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History and Philosophy of Science and Social Sciences (miscellaneous)

Education

In this special issue of the Australasian Journal of Educational Technology, we take a step back from the events of the last 2 years and the changes that we have seen in the education arena, to remember that which has remained constant – how students learn best. Developing teaching and learning pedagogy based on lasting education theory and practice makes the past of education relevant to the present and future and creates a context where innovation can be scaled and taken further, from a single instance of impact to many. In this editorial, we present an argument for going back to our roots and present examples of the effective use of established theories of learning that continue to advance online education practice. We discuss the scaling of educational best practice to more students and more institutions, and we provide recommendations for creating sustainable and lasting future practice.

Computer Science Applications and Education

Cardiology and Cardiovascular Medicine

Aims In response to pro-fibrotic signals, scleraxis regulates cardiac fibroblast activation in vitro via transcriptional control of key fibrosis genes such as collagen and fibronectin; however, its role in vivo is unknown. The present study assessed the impact of scleraxis loss on fibroblast activation, cardiac fibrosis, and dysfunction in pressure overload-induced heart failure. Methods and results Scleraxis expression was upregulated in the hearts of non-ischemic dilated cardiomyopathy patients, and in mice subjected to pressure overload by transverse aortic constriction (TAC). Tamoxifen-inducible fibroblast-specific scleraxis knockout (Scx-fKO) completely attenuated cardiac fibrosis, and significantly improved cardiac systolic function and ventricular remodelling, following TAC compared to Scx+/+ TAC mice, concomitant with attenuation of fibroblast activation. Scleraxis deletion, after the establishment of cardiac fibrosis, attenuated the further functional decline observed in Scx+/+ mice, with a reduction in cardiac myofibroblasts. Notably, scleraxis knockout reduced pressure overload-induced mortality from 33% to zero, without affecting the degree of cardiac hypertrophy. Scleraxis directly regulated transcription of the myofibroblast marker periostin, and cardiac fibroblasts lacking scleraxis failed to upregulate periostin synthesis and secretion in response to pro-fibrotic transforming growth factor β. Conclusion Scleraxis governs fibroblast activation in pressure overload-induced heart failure, and scleraxis knockout attenuated fibrosis and improved cardiac function and survival. These findings identify scleraxis as a viable target for the development of novel anti-fibrotic treatments.

Psychiatry and Mental health, Geriatrics and Gerontology, Clinical Psychology, General Medicine, and General Neuroscience

Background: Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) differ in their memory, attention, and visuoconstructional characteristics. The subscales of the well-known Mini-Mental State Examination (MMSE) provide an opportunity to assess these characteristics. Previous research has shown that analysis of the MMSE subscale performance of AD and DLB patients helps to differentiate them. Objective: Study the MMSE scores of AD and DLB patients to see if the ability of previously reported analyses to differentiate them could be improved. Include other dementia patients for perspective. Methods: We studied the MMSEs of all patients seen in our clinics during an 18-month period. Different equations were studied, derived from the subscales of Memory (M, 3 points maximum), Attention (A, 5 points maximum), and Pentagon-copying (P, 1 point maximum). Results: We obtained 400 MMSEs, 136 from AD patients and 24 from DLB patients, scoring range 1–30. The equation P minus M provided the best discrimination between AD and DLB. Using a P-M score = 1 to identify AD, the positive predictive value was 0.97, negative predictive value 0.22, specificity 0.92, and sensitivity 0.43. As a secondary finding, the P-M = 1 equation was also helpful to differentiate AD from Parkinson’s disease dementia. Conclusion: Considering AD versus DLB in our clinic population, a demented patient who was unable to recall the three memory words on the MMSE but able to copy the intersecting pentagons had a 97% likelihood of having AD. Additional work is needed to improve the sensitivity of the P-M = 1 equation.

Pharmaceutical Science and Pharmacy

Computer Science Applications and Education

removable partial dentures, complete dentures, phonetics, awareness, dental students, and dental education

Phonetics plays a major role in the fabrication of prostheses. This study aimed to assess the knowledge of students regarding the role of phonetics in denture fabrication and to improve the educational process and the clinical application. The study was conducted at the College of Dentistry, Imam Abdulrahman Bin Faisal University, and involved a survey of 344 dental students and interns. The questionnaire contained 20 questions and was divided into three sections: general knowledge, clinical correlations, and clinical evaluations. The data were collected and analyzed statistically using independent t-tests, one-way ANOVA, and Tukey’s post hoc tests. The response rate was 100%. Male and female students only differed significantly in terms of their scores for answers to general knowledge questions, with females achieving better results (p = 0.023). General knowledge varied significantly between fourth-year students and all other levels (p < 0.001), and fifth-year students and interns (p = 0.027). The clinical correlations varied significantly between fourth-year students and interns (p = 0.01), whereas the clinical evaluations varied between all the academic years and interns (fourth-year, p < 0.001; fifth-year, p = 0.003; and sixth-year, p = 0.017). The interns obtained the highest scores in all sections. There was a lack of awareness among dental students of some aspects of the role of phonetics in denture fabrication. The study highlights the deficiencies that need to be addressed and the need for adjustments to the curriculum related to removable prosthodontics in order to improve the knowledge of students regarding the role of speech in denture fabrication.

