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Safety and efficacy of dexmedetomidine in interventional chest procedures: A systematic review
No full textBackground: Interventional chest procedures, including medical thoracoscopy (MT) and video-assisted thoracoscopic surgery (VATS), are integral to diagnosing and treating thoracic conditions. Dexmedetomidine is increasingly used for sedation in these procedures due to its favorable pharmacological profile, yet its comparative efficacy and safety remain inadequately defined. This systematic review aims to comprehensively summarize the available evidence on the efficacy and safety of dexmedetomidine for sedation during MT and VATS. Methods: Following PRISMA guidelines, we searched 4 electronic databases (PubMed, Web of Science, Cochrane Library, Scopus) for studies published until August 2024. We included randomized controlled trials (RCTs) and observational studies that assessed dexmedetomidine in patients undergoing MT or VATS. Outcomes measured included pain scores, postoperative complications, and lengths of hospital or care unit stay. Results: Seven studies (six RCTs and one prospective cohort study) involving a total of 442 patients were included. Dexmedetomidine demonstrated enhanced analgesic efficacy in comparison to midazolam across multiple investigations. Although dexmedetomidine has shown promise in reducing intensive care unit durations in certain studies, its influence on overall hospital length of stay exhibited variability. Adverse events were largely comparable between the 2 sedatives, although instances of hypotension were noted more frequently with dexmedetomidine in some comparisons. Conclusion: Ultimately, dexmedetomidine has emerged as a reliable sedative option for thoracoscopic interventions, providing efficient pain relief while maintaining stable respiratory parameters. Nonetheless, its cardiovascular ramifications warrant vigilant oversight. This review highlights the imperative for additional standardized research to validate these outcomes and inform evidence-based sedation protocols
Becoming fathers, becoming caregivers: A qualitative exploration of intersectional influences shaping caregiving in an urban poor South Indian setting
No full textBackground Caregiver engagement is crucial for early child development; however, research on paternal involvement remains limited, particularly in urban settings of the Global South. This exploratory study aimed to understand how fathers’ lived experiences and aspirations, along with systemic inequities, shape their parenting practices in urban poor settings in Bangalore, South India. Methods Ten fathers of children aged 4–6 years from low socio-economic backgrounds in the MAASTHI birth cohort were purposively selected for in-depth interviews, conducted using a pre-tested topic guide in Hindi and Kannada. All interviews were transcribed, translated, and analysed using a thematic analysis approach. Results Fathers prioritized their children’s education and safety, often viewing financial provision as their primary role due to ingrained gender norms and economic hardship. Most worked long hours in informal employment, thereby limiting their participation in daily caregiving, which was typically handled by their mothers. Fathers’ own childhood experiences influenced their parenting, with those who experienced adversity often aiming to break intergenerational cycles by being more emotionally present and supportive. While structural barriers limited involvement, many fathers expressed a strong desire to be more engaged, thereby challenging traditional roles. Safety concerns in their neighbourhoods further shaped protective parenting practices. Despite these constraints, some fathers reported that they preferred spending time with their families and participated in co-parenting through shared decision-making and engaging in play. Conclusion This study highlights the intersectionality between gender, socio-economic status, and intergenerational adversity in shaping fathering practices. To promote inclusive caregiving, early childhood programmes must actively include fathers and address both individual and structural barriers that constrain their involvement.This study is funded by the DBT/ Wellcome Trust India Alliance Team Science Grant [Grant No. IA/TSG/20/1/600023] to GRB, PNS. PNS was also supported by the DBT/ Wellcome Trust India Alliance CRC Grant [Grant IA/CRC/20/1/600007]
Constitutional Control over the Negative Deviation from the Legislative Purpose: A Study on Egyptian Constitutional Court Rulings and Qatari Legislation Models
No full textيهدف البحث إلى معالجة مسألة مهمّة تتعلق بالرقابة الدستورية على عيب الانحراف التشريعي الغائي السلبي، سواء أكان في صورة الإغفال التشريعي أم التسلب من الاختصاص.
وتتجلى أهمية البحث في حداثة فكرة الرقابة الدستورية على الانحراف الغائي السلبي؛ إذ تثور المشكلة حينما يَصدر التشريع مُغفلًا بعض الجوانب التي يترتب على إغفالها إهدارٌ لغاياتٍ تطلّب الدستور تحقيقها، أو عندما يتنازل المشرع عن اختصاصه بالتشريع لسلطة أخرى، فتُهدر الغايات الدستورية من إسناد تنظيم هذا الموضوع إليه، وفي كلتا الصورتين تأتي الرقابة الدستورية على الانحراف الغائي السلبي لمعالجة هذه المسألة.
