Organ transplantation from living related donors in Bangladesh first began in October 1982, and became commonplace in 1988. Cornea transplantation from posthumous donors began in 1984 and living related liver and bone marrow donor transplantation began in 2010 and 2014 respectively. The Human Organ Transplantation Act officially came into effect in Bangladesh on 13th April 1999, allowing organ donation from both brain-dead and related living donors for transplantation. Before the legislation, religious leaders issued fatwa, or religious rulings, in favor of (...) organ transplantation. The Act was amended by the Parliament on 8th January, 2018 with the changes coming into effect shortly afterwards on 28th January. However, aside from a few posthumous corneal donations, transplantation of vital organs, such as the kidney, liver, heart, pancreas, and other body parts or organs from deceased donors, has remained absent in Bangladesh. The major question addressed in this article is why the transplantation of vital organs from deceased donors is absent in Bangladesh. In addition to the collection of secondary documents, interviews were conducted with senior transplant physicians, patients and their relatives, and the public, to learn about posthumous organ donation for transplantation. Interviews were also conducted with a medical student and two grief counselors to understand the process of counseling the families and obtaining consent to obtain posthumous cornea donations from brain-dead patients. An interview was conducted with a professional anatomist to understand the processes behind body donation for the purposes of medical study and research. Their narrative reveals that transplant physicians may be reticent to declare brain death as the stipulations of the 1999 act were unclear and vague. This study finds that Bangladeshis have strong family ties and experience anxiety around permitting separating body parts of dead relatives for organ donation for transplantation, or donating the dead body for medical study and research purposes. Posthumous organ donation for transplantation is commonly viewed as a wrong deed from a religious point of view. Religious scholars who have been consulted by the government have approved posthumous organ donation for transplantation on the grounds of necessity to save lives even though violating the human body is generally forbidden in Islam. An assessment of the dynamics of biomedicine, religion and culture leads to the conclusion that barriers to posthumous organ donation for transplantation that are perceived to be religious may actually stem from cultural attitudes. The interplay of faith, belief, religion, social norms, rituals and wider cultural attitudes with biomedicine and posthumous organ donation and transplantation is very complex. Although overcoming the barriers to organ donation for transplantation is challenging, initiation of transplantation of vital organs from deceased donors is necessary within Bangladesh. This will ensure improved healthcare outcomes, prevent poor people from being coerced into selling their organs to rich recipients, and protect the solidarity and progeny of Bangladeshi families. (shrink)

Collecting data using an appropriate sampling technique is a challenging task for a researcher to do. The researchers will be unable to collect data from all possible situations, which will preclude them from answering the study’s research questions in their current form. In light of the enormous number and variety of sampling techniques/methods available, the researcher must be knowledgeable about the differences to select the most appropriate sampling technique/method for the specific study under consideration. In this context, this study also (...) looks into the basic concepts in probability sampling, kinds of probability sampling techniques with their advantages and disadvantages. Social science researchers will benefit from this study since it will assist them in choosing the most suitable probability sampling technique for completing their research smoothly and successfully. (shrink)

Background Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales. Methods This study (...) reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation. Results and discussion According to Islamic law, organ donation is an act of _sadaqatul jariyah,_ and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maxim _eethaar_, undermining donors of ‘selfless’ or ‘altruistic’ motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran’s unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran’s unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of ‘buyer and seller’, ensuring the philosophy of ‘donor and recipient’ is maintained. Conclusions Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors’ health and reducing human suffering without legalizing the human organ trade. (shrink)

This article examined the effect of culture and religiosity on perceptions of business ethics among students in a tertiary institution in Malaysia. A structured questionnaire was developed with scenarios on various aspects of business ethics, and self-administered to the students in the business studies program. The results from 767 respondents showed that there were significant differences among the Malays, Chinese, and Indian students on seven scenarios namely selling hazardous products, misleading instructions, selling defective products, padding expense account, taking sick to (...) take a day off, keeping quiet on defective products, and respond to supplier's take good care of clients attitude. There was also an association between culture and religiosity. The MANOVA results also showed that culture and religiosity have an effect on perceptions of business ethics. (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)

