The lineage of al-li`an child and his inheritance from his father, who denied him and performed oath of condemnation (al-mula’anah) is considered one of the crucial issues in the Sharia and the law. This is because of the serious effects of denying his lineage from his father, which leads to depriving the child of the inheritance of the father and his family. Some courts accepted the analysis of the DNA when denying the child's lineage. Based on this fact, the issue has raised, especially when there is a conflict between the father’s denial of his son and the court’s finding based on DNA result. Which one is to be accepted if the father denied while the court confirmed his child’s lineage? This study aimed at introducing al-li`an child from Sharia and legal points of view, and the importance of analyzing the genetic footprint (DNA) as a guide to be used when there is a conflict between husband and wife in their opinions. The research methods used in this study are the inductive approach by tracking the views and evidence of the Islamic jurists and examining the reasons for the disagreement among them. In comparison, the analytical and comparative methods are used to discuss and analyze the opinions of the jurists and their evidence and compare these provisions with what is being practiced in Malaysian law. This study has reached some important results among others: the child of al-li`an remains a legitimate child as long as the father did not deny his lineage. The final decision on denying or confirming child’s lineage is based on the analysis of the genetic fingerprint (DNA result). Therefore, the lineage of al-li’an child and his inheritance right remains valid or undeniable unless the analysis result of the genetic fingerprint conforms with the statement of the father who denied his child lineage through al-li`an (oath of condemnation).

Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. Findings In the first phase, from a longlist of 103 candidate indicators, 23 were prioritised as core indicators of elective surgical system preparedness by 69 clinicians (23 [33%] women; 46 [67%] men; 41 from HICs, 22 from MICs, and six from LICs) from 32 countries. The multidomain SPI included 11 indicators on facilities and consumables, two on staffing, two on prioritisation, and eight on systems. Hospitals were scored from 23 (least prepared) to 115 points (most prepared). In the second phase, surgical preparedness was measured in 1632 hospitals by 4714 clinicians from 119 countries. 745 (45·6%) of 1632 hospitals were in MICs or LICs. The mean SPI score was 84·5 (95% CI 84·1–84·9), which varied between HIC (88·5 [89·0–88·0]), MIC (81·8 [82·5–81·1]), and LIC (66·8 [64·9–68·7]) settings. In the third phase, 1217 (74·6%) hospitals did not maintain their expected SVR during the COVID-19 pandemic, of which 625 (51·4%) were from HIC, 538 (44·2%) from MIC, and 54 (4·4%) from LIC settings. In the mixed-effects model, a 10-point increase in SPI corresponded to a 3·6% (95% CI 3·0–4·1; p<0·0001) increase in SVR. This was consistent in HIC (4·8% [4·1–5·5]; p<0·0001), MIC (2·8 [2·0–3·7]; p<0·0001), and LIC (3·8 [1·3–6·7%]; p<0·0001) settings. Interpretation The SPI contains 23 indicators that are globally applicable, relevant across different system stressors, vary at a subnational level, and are collectable by front-line teams. In the case study of COVID-19, a higher SPI was associated with an increased planned surgical volume ratio independent of country income status, COVID-19 burden, and hospital type. Hospitals should perform annual self-assessment of their surgical preparedness to identify areas that can be improved, create resilience in local surgical systems, and upscale capacity to address elective surgery backlogs. Funding National Institute for Health Research (NIHR) Global Health Research Unit on Global Surgery, NIHR Academy, Association of Coloproctology of Great Britain and Ireland, Bowel Research UK, British Association of Surgical Oncology, British Gynaecological Cancer Society, and Medtronic.

Islamic law, as well as Indonesian law, prohibits the intentional killer's entitlement to inheritance and bequest to him. This research aims to study the ruling on the felony of murder by transmitting Coronavirus (Covid-19) infection. Subsequently, the impact of inheritance and wills due to transmitting this infection deliberately or unintentionally. The research uses the descriptive approach and the analytical method in defining the felony of incapacitating murder and analyzing the impact of transmitting infection with this pandemic virus. The research comes with several results, including that whoever deliberately transmits infection with the Coronavirus (Covid-19) to people is regarded as the Spoilers on the land, that this felony deserves the punishment, that he is forbidden from inheriting if he is the heir, and that he is forbidden from the approval of the will if it is bequeathed to him.

Determining the gender of the heirs is important in the ruling of Islamic inheritance. Hence, Muslim jurists made efforts in determining the gender of hermaphrodites. Taking the safer position, the common practice is for the inheritance to be divided into two: the greater part of the share is withheld and the lesser portion is given out to the hermaphroditic inheritors along with their heirs until their gender is certified. This typically leads to disagreements among the jurists, hence, subsequently leading to a tedious process of certification. This protracted disagreement combined with a much prolonged certification process may harm the inheritors’ right due to the delay in judgement. This research aims to define the biological identity of a hermaphrodite and determine his sex according to the medical concept, as well as integrating the methods adopted by Muslim scholars to solve the issue of hermaphrodite inheritance. Both descriptive and analytical approaches are used in ensuring accurate knowledge transfer and trust in attribution. This research has found that the medical definition of a hermaphrodite is the most accurate and the most correct to end the dispute when dividing inheritance. Hence, this opens a wider area for further research that relies on medical information as evidence to be taken when studying Islamic legal rulings in ensuring the cohesion of society by preserving the rights of its members and maintaining their material and moral properties.

