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The emergence of fintech services in the insurance industry has been a transformative force, reshaping how insurance companies operate, how policies are sold, and how customers interact with their insurers. Financial technology developments, also known as ''fintech,'' are changing how financial services are offered, presenting novel possibilities for the insurance industry worldwide. However, in the Malaysian insurance and takaful industry a good number of customers are still dependent on conventional channels like agents and brokers continue to be important sources for purchases and payments related to insurance instead of using Fintech services. The insurance industry's success and growth are highly dependent on adopting technological services offered by companies to make the process efficient and profitable. So, this study aimed to empirically identify the determinants influencing Malaysia's insurance and takaful industry customers to accept the fintech services for insurance-related transactions and activities. The research combined two prominent technology adoption models UTAUT2, and Delone and Mclean IS Success, and proposed a new research framework. The data for the research has been collected from the insurance and takaful industry customers through Google Forms. Finally, 350 responses were received. The PLS-SEM method was utilized to investigate the data by Smart PLS 3.2.9 software. The result of the study revealed that effort expectancy, information quality, service quality, system quality, and perceived risk impact behavioral intention to use fintech services (BI). In addition, the actual use of fintech services is impacted by behavioral intention. Nevertheless, no impact was found in the case of performance expectancy and social influence on BI. The findings of the study are helpful for academicians, researchers, and insurance companies to explore determinants for fintech services acceptance.

This research investigated the influence of water-absorbent polymer balls (WAPB) on reinforced concrete beams’ structural behavior experimentally. Four self-compacted reinforced concrete beams of identical geometric layouts 150 mm × 200 mm × 1,500 mm, reinforcement details, and compressive strength fc′{f}_{\text{c}}^{^{\prime} } ≈ 50 MPa were castellated. Each beam contained a volume percentage of WAPB that differed from the others, and the considered percentages were V b = 0, 1, 2, and 3%. A static test under two-point loads was adopted to evaluate the structural behavior of the tested beams. The results indicated that the maximum load capacity of the tested beams was increased by 2.0, 3.0, and 7.14% for the volume percentages of 1, 2, and 3%, respectively, as compared to the reference beam (V b = 0%). It was also observed that the impact of V b = 3% was higher than that of the other percentages. For all the tested beams, the mode of failure was a flexural failure that is compatible with the considered preliminary design. The results showed that increasing the percentage of polymer to 3% had a significant effect on the deflection, as the deflection was directly proportioned to the percentage of WAPB.

Heshu Sulaiman Rahman,1,2 Darya Saeed Abdulateef,1 Narmin Hamaamin Hussen,3 Aso Faiq Salih,4 Hemn Hassan Othman,5 Trifa Mahmood Abdulla,1 Shirwan Hama Salih Omer,1 Talar Hamaali Mohammed,1 Mohammed Omar Mohammed,6 Masrur Sleman Aziz,7 Rasedee Abdullah8 1Department of Physiology, College of Medicine, University of Sulaimani, Sulaimaniyah, Republic of Iraq; 2Department of Medical Laboratory Sciences, Komar University of Science and Technology, Sulaimaniyah, Republic of Iraq; 3Department of Pharmacognosy and Pharmaceutical Chemistry, College of Pharmacy, University of Sulaimani, Sulaimaniyah, Republic of Iraq; 4Department of Pediatrics, College of Medicine, University of Sulaimani, Sulaimaniyah, Republic of Iraq; 5Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Sulaimaniyah, Republic of Iraq; 6Department of Medicine, College of Medicine, University of Sulaimani, Sulaimaniyah, Republic of Iraq; 7Department of Biology, College of Education, Salahaddin University, Erbil, Republic of Iraq; 8Faculty of Veterinary Medicine, Universiti Putra Malaysia, UPM, Serdang, Selangor, 43400, MalaysiaCorrespondence: Heshu Sulaiman RahmanDepartment of Physiology, College of Medicine, University of Sulaimani, Sulaimaniyah, 46001, Republic of IraqTel +964 7726159598Email heshu.rhaman@univsul.edu.iqAso Faiq SalihDepartment of Pediatrics, College of Medicine, University of Sulaimani, Sulaimaniyah, Republic of IraqEmail aso.salih@univsul.edu.iqAbstract: Over the last few decades, there have been several global outbreaks of severe respiratory infections. The causes of these outbreaks were coronaviruses that had infected birds, mammals and humans. The outbreaks predominantly caused respiratory tract and gastrointestinal tract symptoms and other mild to very severe clinical signs. The current coronavirus disease-2019 (COVID-19) outbreak, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a rapidly spreading illness affecting millions of people worldwide. Among the countries most affected by the disease are the United States of America (USA), India, Brazil, and Russia, with France recording the highest infection, morbidity, and mortality rates. Since early January 2021, thousands of articles have been published on COVID-19. Most of these articles were consistent with the reports on the mode of transmission, spread, duration, and severity of the sickness. Thus, this review comprehensively discusses the most critical aspects of COVID-19, including etiology, epidemiology, pathogenesis, clinical signs, transmission, pathological changes, diagnosis, treatment, prevention and control, and vaccination.Keywords: recent advancements, COVID-19, pandemic infection, global outbreak, a comprehensive review