Ophthalmology and General Medicine

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.

Pulmonary and Respiratory Medicine

Background: Several studies have demonstrated gender influence on asthma prevalence, being higher among males during early childhood. Little is known about the impact of gender and age on asthma exacerbation characteristics in pediatrics. This study aimed to determine the differences in acute asthma between males and females in three different age groups regarding perinatal characteristics of asthmatic patients, comorbidities, medication adherence, level of blood eosinophils, and pattern of hospitalization.Methods: The medical records of 130 pediatric patients with asthma, who presented to the emergency department at Jordan University hospital with asthma exacerbations, were retrospectively reviewed. Demographic information and clinical characteristics were collected.Results: The mean age of patients was 10.7±4.7 years. The age at diagnosis and gestational age were significantly higher in older children. Furthermore, younger children were significantly more likely to experience winter exacerbations and more emergency presentations. Male patients were considerably younger than their female counterparts and were diagnosed younger. In addition, male patients were more likely to have eosinophil levels higher than 3% than female patients.Conclusion: Gender plays a role in the development and outcome of asthma exacerbations at different ages of pediatrics. A better understanding of gender-based and age-based differences in asthma dictates a personalized approach to treatment.

General Engineering

Purpose: To investigates if there is an association between demographic characteristics with sleep quality and general health. Also, to measure the association between lack of sleep and mental health, and to determine the relationship between sleep problems and social health. Methods: A quantitative cross-sectional analytical study was conducted among 270 students at Imam Abdulrahman bin Faisal University in Dammam. Data was collected by using primary data collection method through an online questionnaire. The questionnaire included demographic characteristics, Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality and General Health Questionnaire – 28 (GHQ-28) to assess general health. Chi-square was used to find the relationship between sleep quality, general health, and demographic characteristics, then logistic regression was used to observe the association between sleep quality and general health. Results: About 51.5% of students had poor sleep quality, 47.8% had poor general health, and a total of 48.82% of students had both poor sleep quality and general health. Demographic factors among males showed a significant association with sleep quality and general health. Female participants had a higher percentage of poor sleep quality and poor general health compared to male counterparts. Also, sleep quality showed a significant association with mental and social health. Finally, poor sleep increases the chance of having poor health by 2.7 times (95% CI: 1.672 - 4.486). Conclusion: This study has demonstrated that the quality of sleep significantly affects the quality of health among college students. Also, sleep quality was observed to have a stronger effect on mental health than social health.

Social Media Marketing, Brand Equity, Entrepreneurship, Buying Intentions, Jordanian Context

The current research aims to provide a comprehensive insight into the effect of social media marketing on customer buying intention. Furthermore, the study explores empirically and explains the mediating influences of brand equity, particularly the role of brand image and awareness, on customer buying intention. The research was explored using a quantitative approach. A convenience sampling technique was adopted. The valid responses received were 237. The hypothesis testing followed Structural Equation Modelling. The findings concede that all social media marketing sub-constructs significantly affect buying intention, whereby accessibility has the strongest influence. Brand equity mediates the relationship between social media marketing and purchase intention. The findings concede that all social media marketing sub-constructs significantly affect buying intention, mediated by brand equity, particularly by building brand image and brand awareness. The proposed model provides new insights into the social media marketing drivers affecting buying intentions and engagement with an entrepreneurial brand. This research reaffirms that social media marketing can hugely influence the success of Jordanian entrepreneurial firms.

General Engineering

Computer Science Applications and Education

Neurology (clinical) and Neurology

Objective To examine the relative risk of suicide mortality in patients with Huntington’s disease (HD). Methods A case–control study design was used. We used linked electronic records from primary care, secondary care and Office for National Statistics from England from 2001 through 2019. Controls were matched to cases by general practice and suicide date. Odds ratios (ORs) were adjusted for gender and age at suicide/index date. Results Data were available for 594,674 individuals. Patients with HD who died from suicide were significantly younger at time of death than patients with HD who died from causes other than suicide (p Conclusion The markedly elevated suicide risk in patients with HD suggests that implementation of suicide risk assessment may improve survival in individuals with these diseases, especially in younger patients.