COVID-19 has made medical education delivery changed around the world. High stakes examinations have to take place despite the ongoing pandemic. Careful planning and considerations are mandatory in order to cater for the physical and social distancing new norms. The safety of everyone involved in the examinations (students, academics, patients and support staff) is put at the utmost priority to prevent further disease transmission. Universiti Sains Islam Malaysia (USIM) has made a drastic change in the conduct of its final professional examination for the undergraduate medical students. The traditional one long case and three short cases clinical examinations were converted to objective structured clinical examination (OSCE), comprising sixteen manned stations lasting 10 minutes each. The COVID-19 pandemic has become the stimulus for a paradigmatic shift in the final undergraduate medical students’ examination at the Faculty of Medicine and Health Sciences, USIM. This paper describes how the paradigmatic shift resulted in a successful conversion of assessment method from the traditional one long case and three short cases clinical examinations to sixteen manned objective structured clinical examination (OSCE) stations. The feedback from the examiners and students were highlighted. The COVID-19 pandemic has brought a new insight to the faculty members on alternative teaching and learning methodologies as well as how assessments can be conducted in the faculty. When left with not many choices, faculty members who were previously not convinced towards OSCE for summative assessment are now seeing OSCE as the way forward

The COVID-19 pandemic has caused the clinical attachment for medical students to be deferred in ensuring reduction of viral transmission. Patients encounter was near impossible, thus suspending medical students’ clinical skills on real patients. Despite this, the final examination had to be conducted. Hence, appropriate planning was made to ensure candidates were well prepared. A paradigm shift was made by Universiti Sains Islam Malaysia (USIM) with regards to the medical education delivery and the final undergraduate examination organization. The traditional in-person teaching and learning sessions were converted to video conferences and small group discussions to ensure social distancing. Objective structured clinical examination (OSCE) consisting of sixteen manned and twenty unmanned stations were introduced to replace the conventional one long and three short cases clinical examinations. The pandemic became the biggest obstacle for the final year medical students physically and psychologically. Familiarisation with the new format of learning and examination has to be made within three months. Online learning materials became resourceful during revisions. Simulated OSCE conducted by the lecturers, were advantageous to the students in ensuring familiarity to the new examination technique. Role-plays involving students’ family members and colleagues as patients, aided the candidates to rehearse their physical examinations and history taking techniques. The intensive teaching and learning sessions have enabled the candidates to be equipped with the new examination requirement. Reflection: Generally, candidates favour OSCE over traditional clinical examinations. This preponderance was due to OSCE capability in assessing the entire aspects of knowledge and skills in variable rotations throughout medical school.

Background :Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results :650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons’ preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

Background Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) (https://clinicaltrials.gov/ct2/show/NCT03163095). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study. Methods The COOL trial is the largest prospective randomized controlled trial examining the random allocation of SCIAS patients intra-operatively to either formal closure of the fascia or the use of the OA with an application of an NPPT dressing. Patients are eligible if they have free uncontained intraperitoneal contamination and physiologic derangements exemplified by septic shock OR severely adverse predicted clinical outcomes. The primary outcome is intended to definitively inform global practice by conclusively evaluating 90-day survival. Initial recruitment has been lower than hoped but satisfactory, and the COOL steering committee and trial investigators intend with increased global support to continue enrollment until recruitment ensures a definitive answer. Discussion OA is mandated in many cases of SCIAS such as the risk of abdominal compartment syndrome associated with closure, or a planned second look as for example part of “damage control”; however, improved source control (locally and systemically) is the most uncertain indication for an OA. The COOL trial seeks to expand potential sites and proceed with the evaluation of NPPT agnostic to device, to properly examine the hypothesis that this treatment attenuates systemic damage and improves survival. This approach will not affect internal validity and should improve the external validity of any observed results of the intervention. h

Islam has approved the system of inheritance based on accepted scholars justification. In kinship, this legislation has strengthened the bonds between the heir and the bequeathed. Likewise, the inheritance between spouses as long as the marriage exists between them. And he gave the freedman the right to inherit from his slave who had freed him. This study aimed to clarify and analyze the entitlement to inheritance in Muslim new. The problem of the research lies in the one who has the priority of the inheritance in new Muslims, if there are no other justifications for inheritance. This study relied on the inductive approach, by following the opinions of the jurists and their evidence regarding the conditions for inheritance entitlement in Islam currently; and examining the entitlement of Bayt Al-Mal as the beneficiary of the new Muslims who have no heirs. It also relied on the comparative analytical method in discussing and analyzing the opinions and evidence of jurists; comparing these provisions with what is being done in the fatwa departments today. This study concluded important results, including: The Bayt Al-Mal is a custodian of Muslims' money from loss, and not an inheritor. If the owner of this money is known, it will be returned to him, and if the owner of the money is not known, it will be distributed in the interests of the Muslims. The person who guides the new Muslim should be given precedence of inheritance in the Syariah. While, a new Muslim who does not have a legal inheritance has the right to bequeath all his money to whoever was a reason for his conversion to Islam, whether he was a person or an institution.

The Islamic law of inheritance for an unborn child is an important matter in Syariah because this subject can affect the inheritance of other heirs. The presence of the fetus can either affect the total amount of inheritance or reduce the amount of inheritance of the heirs depending on the reasons and conditions. Therefore, to assist the division of the inheritance; hypotheses are made on the gender and number of fetus as to allow the inheritors to have the inheritance by the least possibility or amount and the rest of the inheritance is frozen until the child is born which may extend to years. This is what resulted in disagreement among the jurists regarding the duration of this waiting period as it varies from two to four years, which is not a short period. When the inheritance is material, it is often difficult for the souls to wait. Therefore, this study intends to examine the inheritance of an unborn child according to medical evidence. This will lift the ongoing dispute between the jurists about the period of the least pregnancy and the duration of the longest pregnancy. In conclusion, we relied on the evidence of the medical sciences as a factor to take when defining everything on pregnancy and issues surrounding it to assist in Islamic law of inheritance.