Interest is one of the main factors motivating an individual's behavior, and its effect in the learning process has been widely confirmed in educational psychology. The purpose of this study was to explore the influence of individual interest, topic interest and situational interest on the user's video click behavior in the online video browsing situation. We constructed an online experiment in which each participant was asked to use questionnaires to assess their responses to video categories, titles, and covers from the video-sharing website, Bilibili. Based on these responses, we obtained individual interests, topic interests, situational interests, and click behavior of the participants toward the videos. Correlation, regression and mediation analyses were conducted to explore the effects and mechanisms of the three interests on click behavior. The results found: (1) individual interest may have a positive but relatively weaker effect on click behavior, and (2) topic interest and situational interest positively predicted click behavior in all categories. The mediation analysis found: (1) in the otomads and fashion categories, the effect of individual interest on click behavior was partially mediated by topic and situational interest, and (2) in the anime, digits, life, dance, music, game, entertainment, and knowledge categories, the effect of individual interest on click behavior was fully mediated by topic interest and situational interest. These results revealed the facilitating effects and different effect modes of individual, topic, and situational interest on click behavior. These findings shed light on the influence mechanism of interests on video click behavior in different video categories and provide new insights into related applications such as recommender. When a user is browsing an online video-sharing platform, how does the information they receive prompt them to click and watch a certain video? This is a valuable question for both researchers and practitioners. In the field of information technology, recommendation algorithms can use the user's past click records as a label to build models to select new videos that are more likely to be clicked by the user Lv, . AlthougAs a psychological term, interest is defined as a motivational variable  all three interests can facilitate the occurrence of click behavior, and (2) the three interests are weighted differently and act in different ways in the click decision. The empirical evidence from these experiments may help us to better understand the cognitive process of online video selection and provide reference to recommendation research from a psychological perspective.n = 236) and 36.8% male subjects (n = 126). The average age was 22 (SD = 2.99), ranging from 18 to 44  are featured in Bilibili. Meanwhile, most of the page is occupied by video titles and video covers, which are matched in pairs and shown together. The video cover is a picture containing some visual elements of the video and the video title is located below the picture, stating the specific topic of the video by text . AccordiTo select the representative videos in the category, the study obtained the required materials from videos with almost 500,000 views within 7 days, which means that the video obtained moderate popularity. In each video category, the earliest six videos that met the criteria were selected as the materials representing the category by randomly refreshing the page, and finally, we obtained 60 videos in total (six for each category). To minimize possible bias while controlling the time cost for a single participant, all the participants were randomly divided into six groups. Each group was randomly assigned one video for each video category during the experiment, which means that the participants in different groups received different experimental materials and the participants in the same group received the same experimental materials.A short questionnaire was adapted from a personal interest scale Ainley, , which wAinley's Topic Interest Scale measures the level of topic interest by using only one item related to the title Ainley, . To measOur questionnaire to evaluate situational interest was similar to the above, consisting of the seven items but asking about specific video covers. Sample items included the following: “Seeing the cover of this video, I am interested in the cover:” and “Seeing the cover of this video, I think the video is interesting:” Also, a mean score was calculated from seven items.The probability of clicking on the video was reported by participants, ranging from 0 (must not click) to 100 (definitely will click).The study was conducted through an online webpage containing all the stimuli and questionnaires and made up of three main stages. Each participant would finish three questionnaires . First, As participants had already read all the titles in the second stage, and a video cover usually contained varying numbers of keywords of the title, we also presented the corresponding video title closely below each cover picture in the third stage. Considering the participant would process both topic-related and situation-related information in this circumstance, the final situational interest score was calculated by subtracting the topic interest score from the original situation interest score.To explore the effects of the different interests on click behavior, correlation analysis was first conducted to illustrate their basic relationship. Regression analysis was then used to determine which interest has a greater impact on click behavior. After that, we constructed a mediation model to further analyze the mechanism of interest's influence on click behavior. All these analyses were conducted by Jamovi 2.2.2.To analyze the relationships between different interests and click probabilities, we first conducted Pearson's correlation analysis on the whole sample, with one individual's response to a video as one case. Then the same analysis was conducted separately in each video category. Taking all samples into consideration, individual interest, topic interest, and situational interest were all significantly correlated with click behavior. In all categories, the relationship between interest and click behavior was consistent with the result of analysis on all samples, and in most categories, the correlation coefficient of the topic interest was higher than the other two interests (see results in t(122) = 2.35, p = 0.02] for male subjects, in the fashion category  for female subjects, and in the whole sample for female subjects , with a lower regression coefficient than the other two interests. The regression coefficients of topic interest and situational interest also varied in different categories.This study utilized the ordinary linear regression method to explore the relationship between different interests and click probability. Different interests were treated as the independent variable, gender of users as the control variable, and click probability as the dependent variable in our analysis. As shown in The results of correlation analysis showed the facilitative effects of all three interests on click behavior, while individual interest was not significant in the linear regression model in many video categories. To further explore how different types of interests affect click behavior in different video categories, we conducted mediation analyses. As one video category contains mass-specific videos, topic interest and situational interest triggered by a specific video may have more direct effects than the individual interest triggered by video categories. In this step, we explored whether topic interest and situational interest mediate the effect of individual interest on click behavior.For all samples, the topic interest partly mediates the effect of individual interest on click behavior which means the direct effect and the indirect effect is significant. Situational interest's mediating effect is not significant in statistics. The mediation analysis results also vary across categories. According to the relationship between individual interest and click behavior, the analysis results can be divided into two main types: partly mediating effect and full mediating effect (see results of each category in In the otomads and fashion categories, the relationship between individual interest and click behavior is partly mediated . More spIn the anime, digits life, dance, music, game, entertainment, and knowledge categories, the relationship between individual interest and click behavior is fully mediated . More spThrough correlation analysis, regression analysis, and mediation analysis, we explored the role of individual interest, topic interest, and situational interest on click behavior in online video browsing situations. For all samples and each category, the results of correlation analysis showed that individual interest, topic interest, and situational interest all had a significant positive relationship with click behavior. All three interests had a facilitative effect on click behavior, which supported our first preliminary hypothesis. This result was also consistent with the previous studies showing the effects of interest on learning (Ainley et al., The mediation analysis further revealed the influence pattern of the three interests on click behavior, and there were mainly two different patterns for different categories of videos.For the otomads and fashion categories, users' interest in the category did have an impact on the possibility of them clicking on the video. Users who follow these categories were more likely to click on videos in these categories, and at least part of that effect was independent of the title and cover of the video. This means that even though the specific content of the video does not really interest the user, there is a certain possibility that the user will click on the video. In these categories, the user's internal needs and knowledge reflected by individual interest played a role in facilitating the further exploration of a video, which was consistent with the role the individual interest played in learning studies (Fransson, For the anime, digits, life, dance, music, game, entertainment, and knowledge categories, the effect of individual interest was fully mediated by topic interest or situational interest, or both. The user's individual interest in these domains did affect the probability of clicking on a video in these categories, but that was essential because the domain interest predicted the interest in a specific video title or a specific video cover in this category. The topic interest and situational interest finally triggered click behavior, which means that for these categories, users might not click on a video if the specific content of the video does not interest them.Considering the results of all analyses together, we found that three types of interest had different predictive power on online video click behavior and revealed how they have an impact on click behavior, which supported the second hypothesis. In most video categories, topic interest plays the most important role in predicting click behavior, which means that the cognitive processing of the video title will greatly affect the occurrence of subsequent exploration behavior (Prestwich et al., Individual interest also has a significant effect on click behavior, which implies that the user's inherent preference and tendency will predict further exploration behavior (Perera and Zimmermann, The differences in the result patterns in different categories also provide us with more knowledge about the specific effects of interest. The results in the otomads category showed that situational interest was more important in predicting click behavior than topic interest. The reason for this phenomenon needs to be investigated from the characteristics of the video in the otomads category. Otomads refers to a kind of adapted video that subverts the classics, deconstructs the tradition, promotes the personality, strengthens the focus, and satirizes the society by dissecting social hot issues and then repeating and re-creating them. The video cover in otomads is often an adaption of the original video