articles+ search results

Trigger fingers, Metabolic syndrome, Smoking, inflammation, Orthopedic surgery, RD701-811, Diseases of the musculoskeletal system, and RC925-935

Abstract Purpose To investigate the health-related factors and analyze the expression of epigenetic related genes and inflammatory genes in metabolic syndrome Trigger Finger (TF) and smoker TF. Methods Samples from patients’ fingers with symptomatic TF were collected. There were seven groups: healthy control group, carpal tunnel syndrome (as a control for gene expression analysis), TF, diabetic TF, hypertensive TF, dyslipidemic TF and smoker TF. The expression levels of epigenetic related genes and inflammatory genes in metabolic syndrome TF and smoker TF were evaluated by the reverse transcription–polymerase chain reaction (RT-PCR) technique. The Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI) questionnaires, disability of the arm, shoulder and hand (DASH) and numeric pain rating scale were given to the participants to fill out. Results There was a significant increase in hand dysfunction in the metabolic TF groups and smoker group compared to the TF group (p

Chemistry and QD1-999

Periodontal disease, Chronic migraine, Headache, Leptin, Chronification, Dentistry, and RK1-715

Migraine is a neurologic illness that produces intense throbbing pain on one side of the head and affects roughly 1 billion people worldwide. Recent research indicates a relationship between periodontitis and chronic migraines. This study aimed to review the association between chronic migraines and periodontitis through a systematic literature review.Four research databases (Google Scholar, PubMed, ProQuest, and SpringerLink) were searched according to PRISMA guidelines to retrieve the studies included in this review. A search strategy was developed to answer the study question with appropriate inclusion and exclusion criteria. Out of 34 published studies, 8 studies were included in this review. Three of the studies were cross-sectional, 3 were case-control, and 2 were clinical report and medical hypothesis papers. Seven of the 8 included studies showed that there is an association between periodontal disease and chronic migraine. The elevated blood levels of some biomarkers such as leptins, ProCalcitonin (proCT), calcitonin gene-related peptides (CGRPs), Pentraxin 3 (PTX3), and Soluble Tumor Necrosis Factor-like Weak Inducer Of Apoptosis (sTWEAK) play a significant role in this association. The limitations include a small sample size, the influence of anti-inflammatory drugs, and a self-reported headache measure that is subject to misclassification bias.This systematic review reveals a supposed correlation between periodontal disease and chronic migraine, as evidenced by various biomarkers and inflammatory mediators. This suggests that periodontal disease could potentially contribute to the development of chronic migraine. However, to further assess the potential benefits of periodontal treatment in patients with chronic migraine, additional longitudinal studies with larger sample sizes and interventional studies are needed.

birth defects, pattern, prevalence, Saudi Arabia, Medicine, Pediatrics, and RJ1-570

Introduction: Birth defects are a significant concern since they can lead to permanent disability and death. This study comprehensively reviews the prevalence and patterns of birth defects in Saudi Arabia. Methods: A systematic analysis of the literature retrieved from three databases (Pub Med, Science Direct, and the Saudi digital library) published between 1989 and 2022 was performed. Observational studies that addressed the prevalence and patterns of birth defects in Saudi Arabia were chosen based on the eligibility criteria, while systematic reviews, review articles, non-relevant articles, and studies that did not fulfill the eligibility criteria were excluded. Quality and risk of bias were evaluated based on the JBI and GRADE tools, respectively. Results: We identified 26 eligible publications of 1277 records that included 297,668 patients from different regions of Saudi Arabia. The highest overall prevalence of birth defects was 46.5 per 1000 live births compared to a lowest rate of 8.6 per 1000 in one study. Several studies have reported positive associations of consanguinity, maternal folic acid supplementation, family history of birth defects or genetic abnormalities, and maternal co-morbidities. The most frequent birth defects include cardiac, genitourinary, craniofacial, and nervous system defects. Conclusion: Robust findings have improved our understanding of the prevalence and pattern of birth defects in Saudi Arabia. Importantly, future studies will likely require multicenter collaboration to arrive at appropriate sample sizes in the context of the effects of risk factors on elevated prevalence. Furthermore, quantitative data require careful evaluation in more complex statistical models.

electronic cigarettes, adults, dependence, harm, addictiveness, Diseases of the respiratory system, RC705-779, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, and RC254-282

Introduction Electronic cigarettes (e-cigarettes) have become one of the most common forms of nicotine delivery used by youth and young adults worldwide. Given the lack of epidemiologic data in Kuwait, this study sought to estimate the prevalence of e-cigarette use, assess perceptions of harm and addictiveness of e-cigarettes, measure the level of dependence on e-cigarettes and assess factors associated with dependence level among adults. Methods A cross-sectional study enrolled adults (n=3032, aged ≥18 years) living in Kuwait using a web-based questionnaire. Participants self-reported ever and current (past 30-day) e-cigarette use and self-completed the 10-item Penn State E-cigarette Dependence Index. Associations were evaluated using multinomial logistic regression. Results The prevalence of ever and current e-cigarette use was estimated to be 40.2% (1220/3032) and 29.4% (892/3032), respectively. The prevalence of current e-cigarette use was higher in males compared to females (47.6% vs 14.4%, p

Nanosponges, crosslinker, nanocarrier, cyclodextrin, analgesics, drug efficacy, Therapeutics. Pharmacology, and RM1-950

AbstractCyclodextrin nanosponges are solid nanoparticles, designed by cross-linking of cyclodextrin polymer; it has been used widely as a good delivery system for water insoluble drugs. The aim of this study is to enhance the solubility of Piroxicam (PXM) using β-Cyclodextrin based nanosponges formulations. PXM nanosponge (PXM-NS) formulations were prepared using β-cyclodextrin and carbonyldiimidazole as a cross linker, three ratios of β-cyclodextrin to crosslinker in addition to three drug to nanosponges ratios were tested. Piroxicam nanosponge formulations were characterized for its particle size, zeta potential, physical compatibility and in vitro release. Stability studies at three temperatures (4 °C, 25 °C and 40 °C) were done for optimal formula. Finally, the in vivo analgesic activity and pharmacokinetic parameters of the optimal formula were conducted. The optimized PXM-NS formula (PXM-NS10) showed particle size (362 ± 14.06 nm), polydispersity index (0.0518), zeta potential (17 ± 1.05 mV), and %EE (79.13 ± 4.33). The dissolution study showed a significant increase in the amount of PXM dissolved compared with the unformulated drug. Stability studies confirmed that nanosponge showed accepted stability for 90 days at 4 °C and 25 °C. In vivo analgesic studies verified that there was a significant enhancement in the analgesic response to PXM in mice, and 1.42 fold enhancement in the relative bioavailability of PXM-NS10 as compared to commercial tablets. Nanosponge prepared under optimal conditions is an encouraging formula for increasing the solubility and therefore the bioavailability of Piroxicam.

Science (General), Q1-390, Social sciences (General), and H1-99

Introduction: Nonconvulsive status epilepticus (NCSE) is an important and often unrecognized cause of impaired awareness especially in critically ill patients, which can easily be missed. Electroencephalography (EEG) findings in clinically suspected cases are the mainstay of diagnosis. Review summary: The EEG diagnostic criteria for NCSE have evolved over the past three decades. Furthermore, recent advancements in EEG technologies such as continuous EEG monitoring, and emergency department EEG, along with development of different diagnostic criteria, have increased the detection rate for NCSE in suspected cases. However, treating physicians should have a higher index of clinical suspicion and a lower threshold for recommending this valuable investigation. The introduction of different diagnostic criteria has made it easier for electroencephalographers to report NCSE; nevertheless, diagnosis is not always straightforward. This narrative review aimed to define and discuss the available literature on different EEG diagnostic criteria for NCSE. Conclusion: There is a need for further prospective research to strengthen the diagnostic accuracy of the available diagnostic criteria, the modified Salzburg Consensus Criteria for NCSE (mSCNC) and updated American Clinical Neurophysiology Society (ACNS) 21 criteria, to verify their accuracy to detect NCSE in comatose patients.

Anti-Epileptic drugs, Levetiracetam, Pharmacokinetics, Liver enzymes, High-performance liquid chromatography, Saudi Arabia, Therapeutics. Pharmacology, and RM1-950

Background: Epilepsy is a common global neurological disorder. About 30% of epileptic patients are managed with anti-epileptic Drugs (AEDs). Since 2000, Levetiracetam (LEV) has been marketed around the world as an AED under the brand name Keppra, and recently more generics are found in the Saudi market as cheaper alternatives. The objective of this study is to evaluate the bioequivalence of LEV brand and generics available in the Saudi market in mice. Methods: Pharmacokinetics (PK), liver function test, and behavioral studies were conducted for LEV brand and generic in different groups of Blab/c mice. Results: PK results show a significance difference in PK parameters mostly evidenced with generic 3, then generic 2. The only significant different between Keppra and generic 1 was in T1/2. In addition, Keppra did not significantly increase liver enzymes in comparison to other generics. On the other hand, other generics showed less favorable results in increasing liver enzymes. Keppra reduced the number and intensity of epileptic attacks, had no mortality rate due to epilepsy, and was associated with less sever seizures attacks. Conclusion: Keppra, the brand form of LEV, has better safety and efficacy profiles in mice compared to 3 generics found in the Saudi market. Therefore, we recommend evaluating the same parameters tested in this study in patients utilizing similar generics and brand to establish the existence of bioequivalence between LEV brand and generics.

Medicine and Science

Abstract Globally, COVID-19 affected radiopharmaceutical laboratories. This study sought to determine the economic, service, and research impacts of COVID-19 on radiopharmacy. This online survey was conducted with the participation of employees from nuclear medicine and radiopharmaceutical companies. The socioeconomic status of the individuals was collected. The study was participated by 145 medical professionals from 25 different countries. From this work, it is evident that 2-deoxy-2-[18F]fluoro-D-glucose (2-[18F]FDG), and 99m Tc-labeled macro aggregated albumin 99mTc-MAA were necessary radiopharmaceuticals used by 57% (83/145and 34% (49/145;) respondents, respectively for determining how COVID infections affect a patient’s body. The normal scheduling procedure for the radiopharmacy laboratory was reduced by more than half (65%; 94/145). In COVID-19, 70% (102/145) of respondents followed the regulations established by the local departments. Throughout the pandemic, there was a 97% (141/145) decrease in all staffing recruitment efforts. The field of nuclear medicine research, as well as the radiopharmaceutical industry, were both adversely affected by COVID-19.

Choose a surgeon, Factors, Social media, surgeon's qualifications, Public attitudes, Surgery, and RD1-811

Aim: It is a complex decision for patients and their families to select a qualified surgeon who meets their needs. Understanding these needs enables surgeons to build stronger relationship with patients. This study aimed to identify influencing factors, variables, and criteria that individuals consider when selecting surgeons for elective surgeries. Methods: This is a nationwide cross-sectional study conducted among patients who have undergone elective surgeries in Saudi Arabia. The data were collected with an anonymous self-administered pre-validated questionnaire. The collection of data was carried out through web-based questionnaires using google forms. The questionnaire contains socio-demographic characteristics (i.e., age, gender, education, etc.) and different factors to assess patients' perceptions in choosing a surgeon. Result: Patients' overall number was 3133 (56.2 % females vs 43.8 % males). The most common age group was 18 to 34 years old (63.7 %). The prevalence of patients who were able to choose the right surgeon to perform an operation was 79.8 %. Patients' top choice when selecting a surgeon was according to the surgeon's manner followed by the qualifications then the reputation. Females are choosing a surgeon according to his/her manner while males are choosing according to his/her qualifications. Conclusion: Surgeons' manner and qualifications are the most considered factors among when selecting a surgeon while the realistic factors such as accreditation of a facility and surgeon's scientific roles, quality improvement, and patient safety are ignored among the public. This requires condensed educational efforts and further research to determine the advertisements and social media effects on patients' decisions related to their health.

