Concept Of Action Research Articles

On concepts of action and behavior as the implicit point of agreement between Enactivism and Radical Behaviorism

In psychology, the principle of “Behaviorism” has a negative connotation. The ascription of the philosophical stance as “behaviorist” is usually nuanced with criticism, and those labeled behaviorists often deny it (For example, Gallagher says, “But then, a surprise! Barrett also wants to recruit the behaviorists, and specifically, B. F. Skinner. Is this “the enemy of my enemy is my friend” type of strategy? Can we maintain peace within our own ranks if we mix phenomenologist with behaviorists?” (Gallagher, Philosophical Studies, 176(3), 839-851, 2019 p. 841)). However, some recent re-evaluations have rescued Behaviorism by indicating that these arguments were based on a caricatured view. This study further argues a point of agreement in their fundamental concept of “behavior” and “action,” leading to a more productive relationship, in three steps. First, it starts with an overview of the development of Behaviorism. This step identifies that the concept of “behavior” in the sense of contemporary Behaviorism has interactive properties between an agent and the environment instead of mere physical movements, which can be summarized in two key features: modern Behaviorism understands behavior (1) in relation to subsequent events and (2) as inseparable from mental phenomena, which is discussed in usual cognitive science; it also understands mental phenomena as something observable in behaviors (Sect. 1). Next, we demonstrate that some of the distorted criticism of Behaviorism arises due to a lack of understanding of behavior (Sect. 2). It is revealed that the characterization as Behaviorism per se should be value-neutral once the behavior concept is accurately articulated. Finally, Sects. 3 and 4 shed light on the approach taken by enactivists in their treatment of actions, aligning them with the concept of behavior. It will be contended that these theories exhibit the presence of two characteristics previously outlined within Behaviorism.

Clinical validation of explainable AI for fetal growth scans through multi-level, cross-institutional prospective end-user evaluation

We aimed to develop and evaluate Explainable Artificial Intelligence (XAI) for fetal ultrasound using actionable concepts as feedback to end-users, using a prospective cross-center, multi-level approach. We developed, implemented, and tested a deep-learning model for fetal growth scans using both retrospective and prospective data. We used a modified Progressive Concept Bottleneck Model with pre-established clinical concepts as explanations (feedback on image optimization and presence of anatomical landmarks) as well as segmentations (outlining anatomical landmarks). The model was evaluated prospectively by assessing the following: the model’s ability to assess standard plane quality, the correctness of explanations, the clinical usefulness of explanations, and the model’s ability to discriminate between different levels of expertise among clinicians. We used 9352 annotated images for model development and 100 videos for prospective evaluation. Overall classification accuracy was 96.3%. The model’s performance in assessing standard plane quality was on par with that of clinicians. Agreement between model segmentations and explanations provided by expert clinicians was found in 83.3% and 74.2% of cases, respectively. A panel of clinicians evaluated segmentations as useful in 72.4% of cases and explanations as useful in 75.0% of cases. Finally, the model reliably discriminated between the performances of clinicians with different levels of experience (p- values < 0.01 for all measures) Our study has successfully developed an Explainable AI model for real-time feedback to clinicians performing fetal growth scans. This work contributes to the existing literature by addressing the gap in the clinical validation of Explainable AI models within fetal medicine, emphasizing the importance of multi-level, cross-institutional, and prospective evaluation with clinician end-users. The prospective clinical validation uncovered challenges and opportunities that could not have been anticipated if we had only focused on retrospective development and validation, such as leveraging AI to gauge operator competence in fetal ultrasound.

Combinatorial Properties and Invariants Associated with the Direct Product of Alternating and Dihedral Groups Acting on the Cartesian Product of Two Sets

Group theory, an area in mathematics, has undergone extensive research, but not exhaustively. In group theory, especially symmetric groups have been studied in terms of properties and actions. In this research, two groups of the Symmetric Group (Alternating and Dihedral Groups) are studied in terms of their properties and also their direct product between them. Also, ordered sets are studied in this research where their Cartesian product is looked at. Finally, this research combines the direct product of two symmetric groups (alternating group and dihedral group) and the Cartesian product of two ordered sets (&amp;lt;I&amp;gt;X&amp;lt;/I&amp;gt;×&amp;lt;I&amp;gt;Y&amp;lt;/I&amp;gt;) by group action. This research therefore focuses on determining the combinatorial properties (transitivity and primitivity), invariants (ranks and subdegrees), and structures (suborbital graphs) of this group action. To accomplish this, orbit-stabilizer theorem is used to compute transitivity, block action concept is applied to determine primitivity, and Cauchy-Frobenius lemma is used to compute ranks and subdegrees. For &amp;lt;i&amp;gt;n&amp;lt;/i&amp;gt; ≥ 3, it has been confirmed that the group action is transitive and also imprimitive. The rank of this group action is 6 and the subdegrees are obtained using the formula of Theorem 3.3. This research adds new concepts in group theory which will be useful in other areas like graph theory and also application in real life situations.

