Egyptian Universities Research Articles

Enhanced recovery urinary protocol for patients undergoing hip surgery: a quasi-experimental study.

Postoperative urinary retention (POUR) is a common complication after hip surgery. The enhanced recovery urinary protocol (ERUP) is a tool that employs several perioperative strategies to facilitate optimal conditions for surgery and recovery. The aim of this study was to evaluate the effect of ERUP on POUR in patients undergoing hip surgery. A controlled pre- and post-quasi-experimental study was conducted. Data was collected between May 2018 and January 2019 at the orthopedic department of one of the largest teaching hospitals affiliated with Menoufia University in Egypt. A convenience sample of 100 Egyptian patients (of both genders) undergoing elective hip surgery was equally allocated into two groups. The control group (n = 50) was given traditional routine perioperative nursing care, while the intervention group (n = 50) was subjected to ERUP. Data was collected from socio-demographic, medical, and surgical data sheets, preoperative medication assessment sheets, postoperative data sheets, and fluid balance charts. ERUP application significantly reduced the length of hospital stay and the incidence of POUR in the intervention group. Implementation of the ERUP is recommended for patients undergoing hip surgery, as it has a significantly positive effect on reducing the incidence of POUR.

Influence of individuals factors on employees' turnover intention: an analysis on private universities in Egypt

Influence of individuals factors on employees' turnover intention: an analysis on private universities in Egypt

An experimental investigation of the impact of sustainable ERP systems implementation on sustainability performance

Purpose This paper aims to investigate the influence of sustainable enterprise resource planning (S-ERPs) systems implementation on sustainability performance. Design/methodology/approach A 1 × 2 experiment was conducted, involving a sample of 72 professional accountants enrolled in MPA, MBA and DBA programs at two prominent Egyptian universities. Simple linear regression was used to analyze the data. Findings The results reveal positive relationships between the implementation of S-ERPs and economic, environmental and social sustainability performance. Research limitations/implications Considering the research methodology used, which relies on a laboratory experiment design; nevertheless, empirical data derived from a quasi-experiment conducted in a real-world context would offer valuable insights into the existing literature. Practical implications For manufacturing sector managers, the results offer value as organizations can benefit from S-ERP adoption in the internal and external integration of sustainability functions. The findings also provide decision-makers in the manufacturing context, particularly in emerging countries, with tangible reasons to consider S-ERP adoption for holistic sustainability benefits including waste management, resource consumption reduction and management of sustainable supply chain complexities. Further, the findings provide valuable insights for ERP vendors on how they can develop their ERP packages to align with software sustainability criteria. Originality/value This study is among the few that experimentally investigates the influence of S-ERPs implementation on sustainability performance within the manufacturing sector, especially in an emerging context such as Egypt. This unique contribution provides valuable insights into the complex connection between technology adoption and sustainability outcomes.

Developing a Model for a Distance Learning Environment to Confront Crises and Disasters

The current era is characterized by many accelerating events that directly affect education, most of which have a negative impact. Natural disasters, epidemics, wars, and other events are among these events. In recent years, the world has witnessed the COVID-19 pandemic, which has made it clear beyond doubt that institutions' educational systems were not prepared with alternative educational systems to confront such disasters, and thus, education was greatly affected, the effects of which are still present today. Therefore, it is necessary to prepare for such events by designing and developing electronic learning environments through which learning can be transferred safely and effectively. Such environments are comprehensive and self-sufficient to transfer learning in its three aspects: cognitive, skill, and psychological aspects of the learner. Considering this, the current research was interested in designing a model for an e-learning environment for distance learning that provides everything the learners may need. It includes scientific and health knowledge, mental and physical exercise, and educational platforms for interaction. This is considering a survey study of students at Ain Shams University, one of the largest universities in Egypt, in several faculties to determine the extent of the shortcomings in the electronic platforms used during and after the COVID-19 pandemic as an example of one of the most dangerous disasters that the world has witnessed in contemporary times, which directly affected education in all educational institutions. The results revealed a clear need for improvement in these platforms regarding general design, communication tools, strategies, educational activities, and feedback. Hence, there is an inevitable need to develop a model for an e-learning environment for distance education that can be used effectively to transfer learning, especially in crises, disasters, and epidemics.

