Understanding choice of family planning provider is fundamental for policy makers and program managers as they seek ways to both improve the coverage and increase the sustainability and efficiency of family planning services for Egypt to achieve its population objectives. This study focuses first on providing a descriptive profile of the patterns of reliance on sources of family planning services during the early 2000s. Binomial logit models are then estimated to obtain a more in depth understanding of the determinants of (...) the choice of family planning providers in Egypt using the 2000 Egypt Demographic and Health Survey. The study offers insights into a number of aspects of family planning service provision about which there has been less previous investigation. There are marked differences in the extent to which Egyptian women rely on public or private providers for family planning services depending on the type of method they are seeking. Among the more important findings is the consistency women display in the choice of provider among women reporting multiple segments of use. With regard to the determinants of the choice of provider for family planning services, perhaps the most interesting finding is that household wealth was not a significant determinant of the choice of provider. This may reflect that private sources met the demand for family planning services of significant proportions of women in rural areas and among those in the low income groups. (shrink)

Human skills are acquired not by a single uniform process, but in a series of stages, as Piaget has shown. We have investigated such a sequential process by taking as an illustrative example the game of table tennis. The aims in each stage of learning are qualitatively different, and we show in detail how knowledge gained during one stage provides essential information for subsequent stages. Conclusions are drawn which may be important for artificial intelligence work generally. The question of practical (...) implementation of a system such as discussed is considered briefly. (shrink)

There is no doubt that custard apple diseases are among the important reasons that destroy the Custard Apple plant and its agricultural crops. This leads to obvious damage to these plants and they become inedible. Discovering these diseases is a good step to provide the appropriate and correct treatment. Determining the treatment with high accuracy depends on the method used to correctly diagnose the disease, expert systems can greatly help in avoiding damage to these plants. The expert system correctly diagnoses (...) Custard Apple disease to make it easier for farmers to find the right treatment based on the appropriate diagnosis. Objectives: A specialized syllable language system was established for the diagnosis of Custard Apple plant disease. (shrink)

The aim of this paper is to provide a conceptual framework that will help in understanding and evaluating, along social and ethical lines, the issue of killing day-old male chicks and two alternative directions of responsible innovations to solve this issue. The following research questions are addressed: Why is the killing of day-old chicks morally problematic? Are the proposed alternatives morally sound? To what extent do the alternatives lead to responsible innovation? The conceptual framework demonstrates clearly that there is a (...) moral “lock-in”, and why the killing of day-old chicks is indeed an issue. Furthermore, it is shown that both alternative directions address some important objections with regard to the killing of day-old chicks, but that they also raise new dilemmas. It also becomes clear that the framework enables and secures anticipation, reflection, deliberation with and responsiveness to stakeholders, the four dimensions of responsible innovation, in a structured way. (shrink)

The study aimed to identify the knowledge management processes and their role in achieving competitive advantage at Al-Quds Open University. The study was based on the descriptive analytical method, and the study population consists of academic and administrative staff in each of the branches of Al-Quds Open University in (Tulkarm, Nablus and Jenin). The researchers selected a sample of the study population by the intentional non-probability method, the size of (70) employees. A questionnaire was prepared and supervised by a number (...) of specialists in order to obtain the results of the study. The study concluded that there is a positive direct relationship, that is, the higher the degree of application of knowledge management processes, the greater the degree of competitive advantage. Knowledge Technology came first with a score of 80.02% on all items. Competitive advantage came second with 81.74%. In the third place came "knowledge generation" where the total score on all paragraphs in this area (78.24%). In the fourth place, "knowledge transfer" (77.21%). "Developing and storing knowledge" came in fifth place (77.13%). "Acquisition of knowledge" came in sixth place (76.45%). Knowledge Organization ranked seventh (74.26%). The study recommended that the university should enable the employees to benefit from the experiences and expertise available to help generate knowledge. The University encourages the creation of knowledge through the system of incentives and open the way for creators to apply their creations and spread and invest in excellence and creativity. The university should design work performance levels based on the integration of knowledge and organize it according to policies that support freedom of research. The need for Palestinian universities to adopt a knowledge management approach. The need to adopt a system of incentives that rewards cognitive efforts, and give workers enough freedom to enable them to apply their knowledge. (shrink)

