articles+ search results

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.

Strategy and Management, Arts and Humanities (miscellaneous), and Education

stroke, free-floating thrombus (fft), secondary polycythemia vera (pv), dual antithrombotic, Medicine (General), R5-920, General Medicine, International Medical Case Reports Journal, Case Report, free-floating thrombus, FFT, secondary polycythemia vera, and PV

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

Computer Science Applications and Education

General Chemistry

Since it was declared a worldwide pandemic, COVID-19 has ravaged almost all over the world and has overloaded several health-care systems. The pandemic also resulted in job losses as a result of lengthy shutdowns, which burdened the global economy. Even though significant clinical research progress has led to a better perceiving of the virus (SARS-CoV-2) nature and the disease (COVID-19) management, preventing the virus's spread has become a major concern as SARS-CoV-2 continues to wreak havoc around the world. Several countries suffered from the second or third wave of viral disease outbreaks, primarily caused by the mutation of SARS-CoV-2. Imaging is critical in the diagnosis and follow-up of patients with new coronavirus-infected pneumonia (NCIP). The primary imaging modality in clinically suspected cases is CT scan and it is useful for monitoring imaging changes following therapy. Therefore, CT is regarded as a useful diagnostic technique for clinically suspected cases of COVID-19. CT has the ability to detect patients who have a negative reverse transcription–polymerase chain reaction (RT-PCR) but are highly suspicious of NCIP in terms of clinical problems. In addition, the results of a CT scan may also reveal information concerning the severity of the condition. In this review article, the diagnosis of COVID-19 is discussed and CT characteristics are defined based on the newest research for the diagnosis and management of COVID-19.

large vessel occlusion, stroke, healthy middle-aged, viral hypercoagulability, sars-cov-2, independent risk factor, Medicine (General), R5-920, Case Report, International Medical Case Reports Journal, and General Medicine

Ali Alhashim, Mustafa Alqarni, Majed Alabdali, Mohammed Alshurem, Aishah Albakr, Kawther Hadhiah, Danah Aljaafari, Rawan Alyami Neurology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaCorrespondence: Ali AlhashimNeurology Department, Medical College, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi ArabiaTel +966509444833Email ahalhashem@iau.edu.sa; ali_al_hashem@hotmai.comBackground: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) due to novel coronavirus disease 2019 (COVID-19) has led to an unprecedented worldwide pandemic with diverse respiratory symptoms as well as systemic manifestations and complications. The neurological manifestations of COVID-19 include, but are not limited to, headache, cerebrovascular disease, and skeletal muscle injury.Case Report: Herein, we present a case of stroke with large vessel occlusion in a middle-aged man, who recently recovered from severe SARS-CoV-2 infection. This patient is not known to have any medical illness or surgical history and has no cerebrovascular risk factors. Moreover, the patient underwent extensive investigations, including neuroimaging, cardiac and laboratory work-up with no evidence of stroke etiology.Conclusion: The mechanism of cerebrovascular events in the setting of COVID-19 is still uncertain and probably multi-factorial. The prevailing hypothesis is a strong thrombotic tendency, which may even be prolonged after complete recovery. In our patientâs case, hypercoagulability in the context of viral infection is the most likely mechanism for the stroke. Further studies are needed to find out the exact pathogenesis of thromboembolic events in the setting of COVID-19 infection as well as the efficacy, safety, dosage, and duration of anticoagulants in such conditions.Keywords: large vessel occlusion, stroke, healthy middle-aged, viral hypercoagulability, SARS-CoV-2, independent risk factor

Research Article, COVID-19, Telemedicine, Remote programing, Cochlear implant, Questionnaire, Speech and Hearing, Sensory Systems, Otorhinolaryngology, and Physiology