A quality of life promoting model for the elders Apllying social laboratory concept in health region 5, ministry of public health

This research and development project aimed to promote and evaluate the effectiveness of a quality of life of the elders applying social laboratory concept. The study was conducted in three phases, Phase 1: Situational analysis to identify quality of life issues among 270 elders’ participants. Phase 2: Development of the model and piloting with a sample of 30 participants. Phase 3: A pilot implementation and evaluation of the model with 30 experimental and 30 control participants. The study was conducted from June to September 2024. The tools used included, A WHOQOL–BREF–THAI questionnaire for assessing the quality of life of elders, A questionnaire on lifestyle behaviors, and A quality-of-life enhancement model for elders applying social laboratory concept. Data were analyzed using t-tests. Findings, Phase 1: The quality of life of elders in Health Region 5 of the Ministry of Public Health was found to be at a moderate level. Phase 2: A prototype model was developed, emphasizing participatory planning based on social action concepts. The PRIME Model was introduced, comprising, P: Purpose, Plan, and Partnerships, R: Research, Response, and Reflection, I: Insight, Interest, and Influence, M: Materials, Monitoring, and Maintenance, E: Experience, Empowerment, and Environment. This model was aligned with six key lifestyle behaviors for elders. Phase 3: The prototype model was applied to the experimental and control groups, each consisting of 30 participants, over a six-week period. The results revealed, A significant improvement in the quality of life among the experimental group compared to pre-intervention levels (p-value &lt; .001). A significant enhancement in lifestyle behaviors in the experimental group compared to pre-intervention levels (p-value &lt; .001). A significant improvement in overall health status among the experimental group compared to pre-intervention levels (p-value &lt; .001). To sustain and improve the quality of life and health behaviors of elders, continuous application of the quality-of-life enhancement model based on the social laboratory concept is essential.

Recent Advances for the Development of Sustainable Transport and Their Importance in Case of Global Crises: A Literature Review

The 21st century is a time of rapid development, marked by technological advances, globalization, and international cooperation. It is also a period that has witnessed numerous global crises. In light of recent events, such as the migration crisis, the COVID-19 pandemic, and the escalation of the conflict between Ukraine and Russia, it is crucial to consider how to ensure economic stability and enhance the security of the transportation sector in the face of emerging threats. The goal of this publication is to identify the latest solutions in sustainable transportation development and to highlight their relevance in the context of potential global crises. To achieve this, a systematic review of the current research on transportation industry innovations was conducted using 4 different databases, yielding 492 results. From these, 223 publications were selected for analysis based on established criteria. The selected transport solutions were grouped into specific categories, and then their relevance in the context of global crises was discussed. The findings highlighted key solutions essential for economic stability and transport sector safety in potential crisis situations, while also pointing to further research directions. Additionally, they offer actionable concepts for transport organizers to promote a more resilient and sustainable flow of passengers and goods in anticipation of future crises.

DISPUTE BOARDS COMO MEIO DE RESOLUÇÃO DE CONFLITOS NA LEI DE LICITAÇÕES E CONTRATOS ADMINISTRATIVOS (LEI N. 14.133/2021): A IMPLEMENTAÇÃO DOS DISPUTE BOARDS NOS CONTRATOS ADMINISTRATIVOS

This article analyzes the application of Dispute Resolution Committees as a means of resolving conflicts in administrative contracts, focusing on the Law on Tenders and Administrative Contracts (Law no. 14,133/2021). Dispute Boards emerge as a preventive and effective tool to deal with the complexity and high amounts involved in public contracts, such as concessions and public-private partnerships (PPPs). The study addresses the origin and concept of Dispute Boards, their preventive and resolutive action in contracts, and their increasing use in the public sector, highlighting the challenges and limitations in this context. Furthermore, it deals with Dispute Boards compared to other conflict resolution mechanisms, such as arbitration and mediation, comparing their advantages and advantages. Finally, areas for future research are suggested, such as the economic impact of Dispute Boards and the analysis of practical cases involving large-scale public contracts.

