A service driven method for evaluating business and IT alignment

The adoption of Information Technology (IT) in organisations has brought significant benefits to business operations. However, achieving business and IT alignment has been and continues to be a major challenge for researchers and practitioners. The rapid changes in business and IT environments and the influence of social aspects on the business value generated by IT have contributed to its increased complexity. In order to be aware of the state of this alignment, organisations are advised to conduct a business and IT alignment assessment. The outcomes of such assessments provide a platform to achieve a better state of business-aligned IT. However, existing methodological approaches to evaluate business and IT alignment at the operational level have lacked the involvement of social values, to be balanced with other tangible values, as factors in the alignment assessment. Addressing this issue is the motivation for this research. Guided by the Design Science Research (DSR) paradigm, the Business and IT Alignment Assessment Method (B-ITAAM) is developed as the main research contribution. B-ITAAM comprises, in a novel approach, a set of business analysis techniques that assist for a comprehensive business-aligned IT assessment. Principles and concepts from multiple theoretical and methodological perspectives have been adopted to form the theoretical foundations upon which the assessment method is based. As such, concepts from Strategic Management are adopted to establish a link between the strategic and operational levels of an organisation to guide the alignment assessment. Principles from Socio Technical Systems and Organisational Semiotics form the basis for eliciting social values from relevant stakeholders influencing the value of business and IT. Additionally, principles from Service-Oriented Architecture and Enterprise Architecture enable the evaluation method to be service driven. Finally, principles from Task Technology Fit and Social Exchange theories support, respectively, the establishment and assessment of the business and IT alignment. B-ITAAM was applied in a higher education institution to evaluate its viability as an effective business and IT alignment assessment method. The application resulted in a set of recommendations that aim to enhance the alignment of a set of business and IT services offered by the institution, which received appraisal from nine experts involved in the institution. The application also reveals the complexity of the business and IT alignment assessment in the higher education sector, which, until now, has received little attention in business and IT alignment research

A genetic algorithm for shortest path with real constraints in computer networks

The shortest path problem has many different versions. In this manuscript, we proposed a muti-constrained optimization method to find the shortest path in a computer network. In general, a genetic algorithm is one of the common heuristic algorithms. In this paper, we employed the genetic algorithm to find the solution of the shortest path multi-constrained problem. The proposed algorithm finds the best route for network packets with minimum total cost, delay, and hop count constrained with limited bandwidth. The new algorithm was implemented on four different capacity networks with random network parameters, the results showed that the shortest path under constraints can be found in a reasonable time. The experimental results showed that the algorithm always found the shortest path with minimal constraints

Safety of pregnancy in uterine fibroids

Uterine fibroid is one of the most common intrauterine masses among females at the reproductive age. Pregnancy and uterine fibroids are highly correlated. Pregnancy-related hormones influence the size of uterine fibroids, and fibroids have many impacts on pregnancy. Although most if the uterine fibroids are asymptomatic during pregnancy, serious complications may occur. The main complications include abortion, premature rupture of membranes, premature labor, abruptio placentae, peripartum hemorrhage, fetal malpresentation, fetal intrauterine growth retardation, small for gestational age infants, and fetal anomalies. The main risk factors for complications are related to the fibroid number, size, volume, location, and type. Large, multiple, retroplacental, submucosal, subserosal, pedunculated, or low-lying fibroids carries the highest risk for complications during pregnancy. This review will address the prevalence of uterine fibroids during pregnancy, its effects, and complications

CAUSES AND MANAGEMENT OF VIRAL EYE INFECTION

Introduction: The eye is a fascinating organ for several reasons. It is not only have a composite structure, however it is considered an immune-privileged organ. The anatomy of the eye is composed of the anterior and posterior parts, the line of division is posterior to the lens. The anterior chamber lies within the anterior segment and is an immuneprivileged anatomical location, this is due to the fact that the T-cell response in this area is suppressed This protects the eye from potentially destructive immune attacks however it also makes defence against infectious agents challenging, particularly where T-cell responses are critical for immunological defence. Viruses could get into the eye by direct inoculation, or through haematogenous or neuronal spread. The diagnoses of viral eye infections are usually clinical one, helped by taking a thorough history and performing ophthalmic examination. But in challenging cases the lab tests are essential. In this review, we will discuss the most recent evidence regarding Causes and management of viral eye infection Aim of work: In this review, we will discuss the most recent evidence regarding Causes and management of viral eye infection Methodology: We did a systematic search for Causes and management of viral eye infection using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: A wide range of of viruses can affect the eye and cause viral eye infections, either as a primary infection or reactivation. Some affect the eye directly while the others indirectly but may still manifest with eye disease. One virus may affect several parts of the eye, while different viruses may cause the same eye disease. This could complicate the clinical diagnosis of viral eye disease, but the lab tests like PCR and antibody tests could assist in challenging cases where there may be diagnostic dilemma. The HIV epidemic has had an huge impact on ophthalmology clinics, this is because the virus can cause different eye diseases, and the associated decrease in cell-mediated immunity makes the person highly susceptible to opportunistic viral eye infections, sometimes with severe morbidity. There could be other viruses that may affect the eye that we did not discuss. Key words: Causes, management, viral eye infection