Education

In response to the special issue on democratizing creative educational experiences (CEE), we conducted a thematic analysis of recent scholarship on creativity and decolonization (2010–2021) and analyzed recurring tensions across literature grounded in Indigenous, Black, feminist, and non-western epistemological perspectives on creativity. We found themes that are not new but are yet to be taken up consistently and credibly in western creativity and education research and practice. For instance, spirituality emerges as a valuable ingredient for creativity, body as inseparable from the mind, dialectic resistance and resilience as acts of creative existence, and non-human agency as essential to the creative process. Informed by these themes, we share implications for research and practice, seeking new spaces inclusive of historically ignored onto-epistemologies.

General Medicine

Political Science and International Relations, Sociology and Political Science, Cultural Studies, ComputingMilieux_COMPUTERSANDEDUCATION, arts and design, college students, creativity, meditation, and mindfulness

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.

General Medicine

Computer Science Applications and Education

Artificial Intelligence, Computer Networks and Communications, Computer Science Applications, Communication, Information Systems, and Software

This study aims to provide comprehensive insights into the social media marketing characteristics affecting customer buying intention. The model was theoretically based on and explored using a quantitative approach. A survey strategy was adopted, and a five-point Likert questionnaire was distributed to Jordanian citizens. A total of 237 responses were received. The hypothesis testing followed structural equation modeling using SPSS software. The findings suggest that all social media marketing subcontracts exhibit a significant positive effect on buying intention, whereby accessibility is the highest. Customer involvement also moderates the relationship between social media marketing and customer buying intention. The proposed model provides new insights into social media marketing drivers affecting buying intentions and engagement with an entrepreneurial brand or product. This study reaffirms that social media marketing can significantly influence the success of Jordanian entrepreneurial firms and understanding how to use this tool effectively can significantly change how businesses operate.

General Medicine

Introduction: The onset of the COVID-19 pandemic resulted in governments implementing new regulations to divert healthcare resources, which in return led to the postponement of elective and semi-elective surgical procedures. Therefore, many surgeons and as well as surgeons in training reported feeling redundant, which eventually resulted in psychological distress. This study aimed to assess the sociodemographic differences in the psychological impact resulting from the COVID-19 pandemic and outline the effect it had on surgical training. Methods: This is a cross-sectional study conducted in Kuwait. Data were collected by distributing a questionnaire electronically to surgeons and surgeons in training. The survey included questions aimed at assessing both the effect of the pandemic on surgical training and the psychological impact it had on surgeons, assessing the latter using the Depression, Anxiety and Stress Scale-21 screening tool. Results: The response rate for the study was 52%, with the majority being junior male surgeons. A majority of surgeons in training reported postponement of their scheduled academic teaching sessions (78.9%) and pre-assigned surgical rotations (65.8%). In terms of the psychological impact of the pandemic, a majority of the participants reported an element of depression and stress, 61.2% and 55%, respectively, while approximately half, 48.1%, had symptoms associated with anxiety. Conclusion: The COVID-19 pandemic had a negative association with the psychological well-being of a significant proportion of surgeons and associated surgical training programs.

Surgery

Lipoid proteinosis (LP) is a rare autosomal-recessive disease characterized by the deposition of hyaline material infiltrating multiple body organs, including the larynx. The possible clinical presentations are wide-ranging. Laryngeal involvement results in dysphonia that is noted at birth or infantile years. The diagnosis is based on histological findings, and the management options vary depending on the severity of the symptoms. In this paper, we report an unusual case of LP with laryngeal involvement in an adult patient, along with a review of current literature.

Assessment, Filipino Immunizing Pharmacist, Engagement, COVID-19, KAP Model, and General Medicine

The immunization practice of pharmacists has only been recently approved in the Philippines; thus, it is imperative to assess their engagement using the Knowledge, Attitudes, Practices (KAP) model. A descriptive quantitative-correlational study that utilized a convenience sampling technique was conducted with 90 respondents. A 49-item self-made questionnaire was employed through Google forms. The data collected was subjected to various statistical treatments for descriptive and correlational analysis. Results showed that respondents have a high level of knowledge regarding the prevention of Adverse Events Following Immunization (3.81), and critical thinking and decision-making upon its occurrence (3.92). The respondents' attitudes also showed high levels of agreement toward the promotion of immunization (3.89) and patient counseling (3.97). Moreover, the majority of the respondents administered vaccines (87.78%) and COVID-19 was the vaccine given the most (77.78%). Their responses showed a high level of practice in the immunization process (3.95), documentation and record-keeping (3.80), and addressing misconceptions (3.94). Most of their sociodemographic profiles do not have a significant relationship with their KAP except for the area of practice that had a correlation to knowledge. Thus, this study proves that Filipino immunizing pharmacists have a high level of engagement amidst the pandemic and continuous training and certification are needed to further strengthen this, especially during public health emergencies.

