre-k, kindergarten, and first grade children from a longitudinal study of literacy development were analyzed. Children were assessed on EF, reading, and math skills in fall and spring. Results revealed unique effects of kindergarten, but not first grade, on growth in EF and reading over and above the effect of age. Schooling was unrelated to growth in math. Because kindergarten represents the first year of elementary school and children’s first exposure to a formal schooling environment, kindergarten schooling may be uniquely positioned to produce greater gains in academic and behavioral outcomes compared to other grades. (shrink)

In recent decades we have been given one of the most interesting concepts in Islamic intellectual history, `the scientific miracle of Qur’ān whereby the proponents have almost established the scientific theories in the Qur’ān. However, such ardent claims must not come to be without any inspiration and methodology. This article, firstly, tries to trace the inspiration of such concept and then describe the methodology. However, as exciting as this concept seems, the methodology brings forth a very negative approach to prove (...) the miracle of the Qur’ān, which is value free. That negative value free mentality which is related to the status of prophet of Islam will be exposed and it will detail how the status of prophet of Islam was abated so badly to prove the science from the Qur’ān. To counter this negative narrative and to reveal the true status of prophet of Islam, arguments will be presented from the Qur’ān and Ḥadīth which are incontrovertible. Let it be known than, this analysis is not general but particular. However, it will be a novel critique to re-visit this concept. (shrink)

According to the Accreditation Board for Engineering and Technology, Inc. [ABET], 2019), any approved engineering program must provide the student with “an ability to recognize ethical and professi...

BackgroundOrgan donation has become one of the most effective ways to save lives and improve the quality of life for patients with end-stage organ failure. No previous studies have investigated the preferences for the different consenting options for organ donation in Egypt. This study aims to assess Egyptians’ preferences regarding consenting options for posthumous organ donation, and measure their awareness and acceptance of the Egyptian law articles regulating organ donation.MethodsA cross sectional study was conducted among 2743 participants over two years. (...) Each participant was required to rank eleven consenting options from 1 to 11, and to report his awareness and acceptance of the seven articles of the Egyptian law of organ donation.Results47% of the participants expressed willingness to donate their organs after death. This percentage increased to 78% when consenting options were explained to participants. “Informed consent by donor only” was the most preferred type of consent for one third of respondents. Awareness of the law articles regulating organ donation was relatively low ranging from 56% to 23%.ConclusionCurrently, around half of the Egyptian population agree to posthumous organ donation. This percentage could be increased significantly by raising the awareness about how the process of donation could be regulated and how the patient’s right of decision could be protected. (shrink)

This paper provides a critical review of economic outcome metrics used in healthcare value assessment, emphasizing the evolving landscape of resource allocation, patient-centered approaches, and standardization efforts. With healthcare costs rising globally, the efficient allocation of limited resources is essential. Metrics like Quality-Adjusted Life Years (QALYs), Disability-Adjusted Life Years (DALYs), Incremental Cost-Effectiveness Ratios (ICERs), and Cost-Benefit Analysis (CBA) are central to guiding funding decisions, influencing insurance coverage, and shaping treatment prioritization. Emerging trends, such as the integration of artificial intelligence (AI) (...) and big data, are enhancing the precision of these assessments, while patient-centered metrics underscore the importance of patient satisfaction and quality of life. Additionally, there is a growing push for the standardization of these metrics to create consistent frameworks across diverse health systems. This paper explores case studies, practical applications, and future directions to provide insights into how healthcare systems can adopt more effective, globally aligned economic assessments. (shrink)

