Strategic ambidexterity and its role in achieving contemporary initiatives: an exploratory study of opinions of a sample of managers of travel and tourism companies in holy governorate of Kerbala-Iraq

The research aim to explore influential role of strategic ambidexterity through its two contradictory dimensions (exploration and exploitation) as two strategies that contemporary organizations can adopt in light of achieving contemporary initiatives required by current environment, especially tourism sector in Iraq after the paralysis it suffered as a result of spread of Corona virus and impact of repercussions of this pandemic on various Both industrial and service sectors, as researchers targeted tourism companies in Karbala governorate, which are characterized by attracting tourists to various visitors for religious tourism and in return, it is a port for their roaming to other cities and countries through tourism companies that need to keep pace with surrounding environment of developments and changes based on adoption of the two strategies of ambidexterity in Facing those changes and responding to them, as well as their readiness for rapid developments in this sector, as the questionnaire was adopted as a main tool for collecting data on this study by presenting it to the executive directors of those companies with (40) respondents, and after conducting necessary statistical tests using SPSS program, it was found that there are a strong positive and significant correlation between study variables, as well as a significant effect For strategic ambidexterity across its two dimensions in achieving and promoting contemporary initiatives at corporate level, the study communit

Green synthesis of novel pyrazole containing Schiff base derivatives as antibacterial agents on the bases of in-vitro and DFT

A series of pyrazole containing Schiff bases were synthesized, by the reaction of 3,5-dimethyl-1-phenylpyrazole-4-carboxaldehyde and the corresponding active amines under microwave irradiation. The structures of the synthesized compounds were established by spectroscopic data (FT-IR, 1H NMR, 13C NMR and ESI-MS) and elemental analyses. The anti-bacterial activity of these compounds were tested in vitro by the disc diffusion assay against two Gram-positive and two Gram-negative bacteria, and then the minimum inhibitory concentration using chloramphenicol as reference drug. All the molecules were modeled and optimized by using density functional theory, DFT/B3LYP method. Calculated descriptors, the lower unoccupied molecular orbital and the density were used to interpret the antibacterial activity of the compounds. The results showed that compound 3 is better inhibitor of both types of test bacteria as compared to chloramphenicol

Impact of Health Insurance on Accessibility of Physical Therapy’s Patients at King Fahd Hospital of the University-AL Khobar

Physiotherapy plays an essential role in modern healthcare delivery as it provides a wide range of non-surgical treatments to treat chronic diseases. Physiotherapy includes many clinical guidelines as treatment and rehabilitation services improve patients' lives. Changes in health insurance policies and coverage affect costs Borne by patients and their families; this can lead to a variety of services and barriers to appropriate healthcare. The study goal is to describe the impact of Health Insurance on Accessibility among Physical Therapy Patients at King Fahd Hospital of the University-AL Khobar to describe the benefits of Health insurance on accessibility among physical therapy patients and to explore the barriers and challenges of Health insurance on accessibility among physical therapy patients.We carried out a descriptive cross-sectional survey design to describe the physical therapy patients' perception toward health insurance accessibility at King Fahd Hospital of the University-AL Khobar. Data were collected on Monday, March 9th, 2021, through self-administered questionnaires that 740 surveys were distributed, and only 544 patients participated in the survey. The data finished collecting on April 1st, 2021. Statistical Package for Social Science (SPSS) was used to analyze the data. Overall, 544 respondents completed the survey. This study clearly shows that access to health care services is a significant concern that accessibility of physical therapy was confirmed by 36.6%. Low accessibility due to the high cost of physical therapy was reported by 36.9% of patients included. Accessibility to physical therapy upon need was not written in a high frequency 30% versus 29.6% as not sure. Accessibility to facilities was highly reported by 29.6%; insurance companies enhancing accessibility to physical therapy was not approved by the majority of the included participants 37.1%. Also, insurance companies offering multiple choices for physical therapy were only agreed on 26.8%. Finally, the quality of service differs based on the facility's nature and was approved by 50.2% of included patients. Direct access to physical therapy is an example of providing an innovative primary care service that is achievable, acceptable to both users and service providers, and health insurance will positively impact access to the healthcare system. However, accessibility is a necessary term that must be taken care of to define the need for healthcare to deliver healthcare services and organizational structures to match the community's needs