Financial technology (FinTech) is leading a worldwide revolution to increase financial access. Bangladesh’s financial sector is entering a new era of innovation due to the country’s rapid embrace of financial technology. Mobile FinTech service (MFS) providers achieve unattainable economic peaks every year. The growth of conventional banks’ MFS is significant. However, Islamic banks have a good market share but cannot attract more customers to use the Islamic MFS. This study aimed to determine the factors influencing Islamic bank customers to accept the Islamic MFS. This study utilized a modified UTAUT2 model. Data were collected from 310 Islamic bank customers by using online Google Forms. Structural equation modeling was employed to analyze the data by SMART PLS 3.2.9. The results revealed that social influence, facilitating conditions, price, and perceived credibility have a significant positive effect on Islamic MFS acceptance. However, performance expectancy and effort expectancy showed no impact on Islamic MFS acceptance. This research framework is helpful for academicians and researchers to investigate FinTech acceptance in developing countries. Moreover, the study results are beneficial for MFS providers and FinTech firms.

Introduction: Obstetric complications continue to be the major causes of maternal mortality in low- and middle-income countries. Knowledge of women toward obstetric danger signs is an important part of improving maternal and fetal outcomes. However, the reported level of knowledge on obstetric danger signs is low and inconsistent. Methods: Community-based cross-sectional study design was used. Data were collected from randomly selected 740 pregnant women. A pregnant woman said to have good knowledge of obstetric danger signs if she spontaneously mentioned at least two of the danger signs during each of the three periods (pregnancy, labor/childbirth, and postpartum) and otherwise said to have poor knowledge of obstetric danger signs. Adjusted odds ratio at 95% confidence interval and a value of p < 0.05 were used to identify the predictors. Results: A total of 740 pregnant women participated in the study with the response rate of 97.5%. One hundred twenty-four (16.8%) of the respondents were knowledgeable about obstetric danger signs. According to our study, age range of 20–24 years (adjusted odds ratio = 6, confidence interval: 2.67–17.44) and 25–29 years old (adjusted odds ratio = 2.4, confidence interval: 1.14–5.10); being housewife (adjusted odds ratio = 0.5, confidence interval: 0.28–0.87); monthly income of ⩽1000ETB (adjusted odds ratio = 0.24, confidence interval: 0.12–0.46) and 1001-2500ETB (adjusted odds ratio = 0.24, confidence interval: 0.12–0.47); and primigravida (adjusted odds ratio = 0.09, confidence interval: 0.04–0.18) and primipara (adjusted odds ratio = 0.15, confidence interval: 0.07–0.30) were factors significantly associated with knowledge of obstetric danger signs. Conclusion: Knowledge of obstetric danger signs among pregnant women was low. Maternal age, average monthly income, maternal occupation, parity, and gravidity were factors significantly associated with the knowledge of obstetric danger signs.

People’s acceptance of technological changes has escalated with time. However, the acceptance and adoption of fintech services hiked after the outbreak of the virulent coronavirus. With this breakout, the adoption of mobile fintech services (MFS) increased among general citizens and business sectors around the world, including in developed, emerging, and developing economies. This study aimed to identify the factors that impact the adoption intention of consumers to embrace and enhance the use of mobile fintech services in an emerging market, Bangladesh. A research model was developed to strengthen the objective of this paper. A total of 218 respondents responded to the questionnaire. The study utilized structural equation modeling to analyze the results in SmartPLS software. The results showed significant positive effects of social influence, trust, perceived benefit, and facilitating conditions on the adoption intention towards MFS. Mobile fintech service providers must keep their users’ needs and literacy rates in mind when designing the user interface (UI). Moreover, they should also cater more efficient services to the users and work based on the feedback received. The customers’ satisfaction will ultimately lead to customers conducting more digital transactions and will contribute to the escalation of fintech transactions, resulting in more financial inclusion.

Congestion at terminal gates is a significant issue that many ports are dealing with. The port of Songkhla, which serves as the main seaport in southern Thailand, has been confronted with this issue, together with an increase in the number of trucks over the last five years. This study aims to investigate alternatives for improving service operations at the terminal gate, including gate lane expansion, queueing policy in exit-gate sharing, and work process reorganization. A simulation model was developed to analyze the queueing performance: truck queue length and gate waiting time. Scenarios analysis was performed and compared to the baseline model to investigate the impact of proposed approaches on gate performance. The simulation results confirm that a gate-sharing policy can alleviate congestion at a certain truck arrival rate. The method of reorganizing work processes by separating customs work from gate operations and placing it in a new work station appears most appealing. It produces a significant improvement in congestion, comparable to the performance of the gate lane expansion approach while requiring less investment.