The Impact of Intellectual Capital on Sustainable Competitive Advantage and Organizational Learning with mediating role of University Entrepreneurship: Evidence from Private Universities in Egypt

The purpose of this research is to empirically investigate the relationship between Intellectual Capital and Organizational Learning in the Private Universities in Egypt. The objectives of this research are: to test the relationship between Intellectual Capital and Sustainable Competitive Advantage, to examine the relationship between Intellectual Capital and University Entrepreneurship, to investigate the relationship between University Entrepreneurship and Sustainable Competitive Advantage, to examine the relationship between University Entrepreneurship and Organizational Learning, to investigate the mediation role of University Entrepreneurship between Intellectual Capital and Sustainable Competitive Advantage, to examine the mediation role of University Entrepreneurship between Intellectual Capital and Organizational Learning and to develop a theoretical framework illustrates the relationship amongst selected variables using structural equation modelling. The methodology will be based on quantitative analysis by using a questionnaire tool to gather required data and structural equation model analyses (SEM) using AMOS software. The main conclusions drawn from this study are the direct effect between Intellectual Capital and Sustainable Competitive Advantage is statistically significant, the direct effect between Intellectual Capital and Organizational Learning is statistically significant, the direct effect between Intellectual Capital and University Entrepreneurship is statistically significant, the direct effect between University Entrepreneurship and Sustainable Competitive Advantage is statistically significant, the direct effect between University Entrepreneurship and Organizational Learning is statistically significant. Finally, the study found that the University Entrepreneurship mediates the relationship between Intellectual Capital and Sustainable Competitive Advantage and the study found that the University Entrepreneurship mediates the relationship between Intellectual Capital and Organizational Learning

The Impact of Periodontal Inflammation on the Severity of Coronary Atherosclerosis.

Introduction Through plausible biological mechanisms, periodontitis causes systemic inflammatory burden and response, thus resulting in damage far beyond the oral cavity. Studies have demonstrated periodontitis to be a significant risk factor for coronary heart disease (CHD) and stroke. The larger the quantum of periodontal inflamed tissue, the greater the chances of periodontitis eliciting bacteremiaand systemic inflammatory responses. Studies have reported that periodontitis and other common oral infections play an important role in the development of atherosclerosis. Therefore, the quantity of inflamed periodontal tissue assumes significance in determining the severity of atherosclerosis. Hence, this study investigates the impact of periodontal inflamed surface area (PISA) on the severity of coronary atherosclerosis. Materials and methods In this cross-sectional study, a total of 160 patients who presented at the department of periodontics of The British University in Egypt (BUE) from 1 January 2023 to 30 September 2023 were enrolled. Patients were only enrolled if they had undergone coronary angiography within the last six months, were less than 60 years of age, shared their previous medical history and coronary angiographic report, and gave informed written consent. Data on classic coronary risk factors and periodontal inflammatory status and angiographic findings were recorded and subjected to appropriate statistical analysis. Results The results revealed that the periodontal inflamed surface area (p = 0.002) apart from age (p < 0.047) and low-density lipoprotein cholesterol(LDL-C) (p < 0.001) is a significant independent predictor of the severity of coronary atherosclerosis. Conclusions The periodontal inflamed surface area is an independent predictor of the severity of coronary atherosclerosis.