Social isolation, Depression, Socialization, Adolescents, Psychiatry, and RC435-571

Abstract Background Social isolation can be defined as the absence of social interactions, contacts, and relationships with family, friends, and neighbors. According to some studies, social isolation was associated with depressive symptoms. At least one out of every five teenagers suffer from a diagnosable mental health problem that impairs their function. Saudi Arabia has a significant adolescent population; however, there are few studies conducted in Saudi Arabia to assess social isolation and its psychological impact among adolescents. This research is intended to study the prevalence of social isolation among adolescents in Riyadh and its association with depression symptoms. Methods A cross-sectional study was conducted among 483 adolescents living in Riyadh, Saudi Arabia. An online self-administered questionnaire was used, and it was composed of three sections which are sociodemographic characteristics, assessment of social isolation, and assessment of depression symptoms. Results The study reported the prevalence of social isolation among adolescents was 10.14%. The prevalence of depression symptoms among adolescents was high (31.68%). There was a significant association between social isolation and symptoms of depression among the studied sample (χ 2 = 12.3, p = 0.002). It was found that being a male, living with both parents, and having low income are significant predictors of social isolation among adolescents; with r 2 = 0.08 and p-value

Infectious bronchitis virus (IBV), DMV/1639, Autogenous vaccine, Layer, Canada, Microbiology, QR1-502, Infectious and parasitic diseases, and RC109-216

The emergence of the Canadian Delmarva (DMV)/1639 infectious bronchitis virus (IBV) type strains was associated with egg production disorders in Eastern Canadian layer operations. While developing vaccines for novel IBV variants is not typically a reasonable approach, the consideration of an autogenous vaccine becomes more appealing, particularly when the new variant presents significant economic challenges. The current study aimed to compare the efficacies of two vaccination programs that included heterologous live priming by Massachusetts (Mass) and Connecticut (Conn) type vaccines followed by either a commercial inactivated Mass type vaccine or a locally prepared autogenous inactivated DMV/1639 type vaccine against DMV/1639 IBV challenge. The protection parameters evaluated were egg production, viral shedding, dissemination of the virus in tissues, gross and microscopic lesions, and immunological responses. The challenge with the DMV/1639 caused severe consequences in the non-vaccinated laying hens including significant drop in egg production, production of low-quality eggs, serious damage to the reproductive organs, and yolk peritonitis. The two vaccination programs protected the layers from the poor egg-laying performance and the pathology. The vaccination program incorporating the autogenous inactivated DMV/1639 type vaccine was more effective in reducing vial loads in renal and reproductive tissues. This was associated with a higher virus neutralization titer compared to the group that received the commercial inactivated Mass type vaccine. Additionally, the autogenous vaccine boost led to a significant reduction in the viral shedding compared to the non-vaccinated laying hens. However, both vaccination programs induced significant level of protection considering all parameters examined. Overall, the findings from this study underscore the significance of IBV vaccination for protecting laying hens.

Surgery and RD1-811

Summary:. Silicone liquid (polydimethylsiloxane) is an inert material commonly used for cosmetic purposes. A combination of both systematic and local devastating complications can cause end-organ toxicity and multi-organ dysfunction. In this article, we examine the literature and present a case of a patient who presented with lower extremity filler migration and granuloma formation 11 years post gluteal silicone injection. A 31-year-old woman who had received a gluteal silicone injection 11 years ago was experiencing painful erythema, progressive fibrosis, and swelling as the result of the injection. The patient was diagnosed with postfiller autoimmune syndrome. Multiple surgical interventions were conducted to remove the permanent filler from her left knee. As a result of multiple surgical sessions, the patient has been managed successfully with no relapses. This case demonstrated complications of an unusual silicone injection technique for gluteal augmentation. Despite silicone being considered inert, complications can arise years after injection, necessitating extensive medical intervention. This case also raises questions regarding the systemic effects of silicone fillers, warranting further research. Through this report, we aimed to enhance awareness and management of similar future cases.

glycated hemoglobin, HbA1c level, acute ischemic stroke, intracranial large artery atherosclerotic disease, functional outcomes, predictor, Neurology. Diseases of the nervous system, and RC346-429

ObjectiveThis study aimed to investigate the effect of the glycated hemoglobin A1c (HbA1c) level on the functional outcome (FOC) in patients with intracranial large artery atherosclerotic disease (ICLAD)-related acute ischemic stroke (AIS).MethodsThis retrospective study enrolled patients with ICLAD-related AIS who were admitted to King Fahd University Hospital between January 2017 and September 2021. Patients were divided into two groups based on the optimal cutoff HbA1c level determined using receiver operating characteristic curve analysis—those with HbA1c ≤6.9% and those with HbA1c >6.9%. Demographic and other clinical characteristics were compared between the two groups using chi-square tests. The association between HbA1c and 90-day FOC was assessed using the chi-square test and odds ratios (ORs). Multivariate analysis was performed to adjust for confounding factors.ResultsA total of 140 patients were included in the analysis. A significant association was observed between the HbA1c level and FOC. Compared to patients with HbA1c ≤6.9%, patients with HbA1c >6.9% were more likely to have an unfavorable FOC [p = 6.9% and unfavorable FOC was sustained even after adjusting for confounding factors (p = 0.008) and atherosclerosis risk factors (p = 0.01). HbA1c >6.9% was also associated with higher ORs for in-hospital complications (p = 0.06, OR = 1.34, 95% CI = 1.02–1.77) and mortality (p = 0.07, OR = 1.42, 95% CI = 1.06–1.92) although these associations did not attain significant p-values.ConclusionHbA1c >6.9% was significantly associated with unfavorable FOC in ICLAD-related AIS. However, further studies with larger sample sizes are required to verify whether HbA1c is an independent predictor of poor FOC. Nevertheless, targeting HbA1c

death, Jordan, metastasis, retinoblastoma, survival, Medicine (General), and R5-920

PurposeTo analyze causes and prognostic factors for death among Retinoblastoma (Rb) patients treated at a single specialized tertiary cancer center in Jordan.MethodsWe reviewed the mortality causes for all Rb patients who have been treated at the King Hussein Cancer Center between 2003 and 2019 and were followed for at least 3 years after diagnosis. The main outcome measures included demographics, laterality, tumor stage, treatment modalities, metastasis, survival, and causes of death.ResultsTwenty-four (5%) of the 478 patients died from retinoblastoma and 5-year survival was 94%. The mean age at diagnosis was 15 months (median, 18 months; range, 4–38 months); eight (33%) received diagnoses within the first year of life. Eleven (46%) were boys, 16 (67%) had bilateral disease, and 3 (13%) had a positive family history. The stage for the worst eye was C for 1 (4%) patient, D in 6 (25%) patients, and E (T3) in 15 (63%) patients. Two patients had extraocular Rb at diagnosis, and four of the patients who had intraocular Rb at diagnosis refused treatment and then came back with extraocular Rb. In total, extraocular disease was encountered in six eyes (six patients). After a 120-month median follow-up period, 24 patients (5%) died of second neoplasms (n = 3) or metastases (n = 21). Significant predictive factors for metastasis and death included advanced IIRC tumor stage (p

Clostridium difficile infection (CDI), Vedolizumab, Crohn’s disease, Ulcerative colitis, Inflammatory bowel disease, 5- Aminosalicylates acid, Therapeutics. Pharmacology, and RM1-950

Introduction: Several studies have shown increased incidence, recurrence, and severity of Clostridium difficile infection (CDI) over the last decade. Patients with inflammatory bowel disease (IBD) who develop CDI are more prone to morbidity and mortality than CDI in patients without IBD. This study seeks to evaluate whether IBD patients who use vedolizumab are at increased risk of CDI compared to IBD patients using other therapies. Methods: This was a retrospective cohort study, and 684 patients with confirmed IBD (228 on vedolizumab, 228 on anti-TNF, and 228 on 5- Aminosalicylates acid therapy) were enrolled from January 2009 to August 2019 at a tertiary referral IBD center at McMaster University Medical Centre (MUMC) in Hamilton, Ontario, Canada. The primary outcome was time to the development of CDI in IBD patients using different therapies. Secondary outcomes included rates of CDI and the association between baseline variables and risk of CDI. A Cox proportional hazards (PH) model was used to evaluate baseline factors and development of CDI. Result: There was no difference in time to CDI between the three treatment groups (log rank p-value 0.37). CDI occurred in 16 patients (2.3%), specifically four patients (1.75%) in the vedolizumab group, four patients (1.75%) in the anti-TNF group, and eight patients (3.5%) in the 5-ASA group. The Cox PH model found current smoking, older age, and concomitant immunomodulator use as risk factors for CDI, after adjustment for other covariates. Vedolizumab was not associated with increased risk of CDI in the model. Conclusion: Biologic therapy with vedolizumab or anti-TNF did not impact risk of CDI. Risk factors for CDI in IBD patients included smoking, older age at the onset of medication, and immunomodulator therapy. Clinicians should have high degree of suspicion for CDI in IBD patients presenting with diarrhea, particularly in those with risk factors identified in this study.

Analgesics, Pain, Suicide, Pregabalin, Gabapentin, Anticonvulsants, Public aspects of medicine, and RA1-1270

Summary: Background: Analgesics prescriptions may provide a marker for identifying individuals at higher risk of suicide. In particular, awareness of which analgesics are implicated may help clinicians assess and modify risk. Method: A case–control study in England using the Clinical Practice Research Datalink (for primary care records) linked with hospital and national mortality electronic registries. We included patients aged ≥15 who died by suicide between 2001 and 2019 (N = 14,515), to whom we individually matched 580,159 controls by suicide date and general practice (N = 594,674). Odds ratios (ORs) for suicide, controlled for age and sex, were assessed using conditional logistic regression. Findings: Suicide risks were highest in those prescribed adjuvant analgesics (pregabalin, gabapentin and carbamazepine) (adjusted OR 4.07; 95% confidence intervals CI: 3.62–4.57), followed by those prescribed opioids (adjusted OR 2.01; 95% CI: 1.88–2.15) and those prescribed non-opioid analgesics (adjusted OR 1.48; 95% CI: 1.39–1.58) compared to those not prescribed these medications. By individual analgesic, the highest suicide risks were seen in patients prescribed oxycodone (adjusted OR 6.70; 95% CI: 4.49–9.37); pregabalin (adjusted OR 6.50; 95% CI: 5.41–7.81); morphine (adjusted OR 4.54; 95% CI: 3.73–5.52); and gabapentin (adjusted OR 3.12; 95% CI: 2.59–3.75). Suicide risk increased linearly with the number of analgesic prescriptions in the final year (p

Abstractive summarization, novelty, warm-started models, deep learning, metrics, Electrical engineering. Electronics. Nuclear engineering, and TK1-9971

Abstractive summarization is distinguished by using novel phrases that are not found in the source text. However, most previous research ignores this feature in favour of enhancing syntactical similarity with the reference. To improve novelty aspects, we have used multiple warm-started models with varying encoder and decoder checkpoints and vocabulary. These models are then adapted to the paraphrasing task and the sampling decoding strategy to further boost the levels of novelty and quality. In addition, to avoid relying only on the syntactical similarity assessment, two additional abstractive summarization metrics are introduced: 1) NovScore: a new novelty metric that delivers a summary novelty score; and 2) NSSF: a new comprehensive metric that ensembles Novelty, Syntactic, Semantic, and Faithfulness features into a single score to simulate human assessment in providing a reliable evaluation. Finally, we compare our models to the state-of-the-art sequence-to-sequence models using the current and the proposed metrics. As a result, warm-starting, sampling, and paraphrasing improve novelty degrees by 2%, 5%, and 14%, respectively, while maintaining comparable scores on other metrics.

