articles+ search results

Eastern Mediterranean region, honor killing, violence against women, femicide, homicide, and Medicine

Honor killing is a violent crime committed by one or more perpetrators, in which the crime’s intention is to restore honor to their family. In this narrative review, the authors investigate the epidemiology of honor killing in the Eastern Mediterranean Region. Furthermore, the social, cultural, and legal aspects of honor killing are discussed. Numerous socio-cultural factors lead to the action of killing for honor in this region. They include deeply rooted patriarchal dominance, the desire to maintain social status, and being poorly educated. Honor killing perpetrators have similar characteristics, such as rating female chastity at a higher price and justifying violence against women. The impact of honor killing on family members is much greater than the perceived families’ beliefs of the community’s rejection of the female’s dishonorable behavior. Silence culture dominates these societies, and many crimes are under-reported in this region. Often, a judicial trial is not conducted for such heinous crimes. Penal code reforms, campaigns to promote human rights, steps to improve the education level, and active participation of civil society in condemning such crimes are a few essential measures that need to be considered in order to curb the social evil of honor killing.

Epilepsy, Neurological conditions, WES, Saudi Arabia, Variants, Medicine, Genetics, and QH426-470

Abstract Background Epilepsy, a serious chronic neurological condition effecting up to 100 million people globally, has clear genetic underpinnings including common and rare variants. In Saudi Arabia, the prevalence of epilepsy is high and caused mainly by perinatal and genetic factors. No whole-exome sequencing (WES) studies have been performed to date in Saudi Arabian epilepsy cohorts. This offers a unique opportunity for the discovery of rare genetic variants impacting this disease as there is a high rate of consanguinity among large tribal pedigrees. Results We performed WES on 144 individuals diagnosed with epilepsy, to interrogate known epilepsy-related genes for known and functional novel variants. We also used an American College of Medical Genetics (ACMG) guideline-based variant prioritization approach in an attempt to discover putative causative variants. We identified 32 potentially causative pathogenic variants across 30 different genes in 44/144 (30%) of these Saudi epilepsy individuals. We also identified 232 variants of unknown significance (VUS) across 101 different genes in 133/144 (92%) subjects. Strong enrichment of variants of likely pathogenicity was observed in previously described epilepsy-associated loci, and a number of putative pathogenic variants in novel loci are also observed. Conclusion Several putative pathogenic variants in known epilepsy-related loci were identified for the first time in our population, in addition to several potential new loci which may be prioritized for further investigation.

Acute annular outer retinopathy, Acute zonal occult outer retinopathy, Invasive ductal carcinoma, Retinal disease, Case report, Ophthalmology, and RE1-994

Abstract Background Acute annular outer retinopathy (AAOR) is an uncommon disease. To date, there are few documented cases in the literature. Our case report is the first to describe a case of acute annular outer retinopathy in a patient with invasive ductal breast carcinoma. Case presentation The patient presented with photopsias and visual loss approximately 3 weeks prior to a diagnosis of invasive ductal breast carcinoma. We have documented the outer annular white ring seen in the acute phase of this disease and correlate it anatomically with Spectral-domain optical coherence tomography (SD-OCT) imaging. We identified RPE atrophy with nodular hyperreflectivity and loss of ellipsoid layer within the white annular ring with corresponding visual field loss. Fundus autofluorescence correlated with structural alterations seen on SD-OCT and showed both presumed active hyperautofluorescent zones with patchy hypoautofluorescent zones of atrophy and a classic annular hyperautofluorescent border. This case provides additional information about the natural history of this rare entity and its prognosis and varied presentation. Conclusions The authors report a single case of acute annular outer retinopathy in a patient with invasive ductal breast carcinoma with the corresponding SD-OCT, fundus autofluorescence and visual field findings, during the acute phase of the disease. These findings provide new insight into the characteristic features, etiology and progression of this rare disease.

low-carbon concrete, sustainability, structural resilience, self-healing concrete application, Building construction, and TH1-9745