This paper presents a new kind of problem in the ethics of distribution. The problem takes the form of several “calibration dilemmas,” in which intuitively reasonable aversion to small-stakes inequalities requires leading theories of distribution to recommend intuitively unreasonable aversion to large-stakes inequalities. We first lay out a series of such dilemmas for prioritarian theories. We then consider a widely endorsed family of egalitarian views and show that they are subject to even more forceful calibration dilemmas than prioritarian theories. Finally, (...) we show that our results challenge common utilitarian accounts of the badness of inequalities in resources. (shrink)

Abstract: Nowadays fresh water severe scarcity is a global concern and it is alarming for the future. In order to fully understand the progress of the water system and its impacts, a sustainability assessment of water resources is needed. This accelerates the achievement of sustainability and management of water resources. This work aims to assess the sustainability of the water resources system by applying the integration approach proposed by (Xu, 2011). This integration approach is based on integrating the DPSIR-ANP method (...) to the System Dynamics (SD) model, which is considered as a unique work in water resources management field. SD is a computer simulation model to understanding the behavior of complex systems over time, while Analytic Network Process (ANP) is a decision finding method used in model complex decision problems which contains feedback connections and loops. DPSIR is an analytical framework for describing the interactions between the economy, society and the environment. This integrated approach enables decision makers to view the sustainability problems of water resources system more comprehensively. The results showed that there is an increasing impact on the sustainability of water resources systems in Egypt over the research period. This is attributed to the increase in water resources consumption due to the increase in population, agriculture expansion and an increase in the value of GDP. So, the officials for managing water resources in Egypt should take actions to increase the efficiency of water use and increasing the renewable water resources for compensating water shortage. (shrink)

The global water crisis is being exacerbated by climate change, even in the United States. Recycled water is a feasible alternative to alleviate the water shortage, but it is constrained by humans’ perceptions. The current study examines how residents’ water scarcity awareness and climate change belief influence their willingness to use recycled water directly and indirectly. Bayesian Mindsponge Framework (BMF) analytics was employed on a dataset of 1831 residents in Albuquerque, New Mexico, an arid inland region in the US. We (...) discovered that residents’ willingness to use direct recycled potable water is positively affected by their awareness of water scarcity, but only if they believe in the impacts of climate change on the water cycle. Meanwhile, the willingness to use indirect recycled potable water is influenced by water scarcity awareness, and the belief in climate change further enhances this effect. These findings implicate that fighting climate change denialism and informing the public of the water scarcity situation in the region can contribute to the effectiveness and sustainability of long-term water conservation and climate change alleviation efforts. (shrink)

Abstract: In this paper an Artificial Neural Network (ANN) model, for predicting the Letters from twenty dissimilar fonts for each letter. The character images were, initially, based on twenty dissimilar fonts and each letter inside these twenty fonts was arbitrarily distorted to yield a file of 20,000 distinctive stimuli. Every stimulus was transformed into 16 simple numerical attributes (arithmetical moments and edge amounts) which were then ascended to be suitable into a range of numeral values from 0 to 15. We (...) naturally chose, arbitrarily, 1,000 distinctive stimuli for this research. We made certain that the scattering remnants the similar after selecting the one thousand stimuli. In this research, a neural network tool (Just NN) was used for the purpose of predicting to classify every of a huge number of black and white four-sided pixel displays as one of the 26 capital letters in the English language. (shrink)

Parkinson's Disease (PD) is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms generally come on slowly over time. Early in the disease, the most obvious are shaking, rigidity, slowness of movement, and difficulty with walking. Doctors do not know what causes it and finds difficulty in early diagnosing the presence of Parkinson’s disease. An artificial neural network system with back propagation algorithm is presented in this paper for helping doctors in identifying (...) PD. Previous research with regards to predict the presence of the PD has shown accuracy rates up to 93% [1]; however, accuracy of prediction for small classes is reduced. The proposed design of the neural network system causes a significant increase of robustness. It is also has shown that networks recognition rates reached 100%. (shrink)

Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges stem (...) from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence. (shrink)