distal hypospadias, double-layered preputial dartos flap, tubularized incised plate urethroplasty, urethrocutaneous fistula, Diseases of the genitourinary system. Urology, and RC870-923

Urethrocutaneous fistula may complicate hypospadias repair. We noticed that double-layered preputial dartos flaps added to tubularized incised plate urethroplasty can reduce the risk of urethrocutaneous fistula. The aim of this study was to compare the outcomes of tubularized incised plate urethroplasty with double-layered preputial dartos flaps to with single-layered local fascial flaps in preventing urethrocutaneous fistula. A retrospective cohort study was conducted between January 2017 and December 2020 at Jordan University Hospital (Amman, Jordan). Boys who were aged between 6 months and 5 years, diagnosed with distal hypospadias, and not circumcised were included. The primary outcome was the occurrence of urethrocutaneous fistula in patients who underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The results showed a total of 163 boys with distal hypospadias; among them, 116 patients underwent tubularized incised plate urethroplasty with a single-layered fascial flap, and 47 underwent tubularized incised plate urethroplasty with a double-layered fascial flap. The development of urethrocutaneous fistula was higher in the group receiving tubularized incised plate urethroplasty with a single-layered fascial flap than in the group receiving tubularized incised plate urethroplasty with a double-layered fascial flap after 1 month, 6 months, and 12 months (6.9% vs 0, 10.3% vs 0, and 5.2% vs 0, respectively), and the difference after 6 months was statistically significant (P = 0.02).

body positions, healthy adults, intra-ocular pressure, muslim prayer, salat, Ophthalmology, and RE1-994

Purpose: There is a lack of research examining the effects of Muslim prayer (Salat) positions on the intra-ocular pressure (IOP). Considering its involvement with postural changes, this study aimed to investigate the changes in the IOP upon assuming Salat positions before, immediately after, and after 2 minutes of prayer in healthy young adults. Methods: This prospective, observational study recruited healthy young individuals aged between 18 and 30 years. The IOP measurements were obtained in one eye using Auto Kerato-Refracto-Tonometer TRK-1P, Topcon at baseline before assuming prayer positions, immediately after, and after 2 minutes of the prayer. Results: Forty female participants were recruited, with a mean age of 21 ± 2.9 years, a mean weight of 59.7 ± 14.8 (kg), and a mean body mass index (BMI) of 23.8 ± 5.7 (kg/m2). Only 16% had a BMI ≥25 kg/m2 (n = 15). All participants started with a mean IOP at baseline of 19.35 ± 1.65 mmHg, which increased to 20 ± 2.38 mmHg and declined to 19.85 ± 2.67 mmHg after 2 minutes of Salat. The difference between the mean IOPs at baseline, immediately after, and after 2 minutes of Salat was not significant (p = 0.06). However, there was a significant difference between the baseline IOP measurements and those immediately after Salat (p = 0.02). Conclusion: A significant difference was found between the IOP measurements at baseline and immediately after Salat; however, this was not clinically significant. Further investigation is warranted to confirm these findings and explore the effect of a longer duration of Salat in glaucoma and glaucoma suspect patients.

feed additives, plant secondary metabolites, rumen fermentation, toxicity, Veterinary medicine, SF600-1100, Zoology, and QL1-991

Plant secondary compounds are potential rumen modifiers that can improve nutrient utilization in ruminant animals. This study evaluated the effect of Moringa (Moringa oleifera) and Neem (Azadirachta indica) leaf extracts on nutrient digestibility, growth performance, and enteric methane production in South African Mutton Merino lambs. Forty 4-month-old ram lambs with a mean body weight of 35 ± 2.2 kg were blocked by weight and from each block, lambs were randomly allocated into one of the following treatments: (i) diet only (fed a total mixed ration TMR-negative control), (ii) Monensin (fed TMR containing Monensin sodium, 15 mg/kg DM), (iii) Moringa (fed TMR, drenched with Moringa extract 50 mg/kg feed DM intake), and (iv) Neem (fed TMR, drenched with Neem extract 50 mg/kg DM intake). Extracts were administered via oral drenching at a concentration determined based on the previous week’s feed intake. There were no differences in dry matter intake, average daily gain, feed conversion efficiency, digestibility, and nitrogen retention across the treatments. However, the extracts tended to reduce methane emitted both in g/head/day (p < 0.08) and g/ kg dry matter intake (p < 0.07). Extracts did not influence any of the blood metabolites in the ram lambs. Although the benefits of utilizing these medicinal plants as rumen modifiers under prolonged feeding conditions is justified, further evaluation is recommended to test Moringa and Neem leaf extracts at higher inclusion levels. Our research group is currently exploring a variety of phytogenic tools for the identification and standardization of key bioactive compounds linked to methane inhibition, in these leaf extracts.

ginger oil, nanoemulsion, Ehrlich’s ascites carcinoma, apoptosis, tumor, breast cancer, Chemical technology, and TP1-1185

Cancer is a disease that is characterized by uncontrolled cell proliferation. Breast cancer is the most prevalent cancer among women. Ginger oil is a natural cancer fighter and anti-oxidant. However, the minimal absorption of ginger oil from the gastrointestinal tract accounts for its limited medicinal efficacy. The present study was designed to evaluate the efficacy of a nanoemulsion preparation of ginger oil on its oral bioavailability and in vivo anti-cancer efficacy. Ginger oil nanoemulsion was prepared by a high-pressure homogenization technique using different surfactants (Tween 20, 40, and 80). The prepared formulations were evaluated for droplet size, polydispersity index (PDI), zeta potential (ZP), pH, viscosity, and stability by calculating the creaming index percentage. The best formulation was evaluated for shape by TEM. The antitumor activity of the best nano-formulation was determined in comparison with the free oil using the in vivo Ehrlich solid tumor (EST) model. The prepared ginger oil nanoemulsion formulations exhibited acceptable droplet size in the range from 56.67 ± 3.10 nm to 357.17 ± 3.62 nm. A PDI of less than 0.5 indicates the homogeneity of size distribution. The oil globules possessed a negative charge ranging from −12.33 ± 1.01 to −39.33 ± 0.96 mV. The pH and viscosity were in the acceptable range. The TEM image of the best formulation appeared to be spherical with a small size. The ginger oil nanoemulsion reduced in vivo tumor volume and weight, extended animals’ life span, and ameliorated liver and kidney function in EST-bearing mice. These effects were superior to using free ginger oil. Collectively, the present study demonstrated that the ginger oil nanoemulsion improved oral absorption with a subsequent enhancement of its anti-proliferative efficacy in vivo, suggesting a nano-formulation of ginger oil for better therapeutic outcomes in breast cancer patients.

optic disc swelling, papilledema, chemotherapy, infiltration, Jordan, and Medicine

Purpose: To analyze the etiology and implications of optic disc swelling in cancer patients treated at a specialized tertiary cancer center in Jordan. Methods: This was a retrospective study of all cancer patients who had optic disc swelling between January 2019 and December 2020 at King Hussein Cancer Center (KHCC). Patients’ data included age, sex, laterality, visual acuity, and the underlying cause and management for the optic disc swelling. Results: Optic disc swelling was present in 58 cancer patients (96 eyes), with 38 (65%) having bilateral involvement. Among these, 33 (57%) were female, and 43 (74%) were ≤40 years old. At diagnosis, 58 (63%) eyes had a best-corrected visual acuity (BCVA) better than 0.5, improving to 73 (76%) eyes at the last follow-up. High intracranial pressure (ICP) was the most common primary cause (30 patients/52%), followed by tumor infiltration of the optic nerve (10 patients/17%), optic nerve compression (7 patients/12%), and optic nerve inflammation (5 patients/9%). Four patients had pseudopapilledema. Among the 30 patients with high ICP, CNS tumors were predominant (21 patients/70%), with only 3 having idiopathic intracranial hypertension. Medications, including ATRA (All-Trans Retinoic Acid) and systemic steroids, contributed to increased ICP in six patients (20%). BCVA was less than 0.5 in all eyes (100%) affected by tumor infiltration, optic nerve inflammation, and ischemic optic neuropathy, while only eight eyes (14%) with optic disc swelling due to elevated ICP had a BCVA less than 0.5 (p < 0.0001). Management included steroids (53 patients/91%), acetazolamide (30 patients/52%), chemotherapy (20 patients/34%), radiation therapy (13 patients/22%), frequent lumbar punctures (12 patients/21%), and surgery (28 patients/48%). Visual acuity improved in 40 eyes (42%), with only 4 eyes (4%) experiencing deterioration. At a 12-month median follow-up period, 11 (19%) patients were dead, 10 (10%) eyes had poor vision (BCVA less than 0.1), and 21 (22%) eyes had BCVA 0.5 or better. Conclusions: Various underlying pathologies can induce optic disc swelling in cancer patients, a grave condition capable of causing vision loss. Notably, tumor infiltration of the optic nerve tends to result in more profound visual impairment compared to papilledema due to elevated ICP. Timely detection is crucial, and immediate symptomatic treatment followed by addressing the underlying cause is essential to prevent irreversible optic nerve damage and vision loss in cancer patients.

Epidermolysis bullosa, Supraglottic stenosis, Laryngeal manifestation, Otorhinolaryngology, and RF1-547

Epidermolysis bullosa (EB) is a group of inherited disorders characterized by increased vulnerability to mechanical stress at the dermo-epidermal junction and basilar layer of the epidermis. Laryngeal EB involvement is a major and life-threatening manifestation of the disease. Due to the nature of EB, granulation tissue and stenosis can occur, usually at the glottic, subglottic, or supraglottic levels, as seen in our patients.We described cases in which four patients with EB presented with supraglottic stenosis and were managed at tertiary hospital in Saudi Arabia. The clinical and therapeutic characteristics of all patients are discussed.

Nursing and RT1-120

Introduction Pregnancy is a significant transitional life experience. It can also be one of the most stressful experiences in life and some women go on to develop postpartum depression. Adopting mindfulness techniques during childbirth may allow women to experience less labor pain and require fewer medical interventions, which improve the mother's health. Objective To investigate the effectiveness of mindfulness in reducing childbirth stress in primigravid women in Saudi Arabia. Methods The researcher recruited primigravid women from an antenatal clinic in a government hospital in the Eastern Province of Saudi Arabia. The study adopted a qualitative interpretive descriptive design, using individual interviews to collect the data before conducting thematic content analysis using NVivo 10.1 software. Results Five key themes emerged from the data: (a) stress reduction, (b) recognition of thoughts and feelings, (c) life satisfaction, (d) insufficient knowledge leads to challenges, and (e) empowerment of a spiritual aspect. Conclusions Mindfulness is an effective technique that supports a mother's physical and psychological well-being.

Nursing and RT1-120

Introduction The postpartum period is accompanied by health risks that impact many women. Postpartum depression (PPD) is a mental health problem that has been neglected in maternal healthcare services. Objective The purpose of this study was to explore nurses’ perceptions towards health services’ contribution to lowering the incidence of PPD. Methods An interpretive phenomenological approach was adopted in a tertiary hospital in Saudi Arabia. A convenience sample of 10 postpartum nurses was interviewed face-to-face. The analysis followed Colaizzi's data analysis method. Results Seven main themes emerged on how to improve maternal health services to contribute to reducing the incidence of PPD among women: (1) maternal mental health, (2) follow-up of mental health status, (3) screening mental health status, (4) enhancing health education, (5) reducing stigma toward mental health, (6) updating resources, and (7) empowering nurses. Conclusion The integration of mental health services into maternal services that are provided to women needs to be considered in the context of Saudi Arabia. This integration will result in high-quality holistic maternal care.

