Miracle-dz/UniFAR-FTUs huggingface dataset:
Examining Healthcare Professionals’ Telehealth Usability before and during COVID-19 in Saudi Arabia: A Cross-Sectional Study

COVID-19 has placed substantial stress on healthcare providers in Saudi Arabia as they struggle to avoid contracting the virus, provide continued care for their patients, and protect their own families at home from possible exposure. The demand for care has increased due to the need to treat COVID-19. This pandemic has created a surge in the need for care in select healthcare delivery specialties, forcing other nonurgent or elective care to halt or transition to telehealth. This study provides a timely description of how COVID-19 affected employment, telehealth usage, and interprofessional collaboration. The STROBE checklist was used. We developed a cross-sectional online survey design that is rooted and grounded in the Technology Acceptance Model (TAM). The TAM model allows us to identify characteristics that affect the use of telehealth technologies. The survey was deployed in November 2021 to local healthcare providers in Saudi Arabia. There were 66 individuals in the final sample. Both interprofessional satisfaction on frequency and quality were positively correlated with the frequency of interactions. The odds for satisfaction of frequency and quality were about 12 times (OR = 12.27) and 8 times 110 (OR = 8.24) more, respectively, for the participants with more than three times of interaction than the participants with no interaction at all. We also found that change in telehealth usage during the pandemic was positively associated with the Telehealth Usability Questionnaire (TUQ) scores. The estimated score for the participants who reported an increase in telehealth usage was 5.37, while the scores were lower for the participants reporting ‘no change’ and ‘decreased usage’. Additional training on telehealth use and integration to improve interprofessionalism is needed.
Using clocks to determine the entropy of black holes and other space-time singularities

Space-time singularities, viz. Big bang, Big crunch and black holes have been shown to follow from the singularity theorems of General relativity. Whether the entropy at such infinite proper-time objects can be other than zero has also been a longstanding subject of research. Currently the property most commonly chosen to calculate their entropy is a multiple of the surface area of the event horizon and usually gives non-zero entropy values. Though popular, this choice still leaves some substantial questions unanswered hence the motivation for alternative methods for entropy derivation. Here, we use a different property, the proper-time at singularities based on the General relativity predicted behavior of clocks, to derive their entropy. We find, firstly within statistical and thermodynamic principles, secondly when this property is taken into account in the Bekenstein-Hawking formula and thirdly illustrating with a natural analogue, that the entropy of black holes and all other gravitational singularities cannot be other than zero as had been earlier classically speculated.
Stakeholder Engagement Process in Water Saving Initiatives for Sustainable Tourist Destination in Samui Island, Thailand

This paper is based on the water-saving initiatives for sustainable tourist destinations launched by the government sector under a project called Save Water, Save Samui (SWSS) at Samui Island, a famous tourist destination in Thailand. For this project, a mixed-methodologies research approach was employed. This research aims to identify stakeholder engagement processes for water-saving initiatives. Quantitative research methods were conducted through a questionnaire-based survey, which provided supportive information from guests and hotels voluntarily involved in the SWSS project. Qualitative research methods were conducted through focus group discussions with hotel staff and in-depth interviews with representatives from hotel businesses, government officers, and locals. Findings showed that stakeholder engagement processes in the SWSS project appeared at three levels: information, response, and involvement. Lessons from the SWSS project addressed limiting aspects of the stakeholder engagement processes, including poor information dissemination, small numbers and few stakeholders involved, inconsistency across the project, and unclear incentive strategies for stakeholder engagement. To move forward, establishing a collaborative relationship among stakeholders is required to facilitate network extension, with the goal of an inclusive and collective action strategy to pursue water saving for tourist destinations in the long term.
Using Stable Sulfur Isotope to Trace Sulfur Oxidation Pathways during the Winter of 2017–2019 in Tianjin, North China