Background: Mint is a grassy, perennial plant, belonging to the oral platoon, fast growing and spreading, its leaves are green in color, fragrant, tart, refreshing, square-shaped leg, bifurcated, erect, ranging in height from (10 - 201 cm). Home to Europe and Asia. The mint plant has many benefits, the most important of which are pain relief, treatment of gallbladder disorders, the expulsion of gases, anti-inflammatory, and relaxing nerves. While the mint plant is the ideal option for the start of gardens, (...) it is prone to some common diseases that affect the plant's growth. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment. Methods: In this paper, the design of the proposed Expert System was produced to help Farmers and those interested in agriculture in diagnosing many of the Mint diseases such as Mint rust, Verticillium wilt, Anthracnose, Powdery mildew, Black Stem Rot, Stem and stolon canker, Septoria leaf spot. The proposed expert system presents an overview of mint diseases are given, the cause of diseases outlined and the treatment of disease whenever possible is given out. CLIPS Expert System language was used for designing and implementing the proposed expert system. Results: The proposed Mint diseases diagnosis expert system was evaluated by Agricultural Students at AL Azhar University and some friends interested in agriculture and they were satisfied with its performance. Conclusions: The proposed expert system is very useful for Farmers and those interested in agriculture. (shrink)

Papaya is a tropical fruit with a green cover, yellow pulp, and a taste between mango and cantaloupe, having commercial importance because of its high nutritive and medicinal value. The process of sorting papaya fruit based on maturely is one of the processes that greatly determine the mature of papaya fruit that will be sold to consumers. The manual grading of papaya fruit based on human visual perception is time-consuming and destructive. The objective of this paper is to the status (...) classification of papaya fruits if it's mature or partially matured or unmatured. A deep learning technique that was extensively applied to image recognition was used. The trained model achieved an accuracy of 100% on a held-out test set, demonstrating the feasibility of this approach. Classification model of VGG16 achieved a 100% accuracy and 112 seconds of training time. (shrink)

Empirical philosophers of science aim to base their philosophical theories on observations of scientific practice. But since there is far too much science to observe it all, how can we form and test hypotheses about science that are sufficiently rigorous and broad in scope, while avoiding the pitfalls of bias and subjectivity in our methods? Part of the answer, we claim, lies in the computational tools of the digital humanities, which allow us to analyze large volumes of scientific literature. Here (...) we advocate for the use of these methods by addressing a number of large-scale, justificatory concerns—specifically, about the epistemic value of journal articles as evidence for what happens elsewhere in science, and about the ability of DH tools to extract this evidence. Far from ignoring the gap between scientific literature and the rest of scientific practice, effective use of DH tools requires critical reflection about these relationships. (shrink)

There is no doubt that tomato diseases are one of the important reasons that destroy the tomato plant and its crops. This leads to clear damage to these plants and they become inedible. Discovering these diseases after a good step for proper and correct treatment. Determining the treatment with high accuracy depends on the method used in the diagnosis. Correctly, expert systems can greatly help to avoid damage to these plants. The expert system diagnoses tomato disease correctly to facilitate farmers (...) to find the correct treatment based on the appropriate diagnosis. Objectives: An expert system has been established based on CLIPS to diagnose tomato plant disease. (shrink)

Background: A bean is the seed of one of several genera of the flowering plant family Fabaceae, which are used as vegetables for human or animal food. They can be cooked in many different ways, including boiling, frying, and baking, and are used in many traditional dishes throughout the world. Beans are one of the longest-cultivated plants. Broad beans, also called fava beans, in their wild state the size of a small fingernail, were gathered in Afghanistan and the Himalayan foothills. (...) In a form improved from naturally occurring types, Beans were an important source of protein throughout old and new world history, and still are today. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment. Methods: In this paper, the design of the proposed Expert System was produced to help farmers and those interested in agriculture in diagnosing many of the Bean diseases such as Fusarium wilt, Charcoal rot or ashy stem blight, Bacterial leaf spot and blight, Mung bean yellow mosaic virus, Cercospora leaf spot. The proposed expert system presents an overview of Bean diseases are given, the cause of diseases outlined and the treatment of disease whenever possible is given out. CLIPS Expert System language was used for designing and implementing the proposed expert system. Results: The proposed Bean diseases diagnosis expert system was evaluated by Agricultural experts and some friends interested in agriculture and they were satisfied with its performance. Conclusions: The proposed expert system is very useful for Farmers and those interested in agriculture. (shrink)