Cyberchondria and smartphone addiction: A correlation survey among undergraduate medical students in Egypt

BackgroundThere is an increase in smartphone usage globally. Cyberchondria (CYB) is characterized by excessive Internet searches for health information. Smartphone addiction is constantly rising among medical students together with CYB as a collateral emerging risk, yet there is limited research available on the topic.MethodsThis cross-sectional study explores the rising phenomenon of smartphone addiction and its potential role in CYB among medical students in seven Egyptian universities. A total of 1435 medical students participated in completing online questionnaires that assessed smartphone addiction and CYB using the Smartphone Addiction Scale-Short Version (SAS-SV) and Cyberchondria Severity Scale (CSS-12). Multivariable regression analysis was applied to assess predictors of smartphone addiction and CYB.ResultsBased on the used scales, 57.6% of students were suffering from smartphone addiction, and 85.8% exhibited a moderate degree of CYB. There was a significant positive correlation between smartphone addiction scores and CYB (p < 0.05). The multivariable regression models revealed that four factors including using Facebook, using WhatsApp, increasing time spent on the Internet per day, and a higher CYB score increase the probability of smartphone addiction. The factors that increase the probability of CYB are using Facebook, an increase in the frequency of Internet searches, a higher degree of worry about one’s health or a family member’s health, and being a smartphone addict.ConclusionSmartphone addiction among undergraduate medical students is prevalent. Social media use, time spent online, and smartphone addiction were linked with the risk of CYB. Regular physical activity decreases the probability of smartphone addiction. Awareness programs and increased mental and physical activities are required to help reduce smartphone addiction among youth.

Challenges of Transnational Education in the Global South

Abstract About ten per cent of Egyptian students are registered in 27 private universities and four private community universities in Egypt, amounting to 300,000 students studying in 169 faculties. Based on resident field experiences and drawing on communications with senior university managers in two private universities spanning six years, this research argues that a number of challenges persist in the implementation of transnational education in Egypt. Through the prisms of rational choice theory and institutional theory, it is found that underfunding, political interference (including ‘pedagogical balancing’) and negative norms set by university owners, managers and students alike, compounded by macro-economic instability, have had a major impact on the student experience and wider society. The findings are to various degrees applicable to other states in the Middle East, Africa and the wider Global South, as well as primary foreign stakeholders, such as the United Kingdom in this case.

EFL Majors' Attitudes toward Distance Learning via MOOCs: A Comparative Study between Egypt and Saudi Arabia

This research aimed to investigate the attitudes of EFL majors in both Egypt and Saudi Arabia towards distance learning with Massive Open Online Courses (MOOCs) and the underlying factors influencing such attitudes. A mixed method was employed to meet such an end, incorporating a quantitative method of investigation (an attitude questionnaire) and a qualitative one (semi-structured interviews). Quantitively, the participants, who were randomly selected, were 218 EFL majors: 114 from the Faculty of Education for Boys in Cairo, Al-Azhar University in Egypt, and 104 from the College of Science and Humanities, Prince Sattam bin Abdulaziz University- Saudi Arabia. Qualitatively, ten EFL majors (five Egyptian and five Saudi) were purposively selected using Convenience Sampling Technique. Quantitatively, the results revealed that both Egyptian and Saudi Arabian EFL majors exhibited negative attitudes toward distance learning via MOOCs. Qualitatively, some underlying factors interpreting the participants’ attitudes were revealed, i.e., a lack of interactivity and social interaction, limited technological proficiency, language barriers, inadequate feedback, unclear learning objectives, insufficient resources, and concerns about the credibility of MOOCs certificates. The research recommended raising the EFL learners’ awareness about MOOCs, empowering them with systematic support to overcome the technical and linguistic challenges, and fostering collaboration among universities and MOOCs services providers.

Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study

BackgroundMental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students.MethodsA cross-sectional study was conducted across ten Egyptian universities during the academic year 2022–2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ).ResultsAmong 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help.ConclusionThe findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

(067) The Outcome of Bulbospongiosus Muscle Injection with Botulinum-A Toxin for Treatment of Lifelong Premature Ejaculation; A Randomized Controlled Trial