المقدمة والأهداف: تترافق الكثير من الأمراض والمتلازمات مع مظاهر فموية، كما هو الحال في اللمفوما. هدفت هذه الدراسة إلى تقييم المظاهر الفموية لدى مرضى لمفوما هودجكن في مشفى تشرين الجامعي ومقارنتها مع الأفراد الأصحاء. المواد والطرائق: شملت هذه الدراسة عينة تألفت من 460 فرد (230 فرد شخصت إصابتهم بلمفوما هودجكن و230 فرد سليمين تم اعتبارهم كعينة شاهدة)، في الفترة بين آذار 2018 وتموز 2020. تم اختيار المرضى استناداً إلى الموجودات السريرية وشروط الدراسة بعد شرح أهداف الدراسة وإجراءات العمل ثم الحصول على موافقة خطية من جميع المرضى الذين شاركوا في الدراسة. تم دراسة الإصابة بالإنتانات الانتهازية داخل الحفرة الفموية. النتائج: شوهدت الإنتانات الانتهازية بأنواعها البكتيرية والفيروسية والفطرية داخل الحفرة الفموية لدى العينة المصابة بنسبة 38.7%. الاستنتاج: تعتبر الانتانات الانتهازية من التظاهرات الفموية المرافقة للمفوما هودجكن.

BACKGROUND Respiratory syncytial virus (RSV) infection causes considerable illness in older adults. The efficacy and safety of an investigational bivalent RSV prefusion F protein—based (RSVpreF) vaccine in this population are unknown. METHODS In this ongoing, phase 3 trial, we randomly assigned, in a 1:1 ratio, adults (260 years of age) to receive a single intramuscular injection of RSVpreF vaccine at a dose of 120 pg (RSV subgroups A and B, 60 itg each) or placebo. The two primary end points were vaccine efficacy against seasonal RSV-associated lower respiratory tract illness with at least two or at least three signs or symptoms. The secondary end point was vaccine efficacy against RSV-associated acute respiratory illness. RESULTS At the interim analysis (data-cutoff date, July 14, 2022), 34,284 participants had received RSVpreF vaccine (17,215 participants) or placebo (17,069 participants). RSV-associated lower respiratory tract illness with at least two signs or symptoms occurred in 11 participants in the vaccine group (1.19 cases per 1000 person-years of observation) and 33 participants in the placebo group (3.58 cases per 1000 person-years of observation) (vaccine efficacy, 66.7%; 96.66% confidence interval [CI], 28.8 to 85.8); 2 cases (0.22 cases per 1000 person-years of observation) and 14 cases (1.52 cases per 1000 person-years of observation), respectively, occurred with at least three signs or symptoms (vaccine efficacy, 85.7%; 96.66% CI, 32.0 to 98.7). RSV-associated acute respiratory illness occurred in 22 participants in the vaccine group (2.38 cases per 1000 person-years of observation) and 58 partici-pants in the placebo group (6.30 cases per 1000 person-years of observation) (vac-cine efficacy, 62.1%; 95% CI, 37.1 to 77.9). The incidence of local reactions was higher with vaccine (12%) than with placebo (7%); the incidences of systemic events were similar (27% and 26%, respectively). Similar rates of adverse events through 1 month after injection were reported (vaccine, 9.0%; placebo, 8.5%), with 1.4% and 1.0%, respectively, considered by the investigators to be injection-related. Severe or life-threatening adverse events were reported in 0.5% of vaccine recipients and 0.4% of placebo recipients. Serious adverse events were reported in 2.3% of participants in each group through the data-cutoff date. CONCLUSIONS RSVpreF vaccine prevented RSV-associated lower respiratory tract illness and RSV-associated acute respiratory illness in adults (260 years of age), without evident safety concerns. (Funded by Pfizer; RENOIRClinicalTrials.gov number, NCT05035212; EudraCT number, 2021-003693-31.) [ABSTRACT FROM AUTHOR]