Osmanlı şer‘iyye sicillerinin bir kısmı Arapça olarak tutulduğu için söz konusu dile hâkim olamayanlar pek yararlanamamaktadırlar. Arapça kayıtlardan istifade etme ve bunların tercümesi ek bir uzmanlık gerektirir. İstanbul kadı sicilleri dahil birkaç örnek dışında bu alanda pek çalışılmamıştır. Bu makalemizde, Arapça siciller üzerinde çalışacaklar için Bursa B-18 numaralı sicilden nitelikli kayıt örnekleri seçilerek günümüz Türkçesi’ne tercüme edilmiştir. Bunun yanında bir kaydın muhteva açısından hangi konuları içerdiğine de değinilmiştir. Ayrıca sicilde yer alan Arapça methiye ve lakaplar da günümüz Türkçesi’ne çevrilmiştir. Sicillerde, (...) Arapça kayıtlar belli bir kalıp içerisinde tutulduğundan, yapılan tercüme örneklerinin, benzer konularda çalışma yapan araştırmacılara kolaylık sağlayacağı düşünülmektedir. (shrink)

The Human Organ Transplantation Act came into officially force in Bangladesh on April 13, 1999, allowing organ donations from both living and brain-dead donors. The Act was amended by the Parliament on January 8, 2018, with the changes coming into effect shortly afterwards on January 28. The Act was revised to extend a living donor pool from close relatives to include certain other relatives such as grandparents, grandchildren, and first cousins. The Act was also revised to allow individuals to prioritize (...) family members in receiving their organs after their death. The aim of this paper is not to carry out an ethical analysis of the Act as a whole but only to focus on aspects relating to priority access for family members to organs. Despite Islam encouraging Muslims to be sympathetic, and to save the life of any member of humankind, saving the life of a relative through organ donation is even more highly valued. The collective and extended structure of the family impacts on the provisions of the Act that only allows Bangladeshis to legally donate their organs to save the lives of relatives and allows individuals to prioritize family members. Recent progress in the practice of organ transplantation raises a number of ethical dilemmas around the allocation of available organs in the context of organ scarcity. A key purpose of introducing incentive into the system of organ allocation is to increase the number of donations from living relatives and initiation of vital organ donations from brain-dead donors. However, allocation criteria based on a living organ donation incentive system would appear to be unethical because there is no provision in the Act with regard to financial compensation for a distant relative donor’s post-operative care in the absence of healthcare coverage. Receiving organs from a distant relative without giving financial compensation for post-operative care places them in a grave health condition and violates the biomedical principle of non-maleficence. An incentive system around brain-dead donors would appear to be ethical as the amended Act allows individuals to prioritize relatives in receiving their organs after death. This provision is intended to initiate the transplantation of vital organs from brain-dead donors as families might bear the cost of keeping the organs alive for transplantation. Regular reassessment of the impact of the Act is necessary to maximize the donation rate of transplantable organs using ethical means. (shrink)

Bangladesh, a Muslim-majority country, has a national organ donation law that was passed in 1999 and revised in 2018. The law allows living-related and brain-dead donor organ transplantation. There are no legal barriers to these two types of organ donations, but there is no legislation providing necessary costs and incentive measures associated with successful organ transplants. However, many governments across the globe provide different types of incentives for motivating living donors and families of deceased donors. This study assesses the merits (...) and demerits of incentive measures already in use around the world and proposes ethical measures that can promote organ donation in Bangladesh. The primary focus of this paper is to present an ethical analysis of the comparison of incentive measures on organ donation between Bangladesh and the Islamic Republic of Iran as two Muslim countries that operate organ donation for transplantation practices according to Islamic principles. In this paper, I mainly argue that providing a fixed bare minimum financial incentive measure to distantly related living donors and families of deceased donors will encourage Bangladeshis to donate organs in a manner that is ethically justifiable, morally permissible, and socio-economically appropriate. The government of Bangladesh should revise the existing biomedical law to include a provision related to incentive measures and set a strict policy to properly regulate these measures as key stewardship that can ethically promote organ donation for transplantation. (shrink)

Social media is a prominent communication platform. Its active usage permeates all generations and it is imperative that the platform be fully optimized for knowledge transfer and innovation diffusion. However, there are several considerations regarding platform usage, including media affordances. Social media affordances enable users to interact with the world around them through features of modality, agency, interactivity, and navigation. Previous studies have indicated that social media affordances significantly influence user behavior and usage. However, research exploring the effect of social (...) media affordances on knowledge acquisition and the reduction of decision-making complexities is limited. Therefore, focusing on 179 paddy farmers in Malaysia, this study examined the effect of social media affordances on information quality, knowledge acquisition, and complexity reduction regarding innovation adoption decisions using a quantitative approach. This study’s findings reveal that social media affordances have a significant effect on perceived information quality, knowledge acquisition, and complexity reduction. (shrink)

