SummaryThe dichotomy between ‘scientific’ and ‘practical’ approaches to guideline development is false and divisive. Instead we should concentrate on developing mechanisms to develop and implement valid guidelines to improve patient care. The development of valid guidelines requires considerable expertise and is time consuming and expensive. It is most efficiently done at a regional or national level. The implementation of valid guidelines requires local action including the identification and modification of valid guidelines and a coordinated evidence-based implementation strategy (Grimshaw & (...) class='Hi'>Eccles 1998). (shrink)

A Charter on Medical Professionalism (CMA) has just recently been developed internationally, and the Canadian Medical Association is calling for public dialogue on medical professionalism now that reforms in the Canadian system of health care are imminent. We posit that good practices are at issue; we outline the essence of these in general and also specifically in the knowing, teaching and intervening components of practice. We also see challenges not to, but in, medical professionalism – first and foremost in the (...) profession's definition of good practices and the payer's confinement of insurance coverage to these. (shrink)

Concerning the ubiquity of social media, this research tried to examine the impacts of using Telegram on Iranian EFL learners’ foreign language motivation, foreign language anxiety, and attitude toward learning. To achieve these purposes, 60 Iranian EFL learners at the intermediate level were selected and randomly divided into two groups: experimental and control. After that, both groups were pretested on motivation and anxiety variables. After pretesting, the participants in the experimental class received treatmentviausing the Telegram application, and the control students (...) were trained traditionally without using any social media. After an 18-session instruction, a post-test of motivation and a post-test of anxiety were given to both groups, and also an attitude questionnaire was distributed among the experimental group to inspect their attitudes toward the Telegram application in language learning. The results of using two one-way ANCOVA tests showed significant differences between the post-tests of the control and experimental groups in favor of the experimental group. The findings demonstrated that using the Telegram application increased the motivation of the experimental group and decreased their level of foreign language anxiety. Also, the results of one sample t-test showed that the participants of the experimental group held positive attitudes toward using the Telegram application in English language learning. The implications of this research can encourage both teachers and learners to use social media-based instruments in English teaching and learning. (shrink)

Nowadays, mobile telephony interruptions in our daily life activities are common because of the inappropriate ringing notifications of incoming phone calls in different contexts. Such interruptions may impact on the work attention not only for the mobile phone owners, but also for the surrounding people. Decision tree is the most popular machine-learning classification technique that is used in existing context-aware mobile intelligent interruption management model to overcome such issues. However, a single-decision tree-based context-aware model may cause over-fitting problem and thus (...) decrease the prediction accuracy of the inferred model. Therefore, in this paper, we propose an ensemble machine-learning-based context-aware mobile telephony model for the purpose of intelligent interruption management by taking into account multi-dimensional contexts and name it “E-MIIM”. The experimental results on individuals’ real-life mobile telephony data sets show that our E-MIIM model is more effective and outperforms existing MIIM model for predicting and managing individual’s mobile telephony interruptions based on their relevant contextual information. (shrink)

AimThe aim of this study was to determine the presence of depressive symptoms and understand the potential factors associated with these symptoms among physicians in Bangladesh during the COVID-19 pandemic.MethodsA cross-sectional study using an online survey was conducted in between April 21 and May 10, 2020, among physicians living in Bangladesh. Participants completed a series of demographic questions, COVID-19-related questions, and the Patient Health Questionnaire-9. Descriptive statistics, test statistics were performed to explore the association between physicians’ experience of depression symptoms (...) and other study variables. Stepwise binary logistic regression was followed while conducting the multivariable analysis.ResultA total of 390 physicians completed the survey. Of them, 283 were found to be experiencing depressive symptoms. Predictors which were significantly associated with depressive symptoms were gender, the presence of sleep disturbance, being highly exposed to media coverage about the pandemic, and fear around COVID-19 infection, being assaulted/humiliated by regulatory forces and by the general public, while traveling to and from the hospital and treating patients during the countrywide lockdown.ConclusionThe findings of this study demonstrate that there is a high prevalence of depressive symptom among physicians especially among female physicians in Bangladesh during the COVID-19 pandemic. Immediate, adequate and effective interventions addressing gender specific needs are required amid this ongoing crisis and beyond. (shrink)