General Medicine, Cell Biology, Developmental Biology, Embryology, and Anatomy

Electronic, Optical and Magnetic Materials

Ophthalmology and General Medicine

Social Sciences (miscellaneous) and Anthropology

With the emergence of Western posthuman understandings, new materialism, artificial intelligence (AI), and the growing acknowledgment of Indigenous epistemologies, an ongoing rethinking of existing assumptions and meanings about creativity is needed. The intersection of new technologies and philosophical stances that upend human-centered views of reality suggests that creativity is not an exclusively “human” activity. This opens new possibilities and assemblages for conceiving of creativity, but not without tensions. In this article, we connect multiple threads, to reimagine creativity in light of posthuman understandings and the possibilities for creative emergence beyond the Anthropocene. Creativity is implicated as emerging beyond non-human spaces, such as through digitality and AI or sources in the natural world. This unseats many understandings of creativity as positioned in Euro-Western literature. We offer four areas of concern for interrogating tensions in this area, aiming to open new possibilities for practice, research, and (re)conceptualization beyond Western understandings.

cardiovascular diseases, cardiovascular system, nervous system diseases, and circulatory and respiratory physiology

Constriction of the large and medium-sized cerebral arteries following an aneurysmal subarachnoid haemorrhage (aSAH) is a well-known condition that primarily affects the anterior circulation supplied by the internal carotid arteries. SAH is a rare but potentially fatal type of stroke. Across the literature, authors have defined vasospasm using terms such as "symptomatic vasospasm," "delayed cerebral ischemia" (DCI), "transcranial Doppler vasospasm," and "angiographic vasospasm." Because posthemorrhagic vasospasm causes significant neurologic morbidity and death, there has been a great deal of interest and research into its physiologic basis and developing effective preventative and treatment strategies. The triple-H therapy hemodynamic augmentation technique, which includes hypertension, hemodilution, and hypervolemia, has been an important part of the treatment. In this article, we'll look at cerebral vasospasm following subarachnoid haemorrhage, including its causes, epidemiology, evaluation, and, most importantly, management.

Original Article, Body mass index, frequency, migraine, obesity, severity, Indice de masse corporelle, fréquence, obésité, and gravité

Introduction: Migraine is a highly prevalent condition, and prevalence of obesity is also increasing. Results of studies addressing association of body mass index (BMI) with migraine and its features are conflicting. In this cross-sectional study, we aim to assess association between BMI and various migraine features. Methods: This study was conducted in the Headache Clinic of King Fahd Hospital of University, Al Khobar, Saudi Arabia. Interviews were conducted by three consultant neurologists. Migraine was defined according to the International Headache Society and BMI was calculated as weight (kilograms)/height (m2). Results: Of total of 121 patients, 79% were female. Almost 87.6% of patients were taking prophylactic medications. Majority of patients had attack for more than 24 h (60.3%), pulsating character (81%), moderate-to-severe intensity (92.6%), associated with nausea and/or vomiting (75.2%), and photophobia/phonophobia (91.7%). About 29.8% of patients were normal weight, 28.1% were overweight, and 39.7% were obese and morbidly obese. There was insignificant association between various categories of BMI and features of migraine, that is, unilateral location (P = 0.385), pulsating character (P = 0.571), moderate-to-severe intensity (P = 0.187), nausea and/or vomiting (P = 0.582), and photophobia and/or phonophobia (P = 0.444). Conclusion: In our study, we did not find an association between BMI and various features of migraine.

General Pharmacology, Toxicology and Pharmaceutics, Pharmacy, Medical education, Social work, Scale (social sciences), Interprofessional education, Geriatrics, medicine.medical_specialty, medicine, Pharmacy practice, Psychology, Health care, business.industry, business, Interprofessional teamwork, and education

Background and purpose The objective was to evaluate (1) students' knowledge in a variety of geriatrics competencies, (2) students' attitudes toward the value of interprofessional practice, and (3) pharmacy students' experiences after an advanced pharmacy practice experience (APPE) in a practice-based interprofessional education (IPE) model. Educational activity and setting Nursing, pharmacy, social work, and health sciences programs who participated in the Richmond Health and Wellness Program (RHWP) interprofessional experience received pre- and post-surveys to assess changes in geriatrics knowledge. An adapted Attitude Toward Health Care Teams Scale (ATHCTS) was used to assess changes in students' attitudes toward the value of interprofessional teamwork. Finally, representative quotes were taken from APPE evaluations to illustrate the pharmacy student experience. Findings Seventy-two out of 82 (87.8%) interprofessional students who participated in the practice-based IPE model at RHWP in the fall 2018 participated in this study. Geriatrics knowledge scores significantly increased by 4.03 (P Summary A practice-based IPE experience can provide many benefits to health professional students. By working as a team, students learn from each other, leading to increased knowledge on several geriatrics competencies. Students understand the importance of IPE experiences, but their attitudes become more positive through application.