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.

competency-based, pharmacy, education, matrix competency framework, Kuwait, entrustable professional activities (EPA), Pharmacy and materia medica, and RS1-441

The development of competency frameworks serves as the foundation for the development of competency-based education. It is vital to develop a country-specific framework to address the specific needs of the local population for pharmacy services. This study aimed to describe the development process of a competency framework for undergraduate pharmacy education in Kuwait with a unique matrix structure. The process started with the development of guiding principles for curriculum revision and implementation, as well as the identification of global educational outcomes. This process was followed by: (A) a needs assessment with key stakeholders; (B) development of the initial competency framework; and (C) refinement of the framework. Qualitative data were thematically analyzed to identify the main competency domains that students need to perform the identified entrustable professional activities (EPAs). Five population needs were identified by the needs assessment, with 17 EPAs suggested to fulfill those needs. In addition, 11 competency domains were identified. The initial competency framework was created as a 3 × 8 matrix, with 3 professional and 8 transversal competency domains. Refinement of the framework resulted in the removal of redundancies and the development of a global behavior competency profile. The development of a matrix competency framework and associated EPAs for Kuwait serves as a foundation for preparing pharmacists to fulfill local population needs and expanding the scope of practice in the country.

Artificial Intelligence, PPE detection, computer vision, object detection, mAP score, Environmental effects of industries and plants, TD194-195, Renewable energy sources, TJ807-830, Environmental sciences, and GE1-350

Personal protective equipment (PPE) can increase the safety of the worker for sure by reducing the probability and severity of injury or fatal incidents at construction, chemical, and hazardous sites. PPE is widely required to offer a satisfiable safety level not only for protection against the accidents at the aforementioned sites but also for chemical hazards. However, for several reasons or negligence, workers may not commit to and comply with the regulations of wearing the equipment, occasionally. Since manual monitoring is laborious and erroneous, the situation demands the development of intelligent monitoring systems to offer the automated real-time and accurate detection of PPE compliance. As a solution, in this study, Deep Learning and Computer Vision are investigated to offer near real-time and accurate PPE detection. The four colored hardhats, vest, safety glass (CHVG) dataset was utilized to train and evaluate the performance of the proposed model. It is noteworthy that the solution can detect eight variate classes of the PPE, namely red, blue, white, yellow helmets, head, person, vest, and glass. A two-stage detector based on the Fast-Region-based Convolutional Neural Network (RCNN) was trained on 1699 annotated images. The proposed model accomplished an acceptable mean average precision (mAP) of 96% in contrast to the state-of-the-art studies in literature. The proposed study is a potential contribution towards the avoidance and prevention of fatal/non-fatal industrial incidents by means of PPE detection in real-time.

Electronic computers. Computer science and QA75.5-76.95

Pediatrics and RJ1-570

BackgroundDietary patterns and nutritional status during adolescence have a direct effect on future health outcomes. ObjectiveThis study aimed to promote fruit and vegetable intake among adolescents using a smartphone app called MyPlate. MethodsThis randomized intervention study was conducted in an urban area of Jeddah, Saudi Arabia. We included 104 adolescents aged 13 to 18 years, who were randomized into intervention (n=55) or control (n=49) arms. We examined the effects of MyPlate on fruit and vegetable intake over 6 weeks in the intervention group. Pre- and postintervention questionnaires were used in the intervention and control groups. ResultsThe control group showed a significant increase in fruit consumption scores between baseline (1.15, SD 0.68) and postintervention (1.64, SD 0.98; P=.01), but no significant difference in vegetable consumption scores was observed before (1.44, SD 0.97) and after intervention (1.55, SD 0.90; P=.54). However, there was no significant difference between scores at baseline and after 6 weeks of using the smartphone app for fruit (1.48, SD 0.99 and 1.70, SD 1.11, respectively; P=.31) or vegetables (1.50, SD 0.97 and 1.43, SD 1.03, respectively; P=.30) in the intervention group. Our findings showed no significant impact of using a smartphone app on fruit and vegetable consumption. ConclusionsThese findings suggest that a smartphone app did not significantly improve fruit and vegetable intake among adolescents. Trial RegistrationClinicalTrials.gov NCT05692765; https://clinicaltrials.gov/ct2/show/NCT05692765

decolonial design education, design pedagogy, minor gestures, decoloniality, critical pedagogy, Drawing. Design. Illustration, and NC1-1940

This paper lays out the groundwork for a concept we define as minor gestures within design education. Moving away from a conversation centered around decolonization—a term, we argue, that has been co-opted to become a placeholder for equality, diversity, and inclusion, and tick-box exercises within academic institutions— we assert that minor gestures create the conditions for meaningful conversations on what it actually means to move towards decolonizing design education. Using examples from our own pedagogical practices, we sketch out and outline a proposition for minor gestures as theory-in-the-making, or an incomplete pathway towards meaningful, structural change.

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.

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

Social Sciences, Management. Industrial management, and HD28-70

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.

covid-19, medical education, acceptance, vaccine, and Medicine

Background: COVID-19 was declared a public health emergency of global concern by the World Health Organization (WHO) on January 30, 2020. Vaccination is one of the most effective methods for halting the pandemic and preventing complications. Vaccine hesitancy is a possible threat to global public health. Understanding the key determinants that influence the community's preferences and demands for a future vaccine may aid in the development of strategies to improve the global vaccination program. The aim of this study was to assess the beliefs, barriers, and acceptance of COVID-19 vaccination among Taif University students in Saudi Arabia. Materials and Method: This was a descriptive cross-sectional study, based study in Taif University, Saudi Arabia. Data was collected using a designed self-administered questionnaire that was shared as a link through social media. 332 students were considered eligible to participate voluntarily. Data were analyzed using the (SPSS) program version 25. Results: Out of 332 participants, 278 (83.7%) were accepting to take the covid vaccine, while 54 (16.3%) refused. Believes in vaccine safety and effectiveness and trust in the ability of the vaccine to prevent the complication, were all associated with high acceptance rate. Fear about side effects is considered a major factor for vaccination refusal. Conclusion: Most of the participants have the willingness to be vaccinated. The majority of students who agreed to take the vaccine were in the medical field, and that is mostly due to their high knowledge exposure. This indicates the importance of raising the awareness of the non-medical students.

Medicine (General) and R5-920

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.

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

self-healing concrete, finite element modeling, structural resilience, sustainability, Building construction, and TH1-9745

The formation of cracks in concrete structures occurs due to a multitude of causes ranging from shrinkage to external loading and environmental exposure. This phenomenon can significantly affect the lifecycle of concrete structures. Self-healing concrete (SHC) is considered a promoted innovation capable of overcoming this inevitable occurrence. In accordance with current SHC development processes, this paper utilizes the numerical simulation approach to test the performance of reinforced SHC beam specimens modeled using the commercial software ABAQUS 6.14 (Vélizy-Villacoublay, France). This paper aims to contribute to the scarce literature on SHC models by utilizing the overlooked dicyclopentadiene (DCPD) agent and ambiguous variability of crystalline admixtures. The SHC is introduced to the beam models at various depths and analyzed using load against displacement curves compared with a reference model of ordinary concrete. The effects of SHC on the mechanical properties of structural elements were determined. The results show a distinct improvement of the load-carrying capacity of SHC beams, indicating an efficient contribution of SHC in structural applications.

basal metabolic index, dental caries, inflammation, obesity, oral health, periodontitis, Medicine (General), and R5-920

Background: Basal metabolic index (BMI) is a unique anthropometric indicator used to define the relative amount of body fat on an individual’s frame. There are many diseases and conditions associated with obesity and underweight. Recent research trials suggest that there is a significant association between oral health indicators and BMI as both are attributed to common risk factors such as dietary, genetic, socioeconomic, and lifestyle issues. Objectives: The main objective of this review paper is to emphasize the association between BMI and oral health with available literature evidence. Methodology: A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were “body mass index”, “periodontitis”, “dental caries”, and “tooth loss”. Results: In total, 2839 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 1135 articles were excluded. The main reasons for excluding the articles were: they were dietary guidelines and policy statements. A total of 66 studies were finally included in the review. Conclusion: The presence of dental caries, periodontitis and tooth loss may be associated with a higher BMI or obesity, whereas, improved oral health might be associated with lower BMI. Promoting general and oral health should be a hand in hand feature, as common risk factors can be embattled.

drugs, FDA, oligonucleotides, peptides, vutrisiran, gadopiclenol, Medicine, Pharmacy and materia medica, and RS1-441

A total of 37 new drug entities were approved in 2022; although that year registered the lowest number of drug approvals since 2016, the TIDES class consolidated its presence with a total of five authorizations (four peptides and one oligonucleotide). Interestingly, 23 out of 37 drugs were first-in-class and thus received fast-track designation by the FDA in categories such as breakthrough therapy, priority review voucher, orphan drug, accelerated approval, and so on. Here, we analyze the TIDES approved in 2022 on the basis of their chemical structure, medical target, mode of action, administration route, and common adverse effects.

active stretching, pectoralis muscles, rounded shoulder posture, strength training, trapezius muscle, and Medicine

Background: The shortening of the pectoralis minor muscle (PMi-M) and weakening of the lower trapezius muscle (LTr-M) affect scapular movement, resulting in the development of a rounded shoulder posture and reduction in the shoulder flexion range of motion (SFROM). Objective: This study evaluated the combined effect of LTr-M strengthening and PMi-M stretching on correcting the rounded shoulder postures and SFROM among young Saudi females. Methods: This study was based on a two-arm parallel-group repeated measures randomized comparative design. A total of sixty female participants with rounded shoulder postures were recruited and randomly allocated into groups 1 and 2 (n = 30/group). Each group performed supervised PMi-M stretching; however, group 2 performed a combination of LTr-M strengthening and PMi-M stretching. The outcomes, including rounded shoulder posture and SFROM, were assessed using the pectoralis minor length test (PMLT) and universal goniometer. A repeated measure ANOVA was used to compare the differences within-group and between-group for the outcomes measures at one-week (baseline) pre-intervention, two weeks, and three -weeks post-intervention. The significance level was set at q > 2.00 and p < 0.05 for all respective statistical analyses. Results: The within-group comparison revealed significant improvements (q > 2.00) in the outcomes of PMLT and SFROM when comparing their post-intervention scores to the baseline scores. The between-group comparison revealed a significant and an insignificant (q < 2.00) difference in the outcomes of PMLT and SFROM, respectively when comparing their scores at the second- and third-week post-intervention. Furthermore, the effect size of the intervention suggests an advantage of group 2 over group 1 in increasing the resting length of the PMi-M only among young Saudi females. Conclusions: The combined effect of LTr-M strengthening and PMi-M stretching was more beneficial than PMi-M stretching alone in correcting the rounded shoulder posture among young Saudi females by increasing PMi-M resting length. However, it could not yield a differential improvement in the SFROM outcome among them.

Efficacy, vestibular rehabilitation, balance, systematic review., Medicine (General), and R5-920

Background: Numerous strategies and techniques are designed to treat disorders that cause body imbalance. These techniques, known as vestibular rehabilitation, focus on various exercises ranging from substitution, adaptation, habituation, and compensation. This systematic review aimed to assess the effectiveness of vestibular rehabilitation in improving balance among patients with different disorders. Material and Methods: A search of research articles in 2021 was accomplished by exploring electronic databases such as Embase, PubMed, and Scopus. Following a systematic screening and searching of articles. Fourteen relevant articles were found that were included in the review. As per the eligibility criteria, all eligible research studies were randomized controlled trials (RCTs). Results: All the included studies revealed the positive effect of vestibular rehabilitation in improving balance, and other symptoms (fatigue, vertigo, ankle sway, falls, and disequilibrium) among patients with different conditions, except one study did not find any difference between vestibular rehabilitation and standard of care. Furthermore, the reported studies indicated the benefits of the vestibular rehabilitation programs tailored to the patient's needs and requirements compared with a single program that may not fit everyone. Conclusion: Vestibular rehabilitation protocols integrated with some technological techniques and home-based exercise programs can be considered safe and effective in improving balance among older adults suffering from different conditions affecting their balance. However, future studies with a relatively large sample size are required to assess the effectiveness of the same interventions in resource-poor settings before large-scale implementation.