After the implementation of the Coal Replacing Project (CRP) in the northern parts of China in 2017, its effect on PM2.5 composition is still unclear. In the study, water-soluble ionic components (WSICs) and stable sulfur isotope ratios (δ34S) of SO42− in PM2.5 collected during the domestic heating period before and after the implementation of CRP in Tianjin were analyzed. Results showed that the average concentrations of both PM2.5 and WSICs have dropped dramatically after the CRP, especially for the SO42− (by approximately 57–60%). After the CRP, the range of δ34Ssulfate was significantly narrowed to 4.1–7.5‰ in January 2018 and 1.4–6.1‰ in January 2019, which suggested that the sulfur source was becoming simple. It was interesting that the δ34Ssulfate value in the pollution period before the CRP was higher than that in the clean period, whereas it showed the opposite tendency after the CRP, which implied that the contribution of sea salt was high during the pollution period before the CRP. The MIXSIAR model calculated that the contributions of the transition-metal ion (TMI) oxidation and NO2 oxidation pathways in the three sampling stages were higher than those of the OH radical oxidation and H2O2/O3 oxidation pathways, indicating that the formation pathway of sulfate was mainly dominated by heterogeneous oxidation. Before the CRP, the NO2 oxidation pathway was the dominant sulfate oxidation pathway during a haze episode, and the TMI oxidation pathway dominated the formation of sulfates after the CRP.
Self-Learning Fuzzy Automaton With Input and Output Fuzzy Sets for System Modelling

Fuzzy Automaton plays a key role in modeling a system as a fuzzy discrete event system and determining the model's properties such as observability and predictability. We recently developed online supervised learning algorithms for the fuzzy automaton to learn its event transition matrix under three different conditions tied to availability of pre- and post-event states, which are the first and only studies in the current literature. In this paper, we first eliminate, in a theoretical manner, the restriction in our prior studies that the individual pre- and post-event states must be identical. We then tackle a more realistic and general condition-learning the transition matrix when neither pre-event nor post-event state is known, which covers the previous three conditions as special cases. The only information assumes to be available is values of the variables and they are only known to be vaguely related to the states. We link the variables to the states through (Gaussian) fuzzy sets owing to the conceptual relationship between a fuzzy set and a fuzzy state. The resulting innovative model is called the Fuzzy Automaton with Input and Output Fuzzy Sets. Stochastic-gradient-descent-based algorithms are derived for the model to iteratively learn online the transition matrix and all the parameters of the fuzzy sets simultaneously. Another significant extension is that unlike our previous models, the new model is capable of determining an individual post-event state even if it is associated with two or more variables, expanding model's utility. It is the first fuzzy discrete event system model that is capable of learning solely based on sensor data without relying on any subjective input from humans, removing a significant bottleneck for real-world applications. Computer simulation results are furnished to exhibit learning performance of this new model. This model will be valuable for solving practical problems in healthcare and various industries, and we discuss in detail its potential in modeling of disease treatment decision-making.
The Determinants of International Migration in Early Modern Europe: Evidence from the Maritime Sector, c. 1700–1800

ABSTRACT This article offers the first multivariate regression study of international migration in early modern Europe. Using unique eighteenth-century data about maritime workers, we created a data set of migration flows among European countries to examine the role of factors related to geography, population, language, the market, and chain migration in explaining the migration of these workers across countries. We show that among all factors considered in our multivariate analysis, the geographical characteristics of the destination countries, size of port towns, and past migrations are among the most robust and quantitatively the most important factors influencing cross-country migration flows.
A corpus-based analysis of the concessive construction just because X doesn’t mean Y