اعتمد البحث المنهج الاستقرائي الاستنباطي التحليلي المقارن؛ فعرض للعديد من أحكام القضاء الدستوري في مصر ثم استنبط المبادئ التي انتهى إليها في هذا الشأن، كما تفحّص العديد من نماذج التشريع القطري التي يُشتبه بوقوعها في الانحراف الغائي السلبي، واستعان بالآراء الفقهية لوضع تعريفات واضحة لصور هذا العيب.
خلص البحث إلى أن المحكمة العليا في مصر لم ترفض الرقابة الدستورية على الإغفال التشريعي، وأنها باشرت بالفعل اختصاصها بالرقابة الدستورية على الانحراف الغائي السلبي في العديد من أحكامها، وبيّن البحث نماذج في التشريع القطري تستدعي تدخلًا من المشرع لتفادي ما شابها من تفريط بالغايات الدستورية.This research is taken from a doctoral dissertation entitled "Constitutional control of the Purpose of Legislation: An Analytical Study between Egypt and Qatar." It addresses the issue of constitutional control over the defect of negative teleological deviation, whether in the form of legislative omission or in the form of evasion of jurisdiction.
The problem arises when legislation is issued neglecting some aspects whose omission would result in wasting the goals that the constitution requires to be achieved, or when the legislator relinquishes his jurisdiction to legislate to another authority, neglecting the constitutional goals of entrusting the regulation of this subject to him. In both cases, constitutional control over negative teleological deviation comes to address this. matter.
The research reviewed many rulings of the constitutional judiciary in Egypt and then deduced the principles it reached in this regard. It also examined many models of Qatari legislation that are suspected of falling into negative teleological deviation. The study concluded with several results, the most important of which are: that the Supreme Court in Egypt did not reject censorship. Constitutionalism on the legislative omission, and the Supreme Constitutional Court has already exercised its jurisdiction to constitutionally monitor the negative teleological deviation in many of its rulings. The research showed examples in Qatari legislation that require intervention by the legislator to avoid neglect of constitutional goals
The role of foreign directors in shaping corporate dividend policies in emerging markets: an empirical application of modified Kanter's framework
No full textPurpose: This study investigates the implications of corporate board international diversity by exploring how foreign directors influence corporate dividend policies in the emerging economies of the Gulf Cooperation Council (GCC) region. Design/methodology/approach: This study analyses nonfinancial firms in the GCC region from 2010 to 2020. It uses various dividend policy proxies and measures of international board diversity using the modified Kanter's framework. The modified Kanter framework categorises boards based on the proportion of foreign directors into uniform, skewed, tilted and balanced. The study deploys a wide range of estimation methods, including pooled, random effect, generalised least squares (GLS), generalised method of moments (GMM), two-stage least squares (2SLS), logit and probit regression, to analyse the data while controlling for relevant firm-specific characteristics. Findings: GCC firms exhibit a low representation of foreign directors in their boardrooms. Those firms with foreign directors experience an average dividend payout ratio of 54% higher than those without foreign directors. Likewise, foreign directors enhance the dividend policy for firms in the GCC countries. Besides, the analysis based on the modified Kanter's framework evidence that both the skewed and tilted boards, which have moderate-level foreign directors, have distinctly positive impacts on the degrees of dividend payouts, thus underlining those the efficient dividend decisions, depending on the boards, require a balance in the international diversity. Research limitations/implications: The findings provide valuable insights to policymakers and investors. They highlight the need for governance reform to improve the international diversity of corporate boards in GCC firms. Likewise, investors in the GCC region should rely on such specific governance attributes (i.e. international diversity) to build their prospects regarding corporate dividend policies. Practical implications: GCC firms should organise their boards to include international directors to increase supervision, reduce agency expenses and strengthen external links. Second, GCC firms should foster a welcoming culture to capitalize on foreign experience and implement additional corporate governance measures. Third, policymakers should establish regulations to ensure the presence of foreign directors on corporate boards. This may reduce agency costs and eventually boost investor trust. Finally, as board members become more acquainted with one another, the beneficial implications of optimization for board international diversity grow. This parallels their thinking and decision-making, contributing to developing more sustainable dividend programmes. Social implications: The findings encourage companies to consider broader cultural backgrounds in leadership, which can drive more inclusive and socially responsible policies. This approach promotes the integration of global insights into local business practices, supporting economic and social development by aligning corporate strategies with the diverse needs of communities and stakeholders. Originality/value: Apart from developed economies, the current study is the first evidence of how the board of directors' international diversity could affect the GCC countries' corporate dividend policy. In addition, the current study introduces a relatively novel variable - international diversity - instead of commonly examined diversity variables such as gender diversity.Scopu