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.

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.

Medicine

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.

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.

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.

Biomarkers, Breast cancer, Ceramide expression, Molecular subtypes, Saudi Arabia, Therapeutics. Pharmacology, and RM1-950

Background/Introduction: Despite advances in the diagnosis and management of breast cancer (BC), it is still associated with high mortality rates. New biomarkers are being developed for the diagnosis, treatment, and prediction of responses of BC. Ceramide (CER), a bioactive sphingolipid, has emerged recently as a useful diagnostic tool in several types of tumors. In this study, we evaluated CER expression in invasive BC and assessed its relation to the molecular subtypes of BC. Materials and methods: The clinical data and histopathological slides of 50 patients with invasive ductal carcinoma were retrieved and reviewed. The cases were then stained with a mouse monoclonal anti-ceramide antibody. Pearson correlation was used to assess the correlation between CER percentage and intensity and other clinical and pathological variables. Results: CER expression showed a direct relationship with estrogen and progesterone receptors Allred scores. However, it showed an inverse relation with tumor grade, HER2/neu status and Ki-67 index. Conclusions: CER expression is likely to be associated with luminal BC molecular subtypes. However, more research is needed to confirm these results and to explore its relation to the different clinical outcomes, including response to treatment and prognosis.

Human papillomavirus, Female schoolteachers, Unawareness, HPV vaccine, HPV vaccine uptake, HPV transmission routes, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, and RA1-1270

Background: Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. This cross-sectional study among female schoolteachers assessed the prevalence of i) unawareness of HPV infection’s causal role in cervical cancer; ii) unawareness of HPV vaccine availability and iii) examined the sociodemographic variables associated both the outcome variables. Methods: This cross-sectional study was conducted among female schoolteachers employed in public and private sectors schools in Kuwait using a structured questionnaire for data collection. Prevalence of each of the outcome variables was computed. Multivariable logistic regression analyses were used to evaluate independent predictors of two dependent variables. Results: A total 1341 female schoolteachers were enrolled. Of the participants, 60% were unaware of HPV causal role in cervical cancer and 88% were unaware of HPV vaccine availability. Among those who were aware of HPV vaccine availability, 83.8% were unvaccinated. Multivariable logistic regression (MLR) model showed that 20–29 years old participants or those with low family income (< 500 KD/month) were significantly (p < 0.05) more likely to be unaware of HPV causal role in cervical cancer. Moreover, participants with family/ personal history of cervical cancer were significantly (p < 0.05) less likely to be unaware of HPV role in causation of cervical cancer. A separate MLR model revealed that the participants were significantly more likely to be unaware of HPV vaccine availability if they were Kuwaiti nationals or non-Kuwaiti Arabs (p < 0.05), employed in public schools (p = 0.003) or less likely to be unaware if they had personal or family history of cervical cancer (p < 0.001). Conclusion: High prevalences of unawareness of causal role of HPV in cervical cancer and unawareness of HPV vaccine availability were recorded. Targeted education among identified sociodemographic groups with high levels of unawareness is warranted. If undertaken, future studies may evaluate the impact of recommended efforts.

removable partial dentures, complete dentures, phonetics, awareness, dental students, dental education, Dentistry, and RK1-715

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.

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.

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.

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.

Technology and Science

Over the years, energy harvesting technologies have been used in various self-powered systems. These technologies have several methods of application depending on their usage. Renewable energy is one of the types of energy harvesting technologies where energy is generated from naturally replenished sources. One of the energy harvesting methods that is commonly used is piezoelectric transducers. Piezoelectric materials are groups of elements that can be used to generate electricity when mechanical energy is applied. When external mechanical stress is applied, the inner lattice is deformed, resulting in the separation of the positive and negative centers of the molecule and thus the generation of a small dipole. Therefore, this paper aims to discuss the output of the piezoelectric transducer by reviewing it depending on two different material types and in other energy harvesting structures. Furthermore, a comparison was made in order to compare the power output of the two materials. Similarly, the most used piezoelectric transducer structures for power harvesting applications were revised. In addition, the parameters that affect the value of the generated power output were discussed using the figures of merit (FOM) concept. Moreover, the according to the FOM concepts, when stress is applied, the electrical energy extracted from a piezoelectric energy harvesting material is determined by the change in stored electrical energy within a piezoelectric material. The figures of merit (FOM) depend on the piezoelectric strain and its permittivity. The piezoelectric strain directly relates to FOM, while the permittivity has an inverse relationship with FOM. Thus, the highest strain constant and low permittivity material will provide the highest energy output. Additionally, lead-based (PZT) material has a strain coefficient d33 equal to 390 Coul/Nx10-12, and permittivity value ranging from 1000 to 3500 and can generate power output that is equal to 52mW at 100Hz, which is higher than the output of the lead-free-based material Barium Titanate (BaTiO3). The output of piezoelectric also depends on the piezoelectric transducer's structure. The circular diaphragm's power output is greater than the bimorph cantilever's power output due to the presence of a proof mass in the center of the diaphragm that provides prestress to the piezoelectric which improves the low-frequency performance of the energy harvester.

Medicine (General) and R5-920

Summary: Background: Hearing loss affects over 50% of people in the US across their lifespan and there is a lack of decision modeling frameworks to inform optimal hearing healthcare delivery. Our objective was to develop and validate a microsimulation model of hearing loss across the lifespan in the US. Methods: We collaborated with the Lancet Commission on Hearing Loss to outline model structure, identify input data sources, and calibrate/validate DeciBHAL-US (Decision model of the Burden of Hearing loss Across the Lifespan). We populated the model with literature-based estimates and validated the conceptual model with key informants. We validated key model endpoints to the published literature, including: 1) natural history of sensorineural hearing loss (SNHL), 2) natural history of conductive hearing loss (CHL), and 3) the hearing loss cascade of care. We reported the coefficient of variance root mean square error (CV-RMSE), considering values ≤15% to indicate adequate fit. Findings: For SNHL prevalence, the CV-RMSE for model projected male and female age-specific prevalence compared to sex-adjusted National Health and Nutrition Examination Survey (NHANES) data was 4.9 and 5.7%, respectively. Incorporating literature-based age-related decline in SNHL, we validated mean four-frequency average hearing loss in the better ear (dB) among all persons to longitudinal data (CV-RMSE=11.3%). We validated the age-stratified prevalence of CHL to adjusted NHANES data (CV-RMSE=10.9%). We incorporated age- and severity-stratified time to first hearing aid (HA) use data and HA discontinuation data (adjusted for time-period of use) and validated to NHANES estimates on the prevalence of adult HA use (CV-RMSE=10.3%). Interpretation: Our results indicate adequate model fit to internal and external validation data. Future incorporation of cost and severity-stratified utility data will allow for cost-effectiveness analysis of US hearing healthcare interventions across the lifespan. Further research might expand the modeling framework to international settings. Funding: This study was funded by the National Institute on Deafness and Other Communication Disorders and the National Institute on Aging (3UL1-TR002553–03S3 and F30 DC019846).

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.

vaccine hesitancy, social media, childhood vaccination, pacv, saudi arabia, Immunologic diseases. Allergy, RC581-607, Therapeutics. Pharmacology, and RM1-950

Vaccination has had tremendous impact on human health. The tendency to hesitate or delay vaccination has been increasing, which has contributed to outbreaks of vaccine-preventable diseases. This cross-sectional study aimed to investigate the prevalence of childhood vaccine hesitancy and social media misconceptions in vaccine refusal among randomly selected parents from October 2019 through March 2020 in the outpatient clinics of King Khalid University Hospital, Riyadh, Saudi Arabia. The data were collected using a three-part questionnaire: the socio-demographic and economic questions, the Parents’ Attitudes about Childhood Vaccines (PACV) survey, and questions concerning social media use. Based on the PACV survey tool, 37 parents (11%) scored a value > 50 and were suggested as hesitant (8% hesitant and 3% very hesitant). Overall, 288 parents (89%) scored < 50, hence deemed to not be hesitant about childhood vaccination. There was no significant association between high educational level or social media exposure with vaccine hesitancy. The most commonly used social media platform was Twitter (40%). In conclusion, we report a low prevalence of vaccine hesitancy about childhood vaccination among parents, with no significant impact of education level or social media on vaccine hesitancy. Further studies are required to replicate these findings in other regions and cities to generalize these observations for Saudi Arabia.

Children, Intensive care, SARS-CoV-2, Mortality, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, and RA1-1270

Background: Characteristics of critical Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) infection in children is not well understood. This study described the clinical characteristics of children admitted to intensive care units (ICU) and explored factors associated with the need for invasive ventilation or mortality. Methods: A multicenter, retrospective, cohort study was conducted over eight medical centers, including all patients younger than 18 years of age and admitted to the ICU due to a direct consequence of coronavirus disease 2019 (COVID-19). Patients who were admitted to the ICU for any alternate reason and tested positive for SARS-CoV-2 by screening test, and patients who were admitted due to multi-inflammatory syndrome in children, were excluded. Demographic, laboratory, imaging, and clinical data were collected. Descriptive statistics were used to compare survivors and non-survivors. Fine and Gray’s hazard model was used to estimate the association between clinical variables and ICU death. Results: During the study period, 25 pediatric COVID-19 patients received care in the ICUs. The median age was 2.78 years (IQR 0.21–8.51), and 60% were male. Only three patients were reported to be previously healthy at admission. Nine (36%) patients required invasive mechanical ventilation, including two were on extracorporeal membrane oxygenation. Four (16%) patients died during ICU care. In univariate analysis, the presence of comorbidity (HR 0.0001; 95%CI 0.00001–0.00016), platelets count (HR 0.99; 95% CI 0.98–0.99), elevated procalcitonin (HR 1.05; 95%CI 1.016–1.09), and circulatory compromise (HR 16.34; 95%CI 1.99–134.35), all at the time of ICU admission, were associated with in-ICU mortality. Conclusion: Our findings suggest that children admitted to the ICU with SARS-CoV-2 infection, generally, have a favorable outcome. Low platelets count, elevated procalcitonin, presence of comorbidity, and shock at the time of ICU admission were associated with death. This study may shed more light on the disease dynamics of critical pediatric COVID-19.

age of acquisition, bilingualism, english as a second language, perception of speech in noise, signal-to-noise ratio, snr loss, Otorhinolaryngology, RF1-547, Industrial medicine. Industrial hygiene, and RC963-969

Background: Previous studies have highlighted that bilingual listeners have a deficit in speech perception in their second language compared with monolingual listeners in noisy listening environments. This deficit may give rise to educational and occupational implications for bilingual speakers who are studying or working in non-native language environments in poor acoustic conditions. Objectives: To compare the speech perception performance of monolingual English speakers and English as a second language (ESL) bilinguals within environments with various levels of background noise and to examine whether bilinguals with an early age of second language acquisition would perform better than those with a late age of acquisition. Study sample: Two groups of adult listeners with normal hearing participated: monolingual British English listeners (N = 15) and bilingual Arabic listeners for whom English was their second language and who were proficient in English (N = 15). The quick speech-in-noise (QuickSIN) test was used to assess signal-to-noise ratio (SNR) loss and SNR-50 for both groups. Results: The QuickSIN test results indicated that bilingual Arabic listeners with normal hearing displayed a mild SNR loss comparable to that observed for a person with hearing loss, indicating a higher SNR needed for this population to achieve a comparable level of comprehension to their monolingual English peers. Conclusion: Results highlight the importance of measuring SNR loss to obtain accurate diagnosis and potential rehabilitative information that is not available from audiogram studies.

