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PurposeThe main objective of this paper is to investigate the factors affecting customer lifetime value (CLV) for Internet service providers in Jordan, namely, technical quality, functional quality, brand credibility, confidence benefits, special treatment benefits, customer satisfaction and commitment.Design/methodology/approachAn online survey was conducted involving a sample of 481 respondents. SPSS was used to analyse the data and test the proposed relationships, while SmartPLS was used to examine the robustness of our results.FindingsResults showed that confidence benefits, special treatment benefits and brand credibility had a significant and positive impact on customer satisfaction and commitment, with brand credibility appearing as the most influential factor leading to customer satisfaction and commitment, and ultimately CLV. Furthermore, research reveals an insignificant relationship between functional quality, technical quality and customer satisfaction.Practical implicationsServices' providers seeking to increase CLV need to build strong and sustainable relationships with their customers.Originality/valueThis study incorporates a set of crucial customer relationship management strategies that could be universally applied to enhance customers benefits and business performance. This is also the first study of its kind conducted in the Middle East, particularly in Jordan.

PurposeThis study examines factors that affect customer lifetime value (CLV) in fast-food restaurants (FFRs) in Jordan. These factors are relational benefits, brand experiences, service quality (SQ), satisfaction, trust and commitment.Design/methodology/approachAn online survey was collected from a sample of 503 respondents. The authors used SPSS to test the constructs' relationships and analyse the data. SmartPLS was used to test the hypotheses.FindingsIn contrast to previous studies, not all dimensions of brand experiences and relational benefits had a significant and positive influence on relationship marketing outcomes (satisfaction, trust and commitment). On the other hand, results demonstrated that SQ had a significant and positive influence on relationship marketing outcomes. Furthermore, research reveals that satisfaction, trust and commitment significantly and positively influenced CLV.Practical implicationsThose FFRs that seek to enhance CLV should build solid and sustainable bonds with their customers. This paper concludes by stating its implications, its limitations and the opportunities available for future research.Originality/valueThis study, which is unique in the Middle East, includes essential strategies for managing customer relationship that can be universally applied to improve customer benefits and maximise the performance of businesses.

PurposeThis paper investigates the factors affecting customer lifetime value from an attitudinal and behavioural brand loyalty perspective in the Internet service industry. Specifically, willingness to pay more and word of mouth are categorised under attitudinal loyalty, while repurchase intention is classified under behavioural loyalty.Design/methodology/approachA self-administered questionnaire online survey via Google Forms was employed comprising a sample of 481 participants from the Internet service providers. The partial least squares structural equation modeling (PLS-SEM) approach was applied for hypotheses testing.FindingsThe current study found that “brand credibility, special treatment benefits and confidence benefits had a positive and significant influence on willingness to pay more, word of mouth and repurchase intention, with confidence benefits and brand credibility showing as the greatest elements resulting in word of mouth and repurchase intentions, whereas special treatment benefits showing as the greatest element resulting in the willingness to pay more. The results of this study did not show any positive significant between service quality dimensions and true brand loyalty (word of mouth, willingness to pay more and repurchase intention). Results also found that confidence benefits, brand credibility and special treatment benefits had an indirect impact on true brand loyalty through customer satisfaction”.Practical implicationsInternet service providers should develop and maintain good relationships with their customers as the excellence of the customer–service provider relationship can enhance customer lifetime value.Originality/valueThe current work measured customer lifetime value in terms of both the behavioural and attitudinal aspects to represent loyalty, while most previous studies consider only one dimension for this representation. Particularly, customers' true brand loyalty is measured using separate components of repurchase intentions (RIs), willingness to pay more (WPM) and word of mouth (WOM) to deepen the understanding of both managerial interest and academic.

Objectives: To assess the otorhinolaryngological (ORL) symptoms, including their prevalence, severity, and early presentations among coronavirus disease-19 (COVID-19) patients in the Saudi population. Methods: This was a multicentric, cross-sectional study carried out on severe acute respiratory syndrome coronavirus-2 positive patients at 3 COVID-19 centres; Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, ALKhobar, Qatif Central Hospital, AlQatif, and Ohud Hospital, Al Madinah Al Munawarah, Saudi Arabia. The validated survey consisted of sociodemographic data, general symptoms of COVID-19, and ORL manifestations. Results: A total of 1734 COVID-19 positive patients were included in the study (mean age: 37.7[+ or -]11.6 years). Most of the cases were mild (51.8%), followed by moderate (45.6%), and severe (2.6%) cases. Approximately 33.7% were asymptomatic. Severity of symptoms was significantly associated with male gender (5=0.017), higher age-group (p=0.04), and smoking (p<0.001). The most common initial ORL presentations were sore throat (20.9%), anosmia (15.5%), hyposmia (10%), and loss of taste (11.4%). Overall, 79.5% showed ORL symptoms as the initial presenting symptoms for COVID-19, with anosmia and sore throat being the most common symptoms. Conclusion: This study confirmed the prevalence of ORL symptoms among COVID-19 patients in Saudi Arabia. Moreover, these symptoms could also be considered for early detection of COVID-19 as they might appear prior to other symptoms. Keywords: COVID-19, coronavirus, otorhinolaryngology, olfactory dysfunction, presentations [phrase omitted]