Importance: Fostamatinib, a spleen tyrosine kinase inhibitor, has been reported to improve outcomes of COVID-19., Objective: To evaluate the efficacy and safety of fostamatinib in adults hospitalized with COVID-19 and hypoxemia., Design, Setting, and Participants: This multicenter, phase 3, placebo-controlled, double-blinded randomized clinical trial was conducted at 41 US sites and 21 international sites between November 17, 2021, and September 27, 2023; the last follow-up visit was December 31, 2023. Participants were adults aged 18 years or older hospitalized with acute SARS-CoV-2 infection and hypoxemia. Data were analyzed between January 10 and March 8, 2024., Interventions: Fostamatinib, 150 mg orally twice daily for 14 days, or placebo., Main Outcomes and Measures: The primary outcome was oxygen-free days, an ordinal outcome classifying a participant's status at day 28 based on mortality and duration of supplemental oxygen use. An adjusted odds ratio (AOR) greater than 1.0 was considered to indicate superiority of fostamatinib over placebo. A key secondary outcome was 28-day all-cause mortality. Safety outcomes included elevated transaminase values, neutropenia, and hypertension., Results: Of the 400 participants randomized (median age, 67 years [IQR, 58-76 years]; 210 [52.5%] men), 199 received fostamatinib and 201 received placebo. The mean (SD) number of oxygen-free days was 13.4 (12.4) in the fostamatinib group and 14.2 (12.1) in the placebo group (unadjusted mean difference, -1.26 days [95% CI, -3.52 to 1.00 days]; AOR, 0.82 [95% credible interval (CrI), 0.58-1.17]). Mortality at 28 days occurred in 22 of 195 patients (11.3%) in the fostamatinib group and 16 of 197 (8.1%) in the placebo group (AOR, 1.44; 95% CrI, 0.72-2.90). Aspartate aminotransferase elevation occurred more commonly in the fostamatinib group (23 [11.6%]) than in the placebo group (11 [5.5%]; AOR, 2.28; 95% CrI, 1.07-4.84). Other safety outcomes were similar between groups., Conclusions and Relevance: In this randomized clinical trial of adults hospitalized with COVID-19 and hypoxemia, fostamatinib did not increase the number of oxygen-free days compared with placebo. These results do not support the hypothesis that fostamatinib improves outcomes among adults hospitalized with hypoxemia during the Omicron era., Trial Registration: ClinicalTrials.gov Identifier: NCT04924660.

Background: In low- and middle-income nations, a significant proportion of maternal and infant deaths are caused by a short birth interval (SBI). In Ethiopia, it is the main factor contributing to maternal and infant mortality. Understanding the spatial distribution of SBIs, i.e., birth intervals of less than 33 months, and the factors that influence them is important for categorizing and promoting targeted interventions. This study used a geographically weighted regression model to evaluate the factors associated with SBIs in hot areas of Ethiopia., Methods: The 2019 Ethiopian Mini Demographic and Health Survey, which is nationally representative, provided the data for this study. The first step in the two-stage cluster design used to collect the data was enumeration areas, and the second stage was households. The survey was conducted between 21 March 2019 and 28 June 2019. A hot spot analysis (local Getis-Ord Gi* statistics) was initially used to investigate spatial variation in SBIs. Geographically weighted regression was used to examine the regional variation in the relationship between SBIs and the factors that cause them., Result: The study indicated that the overall proportion of SBIs among women in Ethiopia was 43.2%. The values for Global Moran's I (Moran's I  = 0.773 and p  < 0.001) showed the presence of significant SBIs clustering in Ethiopian administrative zones in Ethiopia. High-risk areas of the SBIs include Jarar, Doolo, Shabelle, Afder, Liben, Korahe, Nogob, West Harerge, Guji, Sidama, and Assosa zones., Conclusion: Living in a geographic region with a high proportion of uneducated women, women lacking breastfeeding practices, and followers of Orthodox religions increased the proportion of SBIs. Our full map of hot spots for short birth spacing and the factors that affect them helps in the implementation of precise public health measures for decision-makers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Arega, Mitku, Mohammed Hussen, Mamaru Awoke, Berelie Berehan and Alem.)

Mucormycosis or "black fungus" has been currently observed in India, as a secondary infection in COVID-19 infected patients in the post-COVID-stage. Fungus is an uncommon opportunistic infection that affects people who have a weak immune system. In this study, 158 antifungal phytochemicals were screened using molecular docking against glucoamylase enzyme of Rhizopus oryzae to identify potential inhibitors. The docking scores of the selected phytochemicals were compared with Isomaltotriose as a positive control. Most of the compounds showed lower binding energy values than Isomaltotriose (-6.4 kcal/mol). Computational studies also revealed the strongest binding affinity of the screened phytochemicals was Dioscin (-9.4 kcal/mol). Furthermore, the binding interactions of the top ten potential phytochemicals were elucidated and further analyzed. In-silico ADME and toxicity prediction were also evaluated using SwissADME and admetSAR online servers. Compounds Piscisoflavone C, 8-O-methylaverufin and Punicalagin exhibited positive results with the Lipinski filter and drug-likeness and showed mild to moderate of toxicity. Molecular dynamics (MD) simulation (at 300 K for 100 ns) was also employed to the docked ligand-target complex to explore the stability of ligand-target complex, improve docking results, and analyze the molecular mechanisms of protein-target interactions., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Elsevier B.V. All rights reserved.)