General Materials Science, Building and Construction, Materials science, Engineered cementitious composite, engineering.material, engineering, Electrical impedance, Cement, Ultimate tensile strength, Composite material, Fiber reinforcement, Nondestructive testing, business.industry, and business

The influence of ongoing cement hydration and multiple microcrack formation on the electrical impedance of an engineered cementitious composite (ECC) is presented. Impedance measurements were obtained over the frequency range 20 Hz–1 MHz and displayed in the Nyquist format. In addition, the permittivity and conductivity were de-embedded from the measured impedance and presented in both time and frequency domains to elucidate the nature of conduction and polarisation processes. It was found that, over a curing period of 90 days, the ECC displayed a classic impedance response. Both conductivity and relative permittivity were found to be frequency dependent due to bulk relaxation processes operating within the composite. Tensile straining was shown to result in a detectable change in the impedance response, but retained a similar overall profile. When presented in the frequency domain, a downward displacement in both conductivity and relative permittivity profiles was evident with increasing tensile strain. It is shown that the relative permittivity at the high-frequency end could be exploited as a potentially useful indicator for strain/damage detection. The influence of microcracking on the piezo-resistive response of the composite is discussed based on crack patterns obtained from both visual observations and digital image correlation.

General Dentistry, Heat press, Composite material, Cementation (geology), Ceramic, visual_art.visual_art_medium, visual_art, Dentin, medicine.anatomical_structure, medicine, Acrylic resin, Universal testing machine, Bond strength, Silane, chemistry.chemical_compound, chemistry, and Materials science

PURPOSE The aim of this in vitro study was to evaluate the effects of different durations of silane coupling agent application compared to a universal adhesive system regarding the shear bond strength of two ceramic materials. MATERIALS AND METHODS A total of 120 human molars were ground to the dentinal coronal third and then fixed into an acrylic resin holder. Lithium disilicate specimens were divided into two main groups according to the ceramic type: computer-aided design/computer-aided manufacturing IPS e.max CAD and heat-pressed Initial LiSi Press GC (dimensions of 4 × 3× 3 mm). Each main group was subdivided into 6 subgroups (n = 10) according to the duration of the silane and universal adhesive system application (20, 60, or 120 seconds) on the ceramic surface before cementation; then, the cementation procedures were performed. All specimens were subjected to 5000 thermal cycles at 5 and 55°C before testing. The shear bond strength was measured using a universal testing machine. ANOVA and Scheffe post hoc test multiple comparisons tests were conducted (α = 0.05). RESULTS The shear bond strength increased as the duration of the silane and universal adhesive system application increased. The highest bond value for each material was found for the silane application at 120 seconds, with a significant difference between 120 and 60, and 20 seconds for both e. max CAD and Initial LiSi materials (p = 0.029 and p ˂ 0.001, respectively). No significant difference was found between 60 and 20 seconds when silane and universal adhesive system were applied for both e. max CAD and Initial LiSi materials (p = 0.169 and p = 0.120, respectively). All groups treated with the silane primer showed significantly higher values than the universal adhesive system for each application time (p ˂ 0.001). CONCLUSION Increasing the duration of the silane coupling agent and universal adhesive system application to 120 seconds on the ceramic surface before cementation improved the shear bond strength of the ceramic-cement interface. Ceramic pretreatment with silane could be an essential step for bonding ceramic to dentin regardless of silane presence in the universal adhesive system.

General Medicine, Otorhinolaryngology, Surgery, Confidence interval, Birth weight, Consanguinity, Medicine, business.industry, business, Offspring, Consanguineous Marriage, Obstetrics, medicine.medical_specialty, Odds ratio, Logistic regression, Craniofacial, and mental disorders

Orofacial clefts (OFCs) are the most common craniofacial congenital anomalies, and its prevalence is highest among Asian populations. The aim of this retrospective case-control study is to evaluate the effect of parental consanguinity on the frequency of OFCs at Jordan University Hospital over a 15-year-period. The study group consists of all patients with OFCs presented to the major tertiary referral center in Jordan during the last 15 years, along with age and gender-matched controls. The authors analyzed the risk of different predictors, including consanguinity, on the development of OFCs, both cleft lip with or without cleft palate (CL/P) and cleft palate only. A total of 332 participants were included in this study, with a mean age of 74.36 (±48.75) months. The authors included 129 (38.9%) OFCs, and 203 (61.1%) controls. The percentage of parental consanguinity among OFCs group was 41.1%, compared to only 24.1% for controls, a difference that was statistically significant (P = 0.001). On logistic regression analysis, the authors found that parental consanguinity is a significant predictor for the occurrence of OFCs (P = 0.007), where people with consanguineous marriage have 2 times higher risk (odds ratio of 0.504, with 95% confidence interval 0.306-0.830) to have offspring with OFCs. Moreover, lower birth weight babies are also significantly more associated with OFCs (P = 0.014), with an odds ratio of 1.819 (95% confidence interval 1.131 2.926). Among the Jordanian population, the authors found that consanguinity and lower birth weight were the only variables significantly associated with the development of OFCs.