The Infectious Diseases Act entered into force officially on 14 November 2018 in Bangladesh. The Act is designed to raise awareness of, prevent, control, and eradicate infectious or communicable diseases to address public health emergencies and reduce health risks. A novel coronavirus disease was first identified in Bangladesh on 8 March 2020, and the Ministry of Health and Family Welfare issued a gazette on 23 March, listing COVID-19 as an infectious disease and addressing COVID-19 as a public health emergency. The (...) gazette empowers the government to monitor the spread of infection. Despite there being an infrastructure of research ethics committees in almost all hospitals in Bangladesh, a lack of such committees in the clinical setting often forces healthcare professionals to allocate scarce healthcare resources to the task. These personnel are often either influenced by materialistic matters or guided by the emergency policies, without reaching a consensus on how to allocate scarce resources in times of need, especially in the time of the COVID-19 pandemic. Ethical dilemmas often arise when a number of patients with COVID-19, especially in poor and middle-class areas, are denied care while elites are prioritized to receive such scarce resources. Resource allocation in healthcare during the COVID-19 pandemic in Bangladesh appears to be unethical and in direct conflict with the biomedical principles of non-maleficence and procedural justice. The findings of this study suggest that the Act needs substantive changes in the stipulation of policy directing hospitals in the provision of resource allocation framework. Furthermore, parliament should produce guidance outlining how to successfully implement the law with the aim of protecting public health in times of emergency, especially the COVID-19 pandemic. (shrink)

The most prominent form of human communication and interaction is speech. It plays an indispensable role for expressing emotions, motivating, guiding, and cheering. An ill-intentioned speech can mislead people, societies, and even a nation. A misguided speech can trigger social controversy and can result in violent activities. Every day, there are a lot of speeches being delivered around the world, which are quite impractical to inspect manually. In order to prevent any vicious action resulting from any misguided speech, the development (...) of an automatic system that can efficiently detect suspicious speech has become imperative. In this study, we have presented a framework for acquisition of speech along with the location of the speaker, converting the speeches into texts and, finally, we have proposed a system based on long short-term memory which is a variant of recurrent neural network to classify speeches into suspicious and nonsuspicious. We have considered speeches of Bangla language and developed our own dataset that contains about 5000 suspicious and nonsuspicious samples for training and validating our model. A comparative analysis of accuracy among other machine learning algorithms such as logistic regression, SVM, KNN, Naive Bayes, and decision tree is performed in order to evaluate the effectiveness of the system. The experimental results show that our proposed deep learning-based model provides the highest accuracy compared to other algorithms. (shrink)

Background. Imposter syndrome, associated with self-doubt and fear despite clear accomplishments and competencies, is frequently detected in medical students and has a negative impact on their well-being. This study aimed to predict the students’ IS using the machine learning ensemble approach. Methods. This study was a cross-sectional design among medical students in Bangladesh. Data were collected from February to July 2020 through snowball sampling technique across medical colleges in Bangladesh. In this study, we employed three different machine learning techniques such (...) as neural network, random forest, and ensemble learning to compare the accuracy of prediction of the IS. Results. In total, 500 students completed the questionnaire. We used the YIS scale to determine the presence of IS among medical students. The ensemble model has the highest accuracy of this predictive model, with 96.4%, while the individual accuracy of random forest and neural network is 93.5% and 96.3%, respectively. We used different performance matrices to compare the results of the models. Finally, we compared feature importance scores between neural network and random forest model. The top feature of the neural network model is Y7, and the top feature of the random forest model is Y2, which is second among the top features of the neural network model. Conclusions. Imposter syndrome is an emerging mental illness in Bangladesh and requires the immediate attention of researchers. For instance, in order to reduce the impact of IS, identifying key factors responsible for IS is an important step. Machine learning methods can be employed to identify the potential sources responsible for IS. Similarly, determining how each factor contributes to the IS condition among medical students could be a potential future direction. (shrink)