The sustainability of the construction industry is a priority in innovations made towards mitigating its notoriously high carbon emissions. Developments in low-carbon concrete technology are of peak interest today under the scrutiny of emerging policy pressures. Concrete is the external part of most structures vulnerable to permanent degradation and weathering, the possibility of an intrinsic restoration of its engineering properties promises unprecedented advancements towards structural resilience. Existing research in self-healing concrete (SHC) has often concerned the scope of material development and evaluation with inconclusive field testing, hindering its progress towards structural feasibility. This paper presents an overview of recent progress in SHC, and possible opportunities and challenges of popular healing systems are discussed. Moreover, trends are observed to investigate SHC’s influence on the engineering properties of concrete, and future projections of SHC are suggested with identification of potential research needs.

Miscellaneous systems and treatments and RZ409.7-999

fibroblast, myofibroblast, fibrosis, Canada, cell biology, metabolism, Biology (General), and QH301-705.5

Fibroblasts are stromal cells found in virtually every tissue and organ of the body. For many years, these cells were often considered to be secondary in functional importance to parenchymal cells. Over the past 2 decades, focused research into the roles of fibroblasts has revealed important roles for these cells in the homeostasis of healthy tissue, and has demonstrated that activation of fibroblasts to myofibroblasts is a key step in disease initiation and progression in many tissues, with fibrosis now recognized as not only an outcome of disease, but also a central contributor to tissue dysfunction, particularly in the heart and lungs. With a growing understanding of both fibroblast and myofibroblast heterogeneity, and the deciphering of the humoral and mechanical cues that impact the phenotype of these cells, fibroblast biology is rapidly becoming a major focus in biomedical research. In this review, we provide an overview of fibroblast and myofibroblast biology, particularly in the heart, and including a discussion of pathophysiological processes such as fibrosis and scarring. We then discuss the central role of Canadian researchers in moving this field forwards, particularly in cardiac fibrosis, and highlight some of the major contributions of these individuals to our understanding of fibroblast and myofibroblast biology in health and disease.

Night eating syndrome, Binge eating, Psychological symptoms, Depression, Anxiety, Impulsiveness, Science (General), and Q1-390

The objective of this meta-analysis was to find out the prevalence of Night Eating Syndrome (NES) associated with psychological disorders among university students. Extensive search of database yielded 1541 articles matching the search keywords, out of which were 1528 were excluded due to difference in population, outcome, and study design. At the end, only 13 articles were retrieved which aligned with the inclusion criteria. Prevalence of NES associated with psychological disorders in 9432 participants was 8.2% (95% CI 4.9: 13.4) but there was high level of heterogeneity. Female university students had a higher prevalence of the disorder (7.2%) with a high degree of heterogeneity (τ2 = 0.687, I2 = 96%, P

Medicine

Core muscles strength, Dynamic balance, Hospital staff, Miscellaneous systems and treatments, and RZ409.7-999

Abstract Background Healthcare workers are at the risk of developing weakness in core muscles and balance disturbance due to stress at the workplace. The purpose of this study was to examine the relationship between core muscle strength measured with a plank test and dynamic balance assessed with the modified Star Excursion Balance Test (MSEBT) among hospital staff. A convenience sample of 27 healthy male employees at Rabigh General Hospital participated in the study; participants performed MSEBT and plank tests in the gym of the physical therapy department at the hospital. Results The mean age of the 27 participants was 32.19, standard deviation (SD) 4.16 years; mean height was 171.15, SD 6.39 cm; mean weight was 72.37, SD 11 kg; and body mass index was 24.73, SD 3.62 kg/m2. Pearson’s correlation coefficient showed a positive significant correlation between scores on the plank test with leg reach scores on MSEBT. The data showed a highest correlation between scores on plank test with dominant anterior leg reach scores on MSEBT (r = 0.446, p = 0.010), and lowest with non-dominant anterior leg reach scores on MSEBT (r = 0.335, p = 0.044). Conclusion Weak to moderate positive significant correlation between the plank test of isometric core muscle strength and both the right and dominant of the anterior, posteromedial, and composite score on the MSEBT of the lower limb and significantly with non-dominant anterior reach. There was no significant difference between the administrative and health practitioner on the plank test or MSEBT.

