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Abstract Background Globally, the increased use of cesarean sections has become prevalent in high-income and low and middle-income countries. In Palestine, the rate had risen from 20.3% in 2014 to 25.1% in 2018. We have rates as high as 35.8% in some governmental hospitals and some as low as 15%. This study aimed to understand better why there is a variation in cesarean rates in governmental hospitals that use the same guidelines. Methods A qualitative and quantitative research approach was used. In-depth interviews were conducted with 27 specialists, obstetrics and gynecologists, and midwives in five government hospitals. The hospitals were selected based on the 2017 Annual Health Report reported cesarean section rates. The interview guide was created with the support of specialists and researchers and was piloted. Questions focused mainly on adherence to the obstetric guidelines and barriers to the use, sources of information, training for healthcare providers, the hospital system, and the factors that affect decision-making. Each hospital's delivery records for one month were analyzed to determine the reason for each cesarean section. Results The results indicated that each governmental hospital at the system level had a different policy on cesarean sections. The National Guidelines were found to be interpreted differently among hospitals. One obstetrician-gynecologist decided on a cesarean section at high-rate hospitals, while low-rate hospitals used collective decision-making with empowered midwives. At the professional level, all hospitals urged the importance of a continuous training program to refresh the medical team knowledge, in-house training of new members joining the hospital, and discussion of cases subjective to obstetrician-gynecologists interpretations. Conclusion Several institutional factors were identified to strengthen the implementation of the national obstetric guidelines. For example, encouraging collective decision-making between obstetrician-gynecologists and midwives, promoting the use of a second opinion, and mandatory training.

Abstract Background and Aims Despite the significant milestone of vaccine discovery, the spread of misinformation and pseudoscientific claims has resulted in an increasing number of people refusing vaccination in Syria. In this study, we aimed to explore fears and misconceptions towards COVID‐19 vaccines among the Syrian population. Methods We conducted a nationwide cross‐sectional study between January and May 2022, using a convenience sample of 10,006 participants aged at least 18 years and living in Syria. We administered a validated online/paper questionnaire and conducted face‐to‐face interviews. We used SPSS software (version 26) for statistical analysis, assessing our data using frequency and χ2 tests, with p

Heat‐resistant molds (HRM) pose a significant threat to food industries due to their ability to survive in high temperatures (pasteurization range) and grow in a variety of environments. To understand how inhibiting variables affect HRM growth, this study evaluated the impact of high sugar concentration (50–60°Brix), low pH (3.5–4.5), and temperature (5–15) on the time (tv) to develop detectable colonies (colony diameter = 2 mm) of three HRM strains (Byssochlamys nivea, Byssochlamys fulva, Neosartorya fischeri) isolated from mixed fruit products. The study found that all HRM strains had relatively short periods of time to develop detectable colonies at 50°Brix, while no visible growth was observed at 60°Brix. Byssochlamys nivea was found to be the most susceptible to low temperatures, requiring up to 43 days to develop detectable colonies at 10°C and unable to grow at colder temperatures. The tv varied from 6 to 27 days based on pH and isolates. HRM's resistance to high sugar concentrations and ability to grow in cold environments pose a threat to the microbiological safety of fruit products. The evaluated data were fitted to several statistical distribution models to support further research on the quantitative microbiological risk in processed fruit products. This study provides valuable insights into how inhibiting variables affect HRM growth and can inform efforts to minimize their impact on fruit‐based product quality and safety. [ABSTRACT FROM AUTHOR]

The magnetospheric plasma (hot and thin) and the solar wind plasma (cold and dense) are separated by the Earth's magnetopause, in which plasmas of both origins coexist. Different types of plasma diffusions are found due to this plasma mixing, and kinetic Alfvén solitary waves (KASWs) are one of them. In this work, a theoretical approach is taken to study the fundamental properties of heavy ion acoustic KASWs (HIAKASWs) in a magnetized plasma system whose constituents are nonextensive q-distributed two temperature electrons with dynamical heavy ions. The perturbations of the magnetized collisionless plasma system are investigated using the reductive perturbation technique to deduce the Korteweg–de Vries (K–DV) and modified K–DV (MK–DV) equations to determine the fundamental characteristics of small, but finite amplitude HIAKASWs. The presence of nonextensive electrons, magnetic field, obliquity angle (the angle between the external magnetic field and wave propagation), plasma particle number densities, and the temperature of various plasma species are observed to significantly alter the fundamental properties of HIAKASWs. The findings of our present study may be useful for comprehending the nonlinear wave properties in diverse interstellar plasma environments. [ABSTRACT FROM AUTHOR]

Theocracy is the unification of two authorities, political and religious, and it is better to use theocratic authority; because ((we do great injustice to religion when we attribute to it such an absolute and arbitrary rule that takes people's necks in the name of divine will, as there is no religion among the major heavenly religions that one goes to or adheres to, but rather in every era a group of followers of this religion or that has appeared who resort to interpreting some religious texts and presenting personal efforts and subjective interpretations that enable them to reach power, so they have the reins of affairs, and they use in most cases the most despicable ways: such as intrigues, murder and bribery, attracting people with money or terrorism, hypocrisy and lying to God)) The novelist focused in his narrative works, the sample of the research, on the extremist religious authority where fanaticism prevails and the noose tightens on people, as it is an extremist authority that seeks to achieve its interests by various means, and he portrayed this aspect well in some novels that shed light on a dark era in the country's contemporary history. [ABSTRACT FROM AUTHOR]

The development of renewable sources for energy production has assumed a vital role in recent years, particularly with regard to the preservation of energy supplies and the environment. In this regard, municipal green waste (MGW) can be a potential renewable energy source if it is integrated with emerging technology, like pyrolysis. Therefore, this study aimed at investigating the effect of residence time and particle size on the yield and composition of oil derived from MGW using fast pyrolysis in an auger reactor. The residence time and particle size were varied from 1 min to 4 min and 1 mm to 10 mm, respectively, while keeping the temperature constant at 500 °C. At a residence time of 3 min, a 2 mm particle size provided the highest bio-oil yield (39.86%). At this experimental setting, biochar yield of 27.16% and syngas yield of 32.98% were obtained. The characterization of produced bio-oil revealed that a total of nine functional groups were present in the bio-oil. The phenols were highest in amount, followed by aromatics and ketones. The increase in residence time decreased the amount of acidic compounds present in the bio-oil. The water content was decreased by ~11% and the calorific value was increased by ~6% with the increase in particle size from 1 mm to 10 mm. Other properties, such as viscosity, density, cetane number, and flash point, did not change significantly with the change in experimental conditions. With a calorific value of 25+ MJ/kg, although the bio-oil produced from MGW can be used for heating (such as in boilers and furnaces), the use of MGW bio-oil in engines requires appropriate upgrading through procedures like hydrodeoxygenation, catalytic cracking, esterification, etc. [ABSTRACT FROM AUTHOR]