With the rapid growth of informatics systems’ technology in this modern age, the Internet of Things (IoT) has become more valuable and vital to everyday life in many ways. IoT applications are now more popular than they used to be due to the availability of many gadgets that work as IoT enablers, including smartwatches, smartphones, security cameras, and smart sensors. However, the insecure nature of IoT devices has led to several difficulties, one of which is distributed denial-of-service (DDoS) attacks. IoT (...) systems have several security limitations due to their disreputability characteristics, like dynamic communication between IoT devices. The dynamic communications resulted from the limited resources of these devices, such as their data storage and processing units. Recently, many attempts have been made to develop intelligent models to protect IoT networks against DDoS attacks. The main ongoing research issue is developing a model capable of protecting the network from DDoS attacks that is sensitive to various classes of DDoS and can recognize legitimate traffic to avoid false alarms. Subsequently, this study proposes combining three deep learning algorithms, namely recurrent neural network (RNN), long short-term memory (LSTM)-RNN, and convolutional neural network (CNN), to build a bidirectional CNN-BiLSTM DDoS detection model. The RNN, CNN, LSTM, and CNN-BiLSTM are implemented and tested to determine the most effective model against DDoS attacks that can accurately detect and distinguish DDoS from legitimate traffic. The intrusion detection evaluation dataset (CICIDS2017) is used to provide more realistic detection. The CICIDS2017 dataset includes benign and up-to-date examples of typical attacks, closely matching real-world data of Packet Capture. The four models are tested and assessed using Confusion Metrix against four commonly used criteria: accuracy, precision, recall, and F-measure. The performance of the models is quite effective as they obtain an accuracy rate of around 99.00%, except for the CNN model, which achieves an accuracy of 98.82%. The CNN-BiLSTM achieves the best accuracy of 99.76% and precision of 98.90%. (shrink)

Diabetes mellitus (DM) is a colossal burden in global health, its prevalence increases steadily throughout the world. This systematic review explores the pathophysiology and epidemiology of diabetes, which describes the interactions that implicate that is the result of the play between genetic, environmental, and lifestyle factors in the development and progression of the disease. The review also describes a plethora of pharmacological treatments available to manage diabetes, with the oral agent, insulin regimens, and new approaches to therapy. Integrating the wisdom (...) of the best clinical guidelines, those are from American diabetes association (ADA), European association for the study of diabetes (EASD), and International Diabetes Federation (IDF). Since these reviews are consistent with normative standards for evidence-based recommendations of optimal care of diabetes. The review goes further to cover technological advances in the management of diabetes. They include Continuous Glucose Monitoring, advanced insulin delivery systems, and Artificial Pancreas Systems. Such technologies hold more promising routes to better glucose control and patient quality of life. All this comes along with challenges that their deployment and maintenance that run through economic, adherence issues, and unequal access to healthcare. The future research and innovation in the battle against DM will include the application of personalized medicine and the development of advanced digital health solutions. This article will become a treasure for health professionals, researchers, and policymakers who have dedicated themselves to battling the adversities of diabetes mellitus. (shrink)

How is a philosophical tradition created? What role does literary biography play in the formation of intellectual reception history? Through a detailed analysis of the lives and works of post-Avicennan philosophers, this monograph traces the intellectual history and development of the Avicennan tradition from the fifth/eleventh to the eighth/fourteenth century. Section 1 investigates the genres of Arabo-Islamic biobibliographical and prosopographical writings as a source for the history of Arabic philosophy, delineating their literary topoi, the construction of philosophical authority, and the (...) relationship of Sunnī and Twelver-Šīī Islam to Aristotelian logic and philosophy. Section 2 presents fourteen discrete biobibliographical studies with a critical inventory of the works, including those written in the neglected exegetical genres of commentary, supercommentary, gloss, and supergloss, of Avicenna's immediate disciples and the following generations of philosophers who created the Avicennan philosophical heritage in the Islamicate world.--Provided by Publisher. (shrink)

This article examines the nature and reproduction of ‘institutional idiocy’, seen as a form of collective cognitive incapacity generated by cultural conditions. It shows idiocy to be active in numerous paths, wearing different clothes and taking dissimilar forms, spreading to the extent that it dominates communities. An empirically driven framework is established for idiocy-dominated communities – communities with access to futile education and fruitless technology. It demonstrates how idiocy-dominated communities disguise and protect their shared idiocy and handle non-idiotic minorities. It (...) explains that idiocy-intense communities are not necessarily chaotic and arbitrarily organised, entailing ‘formulas of life’, ‘identity politics’ and ‘schools of thought’. It describes that a whole community can thoroughly adapt to life without critical thinking, living in an illusion. Whereas previous works have scrutinised individual idiocy, this research goes beyond this to inspect institutional idiocy by presenting idiocy as a system (and ‘ideology’) that constitutes the foundation of groups. While such notions as technocracy and epistocracy detail the domination of cognitive maturity, this article goes in another direction by recording the domination of cognitive immaturity (idiocracy). It avoids thinking about idiocy binarily (idiocy versus intelligence), viewing it as a question of not intellect but behaviour, culture and ‘being-with’. (shrink)