medical students, medical schools, social accountability, social responsibility, medical education, Education (General), and L7-991

BackgroundGlobally, there is a rising interest in the concept of social accountability (SA). The literature evaluating SA of medical schools is limited; however, some international studies have revealed a lack of understanding of SA by medical students. This study evaluated the perception of SA among medical students at a governmental university in Saudi Arabia.MethodA cross-sectional study with 336 currently enrolled medical students was conducted from September 2020 to May 2021. The data were collected using an electronic survey comprised of the THEnet questionnaire that included 12 items to assess the perception of SA and some demographic variables. The total score was categorized into four groups and compared with the demographic profile of students.ResultsOut of the 336 participants, the mean age was 21.26 ± 0.5 years, with most students in the 19–21 age group (n = 154, 46%), and 189 (56.3%) were males. In addition, preclinical and clinical students had similar representation: 170 (51%) and 166 (49%), respectively. Most participants (173, 52%) scored in the 18–36 range, reflecting good perceived SA. The demographic profile of students (i.e., age, GPA, and year of study) was significantly associated with perceived SA (p = 0.003, 0.002, and < 0.001, respectively).ConclusionThe study concludes that most medical students had a good level of perceived SA about their institution. The preclinical year students exhibited a better perception of SA. The final-year students were more critical about the SA of the institution compared to other students.

Foreign bodies, Respiratory tract, Bronchoscopy, Tracheostomy, Case report, Otorhinolaryngology, and RF1-547

Aspiration of foreign body into the airway is a common emergency in pediatric population and has high risk of morbidity and mortality. Clinical presentation of foreign body aspiration varies between children. Some children may present to emergency department with acute life-threatening presentations that require immediate intervention, while others might have long term coarse of symptoms that were misdiagnosed and mistreated for long time. Variation of clinical presentations based on location of dislodged foreign body in the airway tree and size of the aspirated foreign body. Large impacted foreign body creates extra challenge and possible complications during attempt of retrieval via endoscopy alone. We report a case of large aspirated foreign body that had multiple failed attempts of endoscopic removal, and eventually retrieved using combined endoscopic and open approach without tracheostomy. This technique is safe and efficient in cases that failed conventional endoscopy due to large foreign body size.

Strength, Functional performance, Sprint, Collegiate male football players, Plyometric training, NMES, and Medicine

Background The study’s objective was to analyze the influence of an 8-week neuromuscular electrical stimulation (NMES) with a plyometric (PT) and strength training (ST) program on muscular, sprint, and functional performances in collegiate male football players. Methods Sixty collegiate male football players participated in this randomized controlled trial single-blind study. All the participants were randomly divided into two groups: (1) NMES group (Experimental, n = 30) who received NMES assisted ST and (2) sham NMES group (Control, n = 30) who received sham NMES assisted ST. In addition, participants from both groups received a PT program; both groups received intervention on three days a week for 8-weeks. The study’s outcomes, such as muscular, sprint, and functional performances, were assessed using a strength test (STN) for quadriceps muscle, sprint test (ST), and single-leg triple hop test (SLTHT), respectively, at baseline pre-intervention and 8-week post-intervention. The interaction between group and time was identified using a mixed design (2 × 2) ANOVA. Results Significant difference found across the two time points for the scores of STN: F (1.58) = 5,479.70, p < 0.05; SLTHT: F (1.58) = 118.17, p < 0.05; and ST: F (1.58) = 201.63, p < 0.05. Similarly, the significant differences were found between groups averaged across time for the scores of STN: F (1.58) = 759.62, p < 0.05 and ST: F (1.58) = 10.08, p < 0.05. In addition, after 8-week of training, Cohen’s d observed between two groups a large to medium treatment’s effect size for the outcome STN (d = 10.84) and ST (d = 1.31). However, a small effect size was observed only for the SLTHT (d = 0.613). Conclusions Findings suggest that the effect of PT and ST with either NMES or sham NMES are equally capable of enhancing muscular, sprint, and functional performances in collegiate male football players. However, PT and ST with NMES have shown an advantage over PT and ST with sham NMES in improving muscular performance and sprint performance among the same participants.