Medicine, business.industry, business, Checklist, Physical therapy, medicine.medical_specialty, Surgical safety, and Cross-sectional study

Introduction The aim of this study was to evaluate the change in the healthcare providers' perceptions regarding the World Health Organization Surgical Safety Checklist (WHO SSC) and patient safety in the operating room (OR) at a tertiary hospital in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted at King Abdulaziz Medical City. Data were collected from two years (2011 and 2019) for comparison. The co-investigators distributed a self-administered Likert scale questionnaire in the various operating areas (35 ORs). Results The total sample was 461. Number of participants enrolled from both years was 235 (51%) and 226 (49%), respectively. The results indicated a statistically significant difference in the attitude of the participants regarding all aspects of patient safety in the OR when the two periods were compared (p < 0.001). Similarly, healthcare providers' perceptions regarding the importance of the WHO SSC increased from 50% (2011) excellent to 68% excellent (2019) (p < 0.001). Conclusions Currently, more healthcare providers recognize the importance of the WHO SSC, and more have a positive attitude toward teamwork, communication, and feeling free to speak out when surgical safety is compromised. All of these cultural changes have positive impact on the overall safety of the OR; however, there are still aspects requiring improvement to provide a safer OR and surgery. Educational interventions regarding the importance of communication and teamwork would improve the safety of surgical care in the OR.

Surfaces, Coatings and Films, General Physics and Astronomy, Condensed Matter Physics, Surfaces and Interfaces, and General Chemistry

Neurology (clinical)

ImportancePatients with dementia may be at an increased suicide risk. Identifying groups at greatest risk of suicide would support targeted risk reduction efforts by clinical dementia services.ObjectivesTo examine the association between a dementia diagnosis and suicide risk in the general population and to identify high-risk subgroups.Design, Setting, and ParticipantsThis was a population-based case-control study in England conducted from January 1, 2001, through December 31, 2019. Data were obtained from multiple linked electronic records from primary care, secondary care, and the Office for National Statistics. Included participants were all patients 15 years or older and registered in the Office for National Statistics in England with a death coded as suicide or open verdict from 2001 to 2019. Up to 40 live control participants per suicide case were randomly matched on primary care practice and suicide date.ExposuresPatients with codes referring to a dementia diagnosis were identified in primary care and secondary care databases.Main Outcomes and MeasuresOdds ratios (ORs) were estimated using conditional logistic regression and adjusted for sex and age at suicide/index date.ResultsFrom the total sample of 594 674 patients, 580 159 (97.6%) were controls (median [IQR] age at death, 81.6[72.0-88.4] years; 289 769 male patients [50.0%]), and 14 515 (2.4%) died by suicide (median [IQR] age at death, 47.4 [36.0-59.7] years; 10 850 male patients [74.8%]). Among those who died by suicide, 95 patients (1.9%) had a recorded dementia diagnosis (median [IQR] age at death, 79.5 [67.1-85.5] years; median [IQR] duration of follow-up, 2.3 [1.0-4.4] years). There was no overall significant association between a dementia diagnosis and suicide risk (adjusted OR, 1.05; 95% CI, 0.85-1.29). However, suicide risk was significantly increased in patients diagnosed with dementia before age 65 years (adjusted OR, 2.82; 95% CI, 1.84-4.33), in the first 3 months after diagnosis (adjusted OR, 2.47; 95% CI, 1.49-4.09), and in patients with dementia and psychiatric comorbidity (adjusted OR, 1.52; 95% CI, 1.21-1.93). In patients younger than 65 years and within 3 months of diagnosis, suicide risk was 6.69 times (95% CI, 1.49-30.12) higher than in patients without dementia.Conclusions and RelevanceDiagnostic and management services for dementia, in both primary and secondary care settings, should target suicide risk assessment to the identified high-risk groups.

Psychiatry and Mental health, Clinical Psychology, Ethnic group, Population based study, Incidence (epidemiology), Confidence interval, Suicide Risk, Odds ratio, Asian ethnicity, Medicine, business.industry, business, Demography, Public health, and medicine.medical_specialty

Using multiple linked electronic health databases, we conducted a large case-control study in England from 2001 through 2019 to examine the association between ethnicity and suicide risk. Asian, Black and Other ethnic groups had a significantly lower suicide risk compared to White individuals, with those of Asian ethnicity having the lowest risk (Odds Ratio 0.53, 95% Confidence Interval 0.47-0.60). This ethnicity related suicide risk was significantly altered by socio-demographic characteristics. These factors can inform the assessment and stratification of suicide risk, as well as the targeting of public health measures designed to reduce suicide incidence.

General Medicine, Cell Biology, Developmental Biology, Embryology, and Anatomy

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.

Education

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.