Abstract Introduction Lifelong premature ejaculation (PE) is considered one of the commonest sexual disorder affecting men with an estimated prevalence of 2–5%. [1,2] Many definitions have been proposed for lifelong PE, the most accepted is the ISSM’s which consider PE “ejaculation which always or nearly always occurs prior to or within about 1 minute of vaginal penetration from first sexual experiences (lifelong premature ejaculation) + Negative personal consequences such as distress, bother, frustration, and/or the avoidance of sexual intimacy”.[3] However, there is no doubt that lifelong PE negatively affects the quality of life of the patient and his partner. [2] Proper assessment of this problem in an objective validated way has always been a challenge. [4] Treatment also varied from behavioral techniques, SSRIs and local anaesthetics with very variable outcome, unsatisfactory for many patients. [5] New lines have been always evolving trying to address this resistant category of patients such as injection of the glans penis with filler [6] or neurectomy of the dorsal nerve of the penis. [7] Herein; we assess a new line of treatment for lifelong PE which theoretically can inhibit the stereotyped rhythmic contractions of the bulbospongiosus muscle during the reflex of ejaculation using botulinum-A toxin; in a prospective, randomized, placebo-controlled study. Objective This study aimed to assess a new line of treatment for lifelong premature ejaculation (PE) which is botulinum-A toxin injection into the bulbospongiosus muscle. Methods It was conducted at the Andrology Unit of Tanta University in Egypt between November 2020 and November 2022. Patients with lifelong PE were considered for this study. Those suffering from PE secondary to erectile dysfunction, genital infection or psychic stress were excluded. Patients have been asked to stop any medical treatment that could affect their sexual function eg PDE5i and medications for lifelong PE; for at least 1 month before injection as well as 6 months thereafter. Sixty patients with lifelong PE have been prospectively enrolled and randomized into 2 groups; the test group (group A) was injected with 100 U botulinum-A toxin at 10 U/ml and the control group (group B) which was injected with the same volume of saline into the bulbospongiosus muscle. Injection was done in lithotomy position, using a fanning technique, under US guidance using the superficial probe to localize the site of injection. Fifty-seven patients of 60 completed the follow up protocol. Results Fifty-seven patients of 60 completed the follow up protocol. The IELT, PEP score and female satisfaction showed no statistically significant difference between both groups at the 1, 3 and 6 months post intervention. However, in the treatment group, the median (IQR) PEP score increased significantly after 1 and 3 months with a mean difference of 1.6 and 95 % CI of (0.7–2.5), P=0.001 and 0.9 and 95% CI of (1.07–1.69), P=0.02 respectively. Whereas insignificant change was noted at 6 months, with a mean difference of 0.13.In the control group however, there was no significant change of any of the tested parameters at any the 3 time points. Adverse reactions were minor and observed only in 3 cases (5%). Conclusions botulinum A injection into the BS muscle seems to be safe, but failed to prove efficacy when compared to placebo in treatment of lifelong PE Disclosure No.

Do Smartphone Addiction and Self-Regulation Failures Affect Students' Academic Life Satisfaction? The Role of Students' Mind Wandering and Cognitive Failures.

The purpose of this study is to investigate how smartphone addiction and self-regulation failure influence students' academic life satisfaction considering the impacts of students' mind wandering and cognitive failures. It also sought to look at how students' minds wander, and cognitive failures are affected by smartphone addiction and self-regulation failure among university students. The WarpPLS-SEM software was used to analyze the research data retrieved from a sample of 950 undergraduate students from universities in Egypt and the Kingdom of Saudi Arabia (KSA). In both countries, the findings revealed that students' smartphone addiction and self-regulation failures negatively affect students' academic life satisfaction and positively affect students' mind wandering and cognitive failures. Additionally, smartphone addiction is positively related to failures of students' self-regulation. Besides the negative influences of students' cognitive failures on their academic life satisfaction, cognitive failures mediated negatively the relationship between mind wandering and students' academic life satisfaction. Finally, students' mind wandering mediated the relationship between smartphone addiction, self-regulation failure, and academic life satisfaction. The study introduces fresh insights into the study variables that can be used to expand the literature on academic life satisfaction. The study provides theoretical and practical contributions to students, educators, and policymakers of education.