Taking the idea of waste as an in-use phenomenon, we developed amatrix to explain four categories of waste which result from users’ failure touse a resource properly. These categories were illustrated by examples built onpractical food waste measurements, surveys, theses formatting requirementsand newspaper reports. We have categorized different facets of waste from abusiness perspective; thus, contributed to have improved waste managementpractices. We also showed that parsimony was also a wasteful behaviour.Parsimony was shown to be a waste by its effects on (...) others’ need of fulfilmentand other-worldly consequences for the miser. (shrink)

Purpose This study aims to analyze how English-language versions of e-newspapers in the first two countries affected, China and Japan, which are non-English-speaking countries and have different socio-economic and political settings, have highlighted Coronavirus disease 2019 pandemic news and informed the global community. Design/methodology/approach A text-mining approach was used to explore experts’ thoughts as published by the two leading English-language newspapers in China and Japan from January to March 2020. This study analyzes the Opinion section, which mainly comprises editorial and (...) the op-ed section. The current study groups all editorial discussions and highlights into ten major aspects, which cover health, economy, politics, culture and others. Findings Within the first three months, the media in both China and Japan shifted their focus from health and preparedness to the economy, politics and social welfare. Governance and social welfare were key concerns in China’s news media, while, in contrast, global politics received the highest level of attention from experts in Japan’s news media. Environment and technologies aspects did not receive much attention by the expert’s columns. Originality/value At the initial stage of a world crisis, how leading nations and initially affected nations deal with the problem, how media play their role and guide mass population with experts’ thoughts are highlighted here. The understanding developed in this study can provide guidance to news media in other countries in playing effective roles in the management of this health crisis and catastrophes. (shrink)

Statistical distributions have great applicability for modeling data in almost every applied sector. Among the available classical distributions, the inverse Weibull distribution has received considerable attention. In the practice of distribution theory, numerous methods have been studied and suggested/introduced to increase the flexibility level of the traditional probability distributions. In this paper, we implement different distribution methods to obtain five new different versions of the inverse Weibull model. The new modifications of the inverse Weibull model are called the logarithm transformed-inverse (...) Weibull, a flexible reduced logarithmic-inverse Weibull, the weighted TX-inverse Weibull, a new generalized-inverse Weibull, and the alpha power transformed extended-inverse Weibull distributions. To illustrate the flexibility and applicability of the new modifications of the inverse Weibull model, a biomedical data set is analyzed. The data set consists of 108 observations and represents the mortality rate of the COVID-19-infected patients. The practical application shows that the new generalized-inverse Weibull is the best modification of the inverse Weibull distribution. (shrink)

The question of how we apply knowledge from biomedical science to medical and public health practice has been the subject of heated debates about generalizability and related concepts, such as applicability and inductive inference. In this essay, I interpret the term from the perspective of two causal models: determinism and indeterminism. I suggest that theories of generalizability can be formulated on the basis of both models and take the form of testable but unverifiable hypotheses, an attribute that is common to (...) all scientific theories. Nonetheless, there is one noteworthy difference between the two models: determinism allows one to rationalize a decision to treat a certain kind of patient but only indirectly a decision to treat any particular patient, whereas indeterminism accommodates both types of decisions. (shrink)

This paper aims to introduce a robust framework for forecasting demand, including data preprocessing, data transformation and standardization, feature selection, cross-validation, and regression ensemble framework. Bagging ), boosting and extreme gradient boosting regression ), and stacking are employed as ensemble models. Different machine learning approaches, including support vector regression, extreme learning machine, and multilayer perceptron neural network, are adopted as reference models. In order to maximize the determination coefficient value and reduce the root mean square error, hyperparameters are set using (...) the grid search method. Using a steel industry dataset, all tests are carried out under identical experimental conditions. In this context, STACK1 and STACK2 models provided better performance than other models. The highest accuracies of R2 of 0.97 and 0.97 are obtained using STACK1 and STACK2, respectively. Moreover, the rank according to performances is STACK1, STACK2, XGBR, GBR, RFR, MLP, ELM, and SVR. As it improves the performance of models and reduces the risk of decision-making, the ensemble method can be used to forecast the demand in a steel industry one month ahead. (shrink)