We analyse Peirce's original idea concerning abduction from the perspective of a critical philosophy, the same philosophy in Peirce's background. Peirce's realism is directly related to reason and experience and has ties with the idea of abstraction. We show how the philosophical environment of science abruptly changed, specially for physics, in the last period of the XIX century and the initial period of the XX century, when science was divided in disciplines and set free from the control of philosophy. The (...) phenotype of the physicist changed from abstract into imaginative thinker. Further, abstraction was linked to metaphysics and attacked as such. Elements of phantasy and dogmatism entered the scene in place of abstraction alongside ideas taken from the observable world. We provide evidence that the scientists of the newer kind had problems understanding those of the older school. As a consequence of the problems arisen in conciliating the idea of science grounded in experience and reason with the science actually practised, the former conceptualisation was abandoned. Abduction was then expelled from science. In the late part of the XX century and the early part of our century abduction re-emerged but without its scientific attributes. -/- Influenced by a constructivist, Piagetian, perspective of science, we propose and discuss a small number of conditions that we identify as characteristics of rational abduction: rules for the rational construction of theories. We show how a classical example of belief that satisfies today's most common definition of abduction does not match the standards of scientific retroduction. We further show how the same rules indicate the detachment of Special Relativity from the observable world, a fact actually known to Einstein. Finally, the same rules indicate the initial point in the path to re-conciliate Electromagnetism with the classical view of spatial relations, a matter not possible for the imaginative scientist but not extremely difficult for the abstract scientist. We close arguing that there is an urgent need to develop a critical epistemology, and to give room in science for the abstract scientist. (shrink)

Much problem solving and learning research in math and science has focused on formal representations. Recently researchers have documented the use of unschooled strategies for solving daily problems -- informal strategies which can be as effective, and sometimes as sophisticated, as school-taught formalisms. Our research focuses on how formal and informal strategies interact in the process of doing and learning mathematics. We found that combining informal and formal strategies is more effective than single strategies. We provide a theoretical account of (...) this multiple strategy effect and have begun to formulate this theory in an ACT-R computer model. We show why students may reach common impasses in the use of written algebra, and how subsequent or concurrent use of informal strategies leads to better problem-solving performance. Formal strategies facilitate computation because of their abstract and syntactic nature; however, abstraction can lead to nonsensical interpretations and conceptual errors. Reapplying the formal strategy will not repair such errors; switching to an informal one may. We explain the multiple strategy effect as a complementary relationship between the computational efficiency of formal strategies and the sense-making function of informal strategies. (shrink)

The Centre for Society and Genomics (CSG) was established in 2004, funded by NGI (the Netherlands Genomics Initiative). Funding was continued in 2008. This report summarises the basic outcomes of almost a decade of interactive societal research, in close collaboration with the other centres of the NGI network. There are two reasons for presenting these results. First of all, at the end of this year, the CSG Next programme (2008-2013), encompassing more than 50 research projects conducted at 10 Dutch universities, (...) will be completed. Moreover, we are currently preparing ourselves for the years to come. The network of principal investigators, together with the research communities they represent and the societal and international networks they are involved in, have agreed to continue to work together, on the basis of mutual learning, transdisciplinary collaboration and collegial support. Notably, we offer our networks, experiences and expertise to help prepare the ground for promoting Responsible Research and Innovation (RRI) in the context of Horizon2020, together with our European colleagues. This report summarises what our type of research can achieve and how we want to continue our activities in the future. After a concise sketch of the life sciences landscape as it has evolved during the past seven decades or so, we explain how CSG came about and what kind of approach we have developed. Subsequently, we list our main results, notably in the form of project vignettes, so as to make the harvest of the CSG Next programme as tangible and concrete as possible. Finally, we explain how we see our role in the future. As is already indicated by the title: this is not merely a retrospective summary of our results (CSG harvest), but an invitation to readers (from academia, industry, policy and civil society) to reassemble and to optimally prepare ourselves for things to come, by strengthening and broadening our collaborative efforts, building on what we have achieved so far. (shrink)

A pineapple is a tropical plant with eatable leafy foods most monetarily critical plant in the family Bromeliaceous. The pineapple is native to South America, where it has been developed for a long time. The acquaintance of the pineapple with Europe in the seventeenth century made it a critical social symbol of extravagance. Since the 1820s, pineapple has been industrially filled in nurseries and numerous tropical manors. Further, it is the third most significant tropical natural product in world creation. In (...) the twentieth century, Hawaii was a prevailing maker of pineapples, particularly for the US, be that as it may, by 2016, Costa Rica, Brazil, and the Philippines represented almost 33% of the world's creation of pineapples. In this paper, machine learning based approach is presented for identifying type pineapple with a dataset that contains 1,311images use 946 images for training, 197 images for validation and 168 images for testing. A deep learning technique that extensively applied to image recognition was used. use 70% from image for training and 30% from image for validation. Our trained model achieved an accuracy of 100% on a heldout test set. (shrink)

