Agile methodology implementation in Lebanon

Agile methods are being adopted in the software development industry increasingly and even beyond this sector. Outsourcing software development from developing countries in the Global South is increasing in the industry. With Lebanon being the hub for outsourcing software for the MENA region, practitioners require guidanceto overcome challenges upon agile implementation taking into consideration the Lebanese context. The literature lacks information on agile software development in the Global South, specially Lebanon. The aim of this thesis is to add new knowledge on agile software development industry in Lebanon through studying the extend of agile methodology implementation, agile tailoring, and impediments faced when implementing agile.The methodology implemented is a mixed method qualitative research divided into four phases involving 49 practitioners from 5 different software organizations. The first phase describes the data collection strategy that involves interviews and observations. The second phase involves the data analysis in a within-case analysis using an approach informed by Grounded Theory. The third phase is divided into two parts. Part A involves a cross case analysis comparing the findings from allresearch sites. Part B involves the model creation. The last phase is the intervention study conducted at the chosen Lebanese software development site.This thesis describes the status of agile software development in the chosen Lebanese sites through creating a baseline model. This model uses the swim lane diagram to describe the process of agile software development in one iteration while highlighting the ceremonies, roles, and activities conducted. This thesis also identifies a collection of 22 influences, out of which 10 are novel influences, that affect the practitioner’s ability to implement agile in Lebanon. Of these three arenovel amplifiers: level of information sharing, overcoming geographical distances, and the need to succeed. Also seven are novel impediments: extensive micro management by the CEO and upper managers, the reasons behind the lacking of agile ceremonies, task estimation done by managers in agile, employee’s fear, lack of respect to time, the effects of the economic crisis on daily routines, and nepotism. In addition, the thesis corroborates 12 influences on agile implementation in thechosen Lebanese research sites to the existing literature.The study then applies a cross-case analysis to compare agile implementation in all studied research sites in The Netherlands, Kenya, and India. This analysis reveals two approaches to agile implementation characterized by either a pure implementation of agile methods or mixing agile with traditional methods. The study then introduces illustrative examples demonstrating a step-by-step process totackle non-functional requirements using agile methods and introducing two new artefacts.Then, this thesis creates a novel tailored agile implementation model to fit the Lebanese context. The model tackles the identified influences using agile practices that are tailored when needed. The model is finally validated by engaging with practitioners in the Lebanese research site causing positive changes. These include interventions to overcome task estimation and allocation by managers, reduce employee’s fear, enhance agile understanding, enhance collaboration throughintroducing the previously lacking agile roles and ceremonies, actions to improve Lebanese customer involvement, and actions to mitigate the implementation of agile in the Global South context

Managing non‐functional requirements in agile software development

Non‐functional requirements define qualities of the software system that ensure effectiveness while embedding any constraints and restrictions on the design. A challenge rises with agile implementation in handling non‐function requirements in regulated environments. Thus, a practitioner's perceptions of agile method tailoring are described in relation to inter‐team boundaries and non‐functional requirements. The research comprises 18 practitioner interviews from two multinational agile software development companies. Interviews were recorded, transcribed, and analysed using an approach informed by grounded theory and information flow models were used to compare and contrast interactions of processes. It was discovered that one of the case study companies managed non‐functional requirements as artefacts in their agile methodology, while the other company reverts to conventional plan‐based software development practices of documentation, timeline estimations, and safety critical requirements. This research creates a detailed comparison of these contrasting approaches. The main contribution of this study is a set of proposed recommendations to deal with non‐functional requirements in a regulated environment using agile techniques. The introduction of two new artefacts, Documentation Work Item and Safety Critical Work Item, is recommended and it is accompanied with an illustrative example, to transform the handling of documentation and safety critical requirements in a more agile way

Overcoming team boundaries in agile software development

The usage of agile software development methods is increasing and so is the need for enhancing the collaboration between the different stakeholders. Thus, we chose to investigate the communication tools and challenges across the different boundaries and consequently deduce implications for practitioners. This research addresses inter-team communication by exploring the practitioners' perception on the different communication tools and the challenges faced at the three different boundaries, inter-team, team and customers, and geographically separated teams. We aim to enhance the productivity of software development through enhancing the communication between the different stakeholders. In this research, we use grounded theory approach to gather data from semi-structured open-ended interviews with practitioners in a geographically separated software development company. The findings observed three main inter-team communication means (Slack, Trello, face-to-face) used by practitioners, and how the preference differs among practitioners. This study also focuses on the different challenges faced, such as absence of communication during user story dependency, unclear customer requirements, and cultural differences, when implementing agile across different geographical locations. Our study discovers how team boundaries are overcome when team members adapt to other teams’ preferred communication tool and enhance the boundary spanners’ role. Furthermore, the study highlights how novice and mature teams require a transition time to adjust to the agile methods