The main aim of this paper is to assess the level of knowledge, attitude and practice of university teachers regarding plagiarism in Bangladesh. An online questionnaire consisted of 20 knowledge questions, 23 attitude items, and 18 practice questions was created using Google Forms. The link to the questionnaire was sent via email to university teachers. The total correct answers for knowledge and practice questions, and the total attitude score were converted to percentile scores and categorized accordingly as poor ( mean (...) + 1 SD). Bivariate analyses were conducted to compare the total knowledge, attitude and practice scores based on demographic and academic variables. Multiple linear regressions were used to identify the association between knowledge, attitude and practice scores, and other covariates. The findings revealed an average level of knowledge, attitude and practice regarding plagiarism among the majority of university teachers. The knowledge, attitude and practice scores were significantly higher for teachers who attended academic writing workshops compared to those who did not attend such events. Demographic and academic variables did not impact knowledge and attitude scores. However, the number of papers published in the last two years and their indexing in Web of Science (WoS) or Scopus significantly impacted attitude and knowledge scores. The multiple regression analyses showed that the practice score was significantly associated with age, highest education, and knowledge. (shrink)

This paper attempts to analyze the performance of 57 memberstates of the Organization of Islamic Cooperation based on selectedindicators of some sectors namely demography, economics, educationand technology and innovation. Specifically, it aims at firstly portraying anoverview of OIC performance based on six selected indicators followed byanalyzing the relationship between selected development variables withliteracy and exploring the state of OIC performance as indicated by theirachievement based on selected indicators. The study was undertaken vis-àvisthe prevailing theories on modernization and development as well (...) as thewidely asserted underdevelopment of the contemporary Muslim ummah asclaimed by numerous contemporary Muslim scholars. The data were solicitedamong others from the World Bank Database, Statistical, Economic, and SocialResearch and Training, Centre of Islamic Countries of OIC andsome previous studies. They were then analyzed using SPSS with the resultsbeing generated mainly through the use of descriptive statistics. Among others,the study found that there is a positive correlation between Muslim countries’urban population growth and literacy rate, there is a steady decline in thenumber of OIC countries as they are categorized from lower to higher incomecategory placement and the percentage of the scientific publications of all 57OIC countries is far below that of any one single developed nation. (shrink)

Rationale, aims and objectives Given the increasing prevalence of cataract and demand for cataract extraction surgery, patients must often wait to undergo this procedure. We validated a previously developed priority scoring system in terms of clinical variables, pre-intervention health status, appropriateness of surgery and gain in visual acuity (VA) and health-related quality of life (HRQoL).Methods Explicit prioritization criteria for cataract extraction created by a variation of the Research and Development (RAND) and University of California Los Angeles appropriateness methodology were retrospectively (...) applied to a prospective cohort of 5257 patients on waiting lists to undergo cataract by phacoemulsification at 17 hospitals in Spain. Demographic data, clinical data and data related to surgical technique were collected by trained ophthalmologists. Patients were evaluated by their ophthalmologist before the intervention and 6 weeks afterward. They also completed, by mail, the Visual Function Index (VF-14) before the intervention and 3 months afterward.Results High-priority patients experienced greater improvement in VA and HRQoL than those classified as intermediate or low-priority (P < 0.0001), even after adjusting by VA and the VF-14 score at baseline. The time to intervention was the same for high-priority patients as it was for intermediate and low-priority patients.Conclusions The priority score we developed identified patients most likely to experience the greatest improvements from cataract extraction. Use of this tool could provide a fairer and more rational way to prioritize patients for cataract extraction. (shrink)

Increasingly, clinical research is evaluated on the quality of its statistical analysis. Traditionally, statistical analyses in clinical research have been carried out from a ‘frequentist’ perspective. The presence of an alternative paradigm – the Bayesian paradigm – has been relatively unknown in clinical research until recently. There is currently a growing interest in the use of Bayesian statistics in health care research. This is due both to a growing realization of the limitations of frequentist methods and to the ability of (...) Bayesian methods explicitly to incorporate prior expert knowledge and belief into the analyses. This is in contrast to frequentist methods, where prior experience and beliefs tend to be incorporated into the analyses in an ad hoc fashion. This paper outlines the frequentist and Bayesian paradigms. Acute myocardial infarction mortality data are then analysed from both a Bayesian and a frequentist perspective. In some analyses, the two methods are seen to produce comparable results; in others, they produce different results. It is noted that in this example, there are clinically relevant questions that are more easily addressed from a Bayesian perspective. Finally, areas in clinical research where Bayesian ideas are increasingly common are highlighted. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics committee review, the identification of research participants, obtaining informed consent, the (...) role of gatekeepers in protecting cluster interests, the assessment of benefits and harms, and the protection of vulnerable participants. (shrink)

Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct, and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics committee review, the identification of research participants, obtaining informed consent, the (...) role of gatekeepers in protecting cluster interests, the assessment of benefits and harms, and the protection of vulnerable participants. (shrink)

The placenta invades the adjacent uterus and controls the maternal immune system, like a cancer invades surrounding organs and suppresses the local immune response. Intriguingly, placental and cancer cells are globally hypomethylated and share an epigenetic phenomenon that is not well understood – they fail to silence repetitive DNA sequences that are silenced in healthy somatic cells. In the placenta, hypomethylation of retrotransposons has facilitated the evolution of new genes essential for placental function. In cancer, hypomethylation is thought to contribute (...) to activation of oncogenes, genomic instability, and retrotransposon unsilencing; the latter, we postulate, is possibly the most important consequence. Activation of placental retrotransposon-derived genes in cancer underpins our hypothesis that hypomethylation of these genes drives cancer cell invasion. This alludes to an interesting paradox, that while placental retrotransposon-derived genes are essential for promoting early hominid life, the same genes promote disease-susceptibility and death through cancer. Placental and cancer cells fail to silence retrotransposons that are normally silenced in healthy tissues. This has created new genes that are essential for placental function, yet they are also expressed in cancer. We hypothesize that active retrotransposons are a double-edged sword, contributing both adaptive and deleterious functions to biology. (shrink)

The extended neoteric ranked set sampling plan proposed by Taconeli and Cabral has proven to outperform many one stages and two stages ranked set sampling plans when estimating the mean and the variance for different populations. Therefore, in this paper, the likelihood function based on ENRSS is proposed and used for estimation of the parameters of the inverted Nadarajah–Haghighi distribution. An extensive Monte Carlo simulation study is conducted to assess the performance of the proposed likelihood function, and the efficiency of (...) the estimated parameters based on ENRSS is compared with the well-known ranked set sampling plan and some of its modifications. These modifications include the extended ranked set sampling plan and the neoteric ranked set sampling plan. The results as foreseeable were very satisfactory and gave similar results to Taconeli and Cabral’s 2019 results. (shrink)

PurposeThe main purpose of this study is to assess the effects of COVID-19 on the restaurant businesses of Bangladesh. It examines the socio-economic impacts of the humanitarian disaster of the COVID-19 pandemic from the perspective of restaurant owners. The study also intends to provide recommendations to mitigate effects on the restaurant business.Design/Methodology/ApproachA qualitative research approach was adopted to explore the effects of the COVID-19 pandemic on the restaurant businesses of Bangladesh. A total of 22 in-depth interviews were conducted with the (...) top-ranked restaurant owners in the Rajshahi City Corporation area of Bangladesh. Thematic analysis technique was applied for analyzing the collected data.FindingsThe study found that the restaurant owners were compelled to reduce their number of employees, and forced to ensure social distancing and proper sanitization which increased the expenses. Although online orders and home delivery services have increased significantly, restaurant business operation is gradually turning critical owing to the lack of financial support. Thus, restaurant owners urge the govenrment for financial assistance.Research Limitations/ImplicationsSince this research only focused on one city in Bangladesh, the outcomes of study may have a dearth of generalizability. Hence, the investigators are encouraged to extend the study area.Practical ImplicationsThis study will help restaurant owners and policymakers in formulating contemporary business policies and strategies. Thus, it will be supportive of improving the present condition of the restaurant businesses in developing countries like Bangladesh.Originality/ValueThis paper identified the truculent scenario of the restaurant business during the COVID-19 pandemic. (shrink)