Polycystic ovary syndrome, Binge eating disorder, Health related quality of life, Depression disorder, Riyadh, Biology (General), and QH301-705.5

Background & objectives: Polycystic ovary syndrome (PCOS) is the most common endocrinal disorder, and the greatest cause of infertility in women. Despite availability of individual data on impact of multiple endocrinal, reproductive and even metabolic factors in PCOS individuals, the data on the co-existence of BED and depression in PCOS patients with its relationship on the quality of life in Saudi Arabian females is not found. Hence this study is aimed to elucidate the implication of PCOS on eating behaviour, induction of depression and general health quality in Saudi Arabian population of Riyadh. Materials and methods: This is a cross-sectional study carried out in multiple health facilities of Riyadh from January to March 2019. The study samples (494) were recruited by convenience sampling and administered validated questionnaire by trained research participants. The data obtained was analysed by binary logistic regression using SPSS-IBM 25. Results: Of the total 494 women participated in the study, 23.48% (116) were PCOS individuals. The odds of developing abnormal health related quality of (HRQ) in patients with PCOS was significantly (P = 0.000, OR = 3.472) high when compared to non-PCOS participants. The odds of showing high binge eating disorder (BED, P = 0.007, OR = 2.856) and depression (P = 0.000, OR = 2.497) scores in PCOS participants were significantly more than patients who were not having PCOS. Out of the three parameters studied, abnormal health related quality of life possessed a higher influence of PCOS compared to depression and abnormal eating behavior. Interpretation & conclusion: In conclusion, the present study shows that women with PCOS are at a significant risk for depressive disorders, disorganized eating behavior and impaired quality of life. Therefore, necessary care and screening is required to minimize the impact of PCOS on already burdened individuals.

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, Cytology, and QH573-671

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.

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

Background COVID-19 has affected global communities with multiple neurological complications in addition to other critical medical issues. COVID-19 binds to the host’s angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in the neurons and glial cells, acting as an entry port to the central nervous system (CNS). ACE2 receptors are abundantly expressed on dopamine neurons, which may worsen the prognosis of motor symptoms in Parkinson’s disease (PD). SARS-CoV-2 may lead to an indirect response via immune-mediated cytokine storms and propagate through the CNS leading to damage. In this systematic review, we aim to provide thorough analyses of associations between COVID-19 and neurological outcomes for patients with PD. Methods Using PRISMA statement 2020, a systematic review was conducted to isolate confirmed COVID-19 patients and analyze the PD-associated neurological outcomes using the following databases: PubMed, Science Direct, Google Scholar, and Cochrane databases. The following keywords were used “COVID19, SARS-CoV-2, Parkinson’s disease, Pandemic, Mortality.” A modified Delphi process was employed. Results Of the 355 studies located during the initial round of screening, 16 were included in the final synthesis. Of PD patients who tested positive for SARS-CoV-2, worsening motor symptoms and other viral-associated symptoms were reported. These symptoms included bradykinesia, tremors, gait disturbances, delirium and dementia, and severe spasms of arms and legs. Encephalopathy was presented in 2 of the included studies. Increased mortality rates were identified for hospitalized patients due to COVID-19 and PD as compared to other patient groups. Conclusion Patients with PD may experience substantial worsening of symptoms due to COVID 19. Given the novelty of neurological-viral associations, clinical studies in the future ought to explore the disease severity and neurological outcomes in COVID-19 positive patients with PD as compared to non-PD patients, in addition to understanding the role of ACE2 in increased vulnerability to contracting the infection and as a treatment modality.

violence, emergency department, saudi arabia, and Medicine

Introduction: Emergency departments (EDs) have been identified as the highest risk area within a hospital to be exposed to workplace violence (WPV). This study aimed to estimate the prevalence of WPV against healthcare providers in EDs in Saudi Arabia, to explore the experiences and attitudes of ED staff toward WPV, and to identify the possible risk factors for WPV. Methods: A cross-sectional survey study was conducted with physicians and nurses working in 37 EDs in three provinces in Saudi Arabia, using a convenient sampling method. Over a 1-year period, 787 ED staff members were contacted and a 60% response rate was achieved. Results: The 1-year prevalence of at least one violent act against ED staff was 45%. Verbal threats were the most common type of WPV (42%). The study found that the prevalence of WPV against physicians (47%) was higher than against nurses (41%). However, when comparing the physician and nurse groups, none of the types of WPV was statistically significant. More female participants were exposed to stalking compared to male participants (OR 0.38; 95% CI 0.150.92). Non Arabic speakers experienced more WPV in the form of verbal threats and physical assault than the Arabic speaking group (OR 0.14; 95% CI 0.030.75). Participants working at the Ministry of Health hospitals were more likely to be exposed to a confrontation when off-duty and to stalking. Conclusion: Almost half of the ED physicians and nurses experienced one or more WPV incident during a 12-month period. [SJEMed 2020; 1(1.000): 5-14]

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, Cytology, and QH573-671

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.

medical students, mental illness, mentally ill, stigma, and Medicine

Aim: The study aimed to measure the level of the stigma of medical students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus, towards mentally ill patients. Material and Methods: A cross-sectional survey was conducted in King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh. The data collection was started in July 2017 till March 2018. The students completed a self-administered questionnaire consisting of sociodemographic data and the Community Attitudes toward the Mentally Ill (CAMI) Scale. Results: The sample size was realized as 274 participants. There were no significant differences in all CAMI subscales for the different academic years except for Authoritarianism which showed a significant increase in the level of stigma (P-value = 0.04). Male gender, previous psychiatric treatment, and having a relative with psychiatric illness were associated with higher Authoritarianism and Social Restrictiveness scores and lower Benevolence and CMHI scores. Discussion: More stigma was observed among the 4th year students and it might be due to insufficient academic preparation as well as more exposure to psychiatric rotations. Conclusion: The results support the importance of implementing anti-stigma programs throughout the medical program to improve the healthcare provided to mentally ill patients.

COVID-19 epidemic, country lockdown, online learning, Malaysia, Electrical engineering. Electronics. Nuclear engineering, and TK1-9971

The COVID-19 pandemic has struck the world and forced countries to go into lockdown including education sector. Students have been staying in hostels or houses, unable to go to university campuses. This situation has left university administrators no choice, but to have an online learning channel. Malaysian universities in particular have gone through many challenges to bring their online learning system up and ready to resume education process. However, students have found themselves caught in this situation (pure online learning) with no plan or readiness. Literature reviews showed that students encountered some challenges that could not be easily resolved. This study explored the challenges encountered by students of a government-linked university. This university is one of the largest in Malaysia with over 10 campuses across the country. This study collected 284 valid answers. The findings show that respondents lacked full readiness in this situation physically, environmentally, and psychologically with some differences in perspectives according to their gender, age, and residing state. Respondents were concerned about the implications of lockdown on their performance. The findings of this study indicate that a sudden switch to a pure online alternative creates considerable challenges to students who have no plans to be physically apart from classes. The findings also indicate that the current blended learning process which uses online learning as a support mechanism for face-to-face learning has faced a considerable challenge to replace it, particularly with unprepared students.

digital health (eHealth), evidence-based & research methodology, pediatrics - children, health system - organization and administration, mobile application (app), Medicine, Public aspects of medicine, RA1-1270, Electronic computers. Computer science, and QA75.5-76.95

Embedding digital technologies in healthcare has the potential to streamline and personalize medical care. However, healthcare systems are often fragmented, and therefore achieving a truly integrated digital health program can be challenging. To promote a streamlined, evidence-based approach to implementing digital health solutions in a healthcare system, the Murdoch Children's Research Institute (MCRI) established the Digital Health Translation and Implementation Program (DHTI) bringing together clinicians, researchers and digital health experts. From the program commencement, frontline clinical innovators have collaborated with DHTI team members to develop and implement digital solutions to address pain-points in the healthcare system. Throughout this program, important lessons have been learnt relating to the development, evaluation and implementation of digital solutions in the healthcare system. This paper explores these lessons and makes recommendations for the successful implementation of digital health solutions in healthcare systems under five main categories: (1) design and usability, (2) stakeholder engagement and uptake, (3) project management and resourcing, (4) process and implementation, and (5) evaluation. Recommendations suggested here are designed to support future healthcare-based digital health programs to maximize the impact digital solutions can have on the healthcare system and patients.

college-age, female of childbearing age, isotretinoin, saudi arabia, Dermatology, and RL1-803

Background: The most effective treatment for severe acne is isotretinoin. However, it carries major side effects, such as teratogenicity, depression, and increased lipid profiles. It is advised to monitor the lipid profile and to use two forms of contraception during isotretinoin use. Although it is commonly prescribed, little data are available regarding patients' understanding of isotretinoin. Objectives: The aim of this study is to assess Saudi female college students' knowledge about isotretinoin use and side effects. Methods: Data were collected by a validated online questionnaire disseminated through social media, allowing the collection of information from students from different regions of the country. Results: The total number of responses was 622. The majority of respondents were 18–24 years old, single, and college students; all were female. About 48.6% (282) of the sample used isotretinoin. Most had good knowledge of isotretinoin side effects. Medical students were more knowledgeable than students of other majors, and users were more knowledgeable than nonusers. The most common side effect was dryness. Use among married females was 2.8%, the majority of whom were instructed by their physicians to use only one method of contraception. One respondent got pregnant while using the drug. Conclusion: College-aged females generally have good knowledge of isotretinoin and its side effects. However, awareness about proper contraceptive use while on the drug is lacking.

drugs, FDA, oligonucleotides, peptides, antibody-drug conjugate, inclisiran, Medicine, Pharmacy and materia medica, and RS1-441

From the medical, pharmaceutical, and social perspectives, 2021 has been a year dominated by the COVID-19 pandemic. However, despite this global health crisis, the pharmaceutical industry has continued its endeavors, and 2021 could be considered an excellent year in terms of the drugs accepted by the US Food and Drug Administration (FDA). Thus, during this year, the FDA has approved 50 novel drugs, of which 36 are new chemical entities and 14 biologics. It has also authorized 10 TIDES (8 peptides, 2 oligonucleotides), in addition to 2 antibody-drug conjugates (ADCs) whose structures contain peptides. Thus, TIDES have accounted for about 24% of the approvals in the various drug categories. Importantly, this percentage has surpassed the figure in 2020 (10%), thus reflecting the remarkable success of TIDES. In this review, the approved TIDE-based drugs are analyzed on the basis of their chemical structure, medical target, mode of action, administration route, and adverse effects.

epiregulin, leptin receptor, ERK, EGFR, glucose uptake, energy metabolism, Cytology, and QH573-671

The leptin receptor (LepR) acts as a signaling nexus for the regulation of glucose uptake and obesity, among other metabolic responses. The functional role of LepR under leptin-deficient conditions remains unclear. This study reports that epiregulin (EREG) governed glucose uptake in vitro and in vivo in Lepob mice by activating LepR under leptin-deficient conditions. Single and long-term treatment with EREG effectively rescued glucose intolerance in comparative insulin and EREG tolerance tests in Lepob mice. The immunoprecipitation study revealed binding between EREG and LepR in adipose tissue of Lepob mice. EREG/LepR regulated glucose uptake without changes in obesity in Lepob mice via mechanisms, including ERK activation and translocation of GLUT4 to the cell surface. EREG-dependent glucose uptake was abolished in Leprdb mice which supports a key role of LepR in this process. In contrast, inhibition of the canonical epidermal growth factor receptor (EGFR) pathway implicated in other EREG responses, increased glucose uptake. Our data provide a basis for understanding glycemic responses of EREG that are dependent on LepR unlike functions mediated by EGFR, including leptin secretion, thermogenesis, pain, growth, and other responses. The computational analysis identified a conserved amino acid sequence, supporting an evolutionary role of EREG as an alternative LepR ligand.