Abstract This study investigates syntactic and semantic features of the English concessive construction just because X doesn’t mean Y (JB-X DM-Y) grounded in Goldberg’s theory of construction grammar. Based on initial data collected from the British National Corpus (BNC) and the Corpus of Contemporary American English (COCA), our qualitative analysis proved that: (1) syntactically, there should be an unexpressed pronoun it or that serving as the subject of the DM-Y part. The quantitative analysis revealed the productivity of JB-X DM-Y. In terms of vocabulary, just and mean in the construction can be replaced by the adverb simply and verbs indicating inference or making assertions. In terms of structure, JB-X NEG-VP and JB-X NEG-CLAUSE were widely used, and JB-X QUESTION exhibited certain productivity; and (2) semantically, JB-X DM-Y should be seen as the negation of the construction Y, because X. It presented the meaning of inference denial and concessive meaning, corresponding to the inferential-because construction and causal-because construction. This article provides a systemic discussion about JB-X DM-Y and hopes to provide a basic structure for the future analysis of JB-X DM-Y.
Association between Alexithymia and Depression among King Khalid University Medical Students: An Analytical Cross-Sectional Study

Alexithymia is a condition in which a person is unable to explain his/her emotions, bodily sensations, or discuss sentiments. This study aims to determine the prevalence of alexithymia and its relationships with socio-demographics and depression among medical students. A cross-sectional survey was conducted among medical students at King Khalid University (KKU), Saudi Arabia. A stratified random sampling technique was utilized for data collection using the Toronto Alexithymia Scale (TAS-20) and the Patient Health Questionnaire-9 (PHQ-9). A multiple logistic regression model was used to identify the factors associated with alexithymia. A total of 333 students participated in this study, almost two-thirds (64.6%) were from clinical years, and 51.4% were females. The prevalence of alexithymia and depression was 47.4% and 88.9%, respectively. Regression analysis showed females had a doubled risk (OR = 2.09), and students with high-income status showed less probability of having alexithymia (OR = 0.39), whereas people with chronic health problems showed a doubled risk for alexithymia (OR = 2.04). Moreover, depression was significantly associated with alexithymia (OR = 1.91). Our study revealed that the prevalence of alexithymia was high along with depression among studied samples. This raises attention towards finding measures to reduce it for the better performance of students and to avoid psychological problems in the future.
Stakeholder perspectives around post-TB wellbeing and care in Kenya and Malawi

Background There is growing awareness of the burden of post-TB morbidity, and its impact on the lives and livelihoods of TB affected households. However little work has been done to determine how post-TB care might be delivered in a feasible and sustainable way, within existing National TB Programmes (NTPs) and health systems, in low-resource, high TB-burden settings. In this programme of stakeholder engagement around post-TB care, we identified actors with influence and interest in TB care in Kenya and Malawi, including TB-survivors, healthcare providers, policy-makers, researchers and funders, and explored their perspectives on post-TB morbidity and care. Methods Stakeholder mapping was completed to identify actors with interest and influence in TB care services in each country, informed by the study team’s local, regional and international networks. Key international TB organisations were included to provide a global perspective. In person or online one-to-one interviews were completed with purposively selected stakeholders. Snowballing was used to expand the network. Data were recorded, transcribed and translated, and a coding frame was derived. Data were coded using NVivo 12 software and were analysed using thematic content analysis. Online workshops were held with stakeholders from Kenya and Malawi to explore areas of uncertainty and validate findings. Results The importance of holistic care for TB patients, which addresses both TB comorbidities and sequelae, was widely recognised by stakeholders. Key challenges to implementation include uncertainty around the burden of post-TB morbidity, leadership of post-TB services, funding constraints, staff and equipment limitations, and the need for improved integration between national TB and non-communicable disease (NCD) programmes for care provision and oversight. There is a need for local data on the burden and distribution of morbidity, evidence-informed clinical guidelines, and pilot data on models of care. Opportunities to learn from existing HIV-NCD services were emphasised. Discussion This work addresses important questions about the practical implementation of post-TB services in two African countries, exploring if, how, where, and for whom these services should be provided, according to a broad range of stakeholders. We have identified strong interest in the provision of holistic care for TB patients in Kenya and Malawi, and key evidence gaps which must be addressed to inform decision making by policy makers, TB programmes, and funders around investment in post-TB services. There is a need for pilot studies of models of integrated TB care, and for cross-learning between countries and from HIV-NCD services.
The Role of Insulin Receptor Substrate Proteins in Bronchopulmonary Dysplasia and Asthma: New Potential Perspectives