Convergence of reality and Virtuality: How virtual realism transforms player experience and behavior in virtual reality massively multiplayer Online games
No full textVirtual reality is developing rapidly in the massively multiplayer online game segment. While virtual reality is transforming the player experience, the study of its influence on the loyalty and recommendation behavior of players of massively multiplayer online games and virtual reality is, to our knowledge, unexplored empirically. However, loyalty and recommendation are essential to ensuring sustainable revenues for business models in the video game industry that invest in this disruptive technology. This research proposes that the affordances of virtual reality influence the experience (enjoyment and flow) and, through a mediating effect, player’s loyalty and intention to recommend. We also assume that this process varies depending on the type of environment (realistic vs. not realistic). A multi-group partial least squares structural equation modeling approach (n = 560) highlights that, through its affordances, virtual reality is a driver of value creation. It enhances the player’s enjoyment and flow, increases their satisfaction, and accentuates their loyalty and intention to recommend the game. This process is also more pronounced in the context of a realistic massively multiplayer online game in virtual reality. Our study makes new and interesting theoretical contributions and suggests useful managerial implications for professionals in the massively multiplayer online game sector
معرض لريادة الأعمال بتأسيسي جامعة قطر
No full textنظم قسم اللغة الإنجليزية بالبرنامج التأسيسي في عمادة الدراسات العامة بجامعة قطر بالتعاون مع كلية الإدارة و الإقتصاد ومركز ريادة الأعمال بجامعة قطر وبنك قطر للتنمية معرض ملصقات ريادة الأعمال بالجامعة
Exploring the experiences of residents in managing multiple roles at tertiary care hospitals of Punjab, Pakistan
No full textObjectives: No qualitative studies have explored the multiple roles undertaken by medical residents in Pakistan or the impact these roles have on them. This study explores the experiences of medical residents in managing their multiple roles at tertiary care hospitals in Punjab, Pakistan. Methods: An exploratory qualitative study was conducted from February 2023-2024. Using maximum variation purposive sampling, 12 residents across various specialties from four tertiary care hospitals of Punjab, Pakistan were interviewed after informed consent. The data were transcribed, and thematic analysis was performed. Results: The participants reported being involved in providing clinical services, teaching, management of patient records, logistics, and ward operations alongside their training. These multiple roles had a profound impact on their health, academics, research, and provision of services during the training. They also highlighted some challenges and enablers towards performing these roles and responsibilities, e.g., security issues, patient load, politics, and resources. Conclusion: Postgraduate residents perform multiple roles during their training, which impacts their health, academics, and patient safety. There is a need for professional development of the supervisors and residents to ensure that the training and development are not overshadowed by ancillary responsibilities. A structured training program with clear job descriptions, contracts, orientation, and continuous assessment may help improve the experiences of residents
In vitro and in silico analysis of anticancer activity of terpenoids of Dittrichia viscosa (L.) Greuter essential oil
No full textThere is a continuous global search for new anticancer agents from natural sources. In this study, the
essential oils of Dittrichia viscosa (L.) Greuter leaves (DVEO) were extracted by hydrodistillation and
chemically profiled using GC-MS, identifying 25 compounds, mainly terpenoids. DVEO in vitro cytotoxicity
assays against six human cancer cell lines (MDA-MB-231, A549, MCF7, SKOV3, HepG2,
and HCT116) revealed strong antiproliferative effects (IC50 between 16.2 and 30 μg/mL), with selective
safety against normal neonatal human fibroblasts (HDFn, IC50 42 μg/mL) [1]. Virtual screening
and network pharmacology analysis including ADMET screening, protein-protein interaction analysis,
and molecular docking of the predominant compounds -11-hydroxy-eremophyl-6(7),9(10)-dien-
8-one (30.56% area), 3,7,11-trimethyl-1,6,10-dodecatrien-3-ol (10.87%), and geraniol (17.93%)
- identified MMP9, PTEN, and STAT3 as key targets [2,3]. The lead compound, 11-hydroxy-eremophyl-
6(7),9(10)-dien-8-one, showed a high binding affinity with MMP9 (−7.3 kcal/mol), PTEN (−7.0
kcal/mol), and STAT3 (−6.8 kcal/mol). The strong binding affinity of these compounds with the targets
was confirmed through molecular dynamics simulation and binding free energy calculations
(−36.61 kcal/mol), demonstrating stable binding, structural compactness, and residual fluctuations
upon compound binding [3,4]. Density Functional Theory (DFT) further confirmed the compound’s
electronic stability and reactivity [5]. These findings establish D. viscosa essential oil, particularly its
prevalent terpenoids, as promising candidates for anticancer drug development
Wernicke's Encephalopathy Following 40 Days of Water-Only Fasting: A Case Report.