According to the World Health Organisation, three to five million individuals are infected by influenza, and around 250,000 to 500,000 people die of this infectious disease worldwide. Influenza epidemics pose a serious public health threat. Moreover, graver dangers are encountered with influenza subtypes against which there is little or no preexisting human immunity. Such subtypes of influenza have the potential to cause devastating epidemics. Thus, enhancing surveillance systems for the purpose of detecting influenza epidemics in an early stage can quicken (...) response times and save millions of lives. This paper presents three adapting intelligence models: support vector machine regression, artificial neural network using particle swarm optimisation, and our intelligent time series to predict influenza epidemics. The novelty of the current study is that it proposes a new intelligent model to predict influenza outbreaks. The INTS model combines clustering with a time series model to enhance the prediction of influenza outbreaks. The innovation of our proposed model integrates the results obtained from the existing weighted exponential smoothing model with centroids obtained from clustering. We developed a surveillance system for influenza epidemics using Google search queries. The current research is based on a weighted version of the Center for Disease Control and Prevention influenza-like illness activity level obtained from the Center for Disease Control and Prevention data, as well as query data obtained from the Goggle search engine in the USA. The influenza-like illness data was collected from January 4, 2009, to December 27, 2015, stretching across a total time span of 312 weeks. Google Correlate was used to select search queries related to influenza epidemics. In total, 100 search queries were obtained from Google Correlate, 10 of which were better and more relevant search queries selected in this study. The model was evaluated using online Google search queries collected from Google Correlate. Standard measure performance MSE, RMSE, and MAE were employed to estimate the results of the proposed model. The empirical results of the INTS model showed MSE = 0.003, RMSE = 0.036, and MAE = 0.0185, indicating that the errors of the proposed model are very limited. A comparative model of predicting results between the INTS model, alternative Google Flu Trend, and autoregression with Google search data is also presented. The proposed model outperformed the existing models. (shrink)

Repeatedly performing a submaximal motor task for a prolonged period of time leads to muscle fatigue comprising a central and peripheral component, which demands a gradually increasing effort. However, the brain contribution to the enhancement of effort to cope with progressing fatigue lacks a complete understanding. The intermittent motor tasks closely resemble many activities of daily living, thus remaining physiologically relevant to study fatigue. The scope of this study is therefore to investigate the EEG-based brain activation patterns in healthy subjects (...) performing IMT until self-perceived exhaustion. Fourteen participants repeated elbow flexion contractions at 40% maximum voluntary contraction by following visual cues displayed on an oscilloscope screen until subjective exhaustion. Each contraction lasted ≈5 s with a 2-s rest between trials. The force, EEG, and surface EMG data were simultaneously collected. After preprocessing, we selected a subset of trials at the beginning, middle, and end of the study session representing brain activities germane to mild, moderate, and severe fatigue conditions, respectively, to compare and contrast the changes in the EEG time-frequency characteristics across the conditions. The outcome of channel- and source-level TF analyses reveals that the theta, alpha, and beta power spectral densities vary in proportion to fatigue levels in cortical motor areas. We observed a statistically significant change in the band-specific spectral power in relation to the graded fatigue from both the steady- and post-contraction EEG data. The findings would enhance our understanding on the etiology and physiology of voluntary motor-action-related fatigue and provide pointers to counteract the perception of muscle weakness and lack of motor endurance associated with ADL. The study outcome would help rationalize why certain patients experience exacerbated fatigue while carrying out mundane tasks, evaluate how clinical conditions such as neurological disorders and cancer treatment alter neural mechanisms underlying fatigue in future studies, and develop therapeutic strategies for restoring the patients' ability to participate in ADL by mitigating the central and muscle fatigue. (shrink)