Introduction: The daily escalation in incidence and mortality caused by Coronavirus disease (COVID-19) has mandated forced curfew in our country (same as many other countries) to limit the spread of infection. This is predicted to have a more negative impact on cochlear implant (CI) patients since this group of patients needs a unique type of psychological, medical, and technical care in addition to a daily rehabilitation program. Methods: A cross-sectional study based on Arabic questionnaire that looked into the collateral consequences of COVID-19 on the pediatric CI patients. The questionnaire was designed to highlight different problems such as exposure to head trauma or ear infection, difficulties in device maintenance and getting spare parts, impacts of the delay of programing or switch on appointments, and the impacts of missing rehabilitation sessions. Different ways of management of these problems are presented and discussed. Results: A total of 174 parents responded to the questionnaire. The main problem met by the patients was missing their device programing and rehabilitation sessions. Many children had device maintenance and spare parts problems. Virtual clinics were helpful in solving different problems. Additionally, children who needed device programing were scheduled for remote programing sessions. Conclusion: Although the inevitable consequences of the COVID-19 pandemic are catastrophic, they are forcing the medical field to explore new opportunities by sitting up an infrastructure for future usage of telemedicine. Telemedicine is cost-effective and more convenient and enables health-care providers to be immune to future circumstances.

Ophthalmology

Public Health, Environmental and Occupational Health, Nutrition and Dietetics, and Medicine (miscellaneous)

Objective: Preventing a food allergy reaction depends primarily on eliminating allergens from the diet. In October 2019, the Saudi Food and Drug Authority (SFDA) introduced new legislation requiring food establishments providing and selling non-prepacked foods to state the presence of the top fourteen food allergens on their menus. The current study aimed to assess the allergen-labelling knowledge, practices, preferences and perceptions towards the new SFDA allergen-labelling legislation among consumers with food allergy in Saudi Arabia. Design: Observational cross-sectional study using an online questionnaire. Setting: Saudi Arabia; February – March 2020. Participants: Residents of Saudi Arabia with food allergy (n 427), aged 18–70 years. Results: Among participants, only 28·1 % knew that there were governmental regulations in Saudi Arabia regarding food-allergen labelling and approximately two-thirds (67 %) check labels on prepacked food products for allergens. The majority of the participants preferred food products carrying safety statements (84·1 %) and symbols (80·1 %). A total of 47·1 % were aware that regulations in Saudi Arabia require allergens to be declared in ingredient lists, while 51·3 % were aware that advisory allergen labelling is not required by law. Only 26·2 % were aware of the new SFDA legislation regarding provision of allergen information by food establishments. However, the majority (94·4 %) were supportive of the new legislation, and most of them were more likely to eat at restaurants that reported allergen information for food items on the menu. Conclusions: The new SFDA food allergen-labelling legislation needs to be more widely and effectively disseminated to increase the level of awareness among adults with food allergy in Saudi Arabia.

Humanities, Cartography, Social media, and Sociology

Microbiology (medical), Immunology, and Immunology and Allergy

Column: Guest Editors’ Notes, Computer Science Applications, and Education

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

The influence of ongoing cement hydration and multiple micro-crack formation on the electrical impedance of an engineered cementitious composite (ECC) is presented. Impedance measurements are obtai...

Infectious Diseases, Microbiology (medical), and General Medicine

Psychiatry and Mental health, Clinical Neurology, Pediatrics, medicine.medical_specialty, medicine, Epilepsy, medicine.disease, Hydrocephalus, Febrile seizure, Convulsive status epilepticus, Generalized epilepsy, Stroke, Etiology, Status epilepticus, medicine.symptom, business.industry, business, and Original Articles