Endocrinology, Diabetes and Metabolism and Internal Medicine

Background: Factors considered when selecting a diabetes medication for patients with type 2 diabetes (T2D) in clinical practice may differ from those recommended by professional societies. Objective: To identify factors that play a major role in guiding the selection of diabetes medications in the real world. Method: We asked 135 physicians [67% Generalists (Internists and General Practitioners) and 33% Specialists (Endocrinologists and Diabetologists) ] in Saudi Arabia to select a diabetes medication they frequently prescribe in certain clinical scenarios. Then we asked them to rank a set of factors as (“Major,” “Minor,” or “Not” a consideration) according to the degree those factors would typically influence their selection of a particular medication. Results: Sulfonylurea is the most frequently prescribed second-line agent. Majority (89%) reported prescribing GLP-1 receptor agonists (GLP-1 RA) to “50% of their patients with T2D and ischemic heart disease; and over 2/3 prescribe SGLT-2 inhibitors (SGLT-2i) to Conclusion: Despite the recent advances in diabetes therapy, medication cost and inadequate awareness of the cardiovascular and renal benefits of novel diabetes agents, particularly among non-specialists, remain major barriers to the wide adoption of recommendations from professional societies. Policies to improve access to novel diabetes medications and disseminate the awareness about the evidence-based benefits of these medications are needed Disclosure J.A.Abudahesh: None. J.A.Aijebreen: None. D.Z.Alhalees: None. G.Albraithen: None. G.S.Bamogaddam: None. M.Al-sofiani: None.

Public Health, Environmental and Occupational Health

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 < 0.001), and participants who suffered income reduction due to the pandemic, had a history of SARS-CoV-2 infection, and held higher educational degrees had significantly lower satisfaction scores (P < 0.001). When benchmarked with other international publics, countries from the Gulf Cooperation Council had the highest satisfaction level, Jordan had an average score, and Lebanon had one of the lowest satisfaction scores. Conclusion The political crisis in Lebanon merged with the existing corruption were associated with the lowest public satisfaction score whereas the economical instability of Jordan placed the country just before the lowest position. On the other hand, the solid economy plus good planning and public trust in the government placed the other countries of the Gulf Cooperation Council on top of the scale. Further investigation is necessary to find out how the governments of other low-income countries may have handled the situation wisely and gained the trust of their publics. This may help convey a clearer picture to Arab governments that have suffered during the pandemic.

social identity, visibility, self-esteem, religiosity, Muslims, prosocial behaviour, adjustment, youth, discrimination, and anti-social behaviour

Previous research has often found religiosity in youth to be largely adaptive, predicting higher prosocial and lower problem behaviours, higher self-regulation, and higher self-esteem, among other outcomes (French et al., 2008). However, most of this research has been done with youth who were members of the majority faith (e.g., Christians in America, Muslims in Indonesia). Key social-psychological theories suggest that the experience of religiosity and an individual’s subsequent outcomes likely differ as a function of their minority status (Hogg & Reid, 2006; Tajfel et al., 1979). This thesis examines the role of religiosity in Muslim minority youth in Canada. Findings demonstrate that religiosity is still generally protective for religious minority youth, however, these relations are highly dependent upon the strength of an individual’s religious identification, the degree to which they believe they are identifiable as a Muslim, the influence of social norms, and their experiences with discrimination. SSRHC CGS-M, Dean's graduate research fund (UofGuelph)

Genetics, Molecular Biology, Biochemistry, and Biotechnology

Cardiology and Cardiovascular Medicine

Vascular dysfunction underlies numerous significant diseases including diabetes, atherosclerosis and hypertension. Vascular dysfunction can be a result of altered smooth muscle contraction/relaxation, and impaired endothelial cell function within the vessel wall. Vascular fibrosis involves an increase in the thickness of vessel wall. This contributes to either an increase in extracellular matrix (ECM) synthesis or induced vascular smooth muscle proliferation within the vessel wall, or both, causing stiffer vessels with impaired tone and reduced lumen diameter.Our lab identified the transcription factor scleraxis as a novel master regulator of fibrotic signaling in the myocardium, showing scleraxis is sufficient to induce fibroblast to myofibroblast phenotype conversion, a critical step in the development of fibrosis, and directly up-regulates ECM genes in cardiac fibroblasts. Angiotensin II (AngII) was reported to induce vascular fibrosis via activation of the transcription factor Smad3 in aortic vascular smooth muscle cells. Our lab has shown that Smad3 physically interacts with scleraxis, and critically requires scleraxis to drive TGFβ/Smad fibrotic signaling in cardiac fibroblasts.Our preliminary data has revealed that scleraxis is detectable in the arterial wall, and scleraxis expression is elevated in high pressure versus low pressure regions of vessels. Loss of scleraxis in the aortas of scleraxis knock-out mice reveals a discontinuation and disarrangement in the structure of vascular wall. We thus hypothesize that scleraxis is sufficient and necessary to induce vascular fibrosis.Pressure myography data reveals an increase in vascular stiffness and thickness of 3rd order mesenteric arteries of smooth muscle-specific scleraxis overexpression mice. Also, our data shows that vascular stiffness is significantly increased in AngII-induced scleraxis overexpression mice with a relative increase in telemetry blood pressure measurements and pulse wave velocity. Histological sections suggest a reduction of the translamellar ECM accumulations in AngII-induced scleraxis overexpression aortas. To summarize, scleraxis may contribute to vascular stiffness by inducing vascular smooth muscle proliferation.