No full textWernicke's encephalopathy (WE) is an acute neurological disorder that develops due to thiamine (vitamin B1) deficiency. While it is common in chronic alcoholism, WE can also manifest due to other conditions, including extreme fasting. This report presents a unique case of WE occurring after a 40-day water-only fast, emphasizing the importance of recognizing nonalcoholic causes of WE. A 36-year-old male presented with diplopia, gait instability, and confusion following a 40-day water-only fast. Neurological examination revealed bilateral sixth cranial nerve palsy, ataxic gait, and confusion. Magnetic resonance imaging demonstrated bilateral medial thalami and periaqueductal hyperintensities, consistent with WE. He received high-dose intravenous thiamine and electrolyte correction, resulting in substantial improvement. This case underscores the potential occurrence of WE in healthy individuals following extreme fasting. Early identification and treatment with thiamine are essential to prevent irreversible neurological damage. Clinicians should be cautious of WE in at-risk patients without a history of alcohol use.Open Access Fee for the publication of this article was provided by Qatar National Library
Comparative performance of ChatGPT, Gemini, and final-year emergency medicine clerkship students in answering multiple-choice questions: implications for the use of AI in medical education
No full textBackground: The integration of artificial intelligence (AI) into medical education has gained significant attention, particularly with the emergence of advanced language models, such as ChatGPT and Gemini. While these tools show promise for answering multiple-choice questions (MCQs), their efficacy in specialized domains, such as Emergency Medicine (EM) clerkship, remains underexplored. This study aimed to evaluate and compare the accuracy of ChatGPT, Gemini, and final-year EM students when it comes to answering text-only and image-based MCQs, in order to assess AI’s potential for use as a supplementary tool in the field of medical education. Methods: In this proof-of-concept study, a comparative analysis was conducted using 160 MCQs from an EM clerkship curriculum, comprising 62 image-based questions and 98 text-only questions. The performance of the free versions of ChatGPT (4.0) and Gemini (1.5), as well as that of 125 final-year EM students, was assessed. Responses were categorized as “correct”, “incorrect”, or “unanswered”. Statistical analysis was then performed using IBM SPSS Statistics (Version 26.0) to compare accuracy across groups and question types. Results: Significant performance differences were observed across the three groups (χ² = 42.7, p < 0.001). Final-year EM students demonstrated the highest overall accuracy at 79.4%, outperforming both ChatGPT (72.5%) and Gemini (54.4%). Students excelled in text-only MCQs, with an accuracy of 89.8%, and performed robustly on image-based questions (62.9%). ChatGPT showed strong performance on text-only items (83.7%) but had reduced accuracy on image-based questions (54.8%). Gemini performed moderately on text-only questions (73.5%) but struggled significantly with image-based content, achieving only 24.2% accuracy. Pairwise comparisons confirmed that students outperformed both AI models across all formats (p < 0.01), with the widest performance gap observed in image-based questions between students and Gemini (+ 38.7% points). All AI “unable to answer” responses were treated as incorrect for analysis. Conclusion: This proof-of-concept study demonstrates that while AI shows promise as a supplementary educational tool, it cannot yet replace traditional training methods—particularly in domains requiring visual interpretation and clinical reasoning. ChatGPT’ s strong performance on text-based questions highlights its utility, but its limitations in image-based tasks emphasize the need for improvement. Gemini’s lower accuracy further highlights the challenges current AI models face in processing visually complex medical content. Future research should focus on enhancing AI’s multimodal capabilities to improve its applicability in medical education and assessment