Black Thyroid Associated with Thyroid Carcinoma

Objective. Black thyroid is a rare pigmented change seen almost exclusively in patients upon minocycline ingestion, and the process has previously been thought to be generally benign. There have been 61 reported cases of black thyroid. We are aware of 13 cases previously reported in association with thyroid carcinoma. This paper reports six patients with black thyroid pigmentation in association with thyroid carcinoma. Design. The medical records of six patients who were diagnosed with black thyroid syndrome, all of whom underwent thyroid surgery, were reviewed. Data on age, gender, race, preoperative fine needle aspiration biopsy (FNA), thyroid function levels, and pathology reports were collected. Main Outcome. The mean age was 60 years. There were 5 females, 4 of whom were African American. All patients were clinically and biochemically euthyroid. Black pigmentation was not diagnosed in preoperative FNA, and only one patient had a preoperative diagnosis of papillary thyroid carcinoma. The other patients underwent surgery and were found to have black pigmentation of the thyroid associated with carcinoma. Conclusions. FNA does not diagnose black thyroid, which is associated with thyroid carcinoma. Thyroid glands with black pigmentation deserve thorough pathologic examination, including several sections of each specimen

Repurposing the oncolytic virus VSV∆51M as a COVID-19 vaccine

The coronavirus disease 2019 (COVID-19) pandemic imposes an urgent and continued need for the development of safe and cost-effective vaccines to induce preventive responses for limiting major outbreaks around the world. To combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we repurposed the VSV∆51M oncolytic virus platform to express the spike receptor-binding domain (RBD) antigen. In this study, we report the development and characterization of the VSV∆51M-RBD vaccine. Our findings demonstrate successful expression of the RBD gene by the VSV∆51M-RBD virus, inducing anti-RBD responses without attenuating the virus. Moreover, the VSV∆51M-RBD vaccine exhibited safety, immunogenicity, and the potential to serve as a safe and effective alternative or complementary platform to current COVID-19 vaccines

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Caregiver prespectives about assistive technology use with their young children with autism spectrum disorders in Saudi Arabia

Autism Spectrum Disorders (ASD) is a developmental disorder characterized by social impairment, communication difficulties, and restrictive, repetitive, and stereotyped patterns of behavior, which result in delays in normal human development. This study was conducted to examine the perceptions of caregivers of children with ASD concerning the experiences of children as they engage in their daily routines and the caregiver's use of assistive technology to these children using a survey design. Children with ASD have problems in most of the daily routines of living as compared with children with other disabilities. Children with ASD experienced more difficulties in nine of the ten activities examined in this study compared to children with other disabilities. The most problematic activity for children with ASD in the present study was playing routine, reported by 85.7% of the caregiver

The impact of teachers' educational beliefs on the classroom use of computers in Saudi Arabian primary schools

This study examined the factors that the affect the application technology, especially computer technology and applications in Saudi classrooms. Given the importance of technology use in affecting student outcomes, the researcher intended to establish the how teacher's attitudes and beliefs affected the use of such technologies affected its application. This qualitative research was conducted using the survey research design. According to the results of the study, an overwhelming 93.22% agreed that attitudes and beliefs affected how implemented computer use in classroom. Indeed, 71.9% strongly agreed that their attitudes and beliefs had a significant bearing on their use of computer in classroom. However, it is important to note that 17.80% of the respondents disagreed with statement that their beliefs or attitudes affected their use of computers in classroom. Additionally, the researcher examined the factors that hinder computer use computers in Saudi Arabian classrooms. The results of this study indicate that about 42.31% representing about 50 of the respondents indicated that accessibility to computers remained one of the major challenges affecting their use in Saudi classrooms. This indicated a need by the Saudi Educational sector to institute proper technological infrastructure that would enhance accessibility of computers in schools across the country

The Use of Indomethacin for Nocturnal Enuresis in Children With Nephrogenic Diabetes Insipidus: A Case Report and Review of the Literature

Rationale: Nocturnal enuresis is a common symptom of nephrogenic diabetes insipidus (NDI) in children. Published reports on the treatment of nocturnal enuresis in this population are scarce. Presenting concern of the patient: 2 brothers, aged 8 and 9 years, presented for outpatient pediatric nephrology follow-up. Despite being medically stable on their current medication regimen, they both experienced significant distress due to primary nocturnal enuresis, including decreased self-esteem and social stress. Diagnoses: The brothers had primary nocturnal enuresis related to their high urine output from NDI. Interventions: we describe a case of 2 brothers with NDI in whom indomethacin was added to their pharmacologic treatment specifically to address enuresis. Outcome: Both brothers experienced a significant decrease in the frequency of nocturnal enuresis and improvement in their perceived quality of life. Teaching points: Nocturnal enuresis is a bothersome symptom of NDI with adverse psychological effects. Indomethacin can improve nocturnal enuresis in some patients. Treatment with nonsteroidal anti-inflammatory drugs carries a risk of gastrointestinal and kidney side effects. We advocate for a patient-centered approach to the treatment of NDI which includes optimizing both the medical and the psychological needs of the patient