Theory and practice of education and LB5-3640

diabetes, leptin, nanofibers, taurine, Pharmacy and materia medica, and RS1-441

Diabetes poses a high risk for debilitating complications in neural tissues, regulating glucose uptake through insulin-dependent and predominantly insulin-independent pathways. Supramolecular nanostructures provide a flexible strategy for combinatorial regulation of glycemia. Here, we compare the effects of free insulin to insulin bound to positively charged nanofibers comprised of self-assembling amino acid compounds (AACs) with an antioxidant-modified side chain moiety (AAC2) in both in vitro and in vivo models of type 1 diabetes. Free AAC2, free human insulin (hINS) and AAC2-bound-human insulin (AAC2-hINS) were tested in streptozotocin (STZ)-induced mouse model of type 1 diabetes. AAC2-hINS acted as a complex and exhibited different properties compared to free AAC2 or hINS. Mice treated with the AAC2-hINS complex were devoid of hypoglycemic episodes, had improved levels of insulin in circulation and in the brain, and increased expression of neurotransmitter taurine transporter, Slc6a6. Consequently, treatment with AAC2-hINS markedly advanced both physical and cognitive performance in mice with STZ-induced and genetic type 1 diabetes compared to treatments with free AAC2 or hINS. This study demonstrates that the flexible nanofiber AAC2 can serve as a therapeutic platform for the combinatorial treatment of diabetes and its complications.

Hyperviscosity syndrome, Colour vision, Systemic disease, Hematologic malignancy, Leukemia, Ophthalmology, and RE1-994

Purpose: To report a case of subjective intermittent loss of bilateral colour vision and episodic white-out vision in a patient with undiagnosed chronic myeloid leukemia (CML). Observations: A patient initially diagnosed with diabetic retinopathy presented with a chief complaint of subjective intermittent loss of colour vision in both eyes, as well as intermittent bilateral white-out vision. These symptoms previously went uninvestigated until a thorough history revealed concurrent constitutional symptoms including recent night sweats and fevers. Closer fundus examination revealed that the lesions previously thought to be diabetic retinal hemorrhages were Roth spots. Conclusions: and Importance: An unusual chief complaint of colour vision loss and multiple Roth spots in the context of chronic night sweats and fevers prompted further workup. A CBC with differential revealed a markedly increased WBC count and the patient was diagnosed with CML. Cytoreduction therapy led to complete resolution of the patient's visual symptoms and a return to normal WBC count at the most recent follow up appointment. We report, to our knowledge, the only case of colour vision loss as the initial presenting symptom of CML in the current literature, and reiterate the importance of a thorough history, neuro-ophthalmic examination and relevant investigations in patients with unusual visual symptoms, including intermittent loss of colour vision. In this case, we speculate that hyperviscosity syndrome secondary to CML was the cause of this patient's peculiar visual disturbance.

Medicine

Objectives: This study aimed to determine the relationship between glycaemic control and carotid atherosclerotic disease among patients with acute ischaemic stroke (AIS). Methods: This retrospective cross-sectional study took place in the Neurology Department of King Fahad Hospital of University, Khobar, Saudi Arabia, from April to October 2017. Data were collected from the medical records of 244 patients with a diagnosis of AIS confirmed by computed tomography. Doppler ultrasounds of the carotid artery were performed to determine the presence of increased carotid intima media thickness (CIMT) and plaques. Results: Significantly higher mean glycated haemoglobin (HbA1c) levels were noted in cases with high CIMT values (P = 0.002), but not in cases with carotid plaques (P = 0.360). In addition, there was a significant association between diabetes mellitus (DM) and high CIMT (P = 0.045), but not with carotid plaques (P = 0.075). Finally, while dyslipidaemia and age were independently correlated with high CIMT values (P = 0.034 and 0.050 each). Conclusion: High HbA1c levels were associated with high CIMT values, but not with carotid plaques. Therefore, HbA1c levels may be useful as an indirect marker of the initial stages of carotid artery atherosclerosis. Keywords: Glycated Hemoglobin A1c; Diabetes Mellitus; Carotid Intima-Media Thickness; Atherosclerotic Plaque; Stroke.

Medicine

Guillain-Barré syndrome (GBS) is a heterogeneous disorder with a diverse clinical presentation ranging from weakness of certain body regions to tetraparesis with autonomic dysfunction and respiratory failure. Paraparetic GBS is a variant of GBS which is characterised by weakness limited to the lower limbs only. It is crucial to identify such topographical presentations, as a delay in diagnosis can lead to delayed initiation of specific treatment, which can negatively impact the outcome. We report a 29-year-old female patient who presented to the King Fahd Hospital of the University, Al Khobar, Saudi Arabia, in 2017 with rapid onset asymmetrical weakness of lower extremities associated with bladder dysfunction during the immediate postpartum period. The weakness spared cranial nerves and arms and imaging studies of the spine was unremarkable. Cerebrospinal fluid investigations showed cyto-albuminologic dissociation and nerve conduction studies showed features of demyelination. The patient was diagnosed with a paraparetic variant of GBS and treated with intravenous immunoglobulin. She had almost recovered completely at the two–month follow-up. Keywords: Paraparesis; Guillain-Barré Syndrome; Demyelination; Postpartum Period; Case Report; Saudi Arabia.

Fe (III) chelators, Siderophores, Solid phase peptide synthesis, 1-Hydroxypyridine-2-one, Trifluoromethanesulfonic acid (TFMSA), and Science

Dentistry and RK1-715

Background. Detachment of acrylic teeth from denture base material is a common complication in dentistry which accounts for 26–30% of repair cases. This study aimed to evaluate the effect of alumina-blasting, silane coupling agent, and thermal cycling on the shear bond strength of repaired teeth to denture base. Materials and Methods. Specimens (140) of repaired teeth to denture bases were fabricated and divided into 14 groups: 7 groups before thermal cycling and 7 groups after thermal cycling (n = 10). The groups were divided according to surface treatment into no treatment (control), treatment of the base (B), the tooth (T), or both (BT). Each group was further subdivided according to the surface treatment method into alumina-blasting or alumina-blasting and silane coupling agent. After treatment, acrylic discs and teeth were fixed in a jig, and the repair procedure was done. Half the specimens were thermally cycled. Shear bond strength was measured using a universal testing machine. ANOVA and Tukey HSD tests were performed at α = 0.05. Results. Surface treatment significantly improved the bond strength compared to the control group P

citizen science, urban ecology, biodiversity, amphibian, conservation planning, urbanization, Biology (General), and QH301-705.5

As cities adopt mandates to protect, maintain and restore urban biodiversity, the need for urban ecology studies grows. Species-specific information on the effects of urbanization is often a limiting factor in designing and implementing effective biodiversity strategies. In suburban and exurban areas, amphibians play an important social-ecological role between people and their environment and contribute to ecosystem health. Amphibians are vulnerable to threats and imbalances in the aquatic and terrestrial environment due to a biphasic lifestyle, making them excellent indicators of local environmental health. We developed a citizen science program to systematically monitor amphibians in a large city in Alberta, Canada, where 90% of pre-settlement wetlands have been removed and human activities continue to degrade, alter, and/or fragment remaining amphibian habitats. We demonstrate successes and challenges of using publicly collected data in biodiversity monitoring. Through amphibian monitoring, we show how a citizen science program improved ecological knowledge, engaged the public in urban biodiversity monitoring and improved urban design and planning for biodiversity. We outline lessons learned to inform citizen science program design, including the importance of early engagement of decision makers, quality control assessment, assessing tensions in program design for data and public engagement goals, and incorporating conservation messaging into programming.

Forschungsdaten, Geisteswissenschaften, Forschungsdateninfrastruktur, Digital Humanities, and Technology

In bewusst enger Verzahnung von Fach- und Informationswissenschaft entwickelt und implementiert das INF-Projekt des an der Freien Universität Berlin angesiedelten Sonderforschungsbereichs 980 "Episteme in Bewegung: Wissenstransfers von der Alten Welt bis in die frühe Neuzeit" in der gegenwärtigen Förderphase unter dem Titel „Bücher auf Reisen. Informationstechnologische Erschließung von Wissensbewegungen in vormodernen Kulturen” zum einen ein zentrales Forschungsdatenrepositorium für den SFB und betreibt zum anderen gemeinsame Forschung und Entwicklung mit derzeit vier ausgewählten Teilprojekten. Der vorliegende Beitrag skizziert, wie die Kollaboration von Geisteswissenschaften, Computerphilologie und Informatik sowohl innerhalb des INF-Projekts als auch im Zusammenspiel mit den Pilotprojekten ausgestaltet wird, welche Herausforderungen bei gemeinsamer Forschung entstehen und welche Rolle das INF-Projekt eines großen geisteswissenschaftlichen Verbundes in den Nachhaltigkeitsüberlegungen der Heimatinstitution spielen kann.

creative epistemologies, creative paradigms, creative thinking, creativity, creativity research, design, Social sciences (General), and H1-99

Designerly ways of knowing have significant untapped potential to inform creativity research. In this article, I draw upon in-depth interviews with expert design scholars to examine this connection. Thematic analysis reveals how design offers potential lenses on creativity that are not often taken up in dominant psychological discourses around creativity. I situate this by framing the need for design-based knowledge within creativity literature. The findings reflect a view of creativity involving perception, intuition, and ability to re-see the world; creativity as an action-orientated phenomenon; and a focus on the ethics of creativity in an increasingly technology-empowered society. In exploring scholarly definitions of and views about creativity, there are insights on how design offers distinctive viewpoints for paradigms around creativity. Santrauka Dizaineriško pažinimo būdai turi reikšmingų nepanaudotų galimybių praturtinti kūrybiškumo tyrinėjimus. Siekdama išnagrinėti šį ryšį, straipsnyje remiuosi išsamiais interviu su dizaino srityje dirbančiais mokslininkais ekspertais. Teminė analizė atskleidžia, kaip dizainas kūrybiškumui suteikia galimybių, atveriančių jo perspektyvas, kurios nėra pasitelkiamos vyraujančiuose psichologijos diskursuose, susijusiuose su kūrybiškumu. Tam skiriu dėmesio, kūrybiškumui skirtoje literatūroje sukurdama dizainu grindžiamų žinių poreikį. Išvados atspindi kūrybiškumo vaizdą, apimantį suvokimą, intuiciją ir gebėjimą naujaip pažvelgti į pasaulį; kūrybiškumą kaip į veiksmą nukreiptą reiškinį ir į kūrybiškumo etiką visuomenėje, kurioje vis didesnių galių įgyja technologijos. Tyrinėjant mokslinius kūrybiškumo apibrėžimus ir nusistatymus jo atžvilgiu, kyla įžvalgų apie tai, kaip dizainas formuoja išskirtinius požiūrius į kūrybiškumo paradigmas. Reikšminiai žodžiai: kūrybinė epistemologija, kūrybinės paradigmos, kūrybinis mąstymas, kūrybiškumas, kūrybiškumo tyrinėjimai, dizainas, dizaineriški pažinimo būdai, etika, intuicija, suvokimas.

belantamab mafodotin-blmf, 64Cu-DOTATATE, drugs, FDA, 68Ga-PSMA-11, lumasiran, Medicine, Pharmacy and materia medica, and RS1-441

2020 has been an extremely difficult and challenging year as a result of the coronavirus disease 2019 (COVID-19) pandemic and one in which most efforts have been channeled into tackling the global health crisis. The US Food and Drug Administration (FDA) has approved 53 new drug entities, six of which fall in the peptides and oligonucleotides (TIDES) category. The number of authorizations for these kinds of drugs has been similar to that of previous years, thereby reflecting the consolidation of the TIDES market. Here, the TIDES approved in 2020 are analyzed in terms of chemical structure, medical target, mode of action, and adverse effects.