This study examines the influence of the COVID-19 crisis on academic expectations among international students from north-western China. According to past studies, academic expectations are multifaceted, making it critical to test the methods employed to assess this fundamental trait. The outbreak of COVID-19 has resulted in various significant changes in education, which have shifted from traditional to online or mixed formats. As a result, examining international students' academic expectations along with their interactions with adopted technologies is a topic that addresses (...) the current situation and issues. A mixed approach, comprising two different instruments, was followed to achieve this primary objective. While a survey with a questionnaire was undertaken with 551 international students, divided into two groups, ten students were interviewed during and after the lockdowns. The findings revealed that COVID-19 had a significant impact on the academic expectations of students as well as many elements such as training for employment, personal and social development, international student mobility, motivation, social pressure, and social interaction with the help of supporting technologies. In terms of gender, men outperformed women in motivation, social interaction, training for employment, and personal and social development factors. Similarly, as per the grade variable, the same higher trend was seen in postgraduates. Based on these findings, a set of recommendations was put forward. In the future, technology will be helpful in China's educational sector, such as online group collaboration, open education, managing student retention, and supervising teachers' recruitment. (shrink)

Breaking bad news (BBN) to parents whose newborn has a major disease is an ethical dilemma. In Saudi Arabia, BBN about newborns is performed according to the parental preferences that have been reported from non-Arabic/non-Islamic countries. Saudi mothers' preferences about BBN have not yet been studied. Therefore, we aimed to elicit the preferences of Saudi mothers about BBN concerning newborns. We selected a convenience sample of 402 Saudi mothers, aged 18-50 years, who had no previous experience with BBN. We selected (...) them via a simple number-randomization scheme from the premises of a level III Saudi hospital between October of 2009 and January of 2011. We used a hypothetical situation (BBN about trisomy 21) to elicit their preferences about BBN concerning newborns via a structured verbal questionnaire composed of 12 multiple-choice questions. We expressed their preferences as percentages (95% confidence interval), and we used the Kendall's W test (W) to assess the degree of agreement in preferences. The Saudi mothers preferred that BBN be conducted with both parents together (64% [60-69]), albeit with weak levels of agreement (W = 0.29). They showed moderate agreement in their preferences that BBN should be conducted early (79% [75-83], W = 0.48), in detail (81% [77-85], W = 0.52), in person (88% [85-91], W = 0.58), and in a quiet setting (86% [83-90], W = 0.53). With extremely weak agreement, they preferred to have a known person present for support during BBN (56% [51-61], W = 0.01), to have close bodily contact with their babies (66% [61-70], W = 0.10), and to have no another patients present (64% [59-68], W = 0.08). They showed moderate levels of agreement in their desires to detail, in advance, their preferences about process of BBN by giving a reversible, written informed consent that could be utilized for guidance, if needed (80% [76-84], W = 0.36). In our experience, Saudi mothers' preferences about BBN concerning newborns are varied, suggesting that a "one-size-fits-all" approach is inappropriate. A reversible, written informed consent detailing their preferences about BBN that would be kept in their medical records and utilized for guidance, if needed, may be the best solution, given this level of diversity. These findings merit further study. (shrink)

The current study aimed at identifying the effect of strategic control on customer satisfaction with e-marketing in the Kingdom of Saudi Arabia. The study used the descriptive approach. A questionnaire was prepared and administered to a sample of (315) customers in the Kingdom of Saudi Arabia. The study found a statistically significant correlation at the significance level of (0.05) between all strategic control dimensions, customer satisfaction with e-marketing, and customer approval of the positivity towards the practices and advantages of strategic (...) control in e-marketing. There is also a statistically significant effect at the significance level of (0.05) for strategic control dimensions: (management information systems, strategic control methods, strategic evaluation) on customers' satisfaction in e-marketing. The current study recommended the need to pay attention to the strategic control function and benefit from its philosophy and the benefits that accrue to supporting customer satisfaction with e-marketing, and raising the efficiency and awareness of employees about strategic control in an organized manner in order to build their capabilities to support and implement control mechanisms and make the necessary improvements. (shrink)