material to make it more entertaining. Thus, a prominent feature of the video covers in otomads is the use of richer colors and more exaggerated stickers, which could attract more attention from users. This may explain why situational interest in the otomads category plays a greater role in predicting click behavior.The mediation analysis in the otomads and fashion categories showed that individual interest not only promoted click behavior through situational interest or topic interest but also directly promoted click behavior. Such a direct effect was not found in other categories. This may be because the videos in the otomads and fashion categories are distinctive features that attract fans no matter what the specific video content is. Meanwhile, these features should be quite easy to recognize. Thus, the fans of the two categories could identify the otomads or fashion videos from the title and cover, and their desire to exploration could be aroused just by this fact.The effect of individual interest was mediated by topic interest in all categories but mediated by situational interest only in the otomads and anime categories. This means that individual interest can only have an impact on click behavior through situational interest in these two categories. The reason for this result may be that understanding the video cover content in these two categories requires some prior knowledge, which is not easy to obtain in daily life. The users with high individual interest have more prior knowledge about the content of the categories, so they could understand the video covers more easily. For those with low individual interest and less or no prior knowledge, they cannot fully process the visual elements in those covers.It should also be noted that the difference in the predictive powers of individual interest among categories may be caused by different reasons. One possible reason is that the impact of individual interest on click behavior really is different among categories. Another possible influencing factor is the difference in how a video title and cover reflect the category of the video. Although for most categories the title and cover could obviously show the video category, sometimes the title and cover may reflect the category information less clearly in some categories. When users processed titles and covers of different categories in our experiment, the difference in their capabilities of reflecting their categories may also lead to variations in the predictive power of individual interest. Thus, it is reasonable to be more cautious in understanding the difference in the predictive powers of individual interest among different categories.Today, the information overload prevalent on the internet means it is extremely valuable to get users' attention Renjith, , and cliAs a preliminary study, there are also some limitations that need to be noted. Although we have revealed the influence mechanism of different interests on click behavior, the reasons for the inconsistency of influence patterns in various categories are still unclear. This requires further analysis of the differences among video categories. Different categories of videos may differ in the “focus area” when they were produced (Bopp et al., In conclusion, we found that the theoretical division of interest in educational psychology could also be applicable to online video browsing situations. Individual interest, topic interest, and situational interest can promote click behavior to different degrees when users browse online videos, and topic interest generally has the greatest impact except for the otomads category. Topic and situational interests partially or completely mediated the effect of individual interests on click behavior, and the mediation effect varied among different categories. Our results could provide psychological perspectives of interest and click behavior to the recommendation and other relevant applications in the online social media scenario.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.The studies involving human participants were reviewed and approved by the Institute of Psychology, Chinese Academy of Sciences. The patients/participants provided their written informed consent to participate in this study.NZ contributed to the conception, the design of the study, and the manuscript writing. DL collected the data, performed most of the statistical analysis, and wrote the manuscript with input from all authors. ZT conducted part of the experiment and performed part of the statistical analysis. All authors contributed to the article and approved the submitted version.


A practice guide to help nursing homes set up an antimicrobial stewardship (AMS) program was developed based on experiences gained during a project at one of the largest providers of elderly care in the South-east of the Netherlands. The guideline for the implementation of AMS in Dutch hospitals served as a starting point and were tailored to the unique characteristics of a nursing home setting. This practice guide offers recommendations and practical tools while emphasizing the importance of establishing a multidisciplinary approach to oversee AMS efforts. The recommendations and practical tools address various elements of AMS, including the basic conditions to initiate an AMS program and a comprehensive approach to embed an AMS program. This approach involves educating nurses and caregivers, informing volunteers and residents/their representatives, and the activities of an antibiotic team (A-team). The practice guide also highlights a feasible work process for the A-team. This process aims to achieve a culture of continuous learning and improvement that can enhance the overall quality of antibiotic prescribing rather than making individual adjustments to client prescriptions. Overall, this practice guide aims to help nursing homes establish an AMS program through collaborative efforts between involved physicians, pharmacists, clinical microbiologists, and infection control practitioners. The involved physician plays a crucial role in instilling a sense of urgency and developing a stepwise strategy. Antimicrobial resistance is widely recognized as a crucial concern. Antibiotic use and antimicrobial resistance in long-term care facilities (LTCFs) are substantial due to the significant use of antibiotics . SeveralSince 2015, it has been mandatory for Dutch hospitals to implement an antimicrobial stewardship (AMS) program to enhance the quality of antibiotic use. Consequently, a practice guide was developed to facilitate this process . HoweverTo investigate the implementation of an AMS program that tailors hospital recommendations to NHs, a project was conducted in one of the largest providers of nursing home care in the South‒East region of the Netherlands. The project group comprised the following members: a medical director and an elderly care physician from the provider of nursing home care, a pharmacist responsible for medication supply, a clinical microbiologist from the medical microbiology laboratory providing diagnostics to the organization, an infection control practitioner offering services to the elderly care organization, a representative from a national committee focused on optimizing antibiotic use (Dutch Working Party on Antibiotic Policy (Dutch acronym is SWAB)), representatives from a national institute working on the development and dissemination of information and solutions for medication use, and an administrative support staff member. During the 14-month project, the AMS approach was formulated, and an A-team was established. Antibiotic treatment protocols for the most common infections in nursing home residents were revised at the regional level, including urinary tract infections (UTIs), lower respiratory tract infections (LRTIs) and skin and soft tissue infections (SSTIs). Scorecards for data collection and assessment were developed to evaluate all antibiotic prescriptions in 4 out of 28 nursing homes. A new rule regarding the use of urine dipstick tests was implemented, and it was required that culture be conducted in accordance with the guideline . A standThe nursing home facilities met the international definition for nursing homes: ‘A nursing home is a facility with a domestic-styled environment that provides 24-hour functional support and care for persons who require assistance with activities of daily living (ADLs) and who often have complex health needs and increased vulnerability. Residents within a nursing home may stay relatively brief for respite purposes, short term (rehabilitative), or long term, and may also receive palliative/hospice and end-of-life care’ . MoreoveThe lessons learned from this project have been compiled into recommendations, which are presented in the current practice guide to help NHs set up an AMS program.To establish an AMS program, certain basic conditions must be met. The extent to which these conditions are met contributes to the success of the program.One of the crucial conditions is the commitment of the board of directors. This board needs to have a clear vision of the necessity of an AMS program and be willing to allocate the necessary human and financial resources.Another essential condition is ensuring that the human and financial resources required for an AMS program are both adequate and appropriate for the NH. Consequently, assign this specific task to a physician. The baseline situation determines the amount of resources needed, which may vary depending on factors such as existing contracts between cooperating parties and the ability to embed AMS topics into regular processes and meetings. Consider establishing service agreements in which AMS is an integral part of the services for a clinical microbiologist, a pharmacist, and an infection control practitioner who are not employees of the organization. Additionally, having up-to-date treatment protocols and written guidelines for appropriate antibiotic prescribing are needed to easily generate overviews of antibiotic prescriptions. Furthermore, ensuring that physicians mention the indication for the antibiotic prescription in the prescription system will reduce the time investment required for the program. If NHs already have high compliance rates regarding antibiotic prescribing, implementing the program will require less effort. Changes in microbiology culture policies may have financial implications. Finally, purchasing education materials and adapting them may require substantial financial investment and time investment from healthcare workers.To implement an AMS program, it is crucial to form a project team consisting of professionals with relevant expertise. The team should include, at least, a physician who provides medical care to the residents, a pharmacist who supplies the medication to the NH, and a clinical microbiologist of the medical microbiology laboratory that delivers microbiological diagnostic to the NH and has knowledge on local/regional resistance data. To ensure efficient decision-making and create organisation-wide conditions for the success of an AMS program, it is recommended to appoint a medical director or member of the management team to the project team. If this is not feasible, one of the project team members should be authorized on behalf of the management team to determine the responsibilities of each member of the project team. It is also advisable to appoint a healthcare professional to the project team who is well-versed in the nursing home organisation and has received appropriate training in infection control and antibiotic resistance, such as an infection control practitioner.Overall, a comprehensive approach to embedding an AMS program within a NH creates collaboration with and engagement of relevant stakeholders. It incorporates strategies that support the program’s sustainability and success.The implementation of an aligned AMS and infection control program and bringing both policy topics under the responsibility of one committee  can help achieve the following objectives: (1) Prevent the development of antibiotic resistance through appropriate use of antibiotics, (2) Detect the presence and transmission of (drug-resistant) bacteria, and (3) Prevent transmission of (drug-resistant) bacteria through hygiene and infection control measures.Establishing an A-team comprising a physician, pharmacist, and clinical microbiologist can facilitate the development and revision of antibiotic treatment protocols as well as the monitoring of antibiotic use. It is also advised to examine the feasibility of regional collaborations in certain aspects . It can be highly valuable to add an infection control practitioner to the A-team to coordinate the activities. The A-team’s composition allows for a collaborative approach to optimize antibiotic use and promote appropriate prescribing.To obtain physicians’ support for the AMS program, they must be involved from the start. Utilizing existing meetings, such as PTAMs or staff meetings, can be an effective way to keep colleagues informed about the program’s progress, A-team activities, and antibiotic treatment protocols. The A-team may also use these meetings to discuss issues related to antibiotic choices in treatment protocols, deviations from protocols, or experiences from previous cases, which could result in topics for additional education. Such education can increase physician competence and willingness to adhere to antibiotic treatment protocols.It is recommended to provide education on antibiotic use and antibiotic resistance to nurses and carers for various reasons. These healthcare workers are often the first to recognize signs and symptoms of an infection and serve as the primary contact for residents and their representatives. They play a crucial role in relaying information about residents’ conditions to physicians, who do not see residents every day. In addition, they are responsible for carrying out protocols. For example, protocols depicting the use of infection control measures and measures to reduce the risk of a urinary tract infection (UTI) or (aspiration) pneumonia. Often, they also inform residents/their representatives about antibiotic prescriptions. It is important to discuss the feasibility of different modes of education, such as e-learning, which can reach a large target group with relatively little effort, or group discussion training led by an infection control practitioner. Arrangements should also be made regarding whether healthcare workers will receive training during work or during personal time and whether they will have the opportunity to gain accreditation points.In nursing homes, volunteers play an important role in the provision of care, e.g., supporting individual and group activities, assisting caregivers with practical tasks such as serving coffee and tea, aiding in cooking and serving dishes, and offering social and emotional support to residents. This group should be adequately informed about infection control. Specifically, the provision of information on hand hygiene, appropriate measures to take in the event of signs or symptoms of an infection, and food preparation (cooking and serving) should be considered. It is recommended to use reliable, publicly accessible sources of information for the dissemination of general information on infections and antibiotic resistance.In addition to the fact that residents and their representatives should always be able to consult nurses, carers, or physicians, it is recommended to offer them information through various media such as paper copies (folders/newsletters), audio recordings, and video presentations so that they can absorb the information at their convenience. It is imperative to contact the residents’ council of the nursing home to ascertain their information requirements  and determine the most effective way to convey the information to them. The residents’ council should also support the implementation of an AMS program. Similar to volunteers, it is also recommended for this target group to use reliable, publicly accessible sources of information.It is important to define the activities of an A-team, which is responsible for promoting appropriate antibiotic use.It is important to define the responsibilities and authority of the A-team, which include the following: (1) maintaining treatment protocols up-to-date in accordance with (inter)national guidelines, regional resistance data, and culturing policy, and (2) monitoring compliance with treatment protocols based on predetermined selection criteria. Moreover, the A-team derives its authority from its expertise in the field of antibiotics, making its opinion highly valued. In case of deviations from treatment protocols or the A-team’s opinion, prescribing physicians need to state the reason for the deviation in the residents’ record. It is also important to emphasize that although the A-team plays a crucial role in antibiotic management, the ultimate responsibility for prescribing antibiotics remains of the individual physician.The working process employed in hospitals will usually not be applicable in NHs. Therefore, it is essential to identify a working process that fits within the NH setting. Based on the project we carried out, we recommend a periodic retrospective review of antibiotic prescriptions for discussion in the A-team. Ideally, in an onsite meeting prior to regularly scheduled plenary meetings . This approach enables A-team members to gain insight into the prescribing behaviour of the preceding months and discuss deviations or issues identified during the plenary meeting. This approach aims to achieve a learning effect for the prescription of antibiotics in the future for all residents. As a consequence, sustainable improvement of the overall quality of antibiotic treatments can be achieved.To evaluate the activities of the A-team, the following questions could be posed to fellow physicians: (a) How feasible do you consider the treatment protocols to be? (b) If it comes to UTIs, do you think that the nurses adhere to the policy that dipstick tests may only be used after consultation with the physician? (c) What aspects of the A-team’s work process are you satisfied with? (d) Are there any bottlenecks or areas for improvement in the work process of the A-team? (e) Do you agree with the policy regarding culturing? (f) Did you change your prescribing behaviour of antibiotics?To optimize antibiotic prescriptions in NHs, it is recommended to focus on the most common infections, namely, UTIs, lower respiratory tract infections (LRTIs), and skin- and soft-tissue infections (SSTIs). Selection criteria that could be used to identify prescriptions for discussion in the A-team include: (a) prescriptions lacking an indication in the prescription system; (b) prescriptions lacking a (preliminary) stop date in the prescription system; (c) prescriptions with a duration exceeding 7 days; (d) prescriptions for intramuscular or intravenous antibiotics (if applicable); (e) prescriptions for antibiotics other than the first choice based on the applied treatment protocols; (f) prescriptions for combinations of substances, such as amoxicillin + fluoroquinolone; (g) prescriptions for antibiotics regulated for the treatment of particularly resistant microorganisms; and (h) on request of the prescriber.To determine the time investment required for A-team activities, it is recommended to analyse the volume of prescriptions over a period of one to two months based on the predetermined selection criteria. Priority may be given to one or more of the predetermined selection criteria depending on the results of the analysis. In the prioritization, factors to consider could include (but are not limited to) the severity and frequency of deviations from the treatment protocols, as well as selection criteria where improvement can be achieved quickly and easily.We advise to oblige physicians to note the indication for an antibiotic in the prescription system. Prescription systems always offer a free text field that can be used, but often it is possible to add a required field for this information. Adding the indication makes it easier to analyse prescription data in relation to infection types and treatment protocols and saves time for the A-team. In addition, complete and correct registration of kidney function, contraindications, over-the-counter (OTC) medication, intolerances, etc. is essential for pharmacists to intervene when necessary.To ensure optimal functioning of the A-team, it is recommended to define the tasks of each team member. In addition to the A-team’s responsibility for keeping the treatment protocols up-to-date, the following elaboration provides an example of the tasks assigned to each A-team member in monitoring compliance with treatment protocols. The pharmacist generates summaries of antibiotic prescriptions, including the name of the antibiotic, dosage, and duration, based on predetermined criteria. They also review the prescription for potential side effects, toxicity and interactions with other medications used by the resident. The elderly care physician records relevant data from the resident’s medical record on a registration form see Fig.  and requ*Partly based on the scoring system for the appropriateness of antimicrobial therapy from Willemsen et al. [and adapted to the nursing home setting.n et al.  and adapA summary of the recommendations and their elaboration is included in Table In this practice guide, we present a feasible approach for NHs to implement an AMS program. This approach is rooted in the ‘Practical Guide Antimicrobial Stewardship in the Netherlands’ , which iThis approach can be adapted to local or regional collaborations between NHs, pharmacies, and clinical microbiologists. With the described working process of the A-team, we aim to achieve a learning effect for future antibiotic prescriptions for all residents, thereby enhancing the overall quality of the prescriptions. Moreover, the presence of a peer-review system in which physicians review their colleagues’ prescribing behaviour is expected to encourage greater attention to prescribing practices.The hospital practice guide  publisheIn recent years, several systematic reviews have collectively indicated that the implementation of an AMS program has the potential to optimize antimicrobial use in LTCFs –24. The Another crucial aspect to be noted is that in the USA, it became mandatory by law to integrate AMS into infection control programs in NHs in 2016. A survey conducted in NHs showed that the implementation of all seven core elements increased from 43% to 2016  to 71% iIn general, it is crucial to facilitate NHs in implementing an AMS program. NHs should have the flexibility to choose an approach that aligns with their organizational structure. Our current practice guide offers practical tools for establishing an AMS program, which can be considered separate parts of a toolbox. The local context determines the most effective way to utilize the A-team and implement the AMS program’s tools. The involved physician should play a significant role in creating a sense of urgency, prioritizing program elements, and proposing a step-by-step approach. In the Netherlands, the Dutch Association of Elderly Care Physicians has endorsed the role of elderly care physicians in infection control and antibiotic resistance in its general guideline .Given the lessons learned from our project, we recommend retrospectively reviewing antibiotic prescriptions by the A-team until EMR, pharmacy, and laboratory systems are appropriately configured to enable automatic feedback upon an antibiotic prescription at the individual level of residents. Subsequently, the results of these reviews should be periodically discussed during regular meetings, such as PTAMs. This approach has two limitations. First, this approach precludes the possibility of individual client adjustments. Second, our focus is limited to residents who receive antibiotics, whereas those who do not receive antibiotics, even when it may be indicated, are excluded. Therefore, we recommend conducting repeated prevalence studies on antibiotic use among all residents.In conclusion, the development of tailored AMS programs that are feasible in NHs can be facilitated by collaborative efforts between physicians, pharmacists, clinical microbiologists and infection control practitioners, preferably on a regional level.


This study aimed to assess the perceptions of staff working at the University of Jeddah (UJ) Medical Center on the possibility of finding new financing methods for the administration and privatization of the primary and specialized medical care services it provides. A questionnaire link was sent online targeting all staff at the UJ Medical Center (n = 141). The questionnaire comprised 17 items under the following sections: demographic information, staff perceptions about the current status of the services provided by the UJ Medical Center and the possibility of finding new financing methods and additional sources of revenue for the administration. Of the 101 questionnaires returned, the majority were filled by males . One-third of the participants  have between 5 and 9 years of working experience in Medical Administration, and most of them  reported that they have a background in the concept of revenue development/privatization/self-resources/paid treatment. Most were satisfied with the current status of the services provided (average rating = 3.39/5). However, most participants  reported that the UJ Medical Center is not ready for the Revenue Development Project of privatization. The survey respondents demonstrated satisfaction with the medical services provided by the UJ Medical Center and the potential application of the Revenue Development Project. However, streamlining the privatization process according to the governmental structures is crucial for it to be implemented properly at the UJ Medical Center. The Saudi Arabian public health service has a long and storied history . The firThe Saudi Arabian vision 2030 highlights the role of the private sector as the main engine for social and economic reform. It also emphasizes fostering private sector investment in sectors previously funded by the government ,5,6. It The privatization initiative in the medical healthcare setting in Saudi Arabia presents both challenges and opportunities. According to Alkhamis et al., cost containment is a significant influencer of health restructuring worldwide, and governments, including that of Saudi Arabia, are under pressure to build sustainable health models . Public–There is no doubt that development plans have had major success in creating the infrastructure needed to offer treatment services in Saudi Arabia, and the fields of medical education and training for technical staff in the health profession have seen extraordinary advancement . The impMedical centers are considered one of the most important sectors in universities due to the need to provide healthcare to all students and employees of the university and those who are eligible for treatment ,15. PHC Of note, the privatization of medical services at universities in Saudi Arabia is still in its early stages ,7,8. HowIn line with the privatization of medical services in Saudi Arabia, Wasfaty is an e-prescribing service, and a new digital transformation initiative recently introduced. It aims to transfer pharmaceutical care services from primary healthcare centers to community pharmacies. The MOH implemented this service as part of its measures to facilitate medication dispensing services and reduce costs . MoreoveThe privatization of medical services at universities in Saudi Arabia has several potential benefits ,19,20,21These considerations suggest that funding PHC should be a major priority, particularly considering the evidence that it is essential for improving population health and minimizing medical expenses . HoweverThe research design was a cross-sectional survey of all staff that work at the Medical Center (n = 142), University of Jeddah (UJ), Jeddah, Saudi Arabia.The questionnaire was designed and built through the application of brainstorming sessions and panel discussion among the research team., Its design involved multiple steps drafting, content-focused and data-focused pilots, literature reviews, and careful consideration of outcomes to measure. The questionnaire contained 17 questions comprising items of demographics, education and health specialty, staff perceptions around the current status of the medical services provided by the UJ Medical Center and the privatization of medical services, and their opinions whether the Revenue Development Project (RDP) has been implemented to provide medical services for a fee. The aim was to assess staff satisfaction about the services provided by the medical center and staff perspectives on the ways of generating revenue for the primary and specialized medical care services provided. Item types included open-ended, closed, and 5-point Likert scale questions. Some questionnaire items were formulated so as to allow respondents to express their opinions or experiences in their own words, while other questions offered predefined choices or scales to select from.Before use, the research team reviewed the questionnaire for face and content validity, which included three academic staff at the Colleges of Medicine and Applied Medical Sciences and two healthcare administrative staff.Validity testing was followed by piloting the questionnaire using web-based Microsoft Forms to five staff of UJ Medical Center between April and June 2023, using a non-probability convenient sampling technique . As somePotential participants were approached by personalized invitation using university e-mail. Participants had to be staff at the UJ Medical Center; there were no exclusion criteria. Each potential participant was provided with a study information leaflet, and those who agreed to participate were asked to complete the survey electronically.p-value of less than 0.05 was considered statistically significant.The data was analyzed using the SPSS statistical package . Descriptive statistics, including frequencies, ratios, and rates, were used in the analysis. Pearson’s chi-squared test was also used to study the relationship between variables and to determine any association between the expected improvement in medical services when implementing the Revenue Development Project (the main outcome) and each independent variable. A One hundred and one participants completed the questionnaires giving a response rate of 71% (101/142); the majority were males . One-third were educated with a bachelor’s degree , over one-third possessed an undergraduate diploma degree , less than one-third held an MD or PhD degree , and the rest held a master’s degree . The majority of participants were technicians (n = 42), physicians (n = 28), and health specialists (n = 17). The majority were in the age group between 30 and 39 years , and the minority were in the age group of less than 30 years  .The majority were satisfied with the medical services provided by the Medical Center; their responses were ‘Very Satisfied’  and ‘Satisfied’ , However, for less than one-third, the response was ‘Neutral’ . There was an equal number of responses concerning the possible opportunities for improvement of medical services, where the majority indicated that infrastructure , technical infrastructure , supporting medical services  and health education , and logistics and supply services  were the services that most needed improvement. The other half of their responses indicated that the following aspects needed to be improved: empowerment of employees, training programs, communication, and self-management . Over one-third responded that the organization aspects within the Medical Center  and primary medical care (clinics)  needed improvement .The majority of respondents are familiar with the terms revenue development, privatization, self-resources, paid treatment, and business center , while one-third answered that they had no background on the concept . Less than one-third responded “I am not sure” , and the majority of them work in the technical field .The majority of respondents did not believe that the Medical Center is ready to provide its medical services for a fee  . That maThe responses around the potential services in the Medical Center that will represent sustainable revenue when provided for a fee was of an equal number .The majority responded that implementing the role of virtual clinics for all medical clinics would be a potential revenue source for the Medical Center , together with the use of primary medical services  in joint projects with other sectors . According to the respondents, another promising area for potential revenue was organizing scientific conferences and training courses  and investing in unused space for a fee . On the other hand, over one-third  thought that medical research, scientific papers, and providing scientific consulting services to companies, individuals, and various sectors of society would be a potential benefit for the Medical Center. The majority of respondents believed that the Revenue Development Project would contribute to increasing the income of the employees of the Medical Center and motivating them , and that it would contribute to achieving cash savings to manage medical services and bridge the budget deficit  . The majp = 0.855), educational level (p = 0.122), or working experience (p = 0.017).The survey found that there was no significant association between the perceptions for staff on the extent of the expected improvement in medical services when implementing the Revenue Development Project and their working position  assessed the recently implemented e-prescribing and dispensing service at the UJ Medical Center, Wasfaty. They highlighted issues related to medicine availability and access to essential medicines . As AljuTo the best of the authors’ knowledge, this is the first study to explore the potential of finding new sources of funding for medical center administrations as well as additional income streams to deliver paid healthcare in order to attain financial stability for the administration. All study participants were working at medical centers affiliated with different universities. The findings of this study showed that there are some medical services that can be privatized at university medical centers, such as activating laboratory services such as premarital examination, issuance of licenses, and examination of expatriate workers; providing training and scientific courses by the employees; and activating the role of virtual clinics. However, it was reported that there are some challenges to achieve these opportunities as the infrastructure services of the university medical centers are often inadequate to meet the patients’ demands. Furthermore, the lack of budget was reported as one of the most important factors that can lead to a restriction in the delivery of healthcare services. In Saudi Arabia, university medical centers are becoming recognized to deliver healthcare services to the universities’ employees. However, there is a need to raise the standard of healthcare delivery, particularly in the areas of patient safety and clinical efficacy .The universities’ employees are used to receiving free services, including medical care. The results demonstrated that less than 50% (n = 35) of the study participants were satisfied with the administration’s services in the current situation. Therefore, there is a need to improve the logistics and strategies of the universities’ medical centers administration that can impact on healthcare service delivery. Technical assistance is essential to maintaining data security and patients’ privacy by offering all users the highest level of information protection and security . TherefoWhile this study has added to the literature on the privatization of health care, some limitations may reduce the generalizability of the findings, including recruitment biases .The majority of respondents in this study were satisfied with the medical services provided by the Medical Center and the potential application of the Revenue Development Project. However, the majority also believed that the UJ Medical Center is still being prepared for the Revenue Development Project at the current time. Future work should focus on how responsibility is applied and upheld in environments where it has never been performed. In addition, further research is required based on an upper-level administrative perspective, which can add huge value by providing a deeper understanding of the governmental structures to implement privatization properly in the future.


This observational study examines and estimates the trends and impact of population ageing on rural aged care needs in Australia. With its universal health system and subsidised aged care system, Australia is among those countries with a long life expectancy. Being a geographically large country with a relatively small and dispersed population presents challenges for equitable access to aged care service provision. While this is widely acknowledged, there is little empirical evidence to demonstrate the magnitude and location of the aged care service provision gaps in the next decade. We performed time series analyses on administrative data from the Australian Bureau of Statistics and the Australian Institute of Health and Welfare GEN databases. The Aged Care Planning Regions (ACPR) were classified according to geographical remoteness using the Modified Monash Model scale. There is currently a shortfall of 2000+ places in residential aged care in rural and remote areas of Australia based on 2021 data. By 2032, population ageing will mean that an additional 3390 residential care places and around 3000 home care packages will be required in rural and remote communities alone. Geographical disparities in aged care exist in Australia and continue to worsen, requiring immediate action. The population is ageing as people live longer globally. Better public health provisions have contributed to increases in life expectancy for the past 200 years. Improvement in life expectancy does not only occur at birth but is seen across all ages. Geographical disparities exist, and this contributes to inequality in life expectancy between and within countries. Developed countries, such as Australia, have a life expectancy at birth that is over a decade higher than the global life expectancy of 73 years .Recent studies have highlighted ongoing geographical disparities in equity of access to aged care services between urban and non-urban populations and the locational challenges they face ,3. SmallWhile healthcare and aged care are often funded separately, there is a strong interface between the two systems. In Australia, most health and aged care services are subsidised by the government through separate funding streams and delivered by independent care providers. These services range from home care support for those who live independently at home to full-time care in a residential aged care setting. Over the years, there has been an increased preference for older people to live at home with support. A 2019 longitudinal study observed that as older Australians chose transition and home care packages, the number of those in residential care decreased . The 202In an effort to fix decades-long issues of quality and safety in aged care provision, the Australian Government conducted the Royal Commission on Quality and Safety in Aged Care . The repThis article examines the latest detailed publicly available national microdata to provide trends and estimates of the shortfall in aged care provision in rural and remote regions of Australia compared to metropolitan and urban areas, and to estimate how this will be exacerbated by the ageing of the population in those regions.This observational study was based on a time series analysis of administrative data. We employed Australian government forecasts of population, and national survey data on health service utilisation in 2020 and 2021 to identify worsening gaps in aged care provision as the population of more remote communities ages. Data were accessed in February 2023, and we have developed estimates until 2032.Aged care services are defined as ‘regulated care delivered in residential or community settings, including a person’s own home’ . The majEthics approval, consent to participate, and permission to access data were not required since the data were de-identified and publicly available.Two publicly available databases were accessed. Our primary source of population forecasts were those prepared by the Australian Bureau of Statistics (ABS) for the Australian Government Department of Health . These pThe data were assembled into Excel databases, with the primary unit of analysis being the government-defined Aged Care Planning Region (ACPR) . We usedThe Aged Care Planning Regions (ACPR) were classified according to geographical remoteness using the Modified Monash Model (MMM) scale , as depiHaving aggregated for each ACPR, for males and females in each age range, the population and usage of permanent residential care, respite care, transition care, and home care packages at levels 1, 2, 3, and 4, we then computed the average usage of each per 1000 population. This was also computed for the three groupings of ACPRs noted above. We also calculated the amount of each type of aged care that would be used by those in remote communities if they used the same amount as those (in the same age range and gender) in metropolitan and urban ACPRs. We call the difference between this predicted amount and the amount of aged care actually used ‘shortfall’.We then applied the population forecasts developed by the Australian Bureau of Statistics for the Australian Department of Health to the populations in each SA2 area and hence predicted the expected population of each remote community ACPR in the years 2025, 2028, and 2032. On the assumption that those in remote communities would receive aged care at the current level per 1000 population enjoyed by those in metropolitan and urban ACPRs, we computed the additional aged care facilities and packages that would be needed to meet their requirements. Finally, we added the shortfall in 2021 to the additional needs in each subsequent period to develop an estimate of the required additional service provision, by age group and gender, in each ACPR.In June 2021, those in the remote communities received a range of aged care services, as shown in Focusing on those aged 65 and over, As also noted above, we define ‘shortfall’ as the additional provision that would be required to bring the use of aged care services by those in remote community ACPRs to the same level per person as their counterparts of the same age and gender in metropolitan or urban ACPRs. In Partly to compensate for this shortage of residential places, Australia provides home care packages at a level that is assessed based on need. In 2020, there will be a shortfall in the provision of home care packages in remote communities. However, in 2021, at the peak of the COVID-19 crisis, the home care packages provided to those in remote communities were sometimes proportionately higher than those received by their urban and rural counterparts. The higher use of home care packages partly reflects the extra needs of Aboriginal and Torres Strait Islander people, which, of course, are more present in remote communities than in other ACPRs. The GEM data we are using to quantify aged care service use does seek to identify individuals as “Indigenous” or “non-Indigenous”. However, the recording of this data is imperfect, and a significant proportion of the individuals in the database are coded as “not stated/inadequately described”. Nevertheless, it is useful to understand the use of services by Indigenous people who have been identified as such.We then examined the impact of population ageing on the potential shortfall in aged care provision in remote communities for the total population. In what follows, we now focus on the care needs of those aged 65 and over. In addition to making up the shortfall for the groups aged 65 and over in 2021, it will be necessary to meet the needs of the ageing population. By 2025, there will be an additional 16,876 people aged 65 and over living in remote community ACPRs, of whom 5643 will be aged 80 and over. By 2032, this will have increased to 40,176 additional people aged 65 and over, of whom 19,190 will be aged 80 and over.In In addition to the 1861 permanent residential places, 159 respite and transition care places, and 543 home care packages that would be needed to bring aged care service levels to metropolitan and urban levels for those aged over 65, an additional 3222 residential places, 168 respite and transition care places, and 2986 home care packages will be needed to allow for population growth until 2032. Overall, we estimate that 8939 residential, respite, transition places, and home care packages will be needed to remedy the 2021 shortfall and meet the needs of the growing aged population until 2032.This article is relevant to Australian policy as it complements the existing knowledge of the aged care inequity experienced by older people in rural and remote Australia. Our findings highlight how the ageing population will exacerbate existing gaps in the provision of aged care in the next decade. Rural and remote communities will be hit the hardest. The current shortfall of 2000+ places in residential aged care will continue to widen. By 2032, to bring aged care service levels for those aged over 65 to similar levels to those enjoyed in metro-urban settings, a further 3000+ residential care places and 3000 home care packages will be required in remote communities alone.Globally, contemporary issues affecting rural residential aged care provisions can be summarised into cognitive decline, aged care systems, workforce, admission and discharge, and end of life matters . In contThe provision of residential care, transition and respite care, and home care packages for older people is only part of the story. Gardiner et al.  have setAddressing the shortage of health workers in rural, regional, and remote areas has been the focus of many government policy initiatives in recent years . HoweverCOVID-19 has further exacerbated the Australian aged care crisis. Pre-COVID-19, the lower level of the aged care workforce was predominantly occupied by a migrant workforce with poor working conditions and minimal training . OngoingAustralian Journal of Rural Health, published in 2019, explored aspects of the impact of these issues on the quality of life for older Australians in rural and remote communities. Jackson et al. (2019), for example, provide guidance on how policy needs to be adjusted to ensure better service development, service access, and a sustainable workforce in such locations [A special issue of the ocations . Researcocations . Resilieocations . Improviocations .There are strengths and limitations to this paper. We analysed publicly accessible administrative data to quantify and locate the current and projected gaps in aged care provision in small, rural, and remote communities in Australia. As a result of the Royal Commission into Aged Care Quality and Safety, the Australian government has put in place several of its key recommendations. Nearly two-thirds of residential aged care providers are operating at a deficit , and thiWe have provided a snapshot of the future of Australian aged care provision in remote communities by 2032 to inform policy and practise. In working out how to respond to the shortfalls identified in this article, sensitive optimisation of all available methods of improving the quality of life of the ageing population in rural and remote communities is essential. As the ageing population is growing and, with it, more complex care needs, and in light of ongoing aged care reform and workforce shortages, it is necessary to review the existing aged care model in order to deal with the shortfalls identified in this article.


Modern approaches in education technology, which make use of advanced resources such as electronic books, infographics, and mobile applications, are progressing to improve education quality and learning levels, especially during the spread of the coronavirus, which resulted in the closure of schools, universities, and all educational facilities. To adapt to new developments, students’ performance must be tracked in order to closely monitor all unfavorable barriers that may affect their academic progress. Educational data mining (EDM) is one of the most popular methods for predicting a student’s performance. It helps monitoring and improving students’ results. Therefore, in the current study, a model has been developed so that students can be informed about the results of the computer networks course in the middle of the second semester and 11 machine algorithms (out of five classes). A questionnaire was used to determine the effectiveness of using infographics for teaching a computer networks course, as the results proved the effectiveness of infographics as a technique for teaching computer networks. The Moodle (Modular Object-Oriented Dynamic Learning Environment) educational platform was used to present the course because of its distinctive characteristics that allow interaction between the student and the teacher, especially during the COVID-19 pandemic. In addition, the different methods of classification in data mining were used to determine the best practices used to predict students’ performance using the weka program, where the results proved the effectiveness of the true positive direction of functions, multilayer perceptron, random forest trees, random tree and supplied test set, f-measure algorithms are the best ways to categories. It stimulates and attracts students to stay for a long period of time in front of an electronic device in order to study an educational material such as animated infographics that has the benefits of speed attraction and presentation capabilities needed by students and cannot be fulfilled in real environments. Infographics have a number of benefits, including the ability to simplify scientific facts and present them in a visual data format, the ability to reduce explanatory documents, diagrams, and videos to expressive symbols, pictures, and clear denotations, and the ability to be generated more quickly  is a new data mining discipline. The main goals of EDM are to collect data from learners and their learning environments, and to propose new methods for identifying useful trends in this data that tends to be useful in understanding learners and learning environments and factors that link the two together . EducatiBecause of the use of interactive virtual environments, there is a need to track students’ performance and predict the speed of their progress in order to improve their performance. Machine learning algorithms can be used to predict students’ performance. In the current study, animated infographics are used to demonstrate the technique of computer networks learning by the movement of data in wires and the different signals guided to network devices. This study has merged the use of animated infographics in teaching computer networks for the fourth-year computer students’ teachers. Data mining was used to forecast the performance of those students while teaching them through a series of videos built with infographic technology to demonstrate how computer network functioned from the inside due to the inability of seeing it in the conventional environment. Indeed, on the Moodle platform, students’ success was projected by showing a questionnaire that asked students a series of questions about infographics and the degree to which students benefited from presenting science content using infographics in general, as well as assessing the efficacy of teaching with infographics on students. The efficacy of other relevant social and academic data on students using the various classification methods within the datamining and the best strategies was ensured in order to predict the student’s execution through the Weka program at the beginning of the second semester of the academic year (2019/2020).The use of AIS and CCS has great advantages in the process of learning at a time when the ratio of learners to teachers is increasing at the national and global levels, simply as it aids students to understand a particular program or topic and increases data and information retention over time . In addiThere is a wide variety of EDM-related work available, with many intriguing methods and resources aimed at achieving the goals of exploring information, making decisions, and making recommendations. These will be reviewed below to show how far they helped us with this current study. It can be seen in a study on the application of big data in the educational field, A prior review of the previous research revealed: –The efficacy of employing algorithms to anticipate and enhance students’ performance. –The Weka program’s broad usage in forecasting its simplicity of use. –The efficacy of Algorithms Decision Tree (J48), adaBoost SAMME, and adaBoost for prediction in a variety of research, particularly those pertaining to the educational process.Therefore, the role of both AIS and CCS in different educational fields has emphasized the importance of using machine-learning algorithms in the follow up of students’ performance in the future educational stages and predicting their performance, and the dearth of research that integrates machine learning algorithms and infographic within a free Moodle educational platform. After reviewing previous analysis, it is apparent that infographic technology should be integrated with data mining techniques to forecast students’ success. Consequently, the current study is focused on monitoring students’ performance using machine learning techniques and forecasting improvement in their performance using animated infographics technology in virtual environments. From previous studies, the current research used one or more algorithms from each category available in the Weka program to prove the effectiveness of the best algorithms for predicting student performance.In the present study, cloud computing Software - as-a-Service (SaaS) was used. These application software facilities are provided to the users on demand. Users need not worry about its installation, setup, and running of the application because service provider will take care of it such as Moodle that used in this study. Through this type, a new Virtual Cloud Learning Environment (VCLE) system was designed to improve students’ performance in the computer networks course using the model platform most used in the educational field. A set of videos were produced with infographic technology explaining the computer networks course, as the network course required a lot of the student’s effort to understand and imagine what was happening inside the network and how the data was passed in the form of electrical signals in the network wire. Computer as the main content that was presented through cloud computing technology, due to the emergence of the coronavirus, so the Moodle platform was used so that students could obtain scientific material online through the learning platform with the availability of various interaction methods.After designing the infographic and uploading it to the Moodle educational platform, students joined the networking course in the second semester of the academic year 2019/2020. After completing almost half of the course, the next step was to use a questionnaire to measure the effectiveness of the study on the educational platforms by predicting the performance of students after presenting almost half of the educational content to improve the students’ performance in the coming stage when completing of the course. In the current study, cloud-based e-learning worked as shown in Therefore, the suggested system is intended to benefit educational institutions by combining beneficial services that encourage users to complete work correctly and efficiently. As a result, the study includes a number of AIS videos to teach pupils more in-depth computer expertise. Networks, the content shows students how the networks work, and the data passes inside the wires down from the sending device to the receiving device that they cannot imagine or see in the traditional learning method. In order to predict students’ performance from AIS technology, the researcher utilized knowledge discovery and data mining methodology in predicting student’s academic performance. Therefore, the proposed system is divided into two subsystems: the VCLE system and Track Student Performance model.The sample comprised of (300) students from Kafrelsheikh University’s Department of Educational Technology–Computer Teacher Preparation. The students were assigned to a computer network class course. The main topics that were raised in the proposed system are shown in The following components are included in the proposed system: –Users: The users of the VCLE system are students and lecturers who are in charge of producing, organizing, and regulating learning materials, exercises, and content. –VCLE: The VCLE is a new Moodle system that offers flexibility in terms of where services are located and how students can use them. It also allows users to monitor activity as well as choose and arrange data. (A)Creating a website for the computers network course and adjust all the related settings such as the course full and short name, course start and course end, description, appearance, and course format. (B)Adding the course’s objectives and sub-objectives to the system for each lecture. To access the system and browse all of the components, each student was given a login and password. Lectures, AIS, single activities, quizzes, and exams, drag and drop into text, drag and drop into an image, yes or false, and other forms of course subjects were divided. These provided students with automatic feedback. (C)Each lecture included the following:  –Materials for the lecture  –AIS that brought the subject to life and helped students to imagine what would happen in a real-world scenario  (D)To fill in the blank phrase, several questions, such as multiple-choice, are employed, as well as drag and drop int false, and more options are available. After each lecture, the students were instructed with automated feedback. (E)Simultaneous chat rooms. Students might speak with their professor about concerns concerning the lectures or the system. Assignments, workshops, and a wiki were also accessible in the system. (F)Quizzes. After each lesson, students could practice on many quizzes, and the technology provided appropriate automated feedback. (G)Information about the student’s most recent access to the course, current status, and grades. The system could report for each student individually or all students. (H)Exams: After completing the learning procedure required for each objective, students could take the test and receive their final result. All grades were saved in the system, and the lecturer could save and check all of the students’ responses to keep track their advancement.As shown in The intelligent model for tacking students’ performance includes four stages as shown in https://forms.gle/iryvrdCHqHVmjabt7). The questionnaire (This dataset of student’s scores at the Computer Networks course was obtained from fourth-year students in the Computer Teacher Department at Kafrelshiekh University in the second semester of the academic year (2019/2020). An online questionnaire, generated using Google forms, was used to collect the necessary data . First, the online questionnaire data was exported to an Excel file. The various sorts of data were then examined and, if necessary, updated. Our dataset will be ready for machine learning implementation by the end of this point. The types of data were then reviewed and, updated if required. A well-known machine learning toolbox is the Weka toolkit . It usesWeka is an open-source software which consists of a collection of machine learning algorithms for data mining tasks. Therefore, the largest number of classification algorithms available in the Weka program was used in all groups to extract the best algorithms that predict students’ performance. The completed dataset was put into machine learning algorithms, which may then be used to anticipate student academic achievement. The researchers picked 11 machine learning algorithms from five categories: Bayes (naive Bayes), Function , Lazy (IBK), Rules , and Tree . The algorithms were all run, tested, and compared.Finally, the collected data will be used to create a model for predicting academic success of students. The researchers built the intelligent model with the most accurate algorithm possible.Because our data source has a high degree of dimensionality, we tested Weka’s attributes selection methods on it. We used feature selection to reduce the number of overlapping features, prevent over fitting, and potentially increase the feature set’s predictive accuracy. We combined Ranker search techniques with the selection of feature subsets based on correlation  and information-gain  .The ethical committee in our Kafrelsheikh University have reviewed the study protocol and ethically approved the study under the reference No.:334-38-44972-SD.The data were analyzed in two different ways to ensure the correctness of the results. The first method is using the performance measurement validity through the performance measurement equation in Weka program for comparing different classification methods and extracting the best methods for analyzing the data to predict the performance of students after studying using infographic technology. The second method was using the statistical program SPSS to analyze the results of the questionnaire and extract the frequencies, percentages, mean and standard deviation.F-Measure value because it provides a single score that balances both the concerns of precision and recall in one number. F-Measure The researchers compared the effectiveness of applied classifiers through their False Positive (FP): Negative instances, but classified positive.False Negative (FN): Positive instances, but classified negative.The Weka tool that provides built-in algorithms that sustain in the implementation of different classifiers and get results easily. Eleven algorithms will be used in this stage Bayes (naive Bayes), Function , Lazy (IBK), Rules , and Tree  of the three methods used in the current study , and percentage split (66 percent) before (less correlated questions).F-Measure.F-Measure.In F-Measure.F-Measure.In Weka was used to build the classification model. The evaluation was carried out in Weka , with a percentage split (66%) and a supplied test collection, both of which are standard practices in predictive data mining applications. After removing the attributes, the researchers compared the output of each classifier. After removing the attributes, the researchers compared the output of each classifier. Generally, the supplied test set was proved to better than cross validation (10 folds) and percentage split (66%) in measuring students’ performance. In the supplied test set, when comparing the algorithms before and after deleting the variables, the best three algorithms were functions, multilayer perceptron trees, random forest trees and Random Tree.The SPSS program was used to perform a statistical analysis of the questionnaire data, which consists of two parts. The first part is a questionnaire about infographic and its importance, and its help for students in studying and comprehension, while the second part contains the students’ social and academic data.The social and academic data were analyzed according to the students’ GPA, especially the grade of excellence, as shown in  –As for the FAMILY SIZE item in  –Regarding GENDER in  –Regarding the item of HEALTHY STATUS in  –As for the student age item,  –Study time in  –Regarding Internet presence in  –Regarding project acceptance in  –Activity acceptance in Despite being thorough and rigorous, research does have some limits. First, we solely used data from the Moodle platform for this research. Therefore, in order to maximize the generalizability of the results, we advise future researchers to conduct studies employing data from several platforms. Second, this research project only focuses on one technology (infographic) inside a single nation; additional research with other technologies may be required elsewhere. Third, this study produced encouraging results about the function of infographic approach as an outside variable on the Moodle platform; future studies may examine the possibilities of enhancing Moodle through its fusion with other outside variables. Finally, since the sample size is perhaps perceived as being limited, additional research with a larger number of diverse fields may be required.The goal of the present research is developing a prediction model to enable students to notify his potential results, and to evaluate the effectiveness of teaching using Animated Infographics (AIS) by applying a questionnaire in the first half of the second semester. In addition, to find out the students ‘views on teaching the networking course using the mobile infographic through the Moodle educational platform. Consequently, classification algorithms were applied to a data source using Weka, and it was deduced that the algorithms of the supplied test set, functions.MultilayerPerceptron, trees.RandomForest, trees.RandomTree. Algorithms, achieved 93% high accuracy compared to other algorithms. The current study helped prove the effectiveness of teaching using animated infographics based on the Moodle educational platform, taking into account the reasons for the delayed performance of some students after predicting their performance. This helped teachers to improve students ’performance in other courses, which leads to reducing the failure rate and improving the requirements for some students in the next semester exams. The statistical analysis of the questionnaire demonstrated the effectiveness of using the infographic of educational platforms (Moodle) in teaching, according to the Likert scale, which improves students’ performance when teaching other courses using mobile infographics.10.7717/peerj-cs.1348/supp-1Supplemental Information 1Click here for additional data file.