The Mediation Role of Technology Systems in the Relationship Between Education Technology Antecedents on Student Satisfaction

The purpose of this paper is to explore the influence of education technology antecedents and perceptions of usefulness and ease of use of educational technology systems on attitudes towards computer-based teaching in Egyptian universities. The study is built upon on deductive quantitative approach where structured questionnaires were designed and distributed to the students in Egyptian universities. Results based on SEM analysis identify that the technology dimension partially affects the design dimension, as well there is a partially significant association between the technology dimension and attitude towards technology-based teaching. While the design dimension does not have a significant association with attitude towards technology-based teaching, attitude towards technology-based teaching does not have a significant relationship with student satisfaction. Furthermore, there is a partially significant association between course dimensions and student satisfaction.

A Generative Design Approach to Improving the Environmental Performance of Educational Buildings in Hot Arid Climates. (Assiut National University as a Case Study)

The architectural design process is complex, involving diverse objectives that may be contradictory, and on which orientation exerts significant influence. The artificial intelligence application, Generative Design facilitates solving multi-objective design dilemmas through the creation and evaluation of numerous design alternatives. However, its exploration in educational buildings in hot arid climates remains limited. Given the impact of spaces’ function distribution, this study aims to optimize it in the typical plans of educational buildings. Employing a multi-objective design approach to enhance environmental performance. The study is conducted and evaluated in national universities in Egypt as a case study, specifically in Assiut City. The results revealed that the optimum design for a certain objective has not equated to optimal performance for other goals, highlighting an inherent contradiction between them. Among 26,334 possible alternatives for spaces’ function distribution, the difference between the optimal scenario and the least favourable one is significant for the parameters related to study spaces: natural daylighting, and visual comfort, ranging from 10% to 24%, besides around 1% difference for parameters related to the whole building, including energy consumption, thermal comfort, and carbon emission. This research offers a framework applicable to various building types. Additionally, it encourages decision-makers to adopt a no-cost sustainable design approach.

Academic Self-efficacy and its Relationship to Academic Competitiveness, Academic Procrastination, and Cognitive Flexibility among Undergraduate Students

This paper aims to explore the relationship between academic self-efficacy, academic competitiveness, academic procrastination, and cognitive flexibility. In addition, it reveals differences in gender, academic specialization, and study level among undergraduate students. The participants were (450) undergraduate students(300) fourth year, and (150) first year at College of Education at a University in Egypt. Academic self-efficacy, academic competitiveness, academic procrastination, and cognitive flexibility scales were used. Descriptive statistics were performed using SPSS. The findings indicated a positive relationship between academic self-efficacy, academic competitiveness, and cognitive flexibility, whereas negative with academic procrastination. In addition, there are significant differences in academic self-efficacy in favor of females, and in favor of males in academic procrastination, but no gender differences in academic competitiveness and cognitive flexibility. The findings also explored significant differences in academic self-efficacy in favor of scientific specialization, and no specialization differences in academic competitiveness, academic procrastination, and cognitive flexibility. The results also revealed significant differences in study level in academic self-efficacy, academic procrastination, and cognitive flexibility in favor of fourth-year students, whereas no differences were found in academic competitiveness. Some recommendations were presented considering the research results.

Able or disabled: why should neurodiverse students experience improved access to public universities? An exploratory study

Purpose This paper aims to answer the question: To what extent should neurodiverse students experience improved access to public universities in Egypt and why?Design/methodology/approach A systematic qualitative research method was used with data collected through semi-structured interviews with 44 educators in four universities in Egypt. A thematic approach was implemented to analyze the collected data.Findings The addressed educators believe that greater representation of neurodiverse students in their schools should be a priority for the following four reasons: first, neurodiverse students represent a promising new market segment schools could benefit from; second, recruiting more neurodiverse students represents a chance for schools and faculties to prove the social role they can undertake; third, schools can benefit from the unique skills many neurodiverse students have, particularly in mathematical and computational skills; and fourth, the greater the representation of neurodiverse students, the more research projects and funding opportunities educators can obtain.Originality/value This paper contributes by filling a gap in diversity management, higher education and human resources management in which empirical studies on the representation of neurodiverse individuals in public universities have been limited so far.