The primary and secondary sources of Islamic law often assume a binary distinction between ijtihād and taqlīd, ignoring a third level of engagement with the sources, which was conceptualized by some jurists as forming a distinct category. In this article I discuss the evolution of the terms ijtihād, taqlīd, and ittibāʿ, using a conceptual-historical approach. I argue that the use of taqlīd to mean “precedent-following” did not emerge as a technical term until after the time of al-Shāfiʿī. The distinction between (...) precedent-following and verifiable-following did not appear in legal discourse until the time of Aḥmad b. Ḥanbal. I also demonstrate that there were three approaches to these terms in legal discourse after the time of Ibn Ḥanbal, with three groups of jurists defining them in ways that advanced their different visions of law-making. I conclude with a discussion of the debate over the meanings of these terms in the eighteenth and nineteenth centuries. (shrink)

The ISA, based on system theory, is the best way to organize knowledge and exchange it. It depends on defining every system through its boundary, main processes within this boundary, and exchange with the environment through this boundary. It relies upon thermodynamics and information theory and is, therefore, applicable to all kinds of systems, which makes it most suitable for cross-disciplinary investigations and innovation. SD is complex and cross-disciplinary by its very nature and, therefore, the ISA is the best way (...) to investigate its different subsystems. Among the most important subsystems of SD are integrated bio-refineries and bio-fuels, both of which are investigated in this article. (shrink)

Multimodal neuroimaging provides a rich source of data for identifying brain regions associated with disease progression and aging. However, present studies still typically analyze modalities separately or aggregate voxel-wise measurements and analyses to the structural level, thus reducing statistical power. As a central example, previous works have used two quantitative MRI parameters—R2* and quantitative susceptibility —to study changes in iron associated with aging in healthy and multiple sclerosis subjects, but failed to simultaneously account for both. In this article, we propose (...) a unified framework that combines information from multiple imaging modalities and regularizes estimates for increased interpretability, generalizability, and stability. Our work focuses on joint region detection problems where overlap between effect supports across modalities is encouraged but not strictly enforced. To achieve this, we combine L1, total variation, and L2 group lasso penalties. While the TV penalty encourages geometric regularization by controlling estimate variability and support boundary geometry, the group lasso penalty accounts for similarities in the support between imaging modalities. We address the computational difficulty in this regularization scheme with an alternating direction method of multipliers optimizer. In a neuroimaging application, we compare our method against independent sparse and joint sparse models using a dataset of R2* and QS maps derived from MRI scans of 113 healthy controls: our method produces clinically-interpretable regions where specific iron changes are associated with healthy aging. Together with results across multiple simulation studies, we conclude that our approach identifies regions that are more strongly associated with the variable of interest, more accurate, and more stable with respect to training data variability. This work makes progress toward a stable and interpretable multimodal imaging analysis framework for studying disease-related changes in brain structure and can be extended for classification and disease prediction tasks. (shrink)

BackgroundBurnout is a syndrome that results from stressors in the work environment that have not been successfully managed. The prevalence of burnout among schoolteachers was always controversial. COVID-19 pandemic added more stressors to teachers since they had to change their working styles in response to the pandemic lockdowns or curfews. In Saudi Arabia, the prevalence and determinants of burnout among school teachers were not measured by any other group during the COVID-19 pandemic stressors.MethodsA cross-sectional survey was conducted among 879 teachers (...) in the Jazan region, Saudi Arabia, using the Maslach Burnout Inventory, during April 2021. Multistage cluster random sampling was used.ResultsThe mean age of the participants was 41.4 years. Male teachers represented 52.6% of the participants while females represented 47.4%. Most teachers showed burnout symptoms. Consequences of burnout were observed, such as using psychotropic medications, absenteeism, lack of job satisfaction, and changing schools. Using the MBI scale, most teachers showed medium or high emotional exhaustion, low depersonalization, and low personal accomplishment.ConclusionMost teachers showed symptoms of burnout during the COVID-19 pandemic. Being an expert and ability to adapt to technology during the COVID-19 pandemic proved to effectively reduce burnout symptoms. Increasing incentives, early detection, and improving the work environment is recommended to diminish burnout consequences. (shrink)