Government, Perception, Middle East, Arab countries, COVID-19, Level of satisfaction, Public aspects of medicine, and RA1-1270

Abstract Background Public acceptance of governmental measures are key to controlling the spread of infectious diseases. The COVID-19 pandemic has placed a significant burden on healthcare systems for high-income countries as well as low- and middle-income countries (LMICs). The ability of LMICs to respond to the challenge of the COVID-19 pandemic has been limited and may have affected the impact of governmental strategies to control the spread of COVID-19. This study aimed to evaluate and compare public opinion on the governmental COVID-19 response of high and LMICs in the Middle East and benchmark it to international countries. Methods An online, self-administered questionnaire was distributed among different Middle Eastern Arab countries. Participants’ demographics and level of satisfaction with governmental responses to COVID-19 were analyzed and reported. Scores were benchmarked against 19 international values. Results A total of 7395 responses were included. Bahrain scored highest for satisfaction with the governmental response with 38.29 ± 2.93 on a scale of 40, followed by the Kingdom of Saudi Arabia (37.13 ± 3.27), United Arab Emirates (36.56 ± 3.44), Kuwait (35.74 ± 4.85), Jordan (23.08 ± 6.41), and Lebanon (15.39 ± 5.28). Participants’ country of residence was a significant predictor of the satisfaction score (P

citizen science, conservation, evaluation, grizzly bear, government, principles, Veterinary medicine, SF600-1100, Zoology, and QL1-991

Citizen science offers an excellent opportunity to engage the public in scientific data collection, educational opportunities, and applied management. However, the practicalities of developing and implementing citizen science programming are often more complex than considered. Some challenges to effective citizen science include scientists’ skepticism about the ability of public participants to rigorously collect quality data; a lack of clarity on or confidence in the utility of data; scientists’ hesitancy in engaging the public in projects; limited financial commitments; and challenges associated with the temporal and geographic scales of projects. To address these challenges, and provide a foundation upon which practitioners, scientists, and the public can credibly engage in citizen science, the Government of Alberta developed a set of citizen science principles. These principles offer a framework for planning, designing, implementing, and evaluating citizen science projects that extend beyond Alberta. Here, we present a case study using these principles to evaluate GrizzTracker, a citizen science program developed to help inform provincial species-at-risk recovery efforts. While we found that GrizzTracker applied each of the six principles in some way, including successful public engagement, strengthened relationships, and raising public awareness about northwest Alberta’s grizzly bears, we also identified a number of challenges. These included ongoing skepticism from the traditional scientific community about the utility of citizen science and governance challenges related to program leadership, staff capacity, and funding. By using the principles as a guideline, we provide policy recommendations for future citizen science efforts, including considerations for program design, implementation, and evaluation.

cardiac fibrosis, energy metabolism, fibroblast, myofibroblast, glutaminolysis, transcription, Biology (General), and QH301-705.5