The study aimed to identify the effect of applying detection and prevention tools for career fraud in combating and preventing fraud and reducing its risks through an applied study on Palestinian Ministry of Health in Gaza Strip, Palestine. To achieve the objectives of the study, the researchers used the questionnaire as a main tool to collect data, and the descriptive and analytical approach to conducting the study. The study population consisted of (501) supervisory employees working at MOH in Gaza Strip, (...) Palestine. The researchers used the stratified random sample method and the multiple regression method to measure the effect. The study concluded a set of results, the most important of which is a positive evaluation among respondents about the levels of application of tools to detect and prevent job fraud within MOH, and the presence of a high interest in tools to prevent job fraud during the implementation of its various work. The study recommended the necessity for the Palestinian National Authority to develop and approve laws regulating health sector, so that those laws guarantee the prevention of conflicts of interest, especially for the category of doctors, by preventing job duplication of doctors working in the government sector. Also study recommended the need for MOH to adopt principles of health sector governance and begin immediately to implement them. This process to ensure transparency, disclosure and accountability in the business framework in a manner that realizes the effective protection of stakeholders and does not compromise or discriminate in the application of these principles, which ensures that all forms of job fraud are organized in an organized manner and within fixed legal frameworks. (shrink)

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

Abstract— Malware behavior was and still is a key solution, for top security appliances, to monitor algorithmic approaches when performing regular security tasks; scan, detection, cleaning and removal. And even for early actions; when building a security framework and securing all possible access points to all data sources. The first suspect in such scenario is the inner residents; appliances and system functions. Numerous are available at each operating system, and thus, the security is raised and set up frequently with all (...) nowadays, yet, still we are able to identify black wholes and back doors, even with the high security approaches applied at different levels and layers. In this research we are presenting an inevitable security thread, we face frequently in different scenarios, that are the key definition for successful security trespass, which we secure with an ameliorated security shell skeleton. Though the sysinternals are doing sufficient services to help administrators accomplish security tasks; automating administration within large scale environments. (shrink)

Background: There is no doubt that strawberry diseases are one of the most important reasons that led to the destruction of strawberry plants and their crops. This leads to obvious damage to these plants and they become inedible. Discovering these diseases after a good step for proper and correct treatment. Determining the treatment with high accuracy depends on the method used in the diagnosis. Correctly, expert systems can greatly help in avoiding damage to these plants. The expert system correctly diagnoses (...) strawberry disease to make it easier for farmers to find the right treatment based on the appropriate diagnosis. Objectives: The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment. Methods: In this paper the design of the proposed Expert System which was produced to help Farmers and students interested in agriculture strawberry in diagnosing many of the strawberry diseases such as: Leaf Spots, Grey Mold, Red Stele/Red Core, Wilt, Powdery Mildew, Alternaria Spot, Black Root Rot, Anthracnose (black spot), and Angular Leaf Spot. The proposed expert system presents an overview about strawberry diseases are given, the cause of diseases are outlined and the treatment of disease whenever possible is given out. CLIPS language was used for designing and implementing the proposed expert system. Results: The proposed strawberry diseases diagnosis expert system was evaluated by Farmers and they were satisfied with its performance. Conclusions: The Proposed expert system is very useful for Farmers with strawberry problem and students interested in agriculture strawberry. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

In this paper, we propose a new concept named the uniform single valued neutrosophic graph. An illustrative example and some properties are examined. Next, we develop an algorithmic approach for computing the complement of the single valued neutrosophic graph. A numerical example is demonstrated for computing the complement of single valued neutrosophic graphs and uniform single valued neutrosophic graph.