This study aims to evaluate the current level of servitisation in the Gulf Cooperation Council (GCC) markets in the fashion sector and identify various internal and external obstacles that may hinder fashion organisations in the GCC region from fully adopting the servitisation strategy. An exploratory methodology was employed, using a qualitative approach with semi-structured interviews on a purposive sample. The study reveals that the implementation of the servitisation strategy in GCC is in its initial stages. While evidence of the dimensions underlying such a strategy was found, they were not employed and linked as suggested in the literature to generate the required results. Additionally, non-transparent and limited relationships with partners and unskilled employees were identified as the main barriers preventing fashion agents from fully embracing servitisation in the GCC fashion sector. This study uniquely explores servitisation in the GCC fashion sector, filling a significant gap in existing research that has largely overlooked this region and industry. Unlike previous works that broadly address servitisation in manufacturing, this paper delves into the specific challenges and adoption levels within the GCC’s culturally and economically distinct context. By offering nuanced insights from senior managers in leading fashion organisations, it provides valuable empirical evidence and practical implications for both academia and industry, marking a notable contribution to the literature on servitisation strategies in emerging markets.

Background/Objectives: Neutrophil cells’ lysis forms the extracellular traps (NETs) to counter the foreign body during insults to the body. Peptidyl arginine deiminase (PAD) participates in this process and is then released into the extracellular fluid with the lysed cell components. In some diseases, patients with abnormal function of PADs, especially PAD 4, tend to form autoantibodies against the abnormal citrullinated proteins that are the result of PAD activity on arginine side chains. Those antibodies, which are highly distinct in RA, are distinctly anti-citrullinated protein antibodies (ACPA). This study used an in-silico drug repurposing approach of FDA-approved medications to identify potential alternative medications that can inhibit this process and address solutions to the current limitations of existing therapies. Methods: We utilized Maestro Schrödinger as a computational tool for preparing and docking simulations on the PAD 4 enzyme crystal structure that is retrieved from RCSB Protein Data Bank (PDB ID: 4X8G) while the docked FDA-approved medications are obtained from the Zinc 15 database. The protein was bound to GSK 199—an investigational compound—as a positive control for the docked molecules. Preparation of the protein was performed by Schrödinger Protein Preparation Wizard tool. Binding pocket determination was performed by Glide software (Schrödinger Release 2021–3:Schrödinger, LLC., New York, NY, USA, 2021). and validation of molecular docking was carried out through the redocking of GSK 199 and superimposition. After that, standard and induced fit docking were performed. Results/Conclusions: Among the four obtained hits Pemetrexed, Leucovorin, Chlordiazepoxide, and Ioversol, which showed the highest XP scores providing favorable binding interactions. The induced-fit docking (IFD) results displayed the strong binding affinities of Ioversol, Pemetrexed, Leucovorin, Chlordiazepoxide in the order IFD values −11.617, −10.599, −10.521, −9.988, respectively. This research investigates Pemetrexed, Leucovorin, Chlordiazepoxide, and Ioversol as potential repurposing agents in the treatment of rheumatoid arthritis (RA) as they are identified as PAD4 inhibitors.

Objectives:To assess the otorhinolaryngological (ORL) symptoms, including their prevalence, severity, and early presentations among coronavirus disease-19 (COVID-19) patients in the Saudi population.Methods:This was a multicentric, cross-sectional study carried out on severe acute respiratory syndrome coronavirus-2 positive patients at 3 COVID-19 centres; Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, ALKhobar, Qatif Central Hospital, AlQatif, and Ohud Hospital, Al Madinah Al Munawarah, Saudi Arabia. The validated survey consisted of sociodemographic data, general symptoms of COVID-19, and ORL manifestations.Results:A total of 1734 COVID-19 positive patients were included in the study (mean age: 37.7±11.6 years). Most of the cases were mild (51.8%), followed by moderate (45.6%), and severe (2.6%) cases. Approximately 33.7% were asymptomatic. Severity of symptoms was significantly associated with male gender (p=0.017), higher age-group (p=0.04), and smoking (p<0.001). The most common initial ORL presentations were sore throat (20.9%), anosmia (15.5%), hyposmia (10%), and loss of taste (11.4%). Overall, 79.5% showed ORL symptoms as the initial presenting symptoms for COVID-19, with anosmia and sore throat being the most common symptoms.Conclusion:This study confirmed the prevalence of ORL symptoms among COVID-19 patients in Saudi Arabia. Moreover, these symptoms could also be considered for early detection of COVID-19 as they might appear prior to other symptoms.