Fibrosis is an energy-intensive process requiring the activation of fibroblasts to myofibroblasts, resulting in the increased synthesis of extracellular matrix proteins. Little is known about the transcriptional control of energy metabolism in cardiac fibroblast activation, but glutaminolysis has been implicated in liver and lung fibrosis. Here we explored how pro-fibrotic TGFβ and its effector scleraxis, which drive cardiac fibroblast activation, regulate genes involved in glutaminolysis, particularly the rate-limiting enzyme glutaminase (GLS1). The GLS1 inhibitor CB-839 attenuated TGFβ-induced fibroblast activation. Cardiac fibroblast activation to myofibroblasts by scleraxis overexpression increased glutaminolysis gene expression, including GLS1, while cardiac fibroblasts from scleraxis-null mice showed reduced expression. TGFβ induced GLS1 expression and increased intracellular glutamine and glutamate levels, indicative of increased glutaminolysis, but in scleraxis knockout cells, these measures were attenuated, and the response to TGFβ was lost. The knockdown of scleraxis in activated cardiac fibroblasts reduced GLS1 expression by 75%. Scleraxis transactivated the human GLS1 promoter in luciferase reporter assays, and this effect was dependent on a key scleraxis-binding E-box motif. These results implicate scleraxis-mediated GLS1 expression as a key regulator of glutaminolysis in cardiac fibroblast activation, and blocking scleraxis in this process may provide a means of starving fibroblasts of the energy required for fibrosis.

amphibian, biodiversity, landscape connectivity, urban conservation, Environmental sciences, GE1-350, Ecology, and QH540-549.5

Abstract Cities worldwide are expanding in area and human population, posing multiple challenges to amphibian populations, including habitat loss from removal of wetlands and terrestrial upland habitat, habitat fragmentation due to roads and the built environment, and habitat degradation from pollutants, extensive human use and introduced species. We developed an eight‐step urban amphibian conservation framework based on established monitoring, analytical methods and community engagement to enable amphibian conservation in a large urban centre. The framework outlines a process used to conserve biodiversity in a complex landuse and decision‐making environment supported by a series of successive complementary modelling techniques to measure amphibian presence, priority habitat and functional connectivity. We applied the framework in Calgary, Alberta, Canada to illustrate its potential. Here, urbanization has reduced wetlands by 90% and ecological knowledge on amphibians was poor. We improved knowledge on amphibian diversity and distribution, identified core wetlands and movement pathways for amphibian species and identified barriers in the wetland network where construction or restoration measures could re‐establish amphibians or increase their densities. This knowledge was shared with ecologists and city planners for implementation through appropriate policies and plans. Our framework provides a series of stepwise products to improve an urban municipality's ability to restore or conserve priority habitat and movement pathways necessary for amphibian survival under pressure from multiple land uses. The framework provides a platform to identify city plans, policy and or programmes and to derive necessary information to support amphibian conservation.

Online Learning, Teaching, Pedagogy of Care, Technology, Holistic Education, Digital Learning, Special aspects of education, and LC8-6691

This article discusses the importance of pedagogy of care designed for online teaching and learning settings. We offer a model for care in online education built on theoretical foundations, including Jerome Bruner’s (1996) work on folk pedagogies. Through the lens of Bruner’s folk pedagogies, there are new possibilities for developing folk pedagogies designed for care in online spaces. Threading this with experiential learning, humanistic psychology, and theory about technologies, we identify tensions within human-technological intersections, including the intersections of agency between human and machine. While such tensions are important to identify, there is also a need to move beyond the tensions and the implied binary between the human and the technological to envision new assemblages and creative possibilities that afford care and allow for student agency. Stemming from this model, we offer practical implications for educators and researchers towards a human-centered pedagogy of care for online learning pointing to technological futures.

Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, and RA1-1270

Objective: Many studied investigated the manifestations of COVID-19, yet few described the pattern and severity of otolaryngological symptoms. We aim to describe the picture of COVID-19-associated otorhinolaryngological manifestations and recovery to explore individualized treatment, onward referral, and complications prevention. Design: Prospective longitudinal questionnaire-based study. Setting: The online questionnaire was filled 3 times through a remote interview over a period of 1 month from June 2020 to July 2020. Participants: Patients with confirmed COVID-19 by RT-PCR who were clinically stable. Main Outcome Measures: Date of diagnosis, sociodemographic data, and the presence of predictive factors, such as nasal and paranasal disease, anosmia and dysgeusia. Validated tools were used, such as Sino-nasal Outcome Test (SNOT-22), smell test (medical academy screening tool), Voice Handicap Index (VHI), and Reflux Symptoms Index (RSI). Result: The questionnaire was sent to 363 patients and the response rate was 70.80% (n = 257). The mean age was 34.58 years (SD = 11.22) and the rate of male participants was 60.7%. The most common otorhinolaryngological symptoms at the time of enrollment was fever (48.6%), whilst the commonest severe symptom was cough (57%). After 1 month, only 11 participants had persistent severe symptoms, especially sleep and psychological symptoms (73%), and the majority were female (63.6%). All of them had at least 1 comorbidity. There was a significant difference between the mean age of participants with severe symptoms (mean = 27.45, SD = 8.39) and without severe symptoms (mean = 34.90, SD = 2.53, t (255) = 2.17, P = .031). Conclusion: COVID-19 has a wide-ranged spectrum of presentations, with otorhinolaryngological symptoms being the commonest and most serious. Studying these symptoms is vital to advance management options.