In this paper, we investigated multiple machine learning classifiers which are, Multinomial Naive Bayes, Support Vector Machine, Decision Tree, K Nearest Neighbors, and Random Forest in a text classification problem. The data we used contains real and fake job posts. We cleaned and pre-processed our data, then we applied TF-IDF for feature extraction. After we implemented the classifiers, we trained and evaluated them. Evaluation metrics used are precision, recall, f-measure, and accuracy. For each classifier, results were summarized and compared with (...) others. (shrink)

Objective: To examine the current ethical review process of ethics committees in a non-pharmacological trial from the perspective of a clinical investigator.Design: Prospective collection of data at the Study Centre of the German Surgical Society on the duration, costs and administrative effort of the ERP of a randomised controlled multicentre surgical INSECT Trial between November 2003 and May 2005.Setting: Germany.Participants: 18 ethics committees, including the ethics committee handling the primary approval, responsible overall for 32 clinical sites throughout Germany. 8 ethics (...) committees were located at university medical schools and 10 at medical chambers. Duration was measured as days between submission and receipt of final approval, costs in euros and administrative effort by calculation of the product of the total number of different types of documents and the mean number of copies required .Results: The duration of the ERP ranged from 1 to 176 days. The median duration was 26 days at MSUs compared with 34 days at medical chambers. The total cost was €2947. 1 of 8 ethics committees at universities and 8 of 10 at medical chambers charged a median fee of €162 . The administrative effort for primary approval was 30. Four ethics committees required a higher administrative effort for secondary approval .Conclusion: The ERP for non-pharmacological multicentre trials in Germany needs improvement. The administrative process has to be standardised: the application forms and the number and content of the documents required should be identical or at least similar. The fees charged vary considerably and are obviously too high for committees located at medical chambers. However, the duration of the ERP was, with some exceptions, excellent. A centralised ethics committee in Germany for multicentre trials such as the INSECT Trial can simplify the ERP for clinical investigators in and outside the country. (shrink)

While several tests and strategies are recommended for colorectal cancer (CRC) screening, studies suggest that primary care providers often recommend colonoscopy without providing information about its risks or alternatives. These observations raise concerns about the quality of informed consent for screening colonoscopy.

Most people do not know there are different kinds of medical studies; some are conducted on people who already have a disease or medical condition, and others are performed on healthy volunteers who want to help science find answers. No matter what sort of research you are invited to participate in, or whether you are a patient when you are asked, it’s entirely up to you whether or not to do it. This decision is important and may have many implications (...) for your health and well-being, as well as those of other patients now and in the future. Making a good decision – the right one for you – requires you to become educated about topics you may not have thought about before, some of which may be quite complicated. This chapter explains the key issues to help you make a good decision. (shrink)

Abstract: The integration of Artificial Intelligence (AI) into leadership practices is rapidly transforming organizational dynamics and decision-making processes. This paper explores the ways in which AI enhances leadership effectiveness by providing data- driven insights, optimizing decision-making, and automating routine tasks. Additionally, it examines the challenges leaders face when adopting AI, including ethical considerations, potential biases in AI systems, and the need for upskilling. By analyzing current applications of AI in leadership and discussing future trends, this study aims to offer a (...) comprehensive overview of the opportunities AI presents for effective leadership, as well as the strategies required to address its associated challenges. (shrink)

Abstract: Background: Vitamin D insufficiency/deficiency prevalent in all age groups across the world is common in obesity and may play an important role in the risk factors of metabolic syndrome (MS). Objectives: This cross-sectional study is to evaluate the relationship between levels of adiponectin and circulating 25(OH)D, and its effect on metabolic biomarker among overweight/obese female students. Methods: Three hundred female students; with mean age 20.9 ± 3.2 years were attending the Aljouf University, Sakaka, Saudi Arabia. They were randomly selected (...) from university during the studying year 2015 – 2016. Anthropometric and biochemical indices were determined. Results: The study showed 19% of the female’s student were either overweight or obese (15% and 4%, respectively). The frequency of MS diagnosis among the students was 17%, with 13% and 4% had either three or four risk factors, respectively. Overweight/obese subjects had significantly worse anthropometric and biochemical characteristics, including waist/hip ratio, blood pressure (BP), fasting blood glucose (BG), insulin, insulin resistance (HOMA-IR), triglyceride levels (TG), low-density lipoprotein cholesterol levels (LDL-C), leptin, adiponectin, leptin/adiponectin ratio and high-density lipoprotein cholesterol levels (HDL-C) compared to normal weight. Of the subjects diagnosed with MS, 59% had mild and 8.6% had severe 25(OH)D deficiency. There was negative association between 25(OH)D and both FBG and HOMA-IR among young women obese/overweight. Conclusion: In our study, it suggested that low level of adiponectin was strongly correlated with low 25(OH)D levels. Also, the prevalence of MS tends to increase with high occurrence rate of low circulating 25(OH)D levels that is, known cause poor glycemic control and prediction of cardiovascular outcomes. (shrink)