The main objective of this paper is to investigate how service quality and customer satisfaction are correlated to self-reported loyalty intentions in Islamic banks. The paper presents primary data collected by self-administered questionnaires involving a sample of 655 respondents from all local Islamic Banks in Jordan. The results show that compliance, tangibility, responsiveness, assurance, and empathy positively linked to self-reported loyalty intentions, with compliance and assurance appearing as the greatest correlation with self-reported loyalty intentions compared to other service quality dimensions. Islamic banks should focus on continuous improvement of service quality due to the direct correlation with customer satisfaction and loyalty. It is important for Islamic banks to review and endorse all policies and procedures to ensure that their documents and investments are undertaken in line with the requirements of Islamic law. Managers should pay special attention to the service quality provided by their employees and develop their skill set through training and education programmes based on Islamic principles. As the first study of its kind in Jordan, the paper's contribution stems from filling the research gap in examining the relationship between the various service quality dimensions and self-reported loyalty intentions in Islamic banks using the CARTER model.

: Acute pain after video-assisted thoracoscopic surgery (VATS) promotes respiratory splinting, impaired cough, and pulmonary complications, and predicts persistent opioid use. Surgeon-administered intercostal nerve block (ICNB) is a simple regional technique, but its independent effect on early pain and opioid requirement in a contemporary uniportal VATS (UVATS) pathway is incompletely defined. : We performed a retrospective cohort study of 456 consecutive patients undergoing UVATS at a single Israeli center between 2017 and 30 May 2025. Patients receiving an intercostal block were compared with those who did not. Baseline covariates were balanced by 1:1 nearest-neighbor propensity-score matching (caliper 0.2 SD of the logit propensity score). The primary endpoints were pain on postoperative day (POD) 1 (visual analog scale, VAS) and postoperative opioid use; secondary endpoints included later pain, analgesic regimen, postoperative pneumonia, and mortality. : Matching yielded 159 patients per group ( = 318) with all clinically relevant covariates balanced (standardized mean difference [SMD] < 0.13). Median POD1 VAS was lower with the block (4 [IQR 3-4] vs. 5 [5-7]; < 0.001), and 76.1% of block patients were opioid-free versus 10.7% who were not ( < 0.001). The effect was concentrated early and attenuated by POD3. In multivariable analysis the block was independently associated with lower POD1 VAS (adjusted β = -1.64, 95% CI -2.00 to -1.29; < 0.001). Postoperative pneumonia was less frequent in the block group (5.7% vs. 20.1%; < 0.001). Thirty-day and one-year mortality did not differ significantly. : In UVATS, a surgeon-placed intercostal nerve block was associated with lower early postoperative pain that persisted after adjustment for operating surgeon and surgical era, concordant with pooled meta-analytic estimates; associated reductions in opioid use and pneumonia were confounded with surgeon and secular trend and are hypothesis-generating. These single-center, retrospective findings require prospective, protocol-randomized confirmation.

Astrocytes are the most abundant cell type in the mammalian brain and provide structural and metabolic support to neurons, regulate synapses and become reactive after injury and disease. However, a small subset of astrocytes settles in specialized areas of the adult brain where these astrocytes instead actively generate differentiated neuronal and glial progeny and are therefore referred to as neural stem cells 1 – 3 . Common parenchymal astrocytes and quiescent neural stem cells share similar transcriptomes despite their very distinct functions 4 – 6 . Thus, how stem cell activity is molecularly encoded remains unknown. Here we examine the transcriptome, chromatin accessibility and methylome of neural stem cells and their progeny, and of astrocytes from the striatum and cortex in the healthy and ischaemic adult mouse brain. We identify distinct methylation profiles associated with either astrocyte or stem cell function. Stem cell function is mediated by methylation of astrocyte genes and demethylation of stem cell genes that are expressed later. Ischaemic injury to the brain induces gain of stemness in striatal astrocytes 7 . We show that this response involves reprogramming the astrocyte methylome to a stem cell methylome and is absent if the de novo methyltransferase DNMT3A is missing. Overall, we unveil DNA methylation as a promising target for regenerative medicine. Single-cell analysis of the transcriptome, chromatin accessibility and methylome of adult neural stem cells and astrocytes demonstrates that stemness is driven by methylation profiles distinct from those of astrocytes.