Vestibular rehabilitation, Referral, Physical therapy modalities, Evidence-based practice, Vestibular disorders, Balance disorders, and Medicine

Objectives There is compelling scientific evidence about the role of physiotherapists in vestibular rehabilitation. However, patients with vestibular-associated dizziness and balance disturbances are seldom referred to physiotherapists in Saudi Arabia. Therefore, this study aims to achieve insight into perceptions, knowledge, attitudes, and referral practices among Saudi Arabian medical doctors relating to the role of physiotherapists in vestibular rehabilitation. Methods A sample of 381 medical doctors practicing in Saudi Arabia participated in this nationwide cross-sectional study. The sample was obtained from 226 hospitals across 13 provinces of Saudi Arabia by stratified sampling method. The 23-item questionnaire developed by a team of experts was emailed to medical doctors practicing in various hospitals across Saudi Arabia. Results Out of 1,231 medical doctors invited, 381 medical doctors responded, giving a response rate of 30.9%. One hundred ninety-three (50.6%) medical doctors reported managing patients with vestibular rehabilitation. The most preferred specialist for managing patients with vestibular disorders was an Ear Nose Throat (ENT) specialist (n = 173, 89.6%). Related Sample Cochran’s Q test showed statistically significant difference between preferred specialist for managing patients with vestibular disorders (ENT specialists, physiotherapists, nurses, occupational therapists and audiologists) (χ2(4) = 482.476, p = 0.001). Out of 193 medical doctors, 153 (79.2%) reported no role of the physiotherapist in vestibular rehabilitation. One hundred forty-five (75.1%) of medical doctors reported that they were not aware of the role of physiotherapists in vestibular rehabilitation. Only 27 (15.5%) medical doctors reported referring patients with vestibular disorders to physiotherapists. Conclusion The study reports that physiotherapy services are underutilized in vestibular rehabilitation due to limited referral from Saudi Arabian medical doctors. Therefore, there is a need to increase the awareness among Saudi Arabian doctors about the physiotherapist’s role in vestibular rehabilitation.

arts and design, college students, creativity, meditation, mindfulness, Social sciences (General), and H1-99

Given the applied nature of creativity in the arts and design, it is important to understand the conditions and practices that support it. Most research suggests that ideal conditions for creativity are often mental and emotional – involving relaxed, yet alert and focused, states of mind. This article explores the connection between mindfulness and creativity in the experiences of students in a college of arts and design, through a mindfulness teaching practice to support creative processes. In a “scholarship of teaching and learning” inquiry, we consider how mindfulness practice may affect arts and design learners’ feelings about their own creativity. Students in a large United States university school of arts and design practiced mindfulness meditation for several months, and submitted a written reflection on their experience. We qualitatively analyze this to consider how mindfulness supports creative practices in arts and design learners’ education. Our findings involve three key themes, which are: “Processing anxiety and negative feelings”, “Focusing the mind”, and “Managing the ‘Voice of Judgment’”. These thematic findings reflect how arts and design students perceive the effects of mindfulness on their creative process. We offer implications for teaching practices related to mindfulness meditation practice aimed to support learners’ perceptions of their creativity.