In 1999, the Bangladesh government introduced the Human Organ Transplantation Act allowing organ transplants from both brain-dead and living-related donors. This Act approved organ donation within family networks, which included immediate family members such as parents, adult children, siblings, uncles, aunts, and spouses. Subsequently, in January 2018, the government amended the 1999 Act to include certain distant relatives, such as grandparents, grandchildren, and first cousins, in the donor lists, addressing the scarcity of donors. Nobody, without these relatives, is legally permitted (...) to donate organs for transplantation in Bangladesh. The focus of this study was to investigate who should donate organs for transplantation in Bangladesh. The ethnographic fieldwork revealed that potential donors are not always available to immediate family members, and even when they are, they might be medically unsuitable for transplants. These considerations influenced the government in the revision of the Act. Secondly, the findings of the study suggest maintaining the current family-based regulations for living organ donation in Bangladesh. Furthermore, the study highlighted a potential consequence: amending the regulation to permit donations to unrelated recipients could significantly amplify the issue of organ selling and buying. While Islam advises Muslims to be compassionate towards all humankind, it also encourages Muslims to prioritize saving the lives of family members. This religious belief limits Muslims from donating organs to family members. (shrink)

The present study aims to examine the context of academic dishonesty of research students in a public university setting in Bangladesh. In this regard, the researchers conducted interviews with the concerned authorities of the university, i.e., Chairpersons of the Departments, Deans of the Faculties, Proctor of the University, and Director of Students Guidance and Counselling Cell in order to get an impression about the current practice of academic dishonesty by the students of that university; factors influencing these activities and recommendations (...) to uphold academic integrity among the students. The results showed that though there were several instances of academic integrity violation, negligible actions were taken against them due to the absence of an established policy on academic dishonesty. At the same time, the nonexistence of a course on academic integrity and research ethics in the curriculum is also responsible for this scenario. To mitigate this issue, all the concerned authorities strongly recommended formulating a central policy on academic dishonesty for promoting academic integrity and achieving university ranking success in global competitiveness. (shrink)

The overall objective of the study was to examine the pros and cons of the participatory approach adopted in natural resource management in the ecologically protected areas of the Sundarbans mangrove of Bangladesh. A comparative study was done between the people who are involved and non-involved in this approach. Empirical data was collected through personal interviews with a structured questionnaire. The Gini coefficient was measured first and then embedded with the Lorenz curve to draw a line between perfect equality and (...) inequality vis-a-vis. The study revealed that the co-management built awareness in favor of biodiversity conservation and the efficient use of natural resources. Contradictorily, a segment of different hierarchical committees was involved in destructive activities like poisoning the wetlands for fishing. Therefore, a mixed outcome was found. The findings will help the policymakers in identifying the pitfalls and bottlenecks rooted in co-management. Hence, the study recommends revising the approach to ensure the community’s active participation on an equal basis and take action against them who degrade those resources. Exploring profitable alternative income-generating activities is warranted to narrow down the dependency on the Sundarbans mangrove’s natural resources. In order to address the tragedy of the commons, the study advocates for the unity of all knowledge ranging from science to humanistic scholarship for sound policymaking. (shrink)

The government of Bangladesh approved the human organ transplantation law in 1999 and updated it in 2018. This legislation approved both living‐related donor and posthumous organ transplantation. The law only allows family members to legally donate organs to their relatives. The main focus of this study was to explore how Bangladeshis make donation decisions on familial organs for transplantation. My ethnographic fieldwork with forty participants (physicians and nurses, a healthcare administrator, organ donors, recipients, and their relatives) disclosed that the organ (...) donation decision was family‐based. An assessment of the relationship between religion, culture, and biomedicine leads to the conclusion that deciding on donating organs to relatives is primarily family‐based and is perceived to be steeped in Islamic ethical principles and religious cultural tradition. The family‐based consent and motivation for donor‐recipient pair organ transplantation strengthen an altruistic environment for the family and act as the moral and legal authority that ensures ethical healthcare outcomes for Bangladeshis. (shrink)