How does microbiota research impact our understanding of biological individuality? We summarize the interdisciplinary summer school on "Microbiota, Symbiosis and Individuality: Conceptual and Philosophical Issues" (July 2019), which was supported by a European Research Council starting grant project "Immunity, DEvelopment, and the Microbiota" (IDEM). The summer school centered around interdisciplinary group work on four facets of microbiota research: holobionts, individuality, causation, and human health. The conceptual discussion of cutting-edge empirical research provided new insights into microbiota and highlights the value of (...) incorporating into meetings experts from other disciplines, such as philosophy and history of science. (shrink)

Background: Obstetrics and gynaecology are many and common, where a woman suffers from problems related to pregnancy or her reproductive organs. Any part of her body may be affected due to some symptoms that are completely related to the reproductive organs when she is in a critical period for her, whether in her menstrual cycle, pregnancy, or disease conditions. The bulk of cases of diseases related to women and childbirth are dealt with great care and special care, as all diseases (...) related to women are considered very sensitive diseases due to the presence of the disease in sensitive and not simple places. A gynaecologist is a specialist in all diseases and problems related to the female sexual organs. They perform regular preventive medical exams, such as cervical smear tests and breast exams. It also provides consultations for women of all ages about the problems of contraception, infertility and menopause. Objectives: The objective of this expert system is to help and facilitate women in diagnosing diseases related to their obstetrics and gynaecology, a simple expert system has been designed consisting of ten various common diseases that affect women whether During or without pregnancy, Methods: In this system, the system consists of a list of some common symptoms, the correct diagnosis adopted for these diseases, and how to treat diseases in the correct way with the help of a consultant obstetrician and gynaecologist, Dr. Fathi Muhammad Al-Habibi, and these diseases are: uterine cancer, cervical cancer, Infertility, double uterus, ectopic pregnancy, endometrial cancer, female sexual dysfunction, endometriosis, faecal incontinence, female infertility, CLIPS Expert System language was used to design and implement the proposed expert system. Results: The proposed ten obstetrics and gynaecology diagnostic expert system was evaluated by medical students and they were satisfied with its performance. Conclusions: The proposed expert system is very useful for obstetricians and gynaecologists, patients with reproductive system problems, and recent graduates. (shrink)

Abstract: As artificial intelligence (AI) technologies become more integrated across various sectors, ethical considerations in their development and application have gained critical importance. This paper delves into the complex ethical landscape of AI, addressing significant challenges such as bias, transparency, privacy, and accountability. It explores how these issues manifest in AI systems and their societal impact, while also evaluating current strategies aimed at mitigating these ethical concerns, including regulatory frameworks, ethical guidelines, and best practices in AI design. Through a comprehensive (...) analysis of these challenges and proposed solutions, this paper seeks to contribute to the ongoing discourse on responsible AI development, emphasizing the need for a balance between technological advancement and ethical integrity. (shrink)

This edited volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organised around the main stages of the clinical encounter from the patient's perspective. This introductory chapter opens up crucial issues of methodology and of practical application in this highly innovative approach to the role of ethics in healthcare.

Graduates' employability indicates the excellent education and relevant preparation they obtained from their respective degrees. Tracer studies have enabled higher education institutions to profile their graduates while also reflecting on the quality of education they provide. With the foregoing, a tracer study determined the demographic and academic profile of teacher education graduates from 2017 to 2020 in a state university in the West Philippines. It also ascertained the advanced studies they attended after college, their employment data, the relevance of college (...) preparation with their current employment, difficulties they encountered while securing employment and in their present job, and recommendations to strengthen the teacher education program. The study utilized a descriptive survey research design with 80 non-random samples chosen based on availability. The survey was based on the Philippine Commission on Higher Education with modifications elucidated from previous studies. Results showed that graduates took the teacher education program with a strong passion for the teaching profession. More graduates received honors and awards, passed the licensure examinations for teachers, attended advanced studies for professional development, and are employable. Besides, the graduates’ college preparation is relevant to their current employment. Further, difficulties and problems encountered and recommendations to strengthen the teacher education program were noted. These findings may serve as a baseline for curriculum review and give suggestions for future tracer studies. (shrink)

This volume of articles, literature and case studies illustrates the central importance of human values throughout healthcare. The readings are structured around the main stages of the clinical encounter from the patient's perspective.