Excellent Service dalam Peningkatan Kualitas Pelayanan Administrasi Dinas Kependudukan dan Pencatatan Sipil Kota Malang

Population administrative services should be efficient, productive, responsive, and accountable. In this case, public satisfaction should be a top priority. The type of research used is qualitative descriptive research. The aim of this study is to understand the concept of excellent service used to improve the quality of administrative services provided by the Department of Population and Civil Registration of Poor Cities. Primary and secondary data are used, and data collection techniques are done with interviews, documentation, and observations. Data analysis includes collective, reduction, presentation, and conclusion. The concept of Attitude, Attention, and Action (3A) Primary Service is used by the Poor City Civil Registration and Occupation Service. For the attitude points, which have demonstrated behavior and attitude that are purposeful and conscious, and the attention points, which have shown full concern to the applicant in terms of meeting the applicant's needs and giving criticism and advice, For the final action points, I have been responsible for performing tasks according to the service officer's job desk and doing so on the job. Thus, the quality of administrative services in the Department of Occupation and Civil Registration of Poor Cities can be improved and the status of primary service retained in accordance with the concept of excellent service

The construction of linguistic identities in talk about food among Tibetan heritage language learners

ABSTRACT This ethnographic article examines the interactional processes through which Tibetan-Canadian heritage language learners agentively construct their linguistic identities in everyday family interactions. Because food is centrally involved in family routines, as well as broader cultural practices and the articulation of individual tastes, talk about food provides a site for analyzing negotiations of individual agency amid expressions of shared identity. Drawing from previous language socialisation scholarship that approaches family meal times as a resource for constructing identity, this paper analyzes children’s conversations at meal-times, during food preparation, and about food preferences. Through interactional analysis of twelve months of longitudinal video ethnography in two Tibetan-Canadian families, I found that, in these activities centered on food, children used multilingual and multimodal resources to negotiate authority over their cultural and linguistic knowledge. Specifically, children agentively displayed their knowledge of Tibetan language forms, elaborated on their capacities to participate in cultural activities, and instructed parents about their individual preferences. By analyzing these interactional displays of knowledge through the concepts of agency and co-operative action, I argue that children construct their identities as speakers of Tibetan, despite the dominance of English in their language repertoires.

Who Should Be Promoted to Management? Developing Promotion Criteria to Ensure Organizational Success

This article explores effective criteria and processes for promoting the right employees into management roles. Through a review of academic literature and insights from professional experience, key competencies for management success are identified, including technical skills, strategic thinking, interpersonal abilities, coaching talent, and change leadership. A multidimensional framework for defining and assessing these competencies is proposed. Best practices for cultivating a pipeline of future leaders through challenging assignments, training, sponsorship and accountability are also discussed. Case studies of Google and GE's systematic talent evaluation methodologies demonstrate research-based concepts in action. The article argues a multifaceted, evidence-driven approach anchored in competency modeling and integrated talent development optimize the alignment of personnel with organizational needs to ensure sustained excellence through strong leadership over time.

Analisis Konsep Nusyuz dan Implikasinya dalam Perkara Perceraian di Pengadilan Agama Surabaya

This research aims to analyze the concept and implications of nusyuz's actions in divorce cases in the Religious Courts. Nusyuz is defined as a wife's defiance of her obligations to her husband. Nusyuz is also often the basis for filing divorce lawsuits, especially divorce petitions for divorce by the husband. This study examines how nusyuz actions are taken into consideration by Religious Court judges in deciding divorce cases, as well as their impact on the wife's rights, such as those related to iddah liaving, mut'ah living, and child custody. By using normative juridical methods based on analysis of direct trials and court decisions, this research finds that nusyuz actions have significant legal consequences for wives, especially in terms of living and other rights after divorce. However, there are also variations in the judge's assessment of the evidence of nusyuz's actions, which has implications for the final outcome of the divorce case.

An Analytical Theoretical Study of Terrorism According to the Social Action Theory of ‘Talcott Parsons’ as an Instance of Sociological Theories

The main focus of sociology is presenting the social life of people and their behaviours, whether in groups or societies. Sociology, usually, is defined as a field of research which studies the social interaction between people and their behaviours. Thus the sociological theories and scholars have given great importance to social action concept. In this study, which is an extract from a PhD dissertation, the terrorism has analysed sociologically according to the Talcott Parsons’ theory of social action. Since terrorism is one of the common social phenomena around the world, it has various factors and reasons that vary according to the communities’ nature of life. Terrorism, also, is a concept which used for any violent acts committed by an organization, an individual or a group. It has been experienced by humanity in many different ways throughout different eras. Therefore this study has tried to determine a theoretical framework for analysing and reviewing this phenomenon besides talking about it according to the reality of society and its most important causes and effects on the life of society and individuals. Because the Parsons’ theory serves the study aims and gives us the opportunity of conducting and analysing the study in a more detailed approach, it has been utilised for the current study. The main aim of the study is to analyse the phenomenon of terrorism from the perspective of “Talcott Parsons' theory of social action as a sociological theory”.