This study investigates whether and how the intensity of social distancing from the Coronavirus disease 2019 (COVID-19) pandemic influences the corporate social responsibility (CSR) disclosure index. An empirical examination is carried out based on data from the Shanghai Stock Exchange from 2020 to 2022. CSR disclosure index is measured by the percentage of CSR-related press releases from the total press releases published on a certain day. The intensity of the COVID-19 pandemic is measured by the daily confirmed cases among the (...) population in China. This research uses the two-stage least squares regression model to alleviate the endogeneity issues. Findings reveal a reverse correlation between the intensity of the COVID-19 pandemic and the CSR disclosure. The results are consistent and robust to endogeneity tests and sensitivity analyses. Findings support the stakeholder–agency theory and indicate that Chinese managers tend to satisfy the shareholders' interests rather than those of other broad stakeholders. Moreover, Chinese managers tend to choose short-term survival rather than long-term development in times of social distancing. (shrink)

The continuous development of information communication technology facilitates the conventional grid in transforming into an automated modern system. Internet-of-Things solutions are used along with the evolving services of end-users to the electricity service provider for smart grid applications. In terms of various devices and machine integration, adequate authentication is the key to an accurate source and destination in advanced metering infrastructure (AMI). Various protocols are deployed to lead the identification between two parties, which require high computation time and communicational bit (...) operations for system development. Therefore, Kerberos-based authentication protocols were designed in this study with the assistance of elliptic curve cryptography to manage the mutual authentication between two parties and reduce the time and bit operations. The protocols were evaluated in a widely adopted tool, AVISPA, which builds an understanding of the proposed protocol and ensures mutual authentication without unauthorized knowledge. In addition, upon comparing security and performance assessments to the current schemes, it was found that the protocol in this study required less time and bits to transmit information. Consequently, it effectively provides multiple security features making it suitable for resource constraint smart meters in AMI. (shrink)

It is difficult to identify nature with an exact meaning. Depending on circumstances and perspectives the term “nature” has various meanings ranging from spiritual participatory to mechanistic understanding. Having these complexities and ambiguous connotations the current research tries to investigate into some conceptual understanding of nature regarding traditional ideas and modern scientific views. There will also be an endeavor to see nature from a short historical survey. The paper aims to examine these conceptions in the light of environmental sustainability: which (...) understanding of nature seems better to reform the dominating attitudes of humans toward the natural environment? Being critical of conventional and secular meanings of nature, the current paper proceeds to show how an understanding of a different kind can allow humans to behave with their surroundings. In so doing, the present study wants to shed more lights on natural environment, and to add more knowledge to the present discussions of ecological equilibrium. Philosophy and Progress, Vol#69-70; No#1-2; Jan-Dec 2021 P 173-188. (shrink)

This article is a transcription of a dialogue between Mohammad Abu Sayem and John Cobb that took place on June 24, 2019. The major topic covered in the dialogue is the relationship between Cobb's environmental thought and theology.

Assisted Reproductive Technologies (ARTs) have been practiced in Islamic societies within married couples since their introduction. However, there are divergent views over the issue of third-party donation among Sunni and Shia scholars. This paper illustrates the different perspectives of Shia Muslims surrounding, sperm, egg, and embryo donation and ethical aspects thereof. The study reveals that there are different views regarding sperm, egg, and embryo donation among the Shia religious leaders around the world. Many Shia religious scholars, including the Iranian supreme (...) religious leader Ali Hussein Khamenei allow sperm, egg, and embryo donation with certain conditions. However, the conditions stipulated by Shia religious scholars contradict the ethical and legal practices of sperm, egg, and embryo donation. Regarding sperm and egg donation, they declared that the donor child would inherit from a third-party donor and the commissioning parents would be adoptive parents. Thus, according to them, donor anonymity is impossible. Moreover, the Iranian act on embryo donation did not stipulate the right and responsibilities of the donor child and recipient couples and did not clarify the nature and number of embryos that can be donated and implanted. The paper argues that the lack of laws and guidelines on sperm, egg, and embryo donation raises many ethical problems. Based only on religious rulings, third-party donation has been practiced without foreseeing the well-being and safety of donor children, donors, and recipient couples. (shrink)