Neuroprotective effect of ranolazine improves behavioral discrepancies in a rat model of scopolamine-induced dementia

BackgroundRanolazine (Rn), an antianginal agent, acts in the central nervous system and has been used as a potential treatment agent for pain and epileptic disorders. Alzheimer’s disease (AD) is one of the most prevalent neurodegenerative diseases and the leading factor in dementia in the elderly.AimWe examined the impact of Rn on scopolamine (Sco)-induced dementia in rats.MethodsThirty-two albino male rats were divided into four groups: control, Rn, Sco, and Rn + Sco.ResultsA significant decrease in the escape latency in the Morris water maze test after pre-treatment with Rn explained better learning and memory in rats. Additionally, Rn significantly upregulated the activities of the antioxidant enzymes in the treated group compared to the Sco group but substantially reduced acetylcholinesterase activity levels in the hippocampus. Moreover, Rn dramatically reduced interleukin-1 β (IL-1β) and IL-6 and upregulated the gene expression of brain-derived neurotrophic factor (BDNF). Furthermore, in the Sco group, the hippocampal tissue’s immunohistochemical reaction of Tau and glial factor activating protein (GFAP) was significantly increased in addition to the upregulation of the Caspase-3 gene expression, which was markedly improved by pre-treatment with Rn. The majority of pyramidal neurons had large vesicular nuclei with prominent nucleoli and appeared to be more or less normal, reflecting the all-beneficial effects of Rn when the hippocampal tissue was examined under a microscope.ConclusionOur findings indicated that Rn, through its antioxidative, anti-inflammatory, and anti-apoptotic effects, as well as the control of the expression of GFAP, BDNF, and Tau proteins, has a novel neuroprotective impact against scopolamine-induced dementia in rats

Perspectives, practices, and challenges of online teaching during COVID-19 pandemic: A multinational survey

The result of the movement restrictions during the COVID-19 pandemic was an impromptu and abrupt switch from in-person to online teaching. Most focus has been on the perception and experience of students during the process. The aim of this international survey is to assess staffs' perspectives and challenges of online teaching during the COVID-19 lockdown. Cross-sectional research using a validated online survey was carried out in seven countries (Brazil, Saudi Arabia, Jordan, Indonesia, India, the United Kingdom, and Egypt) between the months of December 2021 and August 2022, to explore the status of online teaching among faculty members during the COVID-19 pandemic. Variables and response are presented as percentages while logistic regression was used to assess the factors that predict levels of satisfaction and the challenges associated with online instruction. A total of 721 response were received from mainly male (53%) staffs. Most respondents are from Brazil (59%), hold a Doctorate degree (70%) and have over 10 years of working experience (62%). Although, 67% and 79% have relevant tools and received training for online teaching respectively, 44% report that online teaching required more preparation time than face-to-face. Although 41% of respondents were uncertain about the outcome of online teaching, 49% were satisfied with the process. Also, poor internet bandwidth (51%), inability to track students' engagement (18%) and Lack of technical skills (11.5%) were the three main observed limitations. Having little or no prior experience of online teaching before the COVID-19 pandemic [OR, 1.58 (95% CI, 1.35–1.85)], and not supporting the move to online teaching mode [OR, 0.56 (95% CI,0.48–0.64)] were two main factors independently linked with dissatisfaction with online teaching. While staffs who support the move to online teaching were twice likely to report no barriers [OR, 2.15 (95% CI, 1.61–2.86)]. Although, relevant tools and training were provided to support the move to online teaching during COVID-19 lockdown, barriers such as poor internet bandwidth, inability to track students’ engagement and lack of technical skills were main limitations observed internationally by teaching staffs. Addressing these barriers should be the focus of higher education institution in preparation for future disruptions to traditional teaching modes

Агрессивная форма ювенильной макромастии

ПОДРОСТКИМОЛОЧНЫЕ ЖЕЛЕЗЫ ЧЕЛОВЕКА /АНОМАЛБОЛЕЗНИ РЕДКИЕМАКРОМАСТИЯГИПЕРТРОФИЯМОЛОЧНОЙ ЖЕЛЕЗЫ ПЛАСТИКАХИРУРГИЧЕСКИЕ ОПЕРАЦИИ ВОССТАНОВИТЕЛЬНЫЕМОЛОЧНОЙ ЖЕЛЕЗЫ БОЛЕЗНИ /ТЕР /ХИ

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

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

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112