A Systematic Review of Learning Opportunities Within the Crowdworkers’ Workplace

This systematic review used a qualitative content analysis (QCA) and co-occurrence analysis of scientific papers from multiple disciplines published between 2011 and 2021. It could identify learning opportunities within the crowdworkers&amp;rsquo; workplace, ranging from work management via brand-building and technology-use to the engagement with the community interface, considering multiple constituents of the crowdworkers&amp;rsquo; workplace such as locations and their infrastructure, as well as working hours and expectations by society. The degree to which such learning opportunities occur is shaped by the crowdwork platform, the community interface, digital devices, and the individual workplace environment they encounter. To grasp the reality of crowdwork, the CPSS meta-model by Yilma et al. (2021), Goller&amp;rsquo;s concept of agentic actions (2017), and Billett&amp;rsquo;s workplace curriculum model (2020) are used.

Judging voluntariness: abortion assistance around 1900

ABSTRACT In this article, I focus on a practice that is legally referred to as assisting or abetting abortion. Using the example of Margarethe Hardegger (1882–1963), a Swiss women’s rights activist and socialist who was charged with this crime in 1915, I analyze how she defended her assistance before the criminal court of the city of Bern. I seek to show how her conception of voluntary action as feminist women’s solidarity entered into a battle of interpretation with patriarchal thought and legal-economic ideas of order, whose exponents sought to impute a commercial character to her engagement. Additionally, I explore how the medical profession positioned itself in this dispute and what the women who had abortions with her help had to say. In light of this case study, the article aims to bring out the multiform interpretations of a voluntary social practice and thus gain insight into the contemporary power dynamics and forms of resistance.

The role of action concepts in physical reasoning: insights from late childhood.

A fundamental component of human cognition is the ability to intuitively reason about behaviours of objects and systems in the physical world without resorting to explicit scientific knowledge. This skill was traditionally considered a symbolic process. However, in the last decades, there has been a shift towards ideas of embodiment, suggesting that accessing physical knowledge and predicting physical outcomes is grounded in bodily interactions with the environment. Infants and children, who learn mainly through their embodied experiences, serve as a model to probe the link between reasoning and physical concepts. Here, we tested school-aged children (5- to 15-year-olds) in online reasoning games that involve different physical action concepts such as supporting, launching and clearing. We assessed changes in children's performance and strategies over development and their relationships with the different action concepts. Children reasoned more accurately in problems that involved supporting actions compared to launching or clearing actions. Moreover, when children failed, they were more strategic in subsequent attempts when problems involved support rather than launching or clearing. Children improved with age, but improvements differed across action concepts. Our findings suggest that accessing physical knowledge and predicting physical events are affected by action concepts, and those effects change over development. This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

Ethosomes: A Promising Drug Delivery Platform for Transdermal Application

In recent years, transdermal drug delivery systems have gained considerable attention for their ability to enhance patient compliance and provide consistent drug release. However, the barrier function of the skin’s outermost layer remains the foremost challenge in these systems. As a result, there is a growing interest in the use of ethosomes as a cutting-edge nanocarrier in drug delivery. This review presents the concept and mechanism of action of ethosomes as well as the numerous types and preparation techniques available. It also discusses the significance of characterization methods and how they impact ethosomal properties along with recent advancements and applications in the realm of transdermal drug delivery. Ethosomes exhibit tremendous potential for the pharmaceutical industry, and optimizing preparation methods, performing comprehensive property studies, and exploring their applications are critical areas for future research.

On the Construction of Congruences over Generalized Fuzzy G-Acts

Group action is defined to support Cayley’s claim that every group is isomorphic to a suitable subgroup of a symmetric group. Group actions have a wide range of applications, including the analysis of symmetries of geometric objects and algorithms and cryptographic systems. In 1965, Zadeh introduced the concept of fuzzy sets and provided a mathematical formulation for various concepts in this area. Since then, the concept of fuzziness has been integrated into several branches of mathematics to address the uncertainties of real-life scenarios. This article introduces the concept of group action in a fuzzy environment, termed fuzzy G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-subacts. The study provide the concept of fuzzy G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-orbits and fuzzy G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-stabilizers and clearly outlines fuzzy permutation representations of G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document} and fuzzy G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-morphisms. The research findings significantly contributes to the understanding of fuzzy G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-congruences and fuzzy quotient G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-subacts with the help of fuzzy G\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathcal {G}$$\\end{document}-partitions. This approach not only refines the underlying theories but also opens up new possibilities for practical implementation. Thus, the study demonstrates how the more complex fuzzy theory can expand and enrich the mathematical structures of abstract algebra, making them highly applicable.