Insulin receptor substrates (IRSs) are proteins that are involved in signaling through the insulin receptor (IR) and insulin-like growth factor (IGFR). They can also interact with other receptors including growth factor receptors. Thus, they represent a critical node for the transduction and regulation of multiple signaling pathways in response to extracellular stimuli. In addition, IRSs play a central role in processes such as inflammation, growth, metabolism, and proliferation. Previous studies have highlighted the role of IRS proteins in lung diseases, in particular asthma. Further, the members of the IRS family are the common proteins of the insulin growth factor signaling cascade involved in lung development and disrupted in bronchopulmonary dysplasia (BPD). However, there is no study focusing on the relationship between IRS proteins and BPD yet. Unfortunately, there is still a significant gap in knowledge in this field. Thus, in this review, we aimed to summarize the current knowledge with the major goal of exploring the possible roles of IRS in BPD and asthma to foster new perspectives for further investigations.
Prevalence of HIV among pregnant mothers receiving antenatal care at Kator Primary Health Care Centre, Juba, South Sudan

Introduction: The HIV/AIDS scourge remains a major public health threat in South Sudan particularly to the unborn children due to vertical transmission. Objective: This study aimed to assess the prevalence of HIV among pregnant mothers receiving antenatal care (ANC) services at Kator Primary Healthcare Centre in Juba. Method: The study used a cross-sectional design in which systematically selected ANC records of January to June 2021 were collected and analyzed using SPSS Version 16.0. Fisher’s exact values were obtained to test for significance. Results: The HIV prevalence rate among pregnant mothers receiving ANC services at Kator PHCC was 2.25%. The modal age group was 21-25 years. HIV prevalence was highest among mothers who attained primary education or less, urban dwellers and married mothers in their 3rd trimester of pregnancy. Conclusion: HIV prevalence among pregnant mothers receiving ANC services at Kator PHCC in Juba is comparable to the national average.
Labor Market Integration of High-Skilled Immigrants in Canada: Employment Patterns of International Medical Graduates in Alternative Jobs

Background: International medical graduates (IMGs) in Canada are individuals who received their medical education and training outside Canada. They undergo a complex licensing procedure in their host country and compete for limited opportunities available to become practicing physicians. Many of them cannot succeed or do not have the resources or interest to undergo this complex and unpredictable career pathway and seek alternative career options. In this study, we aimed to understand how IMGs integrate into the alternative job market, their demographic characteristics, and the types of jobs they undertake after moving to Canada. Methods: An anonymous cross-sectional, online, nationwide, and open survey was conducted among IMGs in Canada. In addition to demographic information, the questionnaire included information on employment status, types of jobs, professional experience, and level of medical education and practice (e.g., specialties, subspecialties, etc.). We conducted a survey of 1740 IMGs in total; however, we excluded responses from those IMGs who are currently working in a clinical setting, thus limiting the number of responses to 1497. Results: Of the respondents, 43.19% were employed and 56.81% were unemployed. Employed participants were more likely to be older males, have stayed longer in Canada, and had more senior-level job experience before moving to Canada. We also observed that the more years that had passed after graduation, the higher the likelihood of being employed. The majority of the IMGs were employed in health-related nonregulated jobs (50.45%). The results were consistent across other demographic characteristics, including different provinces, countries of origin, gender, time since graduation, and length of stay in Canada. Conclusions: This study found that certain groups of IMGs, such as young females, recent immigrants, recent graduates, and less experienced IMGs had a higher likelihood of being unemployed. These findings will inform policymakers, immigrant and professional service organizations, and researchers working for human resources and professional integration of skilled migrants to develop programs and improve policies to facilitate the employment of IMGs through alternative careers.
TRAF4 Promotes the Proliferation of Glioblastoma by Stabilizing SETDB1 to Activate the AKT Pathway