Requirements for Najran University to Transform into A Green University in Light of the Experiences of Some Arab and International Universities

This research paper aimed to study the most important requirements for transforming Najran University into a green university, by studying the concept of the green university and the green scale. The study used the descriptive approach to study the experiences of the most important international green universities that occupy an advanced position in the green scale of universities, then the most important Arab universities and Egyptian universities. I also presented a research paper to rank Egyptian, Arab and Saudi universities in the green scale for universities, and through these experiences I came up with a set of requirements that could contribute to the transformation of Najran University into a green university.

Drivers of undergraduate students’ learning perceptions in the blended learning environment: The mediation role of metacognitive self-regulation

In student-centric learning environments, such as blended learning, students’ metacognitive self-regulation is required to plan, monitor, and control their learning processes and achieve positive learning outcomes. The lack of metacognitive self-regulation may lead students to encounter difficulties that, eventually, affect their learning perceptions. Therefore, understanding how to drive students' metacognitive self-regulation is essential to delivering an effective blended learning process that supports students' learning perceptions. This study examines the structural relationships between academic self-efficacy, student–student interaction, student–lecturer interaction, metacognitive self-regulation (including planning, monitoring, and regulating), and perceived learning using structural equation modeling. The data were collected from 1675 undergraduate students who experienced blended learning at Egyptian universities. The findings revealed that academic self-efficacy, student–student interaction, and student–lecturer interaction have significant direct effects on the planning, monitoring, and regulating dimensions of metacognitive self-regulation. Furthermore, metacognitive self-regulation dimensions not only influence perceived learning but also mediate the effects of academic self-efficacy, student–student interaction, and student–lecturer interaction on perceived learning, except for monitoring, which has an insignificant mediation effect on the relationship between student–student interaction and perceived learning. The findings of this study may help researchers, practitioners, and stakeholders gain deep insights regarding how to promote tertiary students’ metacognitive self-regulation and learning perceptions during the blended learning experience.

The possible utility of global longitudinal strain in the risk-stratifying process of non-ST elevation-acute coronary syndrome.

There are various ways that coronary artery disease (CAD) might present itself. Individual risk stratification for non ST-elevation-acute coronary syndrome (NSTE-ACS) patients should determine whether invasive coronary angiography and revascularization should be scheduled. To assess the possible utility of left ventricular global longitudinal strain in the risk-stratifying process of NSTE-ACS. The cardiology department of Zagazig University in Egypt organized and oversaw this cross-sectional study. The practical portion was carried out on 90 patients with NSTE-ACS based on European society of cardiology (ESC) guidelines (and they agreed for invasive strategy) between May 2019 and December 2020 at Salalah Heart Center in Sultanate of Oman. All patients underwent a full clinical examination, 12-lead ECG, and serial high-sensitivity troponin T (hs-TnT) in addition to a thorough history taking process. On patient's admission, the GRACE risk score was assessed. All patients who were suspected of having NSTE-ACS upon admission underwent transthoracic echocardiography, including two-dimensional speckle tracking (2D-ST). Left ventricular global longitudinal strain (LV-GLS %) was measured and analyzed using 2D speckle tracking. SYNTAX Score was determined for all patients. By analysis of the performance of LV-GLS% in prediction of high risk by GRACE score, we found that with cutoff (≥-13.8), the AUC was (0.944) with sensitivity, specificity, PPV, NPV, and accuracy (0.944, 93.3%, 84%, 53.8%, 98.4%, 85.6%), respectively. Global longitudinal strain can predict accurately high-risk NSTE-ACS patients by GRACE score.

Relationship Between Alexithymia, Smartphone Addiction, and Psychological Distress Among University Students: A Multi-country Study.

Increasing dependence on smartphones results in the appearance of psychological problems, especially among young people. This study aims to determine the rates of alexithymia and its relationship with smartphone addiction and psychological distress in university students. A total of 2616 students (mean age = 22.5±3.5 years; 73.1% female) from universities in Egypt, Oman, and Pakistan were included in a cross-sectional and comparative study conducted through a web survey during the COVID-19 pandemic from October to December 2021. The following scales were used: Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Smartphone Addiction Scale-Short Version (SAS-SV). The survey also included questions related to sociodemographic and smartphone usage patterns.