Tutorial action models in universities of Latin America: A systematic review

Introduction: University tutorial action is a process of student intervention framed within educational orientation, and inherent to teaching action, increasingly considered in Latin America, as an effective strategy that reduces student dropout, and increases. the completion of university studies.Objective: Identify the main characteristics of the tutorial action models implemented in universities in Latin America.Methods: A systematic exploratory review of the existing updated literature, published in the last five years in the Web of Science and Google Scholar databases, referring to the Latin American context, was carried out.Results: A total of 21 studies considered relevant to the research were analyzed.Conclusions: It is evident that in the region there are different positions regarding the conception, organization and implementation of the tutorial action. The terms models, project and tutorial action plan are used interchangeably to represent the tutorial action as an object. just as the declared foundations appear imprecisely.

Communication Ethics Facing the Ambivalence of Digital Technology

This article aims to review the concept of action and answer how communication ethics faces the ambivalence of digital technology. Using a critical-normative research method on the works of Aristotle and Hannah Arendt, this study finds that in the face of the ambivalence of digital technology, communication ethics needs to put digital actions back on the consciousness of the perpetrator. In addition, communication ethics must overcome banal clicks and deal with the robotic manipulators of digital systems. There are two ways to use it: first, a complicated way in the form of resistance to digital manipulators, and the second is a soft way, which is to reposition the three virtues, namely courage, honesty, and elegance, to build digital altruism in digital communication ethics.

Androgen Inhibition of Reproductive Neuroendocrine Function in Females and Transgender Males.

Ovarian function is controlled by pituitary secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH), which in turn are governed by gonadotropin releasing hormone (GnRH) secreted from the brain. A fundamental principle of reproductive axis regulation is negative feedback signaling by gonadal sex steroids back to the brain to fine-tune GnRH and gonadotropin secretion. Endogenous negative feedback effects can be mimicked by exogenous steroid treatments, including androgens, in both sexes. Indeed, a growing number of clinical and animal studies indicate that high levels of exogenous androgens, in the typically male physiological range, can inhibit LH secretion in females, as occurs in males. However, the mechanisms by which male-level androgens inhibit GnRH and LH secretion still remain poorly understood, and this knowledge gap is particularly pronounced in transgender men (individuals designated female at birth but identifying as male). Indeed, many transgender men take long-term gender-affirming hormone therapy that mimics male-level testosterone levels. The impact of such gender-affirming testosterone on the reproductive axis, both at the ovarian and neuroendocrine level, is a long-understudied area that still requires further investigation. Importantly, the few concepts of androgen actions in females mostly come from studies of polycystic ovary syndrome, which does not recapitulate a similar androgen milieu or a pathophysiology of inhibited LH secretion as occurs in testosterone-treated transgender men. This review summarizes clinical evidence indicating that exogenous androgens can impair neuroendocrine reproductive function in both female individuals and transgender men and highlights emerging experimental data supporting this in recently developed transgender rodent models.

Jürgen Habermas revisited via Tim Cook's Wikipedia biography: A hermeneutic approach to critical Information Systems research

Critical Information Systems (IS) research is sometimes appreciated for the shades of gray it adds to sunny portraits of technology's emancipatory potential. In this article, we revisit a theory about Wikipedia’s putative freedom from the authority of corporate media's editors and authors. We present the curious example of Tim Cook's Wikipedia biography and its history of crowd-sourced editorial decisions, published on Wikipedia's talk pages. We use a hermeneutic method to subject the theory about Wikipedia's “rational discourse” and “emancipatory potential” to a soft, empirical test. When we examined Cook's Wikipedia biography and its editorial decisions, what we found pertained to authoritative discourse – the opposite of “rational discourse” – as well as Jürgen Habermas's concept of dramaturgical action. Our discussion aims to change how critical scholars think about IS's Habermasian theories and emancipatory technology. Our contribution – a critical intervention – is a clear alternative to mainstream IS research's moral prescriptions and mechanistic causes.