The process of ubiquitination regulates the degradation, transport, interaction, and stabilization of substrate proteins, and is crucial for cell signal transduction and function. TNF receptor-associated factor 4, TRAF4, is a member of the TRAF family and is involved in the process of ubiquitination as an E3 ubiquitin protein ligase. Here, we found that TRAF4 expression correlates with glioma subtype and grade, and that TRAF4 is significantly overexpressed in glioblastoma and predicts poor prognosis. Knockdown of TRAF4 significantly inhibited the growth, proliferation, migration, and invasion of glioblastoma cells. Mechanistically, we found that TRAF4 only interacts with the Tudor domain of the AKT pathway activator SETDB1. TRAF4 mediates the atypical ubiquitination of SETDB1 to maintain its stability and function, thereby promoting the activation of the AKT pathway. Restoring SETDB1 expression in TRAF4 knockdown glioblastoma cells partially restored cell growth and proliferation. Collectively, our findings reveal a novel mechanism by which TRAF4 mediates AKT pathway activation, suggesting that TRAF4 may serve as a biomarker and promising therapeutic target for glioblastoma.
Nociception-Induced Changes in Electroencephalographic Activity and FOS Protein Expression in Piglets Undergoing Castration under Isoflurane Anaesthesia

Simple Summary Efficient analgesia during surgical piglet castration is an important animal welfare issue. The present study is part of a larger study designed to investigate the efficacy of four local anaesthetics (bupivacaine, lidocaine, mepivacaine and procaine) for analgesia during castration. In conscious piglets, it is difficult to distinguish between stress, e.g., due to handling, and pain during castration. Therefore, this study was conducted under light isoflurane anaesthesia. The level of anaesthesia was adjusted such that movement reactions to a peripheral nociceptive stimulus still occurred. We present the results of the investigation of two possible parameters for the detection of nociception: the reaction pattern in the electroencephalogram (EEG) and FOS protein expression in the spinal dorsal horn. In the electroencephalogram, a biphasic reaction pattern in response to noxious stimulation was detected that was attenuated or altered by the application of local anaesthetics. FOS expression, which was examined postmortem, was decreased after the administration of local anaesthetics, except for bupivacaine. Based on these results, local anaesthesia decreases nociceptive transmission during piglet castration in this experimental setup. When combined with the corresponding haemodynamic parameters and the evaluation of defensive movements presented elsewhere, an overall understanding of the nociceptive response to castration can be generated. Abstract The objective of this study was to investigate the electroencephalographic reaction pattern and FOS protein expression in male piglets undergoing surgical castration under light isoflurane anaesthesia with or without local anaesthesia. The experiment was conducted under isoflurane anaesthesia to exclude the effect of the affective components of pain on the measurements. Changes in the oscillatory activity of the cerebral cortex over a 90 s period after noxious stimulation or simulated interventions were analysed. FOS expression was determined postmortem by performing immunohistochemistry in the dorsal horn of the spinal cord. The analysis of the response to an interdigital pinch revealed a biphasic reaction pattern in the electroencephalogram (EEG) that similarly was observed for the surgical stimuli during the castration procedure in the group without analgesia. This EEG response was attenuated or altered by the application of local anaesthetics. Immunohistochemical staining for FOS indicated a lower expression in the handling and in three local anaesthetic groups than in the animals castrated without pain relief. The findings indicate that EEG and FOS expression may serve as indicators for nociception in piglets under light isoflurane anaesthesia. A lower activation of nociceptive pathways occurs during castration after the application of local anaesthetics. However, EEG and FOS analyses should be combined with additional parameters to assess nociception, e.g., haemodynamic monitoring.