Neurology (clinical) and Ophthalmology

Vascular Health and Risk Management, Pharmacology (medical), Cardiology and Cardiovascular Medicine, Public Health, Environmental and Occupational Health, Hematology, General Medicine, and Endocrinology, Diabetes and Metabolism

Ali Alhashim, Kawther Hadhiah, Hassan Al-Dandan, Mugbil Aljaman, Majed Alabdali, Mohammed Alshurem, Danah Aljaafari, Mustafa AlQarni Neurology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaCorrespondence: Ali Alhashim, Neurology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi Arabia, Tel +966509444833, Email ahalhashem@iau.edu.saBackground: Spontaneous simultaneous bilateral basal ganglia hemorrhage (SSBBGH) is an extremely rare condition with only a few published case reports and series. However, there is no systematic review that has been published yet.Objective: The study aims to conduct a systematic review on spontaneous simultaneous bilateral basal ganglion bleeding and a descriptive statistical analysis of collected data on epidemiology, clinical features, etiology, therapeutic approach and prognosis. This review aims to be a clinical reference for busy clinicians when they are faced with such a rare condition.Methodology: This review has been carried out in accordance with recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.Results: Review of 60 cases showed that SSBBGH affected predominantly male patients (70%) with an average age of 50.8 ± 15.33 years and the male-to-female ratio was 2.5:1. The female patients tend to be older with an average age of 54.22 ± 16.67 years. Location of SSBBGHwas more common in the putamen (90% vs 10% non-putaminal). SSBBGH posed a significant mortality rate (33.33%). Among patients who survived, only 40.6% (13/32 report) have had favorable outcomes (mRS ⤠2) and the remaining 59.4% (19/32) ended up with poor functional status (mRS ⥠3-5). The most common implicated etiologies were hypertension followed by alcohol intoxication.Conclusion: SSBBGH is a rare clinical entity with significant morbidity and mortality. Systemic approach can lead to early recognition of etiology and prompt treatment. Hypertension and the putamen are the most common etiology and location of SSBBGH, respectively. History of hypertension and age can help narrow differential diagnosis and limit unnecessary testing or intervention.Keywords: bilateral basal ganglia bleeding, bilateral basal ganglia hemorrhage, non-traumatic, simultaneous

General Medicine, Radiology, medicine.medical_specialty, medicine, Stroke, medicine.disease, Thrombus, Secondary Polycythemia, Neurovascular bundle, Cardiac cycle, Vertebral artery, medicine.artery, business.industry, business, Free floating thrombus, Blood flow, cardiovascular diseases, cardiovascular system, stroke, free-floating thrombus (fft), secondary polycythemia vera (pv), dual antithrombotic, Medicine (General), R5-920, Case Report, free-floating thrombus, FFT, secondary polycythemia vera, and PV

Ali Alhashim,1 Kawther Hadhiah,1 Sarah A Itani,2 Mohammed Alshurem,1 Majed Alabdali,1 Danah Aljaafari,1 Mustafa AlQarni1 1Neurology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaCorrespondence: Ali AlhashimNeurology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaTel +966 509444833Email ali_al_hashem@hotmail.com; ahalhashem@iau.edu.saAbstract: Free-floating thrombus (FFT) of the cervicocranial arteries is a rare neurovascular condition. Up to now, there is no standardized definition for FFT. Therefore, FFT is occasionally mistaken for intraluminal thrombus (ILT) or smooth mural thrombus. The most precise and ideal definition of FFT would be a long-extended intraarterial thrombus that is attached to the arterial wall with its one end, while its other end is surrounded by blood flow and moves freely with the cardiac cycle. FFT usually manifests as an ischemic stroke, thus it is considered as an emergency case. Herein, we report a rare case of symptomatic FFT in the left vertebral artery extending from V0 to V2 segments in a middle-aged smoker, who presented with multiple embolic strokes in different territories of posterior circulation and was successfully treated medically. This case sheds light on the challenges of the clinical approach of FFT in the vertebral artery and it is an attempt to draw attention to the necessity of conducting a large-scale study to find out the ideal approach to manage such conditions.Keywords: stroke, free-floating thrombus, FFT, secondary polycythemia vera, PV, dual antithrombotic