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

IPCC SPECIAL REPORT ON CLIMATE CHANGE AND LAND (SRCCL) -/- Chapter 3: Climate Change and Land: An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems.

In this retrospective for Ethics, I discuss H.M. Oliver’s “Established Expectations and American Economic Policies.” This article, by a then-modestly-famous economist, has been ignored (no citations) since its 1940 publication. Yet it bears directly on a normative problem at the intersection of ethics and economics that challenges today’s policymakers but has received comparatively little philosophical attention: how should we balance potentially desirable institutional change against the disruption of established expectations? -/- Oliver details how the principle of fulfilling established expectations cuts (...) across political lines. Conservatives, he observes, criticized inflation for disrupting expectations, and demanded the protection of established corporations. New Deal progressives achieved “the safeguarding of the economic positions of certain important sections of the American people” (104) via statutes designed to protect income and homeownership status. And labor leaders lobbied for the preservation of occupational status. Oliver criticizes these demands on two grounds. First, they are noncompossible: they can’t simultaneously be fulfilled. Second, they are economically inefficient. He concludes that “in a modern dynamic economy, the preservation of status is not and cannot be a feasible criterion of economic justice” (107). -/- I argue that Oliver accurately recognizes both the wide endorsement and the moral ill-foundedness of fulfilling expectations. However, I criticize Oliver’s belief in the noncompossibility of expectations. The established expectations of the wealthy, middle-class homeowners and retirees, and current workers can all be maintained, but at the price of constricting the opportunities of new graduates, immigrants, and the poor—all groups yet to develop settled expectations. This insight renders the protection of expectations not merely inefficient but also unjust. (shrink)

Animal ethicists have recently debated the ethical questions raised by disenhancing animals to improve their welfare. Here, we focus on the particular case of breeding hens for commercial egg-laying systems to become blind, in order to benefit their welfare. Many people find breeding blind hens intuitively repellent, yet ‘welfare-only’ positions appear to be committed to endorsing this possibility if it produces welfare gains. We call this the ‘Blind Hens’ Challenge’. In this paper, we argue that there are both empirical and (...) theoretical reasons why even those adopting ‘welfare-only’ views should be concerned about breeding blind hens. But we also argue that alternative views, which (for example) claim that it is important to respect the telos or rights of an animal, do not offer a more convincing solution to questions raised by the possibility of disenhancing animals for their own benefit. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

Abstract: The rapid advancement of artificial intelligence (AI) has catalyzed significant developments in autonomous systems, which are increasingly shaping diverse sectors including transportation, robotics, and industrial automation. This paper explores the evolution of AI technologies that underpin these autonomous systems, focusing on their capabilities, applications, and the challenges they present. Key areas of discussion include the technological innovations driving autonomy, such as machine learning algorithms and sensor integration, and the practical implementations observed in autonomous vehicles, drones, and robotic systems. Additionally, (...) the paper addresses critical challenges including safety, ethical concerns, and regulatory issues that influence the deployment and acceptance of autonomous technologies. By examining current trends and future prospects, this research aims to provide a comprehensive overview of how AI is transforming the landscape of autonomous systems and to identify key areas for future research and development. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

Abstract: The integration of Artificial Intelligence (AI) into medical imaging represents a transformative shift in healthcare, offering significant improvements in diagnostic accuracy, efficiency, and patient outcomes. This paper explores the application of AI technologies in the analysis of medical images, focusing on techniques such as convolutional neural networks (CNNs) and deep learning models. We discuss how these technologies are applied to various imaging modalities, including X-rays, MRIs, and CT scans, to enhance disease detection, image segmentation, and diagnostic support. Additionally, the (...) paper addresses the challenges faced in AI-driven medical imaging, including data quality, model interpretability, and ethical considerations. By examining recent advancements and real-world case studies, this paper provides insights into the current state of AI in medical imaging and its potential future directions. The findings highlight the ongoing evolution of AI technologies and their crucial role in advancing medical diagnostics and treatment strategies. (shrink)