Agile software development practices in Egypt SMEs : a grounded theory investigation

Agile information system development methods have been adopted by most software development organizations due to their proven benefits in terms of flexibility, reliability, and responsiveness. However, companies face significant challenges in adopting these approaches. Specifically, this research investigates challenges faced by software development companies in Egypt while transitioning to Agile. As little previous research is available targeting their concerns, we have conducted a grounded theory investigation. Key problem areas were found including lack of cadence in sprints planning, inadequate use of effort estimation and product quality issues. The developed grounded theory reflects on the key problem areas found with SMEs adopting agile practices and can be used by software development practitioners adopting agile methods in Egypt or similar developing countries as an outline for the common problem areas they are expected to find

A glucose biosensor based on novel Lutetium bis-phthalocyanine incorporated silica-polyaniline conducting nanobeads

The facile preparation of highly sensitive electrochemical bioprobe based on lutetium 13 phthalocyanine incorporated silica nanoparticles (SiO2(LuPc2)) grafted with Poly(vinyl 14 alcohol-vinyl acetate) itaconic acid (PANI(PVIA)) doped polyaniline conducting nanobeads 15 (SiO2(LuPc2)PANI(PVIA)-CNB) is reported. The preparation of CNB involves two stages (i) 16 pristine synthesis of LuPc2 incorporated SiO2 and PANI(PVIA); (ii) covalent grafting of 17 PANI(PVIA) onto the surface of SiO2(LuPc2). The morphology and other physico-chemical 18 characteristics of CNB were investigated. The scanning electron microscopy images show 19 that the average particle size of SiO2(LuPc2)PANI(PVIA)-CNB was between 180-220 nm. 20 The amperometric measurements showed that the fabricated SiO2(LuPc2)PANI(PVIA)-21 CNB/GOx biosensor exhibited wide linear range (1-16 mM) detection of glucose with a low 22 detection limit of 0.1 mM. SiO2(LuPc2)PANI(PVIA)-CNB/GOx biosensor exhibited high 23 sensitivity (38.53 μA mM−1 cm−2) towards the detection of glucose under optimized 24 conditions. Besides, the real (juice and serum) sample analysis based on a standard addition 25 method and direct detection method showed high precision for measuring glucose at 26 SiO2(LuPc2)PANI(PVIA)-CNB/GOx biosensor. The SiO2(LuPc2)PANI(PVIA)-CNB/GOx 27 biosensor stored under refrigerated condition over a period of 45 days retains ~ 96.4 % 28 glucose response current

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Elucidation of the Role of Carbon Nanotube Patterns on the Development of Cultured Neuronal Cells.

Carbon nanotubes (CNTs) promise various novel neural biomedical applications for interfacing neurons with electronic devices or to design appropriate biomaterials for tissue regeneration. In this study, we use a new methodology to pattern SiO2 cell culture surfaces with double-walled carbon nanotubes (DWNTs). In contrast to homogeneous surfaces, patterned surfaces allow us to investigate new phenomena about the interactions between neural cells and CNTs. Our results demonstrate that thin layers of DWNTs can serve as effective substrates for neural cell culture. Growing neurons sense the physical and chemical properties of the local substrate in a contact-dependent manner and retrieve essential guidance cues. Cells exhibit comparable adhesion and differentiation scores on homogeneous CNT layers and on a homogeneous control SiO2 surface. Conversely, on patterned surfaces, it is found that cells preferentially grow on CNT patterns and that neurites are guided by micrometric CNT patterns. To further elucidate this observation, we investigate the interactions between CNTs and proteins that are contained in the cell culture medium by using quartz crystal microbalance measurements. Finally, we show that protein adsorption is enhanced on CNT features and that this effect is thickness dependent. CNTs seem to act as a sponge for culture medium elements, possibly explaining the selectivity in cell growth localization and differentiation

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries