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Despite significant progress in Iran's immunization programs, vaccine policymaking in the country still faces various challenges and shortcomings. To address these issues and ensure sustained progress toward achieving comprehensive vaccination policies, it is essential to identify the critical factors influencing vaccine policies in Iran. Our study aims to provide evidence-based insights that can inform the development of effective and equitable vaccine strategies, leading to a more sustainable and efficient approach to vaccination in the country.

This mixed-method study aimed to analyze the factors influencing the future of human vaccine policy using Cross Impact Analysis. Firstly, a scoping review was conducted to identify the factors affecting the future of human vaccine development. Secondly, a semi-structured interview was conducted with experts in this field to add more factors and confirm the identified factors within the Iranian context. Finally, a Cross-Impact Analysis (CIA) approach was applied to comprehend the complex relationships between the identified factors. Thematic analysis was used for the qualitative data, and MICMAC analysis was applied to characterize the relationships between the factors.

Seventeen key driving force factors were identified through comprehensive review and interviews. These factors were assigned weighted values ranging from zero to three and subsequently analyzed using MICMAC software. Employing the Cross-Impact Analysis (CIA) technique, the study characterized the impact of each factor on vaccine policy and elucidated the intricate interactions between them. The findings underscored that robust leadership and governance, an innovative ecosystem, and well-established immunization information systems emerged as pivotal driving forces shaping vaccine policy in Iran.

While this study contributes valuable insights into the driving factors influencing vaccine policy in Iran, it is important to acknowledge several limitations. The results rely on the subjective perceptions of a diverse group of specialists, and future research could delve into additional factors in other countries to identify common themes and differences.

This study provides evidence to assist policymakers in making informed decisions regarding vaccines in Iran. The findings suggest that enhancing access to vaccines, fostering trust in the healthcare system, and prioritizing equity in distribution can contribute to increased vaccination rates and a reduction in vaccine-preventable diseases.

This study provides a unique contribution to the field of vaccine policy by utilizing the cross-impact analysis to examine the complex interactions among various factors. The results of this analysis demonstrate that these interactions can significantly impact the overall system, highlighting the need for policymakers to consider multiple factors when formulating effective strategies. By revealing the significance of these interactions, this research offers valuable insights into the development of successful policies that can shape a desirable future for vaccine policy in Iran. Future studies could ratify the findings from this research by applying other methodological approaches.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.

The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.

Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.

Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

The outbreak of COVID-19 in 2020 has had a profound impact on education institutions at all levels. Open universities, with their privileged delivery method, have been in an advantageous position. In the earlier stages of the pandemic, they made remarkable contributions to assuring learning continuity. However, with more and more conventional universities migrating online, great changes have taken place in the field of higher education, and it is imperative for open universities to adjust their strategies in order to maintain their leading role in a technology-enabled education context. This paper aims to examine what challenges have been faced by open universities during the pandemic and how they will transform in the future.

Six open universities in Asia, Africa and Europe were selected as cases in this research to make a comparative study based on the papers in the volume beyond distance education [1]. Similarities and differences among the cases were analyzed in order to identify the developing trend for open universities in the international context.

The results showed that (1) open universities in these regions demonstrated their resilience in the pandemic; examples were that new technologies have been leveraged to implement totally online delivery with short notice and huge amount of learning resources were offered to the society. (2) However, they encountered challenges of delivering fully online examination due to the lockdown and quarantine policies, and open universities in African and the sole private institution suffered financial pressure due to improving information and communication technology infrastructure and staff training. Another challenge was the fierce competition from conventional universities that open universities in Asia and Europe came across. (3) Four main areas were identified for future development in order to respond to the challenges: No.1 is that programs such as health care, psychology, epidemiology, virology, immunology, data analytics, biology and bio-informatics have stimulated interest for African open universities to develop in the future; No. 2 is that open universities were seeking to innovate their teaching formats; short courses, such as micro credentials, might be developed as agile and flexible offerings which are expected to be suitable to learners in the pandemic context; No 3 is that programs and courses for upskilling in the context of digitalization will be implemented; and No. 4 is that lifelong learning is given a higher priority in order for open universities to stand securely in the higher education sector.

The study may give open university leaders a quick insight into their future development.

Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women.

Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA_1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c_1c of ≥6.5% and 5.7–6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP.

Results: A total of 224 mothers with a mean (±SD) age 26±5 years were enrolled, most of whom were in the 2^nd or 3^rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7–16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p=0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2–14.0; p=0.022). Using HbA_1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve=0.75 (95% CI: 0.70–0.80, p<0.001)), respectively.

Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.

In this study, the authors want to identify current possible causes for citing and referencing errors in scholarly literature to compare if something changed from the snapshot provided by Sweetland in his 1989 paper.

The authors analysed reference elements, i.e. bibliographic references, mentions, quotations and respective in-text reference pointers, from 729 articles published in 147 journals across the 27 subject areas.

The outcomes of the analysis pointed out that bibliographic errors have been perpetuated for decades and that their possible causes have increased, despite the encouraged use of technological facilities, i.e. the reference managers.

As far as the authors know, the study is the best recent available analysis of errors in referencing and citing practices in the literature since Sweetland (1989).

Bacterial vaginosis (BV) is quite common and linked with serious public health issues such as premature delivery and spread of sexually transmitted infections. The study aims to identify different genital mycoplasmas (GM) in high vaginal swabs (HVS) from adult females in Bahrain.

In total, 401 HVS were collected and cultured on MYCOFAST^® RevolutioN 2 test for identification and antibiotic susceptibility. Polymerase chain reaction (PCR) was performed for detection of Mycoplasma genitalium (Mg), Mycoplasma hominis (Mh) and Ureaplasma species. DNA-probe based detection for Gardnerella, Candida and Trichomonas was performed by BD Affirm Assay. Representative PCR amplicons were sequenced by Sanger sequencing.

In PCR, Ureaplasma sp. was the most common GM, followed by Mg and Mh; the prevalence being 21.2, 5.2 and 1.5%, respectively. On the contrary, 10.7% samples showed positivity for Ureaplasma urealyticum (Uu) and 1.7% for Mh in MYCOFAST^® RevolutioN 2. The concordance rates between MYCOFAST^® RevolutioN 2 and PCR for Mh and Ureaplasma sp. were 97.7 and 84%, respectively. Considering PCR as gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of MYCOFAST^® RevolutioN 2 were 33.3, 98.8, 28.6, 98.9 and 37.7, 96.5, 74.4, 85.2% for Mh and Ureaplasma sp., respectively. The Uu and Mh isolates showed antibiotic-resistance ranging from 53%–58% and 71%–86%, respectively.

The prevalence of Ureaplasma sp. was high. Significant co-occurrence of GM was noticed with BV. MYCOFAST^® RevolutioN 2 had lower detection-rate than PCR, so a combination is suggested for wider diagnostic coverage.

The research reflects on status of prevalence of GM in adult females in Bahrain, and their co-occurrence with bacterial vaginosis. Diagnostic approach with combination of tests is suggested for wider coverage. The research has epidemiologic, diagnostic, and therapeutic implications.

This is the first report from the Kingdom of Bahrain reflecting on burden of GM from this geographic location. The diagnostic efficacy of MYCOFAST^® RevolutionN 2 test and polymerase chain reaction was evaluated for GM detection.

This paper aims to determine new-normal uncertainty considerations stemming from the COVID-19 pandemic to consider within transaction-cost analysis for pharmaceuticals. It also aims to propose new-normal market entry strategies to address the uncertainty as a result of COVID-19's implications and provide for lack of knowledge and information in an uncertain business environment by way of Internet of Things (IoT) ecosystem for pharmaceutical market entry.

In this paper, we focus on the uncertainty facet within transaction-cost analysis consideration and utilise a descriptive three-case study approach taking in Johnson and Johnson (J&J), GlaxoSmithKline (GSK) and Novartis to present an ADO (Antecedent-Decisions-Outcomes) understanding of their usual market entry approach, the approach undertaken during the pandemic and the outcomes thereafter facilitating new-normal uncertainty considerations to factor in. Further with this insight, we develop a conceptual framework addressing the transaction-cost analysis implications of uncertainties toward lack of knowledge and information for a new-normal market entry approach and operating strategy for pharmaceuticals applicable due to IoT (Internet of Things).

Uncertainty (external and internal) is different now in the new-normal business environment for pharmaceuticals and boils down to acute shortage of knowledge and information impact to make an appropriately informed decision. Therefore, considering the changed factors to consider, pharmaceuticals need to be able to undertake market entry with vaccines and medicines by way of IoT thereby enabling, the filling of the gap via real-time data access and sharing, including enhancing predictive analysis for sustenance.

The paper's findings have many theoretical implications highlighted in the manuscript.

The paper's findings have many practical implications highlighted in the manuscript.

This is the first study to our knowledge that throws light on transaction-cost analysis theory's uncertainty facet for pharmaceuticals. It is also the first study that provides a new-normal market entry strategy for pharmaceutical companies built on interoperability of real-time IoT.

Biotech companies stand as key actors in pharmaceutical innovation. The high risk and long timelines inherent with their R&D investments might hinder their access to funding, potentially stifling innovation. This study aims to explore into the appeal of biotech companies to capital market investors, whose financial backing could bolster the growth of the biotechnology sector.

This paper uses a dataset of 774 US publicly listed biotech firms to investigate their risk and return characteristics by comparing them to pharmaceutical firms and a sample of matched non-biotech R&D-intensive firms over the sample period 1980–2021. Tests show that the conclusions remain consistent across diverse methodological approaches.

The paper shows that biotech companies are riskier than the average firm in the market index but outperform on a risk-adjusted basis both the market and a matched group of R&D-intensive firms. This is particularly true for large capitalization biotech, which is also shown to provide a diversification benefit by reducing the downside risk in past crisis periods.

This paper provides insight relevant to the current debate about the overall performance of the biotech industry in terms of policy changes and their impact on small, early-stage biotech firms. While small and early-stage biotech firms are playing an increasing role in scientific innovation, this study confirms their greater vulnerability to financial risks and the importance of access to capital markets in enabling those companies to survive and evolve into larger biotech.

The purpose of this study is twofold: first, to determine if pharmaceutical companies can be grouped based on their espoused values, and second, to examine the relationship between these values and company reputation.

A descriptive study design is used with two separate analyses: cluster analysis for grouping the companies; and descriptive data analysis for determining cluster differences.

The findings suggest that there are three value clusters: competent, community and interpersonal, with the community group showing the highest relative reputation, and the interpersonal cluster as the lowest. Brand portfolio composition appears to positively contribute to reputation. The effect of portfolio specialization is based on a company’s closeness to its therapeutic community, which may be influenced by the outward characteristics of its values.

Future research should examine the longitudinal effects of values on reputation combined with case studies.

Regardless of cluster classification, all firms should develop strong ties with their therapeutic communities using both personal and digital/omnichannel strategies.

A company’s values are becoming an important consideration for all customers and stakeholders.

To the best of the authors’ knowledge, this study is the first to systematically examine the activities of leading pharmaceutical firms to link a specific value cluster to company reputation.

The COVID-19 pandemic had a huge impact on people's lives, air travel and tourism. The authors explored travelers' perceptions of COVID rapid antigen tests before boarding aircraft, willingness to fly and the precautionary actions for safe air travel.

All the participants were asked to complete the survey while reflecting on their experiences of air travel during this COVID-19 pandemic. The questionnaire consisted of demographic information of the participants and air travel preferences during pandemic. The survey was conducted through Google Form in both English and Arabic language. The link was shared through emails and WhatsApp.

In this survey, majority had willingness to fly during pandemic. 45.2% preferred to undergo rapid test before boarding, while 41.9% refused owing to no added benefit (23.8%) and nasal discomfort (9.3%) among others. The best indicators to resume safe air travel were COVID-19 vaccination (80.4%), wearing face mask during flying hours (70.8%) and maintain social distancing with aircraft seating (49.6%).

The findings of the current survey could help the organizations and the biosecurity authorities to act and support accordingly and thus reduce passenger anxiety about resuming the flights, thereby increasing willingness to fly and preparing oneself and the aviation industry for future pandemics.

The findings of the current survey could help the organizations and the biosecurity authorities to act and support accordingly and thus reduce passenger anxiety about resuming the flights, thereby increasing willingness to fly, and preparing oneself and the aviation industry for future pandemics.