Medicine

BACKGROUND: Drug shortages are a serious and complex issue in any healthcare system. We conducted this study because the prevalence of drug shortages in Saudi Arabia is largely unknown, while there have been reports of shortages. OBJECTIVE: To explore the prevalence and characteristics of drug shortages as well as identify strategies to minimize their impact on patient care and safety in large hospitals. DESIGN: Questionnaire-based cross-sectional study. SETTING: Pharmacy departments in secondary and tertiary care hospitals in the city of Riyadh. SUBJECTS AND METHODS: Pharmacists in ten hospitals, categorized as Ministry of Health [MOH], MOH-affiliated medical cities, and non-MOH, were recruited using convenience sampling. The European Association of Hospital Pharmacists drug shortage questionnaire was administered to survey pharmacists about drug shortages in their hospitals. MAIN OUTCOME MEASURES: Percentages of drug class shortages, characteristics, and strategies to minimize impact on patient care and safety across each hospital sector. RESULTS: Of 200 pharmacists invited to participate, 120 pharmacists completed the questionnaire (60% response rate). Twenty-four percent were from MOH hospitals, 32% from MOH-affiliated medical cities, and 44% from non-MOH hospitals. A significantly higher percentage of pharmacists from MOH-affiliated medical cities (42.11%) reported encountering drug shortages on a daily basis compared to 13.79% and 15.09% of participants from MOH-hospitals and non-MOH hospitals, respectively (P=.001). The top three drug classes that ≥ 25% of participants reported having shortages of were cardiovascular, antineoplastic, and endocrine drugs. The two most common strategies that were reported to minimize the impact of drug shortages on patient care by more than 70% of participants were informing prescribers and recommending alternative drugs, and alerting hospital staff about the presence of drug shortages using new communication tools. CONCLUSIONS: The relatively high reported rates of drug shortages in some hospitals should encourage health policymakers to address this serious public health problem. LIMITATIONS: The generazibility of the study's findings were limited by the small sample size, convenience sampling technique, self-reported data, and the fact that only pharmacists were invited to participate.

Thioxoquinazolin-4(3H)-one, Anticancer activity, Antioxidant activity, Anticonvulsant activity, Molecular docking, Chemistry, and QD1-999

Abstract Background The quinazoline are an important class of medicinal compounds that possess a number of biological activities like anticancer, anticonvulsant and antioxidant etc. Results We evaluated the previously synthesized quinazoline derivatives 1–3 for their anticancer activities against three cancer cell lines (HepG2, MCF-7, and HCT-116). Among the tested compounds, quinazolines 1 and 3 were found to be more potent than the standard drug Vinblastine against HepG2 and MCF-7 cell lines. All the tested compounds had less antioxidant activity and did not exhibit any anticonvulsant activity. Also, molecular docking studies were performed to get an insight into the binding modes of the compounds with human cyclin-dependent kinase 2, butyrylcholinesterase enzyme, human gamma-aminobutyric acid receptor. These compounds showed better docking properties with the CDK2 as compared to the other two enzymes. Conclusions The overall study showed that thioxoquinazolines are suitable antitumor agents and they should be explored for other biological activities. Modification in the available lot of quinazoline and synthesis of its novel derivatives is essential to explore the potential of this class of compounds. The increase in the threat and with the emergence of drug resistance, it is important to explore and develop more efficacious drugs.

architectural heritage, historicist reconstruction, cultural continuity, environmental sustainability, energy efficiency, Environmental effects of industries and plants, TD194-195, Renewable energy sources, TJ807-830, Environmental sciences, and GE1-350

Although attempts for formulating sustainable approaches in heritage management have been ongoing since the 1980s, sustainability dimensions in the context of ‘reconstruction’ have remained an unexplored research area. By investigating the case of the ruined Khaz’al Diwan in Kuwait, an architectural heritage site in the United Nations Educational, Scientific and Cultural Organization (UNESCO) World Heritage (WH) Tentative List, we explore and compare the roles of the ‘cultural continuity’ and ‘environmental protection’ pillars of sustainability in reconstruction planning. By employing rapid ethnographic surveying and case study methods, we first investigate the approach to ‘cultural continuity’ from the State’s stance and through local community perceptions. Albeit with nuances, the surveying revealed a preference for historicist reconstruction. However, the Khaz’al Diwan, like most of the heritage structures in the Gulf region, was originally constructed with coral stone, which is now protected under environmental laws. How feasible is the use of replacement materials in terms of sustainability perspectives that is also acceptable from heritage perspectives? Considering the high cooling loads required in this climatic region, we prioritized the energy performance of the construction materials of the external walls and the roof. Computer simulations based on scenarios testing same-type and replacement construction materials revealed how the latter could be considered as an alternative in a historicist reconstruction. The discussion revolves around the environmental and cultural parameters that are instrumental in reconstruction planning. This ultimately highlights how reconstruction policies must be shaped to redefine the role and scope of material authenticity to accommodate the local environmental and cultural realities in the wider Gulf region and Middle Eastern context.

angiotensin, tonicity, transporters, virus, thrombosis, hypertension, Biology (General), and QH301-705.5

COVID-19 symptoms, including hypokalemia, hypoalbuminemia, ageusia, neurological dysfunctions, D-dimer production, and multi-organ microthrombosis reach beyond effects attributed to impaired angiotensin-converting enzyme 2 (ACE2) signaling and elevated concentrations of angiotensin II (Ang II). Although both SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus) and SARS-CoV-2 utilize ACE2 for host entry, distinct COVID-19 pathogenesis coincides with the acquisition of a new sequence, which is homologous to the furin cleavage site of the human epithelial Na+ channel (ENaC). This review provides a comprehensive summary of the role of ACE2 in the assembly of Na+-dependent transporters of glucose, imino and neutral amino acids, as well as the functions of ENaC. Data support an osmotic adaptation mechanism in which osmotic and hemostatic instability induced by Ang II-activated ENaC is counterbalanced by an influx of organic osmolytes and Na+ through the ACE2 complex. We propose a paradigm for the two-site attack of SARS-CoV-2 leading to ENaC hyperactivation and inactivation of the ACE2 complex, which collapses cell osmolality and leads to rupture and/or necrotic death of swollen pulmonary, endothelial, and cardiac cells, thrombosis in infected and non-infected tissues, and aberrant sensory and neurological perception in COVID-19 patients. This dual mechanism employed by SARS-CoV-2 calls for combinatorial treatment strategies to address and prevent severe complications of COVID-19.

Medicine

Background and objectives: In Kuwait, information regarding public knowledge and attitudes towards organ donation are scanty. This study aimed to evaluate public knowledge and attitude regarding organ donation and determine factors which predict them. Methods: This cross-sectional study was conducted among 630 participants recruited from 27 randomly selected public cooperative societies and private supermarkets in Kuwait. A self-administered questionnaire was used to collect data. Results: The prevalence rate of knowledge about organ donation was 68%, with a significantly higher rate among females than males (73% vs. 63%, respectively, p = 0.01). A composite score of knowledge was also higher among females than males (8.4 ± 5.8 vs. 6.8 ± 5.8, respectively, p = 0.001). In multivariate analysis, female gender (OR = 1.7; 95% CI =1.2, 2.4) and an educational level of bachelor’s degree or higher (OR = 2.6, 95% CI = 1.7, 3.9) were significant predictors of the knowledge. Among the barriers, more females than males mentioned about the fear of the operative procedures (p

creative thinking, innovation, action research, online activities, developmental learning, Special aspects of education, and LC8-6691

This essay describes one institution’s struggle to grow its EdD program by adding an equivalent online version of a successful face-to-face program. One of the challenges faced was that of creating a comparable experience for online students to share their ongoing action research, an activity that had long been part of the face-to-face version of the program. An innovative, all-day, virtual doctoral research conference was developed and implemented. We describe our creative rethinking of the original event, towards a new, successful, and fully-online redesigned event. Although the event continues to be refined, the inaugural event proved to be a successful solution to the challenge of transferring all components of a face-to-face program over to its online equivalent. Feedback from students who participated in the conference is shared, and recommendations for other EdD programs is offered.

General Works

Algorithms and data-driven technologies are increasingly being embraced by a variety of different sectors and institutions. This paper examines how algorithms and data-driven technologies, enacted by an organization like Facebook, can induce similarity across an industry. Using theories from organizational sociology and neoinstitutionalism, this paper traces the bureaucratic roots of Big Data and algorithms to examine the institutional dependencies that emerge and are mediated through data-driven and algorithmic logics. This type of analysis sheds light on how organizational contexts are embedded into algorithms, which can then become embedded within other organizational and individual practices. By investigating technical practices as organizational and bureaucratic, discussions about accountability and decision-making can be reframed.

methicillin resistant Staphylococcus aureus (MRSA), methicillin susceptible Staphylococcus aureus (MSSA), nasal carriage, medical students, antibiotic susceptibility, and Medicine

Background: Healthcare workers (HCWs) and medical students can be asymptomatic carriers in transmitting methicillin resistant and susceptible Staphylococcus aureus (MRSA and MSSA). Studying epidemiological and antibiotic susceptibility data is necessary to limit the spread of infections, help with treatment and understand the transmission dynamics of MSSA and MRSA. Our study assessed the rate of MSSA and MRSA nasal carriage and its antibiogram among medical students in basic and clinical years at the University of Jordan. Methods: A total of 210 nasal swabs were randomly collected from participants. MSSA and MRSA were identified by culture, biochemical and other phenotypical analysis methods. Antibiotic susceptibility was determined by the disc diffusion method. Results: The nasal carriage of MSSA was 6.6% and 11.4% and that of MRSA was 1.9% and 2.8% among basic and clinical years, respectively. There was no significant difference for the nasal carriage of MSSA and MRSA among basic and clinical year students (p value ≥ 0.05). MSSA resistance ranged between 25% and 33% for trimethoprim-sulfamethoxazole, tetracycline and ciprofloxacin. For MRSA, the highest resistance was to trimethoprim-sulfamethoxazole and tetracycline (67% to 100%), followed by gentamicin and ciprofloxacin (33% to 67%), in all participants in the study. Conclusion: The difference in the carriage rates of MSSA and MRSA among basic and clinical students was statistically insignificant. The continuous awareness and implementation of infection control procedures and guided patient contact are recommended. The results might also suggest that healthcare workers could be victims in the cycle of MRSA nasal carriage, a theory that needs further study.

afamelanotide, bremelanotide, dotatoc, drugs, 68ga-dotatoc, enfortumab vedotin, golodirsen, givosiran, polatuzumab vedotin, oligonucleotides, peptides, pharmaceutical market, Medicine, Pharmacy and materia medica, and RS1-441

2019 has been an excellent year in terms of peptides and oligonucleotides (TIDES) approved by the FDA. Despite the drop in the number of total drugs approved by the FDA in 2019 in comparison with 2018 (48 vs. 59), the total number of TIDES authorized increased (seven vs. three). Year after year, TIDES are increasingly present in therapy, as imaging agents, theragnostic and constituent moieties of other complex drugs, such as antibody drug conjugates. This means a consolidation of these kinds of drugs in the pharmaceutical arena, paving the way in the coming years for the approval of others for diverse medical indications. Here the TIDES approved in 2019 are analyzed in terms of chemical structure, medical target, mode of action, and adverse effects.