The impact of culture and religion on sexual and reproductive health and behavior has been a developing area of study in contemporary time. Therefore, it is crucial for people using reproductive procedures to understand the religious and theological perspectives on issues relating to reproductive health. This paper compares different perspectives of three Abrahamic faiths, i.e., Judaism, Christianity, and Islam on ARTs. Procreation, family formation, and childbirth within the context of marriage have all been advocated by these three major religions of (...) the world. Judaism permits the use of all assisted reproductive technologies when the oocyte and sperm come from the husband and wife, respectively. The different denominations of Christianity have diverse views on reproductive practices. Although the Vatican does not approve of assisted reproduction, Protestant, Anglican, and other religious groups are free to use it. ARTs are acceptable in Sunni Islam, although they can only be carried out if the couples are married. Shia Islam, however, permits third-party donations to married couples under specific restrictions. This comparison reveals that while the three major world religions utilize assisted reproduction in distinct ways, there are also many comparable aspects of each religion. (shrink)

There is a substantial shortage of organs available for transplantation in Bangladesh. This has resulted in the commodification of organs. This study analyzes the religious, cultural, and legal barriers to organ donation in Bangladesh. It is based on the examination of available literature and primary sources i.e. religious decrees and opinions of religious leaders of faith traditions, and the Bangladesh Organ Donation Act, 1999. The literature was retrieved from databases, such as PubMed, BioMed, and Google Scholar using the key words: (...) organ donation in Islam, organ donation in Bangladesh, organ donation and religions. The study found that although many Islamic scholars accept organ donation, both living and cadaveric, under some conditions, some Bangladeshi Muslim clerics oppose donation. They argue that organ retrieval violates the sanctity of the human body and retrieval of organs may harm a living donor or lead to death, and organ donation may encourage the commercialization of body parts. Both commercialization and harming oneself are considered sins. Thus, the divergent views of Muslim clerics are a major barrier to organ donation among the Bangladeshi Muslims. Cultural and social factors also have a negative impact. Most people desire to be buried with their bodies intact. Although the Bangladesh government promulgated the Bangladesh Organ Donation Act, 1999, and amended it in 2018, it restricted donors and recipients to members of the extended family, which also reduced the donor pool. This study argues that the Muslim Orthodox clerics’ stand against organ donation and other cultural and legal issues are the major obstacles to organ donation in Bangladesh. (shrink)

This study examines the role of the principle of Sikh liberalism in promoting communal harmony in today’s world. Communal harmony has been under threat in almost all countries for decades, and bigotry, distrust, and animosity prevail among the followers of diverse faithbased communities. Individuals need to be whole-hearted, liberal in approach, and tolerant toward the followers of other communities to reduce such inconsistencies in our society. The paper explores that the ideology of Sikh liberalism can be a role model for (...) establishing peace in today’s world of communal violence. This work is a sincere effort to deal with several issues, e.g., humanism, tolerance, fraternity, equality, freedom, secularism, religious pluralism, and accessibility to and honor for contrasting opinions, based on the principle of Sikh liberalism, which are the root of Sikh liberalism. The qualitative research evaluates the all-embracing aspects of Sikhism, where the liberal notion of Guru Granth Sahib and the liberal attitudes of the Sikh Gurus, especially Guru Nanak (1469-1539), the founder of Sikhism, have mainly been highlighted. It discovers the role of Sikhism in promoting communal harmony by analyzing the idea of Sikh liberalism. Thus, the study aims to make the states, governments, and the general people aware of their responsibilities and duties towards promoting communal harmony through comprehending the Sikh approaches to liberalism. Philosophy and Progress, Vol#69-70; No#1-2; Jan-Dec 2021 P 189-209. (shrink)

This paper considers the foundation of self-realization and the sense of morality that could justify Arne Naess’s claim ‘Self-realization is morally neutral,’ by focusing on the recent debate among deep ecologists. Self-realization, the ultimate norm of Naess’s ecosophy T, is the realization of the maxim ‘everything is interrelated.’ This norm seems to be based on two basic principles: the diminishing of narrow ego, and the integrity between the human and non-human worlds. The paper argues that the former is an extension (...) of Plato’s idea of self-development or self-mastery while the latter is implicit in Aristotle’s holism. It defends that Self-realization is morally neutral only if the term ‘moral’ is considered in the Kantian sense. However, Naess reluctantly distinguishes between ethics and morality, which makes his approach less credible. The paper concludes that Aristotle’s notion of eudaimonia supports Self-realization to qualify as a virtue. (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)