Age-related macular degeneration (AMD) is recognized as the leading cause of vision loss in older people. Considering the phenomenon of aging societies worldwide, the prevalence of AMD is expected to increase gradually in the future. AMD can be divided into early, intermediate, and late stages, with the early and intermediate stages being mainly asymptomatic, and the late stage being classified as geographic atrophy, neovascular AMD, or both. Current pharmacological treatments for neovascular AMD include anti–vascular endothelial growth factor agents, such as ranibizumab, pegaptanib, and aflibercept. Additionally, it has been reported that the off-label use of intravitreally administered bevacizumab is effective. It is also lower cost than other agents, which makes it an interesting pharmacological approach.This review aims to evaluate the efficacy, safety, and efficiency of bevacizumab for the treatment of neovascular AMD.This review will only consider randomized controlled clinical trials that compare the use of bevacizumab with another pharmacological agent or a placebo in patients aged 50 years and older who are diagnosed with vascular AMD. It will exclude studies that include participants diagnosed with polypoidal choroidal vasculopathy or retinal angiomatous proliferation. To identify and select relevant articles, we will develop a highly sensitive search strategy and apply it in MEDLINE via the PubMed platform. Upon selection of the studies and analysis of the titles, abstracts, and full texts, the results will be presented according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The analysis and extraction of the data will be performed by 2 independent reviewers. Risk of bias will be evaluated with the Critical Appraisal Skills Programme (CASP) checklist. Finally, the same reviewers will also perform a quality assessment of the included studies with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool.The search strategy, after the application of the inclusion and exclusion criteria, identified 15 randomized clinical trials, which are currently being analyzed. This project has no funding and it has been developed by a multidisciplinary research team of pharmacologists and orthoptists. The study was initiated in May 2021 and it is expected to conclude by the end of 2023.This review will provide a synthesis of current information and underlying evidence about the off-label use of bevacizumab in neovascular AMD. It will provide a clearer vision of a possible new pharmacological approach, as well as the most suitable treatment designs, for the treatment of neovascular AMD.PROSPERO CRD42021244931; https://tinyurl.com/p6m5ycpkDERR1-10.2196/38658 Age-related macular degeneration (AMD) is closely associated with visual impairment and is considered the leading cause of vision loss in elderly people -3. IndeeAMD can be divided into early, intermediate, and late stages. The early and intermediate stages are mainly asymptomatic and represent about 90% of cases -8. Late AMD pathogenesis is not yet fully understood, but there is already evidence to elucidate the process underlying the onset and progression of this disease ,10,11. BBecause of the process underlying the development of nAMD, current pharmacological treatments are characterized by the intravitreal administration of molecules specifically targeting VEGF ,14. The The research group follows the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis–Protocols (PRISMA-P) for the elaboration of this protocol . This stIn accord with the natural history of AMD and the American Academy of Ophthalmology Preferred Practice Patterns, the study will only include participants diagnosed with nAMD aged 50 years or older . TextboxInclusion criteriaParticipants diagnosed with neovascular age-related macular degeneration and aged 50 years or olderTreatment with bevacizumab and another pharmacological agent or placeboPresentation of outcomes related to the efficacy, safety, and efficiency of the treatmentRandomized clinical trialExclusion criteriaParticipants diagnosed with polypoidal choroidal vasculopathy or retinal angiomatous proliferationTreatment switched during the studyStudies written in a language other than EnglishStudies published before 2010Patients diagnosed with nAMD and treated with intravitreal bevacizumab will be compared to patients who receive other accepted treatments, such as other anti-VEGF drugs , or to those who receive a placebo.We will analyze several outcomes to evaluate the influence of intravitreal bevacizumab in nAMD in comparison with other established treatments or placebo; these outcomes are related to the efficacy, safety, and efficiency profiles.This review will only consider randomized controlled trials.This review will use MEDLINE, via the PubMed platform, to develop a highly sensitive search strategy to identify and select relevant and eligible studies. Titles and abstracts of retrieved studies will be screened, and the full text of potentially eligible articles will be assessed by 2 independent reviewers. In case of discrepancies, a third reviewer will be included to make a final decision. Inclusion and exclusion criteria will be applied throughout this process to decide whether a study is included or excluded. Relevant data will be extracted from the included studies and inserted in a customized data extraction document by the 2 independent reviewers. The search results will be presented in the final systematic review and presented as a PRISMA flow diagram. In addition, the reasons for excluding studies will be organized and will also be presented in the final flow diagram. As previously mentioned, we will only include articles written in English and published after 2010.I2 statistic and the Kendall τ rank correlation if high values are found; to try to explain heterogeneity across studies, a meta-regression will be conducted. This technique can be performed if there is a suspected variable that may lead to differences in treatment effects across studies. For meta-analysis, we will use the R  packages metafor and meta.The retrieved studies from the MEDLINE database will be exported and analyzed through a systematic reviews web application , which will be used throughout the review for study screening and overall management. The data will be extracted by the same 2 independent reviewers and will include specific parameters concerning the population, intervention, and comparison, as well as outcomes related to the efficacy, safety, and efficiency profiles of the treatments applied. Once again, in case of conflict between the reviewers, a third reviewer will be included to make a final decision. The included studies will be descriptively analyzed and presented in a tabular format. Additionally, the studies excluded from the quantitative synthesis will be subjected to a qualitative analysis in order to gather all available important data. For methodologically and statistically homogeneous studies, we will perform meta-analyses using random effects models to quantify a pooled estimate of the effect of systemic versus ocular adverse events. Meta-analyses will be undertaken separately for each specific study design. We will also consider other subgroup analyses, for instance, of age groups . We will also quantify heterogeneity of the studies using the During the process of data collection, we will consider several parameters that we will extract and organize, including efficacy outcomes , safety outcomes , and efficiency outcomes .All the selected studies will be assessed to evaluate their methodological quality and potential for risk of bias by the same 2 independent reviewers. In case of discrepancies between these 2 reviewers, an additional reviewer will be included to make a final decision. To evaluate the quality and risk of bias in experimental studies, the Critical Appraisal Skills Programme (CASP) randomized controlled trials checklist will be used. We will derive domain-specific and overall quality grading for each study as follows: low risk of bias (A), moderate risk of bias (B), and high risk of bias (C). In addition, we will evaluate the potential of publication bias with funnel plots and the Begg test and Egger test with the trim and fill approach to explore the possible influence of publication bias on the results.The protocol for this systematic review was submitted and registered in 2021 in PROSPERO (CRD42021244931). This protocol follows the PRISMA-P guidelines for the development of systematic reviews and meta-analysis. In case there are modifications to the protocol, they will be reported in the final paper with the rationale behind the origin of such amendments.The study has included 15 randomized controlled clinical trials after applying the inclusion and exclusion criteria, and the data of interest are being thoroughly extracted. A multidisciplinary research team of pharmacologists and orthoptists has been working on the review since May 2021, as well as on the delineation of the protocol, and it is expected that the final results will be released by the end of 2023.AMD is closely associated with blindness and has a significant impact on social, health, and economic factors in society. Currently, this disease has no cure and pharmacological treatment aims to slow its rate of progression. Current drug therapies that are accepted for the treatment of nAMD are costly, and bevacizumab may be a possible alternative treatment. The off-label use of bevacizumab in the treatment of nAMD was first reported in 2006, and since then an increase in its use has been demonstrated . AccordiConsidering the latest reviews on this topic, it is possible to observe that there is already sufficient information regarding the efficacy and safety profiles of bevacizumab in comparison to other pharmacological approaches ,22. HoweThus, the findings from this review will allow a clearer vision of the use of bevacizumab in the treatment of nAMD, as well as its efficacy, safety, and efficiency compared to other drugs and to placebo. Additionally, this key strengths of this study will include synthesizing the information available about the off-label use of bevacizumab in patients diagnosed with nAMD; clarifying the current evidence on the off-label use of bevacizumab in the nAMD context for its efficacy, safety, and efficiency; and developing a comprehensive and highly sensitive search strategy, which will allow the identification of current papers and their underlying evidence. Based on the currently available literature, we are in a position to objectively evaluate bevacizumab for the treatment of nAMD in comparison to other drugs accepted by the respective regulatory authorities.