Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral (...) NS3/4A protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (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)

The paper uses questionnaire responses provided by a sample of ethical investors to investigate willingness to sacrifice ethical considerations for financial reward. The paper examines the amount of financial reward necessary to cause an ethical investor to accept a switch from good ethical performance to poor ethical performance. Conjoint analysis is used to allow quantification of the utilities derived from different combinations of ethical and financial performance. Ethical investors are shown to vary in their willingness to sacrifice ethical for financial (...) performance, and hence to display more heterogeneity than the all-encompassing ‘ethical’ label implies. Because of the existence of sub-groups of ethical investors with different attitudes towards financial reward, an attempt has been made to associate observable investors’ characteristics with their level of willingness to trade-off morality for cash. One sub-group of investors in particular appears highly resistant to the idea of accepting higher financial return as compensation for poor ethical performance. This unwillingness casts doubt on Jensen and Meckling’s widely reported claim that trade-off behaviour is ubiquitous in all areas of life. (shrink)

1. Matn-i Asās al-iqtibās -- 2. Taʻlīqah.

The experience of newborn screening for Krabbe disease in New York State demonstrates the ethical problems that arise when screening programs are expanded in the absence of true understanding of the diseases involved. In its 5 years of testing and millions of dollars in costs, there have been very few benefits, and the testing has uncovered potential cases of late-onset disease that raise difficult ethical questions in their own right. For these reasons, we argue that Krabbe screening should only be (...) continued as a research project that includes the informed consent of parents to the testing. (shrink)

Recent study of Galileo's surviving manuscript notes on motion has revealed that by 1609 he had developed the major part of his theory of projectile motion. During the period of these theoretical advances Galileo was engaged in important related experimental investigations; this has become clear from the study of folios 114r and 116v of the manuscript on motion. This paper provides an interpretation of a manuscript not previously discussed—folio 81r. The analysis provided indicates that it is evidence of an important (...) early experiment of the series in which Galileo studied the projectile trajectory. The reconstruction of the experiment concerned reveals relationships with the enquiries suggested by folio 114r and 116v and indicates that Galileo examined the form of projectile trajectories with some care. (shrink)

The time taken to react voluntarily to a stimulus is far longer than can be accounted for by ordinary processes of nerve conduction and synaptic delay, and varies unpredictably from trial to trial. Though random, the distribution of reaction times usually follows a relatively simple law, which in turn can be explained by the LATER model, in which a decision signal, representing belief in the existence of the target, rises in response to incoming sensory evidence from an initial value to (...) a criterion level at which action is initiated. But the rate of rise fluctuates randomly from trial, to an extent that cannot be explained by sensory noise at the input. These conclusions, confirmed by recording from neurons in the frontal eye fields, suggest that the randomness of reaction time is due to a deliberate, gratuitous, neural process which confers certain biological advantages as well as having implications for general ideas about the nature of ‘free will'. (shrink)

صدر عن المركز العربي للأبحاث ودراسة السياسات كتاب الكشف والبيان عن أوصاف خصال شرار أهل الزمان الذي ألّفه محمد الحافظ بن حسين الصيداوي النجار وحقّقه مهند مبيضين. ويُعدّ هذا الكتاب من أدب المواعظ والأخلاق والتاريخ، وقد جمع فيه صاحبه ثقافة أدبية ودينية واسعة مكّنته من صوغ النص بلغة محكمة منضبطة، وبطريقة منظمة. يأخذنا المؤلف في كتابه إلى دمشق خلال النصف الأول من القرن الثامن عشر، ويصلنا بها حتى عام 1172هـ (1758م). ويُعدّ كلٌّ من الناس والمدينة مدارَ التأليف في هذا الكتاب (...) الذي يبحث فيه مؤلفه عن المجتمع الأمثل والزمان الخالي من الفساد. لكنّ البحث عن شكل أفضل للمجتمع ليس دافع التأليف الوحيد بالنسبة إلى المؤلف؛ فدمشق تستحق زمانًا أفضل مما كانت عليه في عصره الذي جعل الناس سبب سوئه، وهي عنده الظرف والناس هم المظروف، فإنْ صلح المظروف صلح زمان المدينة؛ لذلك نجده يذكّر بدمشق وفضلها وفضائلها. (shrink)