Objectives To assess the etiology of status epilepticus (SE) among the pediatric patients of a tertiary center in Jeddah, Kingdom of Saudi Arabia (KSA). Methods Data from 88 cases was obtained retrospectively from 2006 to 2017 from King Abdulaziz University Hospital (KAUH). Patients aged between 28 days and 14 years with the symptoms of SE were selected for this study. Results The data show that the proportions of SE etiologies were 30.5% for febrile seizure, 11.9% for electrolytes imbalance, 8.5% for hydrocephalus, 6.8% for CNS infections, and 6.8% for neoplasm. The other etiologies of SE were trauma, fever, intractable epilepsy, cerebrovascular accident, hemorrhagic stroke, etc. There were no clear etiologies in 8 cases. Most of the patients were not of Saudi origin (64.3%), boys (67.8%), and had generalized epilepsy types (91.8%), and 58.6% of the patients complied with epilepsy medications. Conclusion The most prevalent etiology of convulsive status epilepticus was a febrile seizure, followed by electrolyte imbalance and hydrocephalus. However, a nationwide study in KSA must be conducted to determine the major etiologies of SE for its effective management and prevention. Educating families and patients regarding antiepileptic drugs is necessary.

Clinical Neurology and Epidemiology

Objectives: The objective of this study was to evaluate the prevalence of medically resistant epilepsy (MRE) in our hospital and to compare the prevalence with that in other populations. Methods: We retrospectively analyzed the data of patients who visited the epilepsy clinics at King Fahd University Hospital, Al-Khobar, Saudi Arabia between January 2017 and December 2018. This study included patients aged ≥14 years who had at least 2 unprovoked seizures 24 h apart. Patients who had provoked seizure(s), paroxysmal events, or syncope or had incomplete medical records were excluded. The definition and classification of the International League Against Epilepsy were used. Moreover, we searched the En­glish literature using PubMed and Google Scholar to compare the prevalence of MRE between our population and other populations. Results: In total, 1,151 patients were screened, and 751 patients were included in the final analysis. Of the 751 patients, 229 (male: 56.3%, female: 43.7%; mean age: 32.07 years, and standard deviation, 12.2 years) had MRE, with a cumulative prevalence of 30%. The etiology was as follows: unknown, 63.3% (n = 145); structural, 31.9% (n = 73); genetic, 3.1% (n = 7); and infectious, 1.7% (n = 4). None of the patients had metabolic or immune-related etiologies. Conclusion: The prevalence of MRE in our population (30%) is close to that in other populations (30–36.5%). Early identification of such patients is crucial to improve their management.

Case Report, Guillain-Barré syndrome, Miller Fisher syndrome, ventilator-associated pneumonia, Pseudomonas aeruginosa, International Medical Case Reports Journal, Medicine (General), R5-920, and General Medicine

Danah Aljaafari,1 Salam Almustafa,2 Abdulrahman Saleh Ali,3 Hosam Aldalbahi,3 Norah Ibrahim Albahli,3 Feras AlSulaiman,1 Anas Al dehailan,1 Majed Alabdali1 1Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Neurology, King Fahad Medical City, Riyadh, Saudi ArabiaCorrespondence: Danah AljaafariDepartment of Neurology, College of Medicine Imam Abdulrahaman Bin Faisal University, 2835 King Faisal Road, Dammam, 34212, Kingdom of Saudi ArabiaTel +966 503864084Background: Miller Fisher syndrome (MFS), a triad of ophthalmoplegia, areflexia and ataxia, is one of the regional variants of Guillain-Barré syndrome (GBS) that might account for a quarter of all cases of GBS, especially in Asian countries. There is history of an antecedent upper respiratory tract infection in up to two thirds of MFS cases. However, association of MFS in adults and pneumonia is rarely reported and in those cases causative pathogen was Mycoplasma pneumoniae. To our knowledge, association of MFS and ventilator-associated pneumonia has never been reported. So, we hereby report the first case of MFS which followed ventilator-associated pneumonia (VAP).Case Report: We report case of a 22-year-old male who was known to have temporal lobe epilepsy and mental retardation. He presented with status epilepticus. He was sedated and put on mechanical ventilation. Two days later, he developed a fever associated with increased tracheobronchial secretions and new infiltrates on chest X-ray. Diagnosis of VAP was made. Upon improvement, he was extubated and shifted out of ICU. Ten days after the onset of fever, he developed gradual onset bulbar weakness and ataxia. On examination, he had generalized areflexia and ataxia. CSF analysis showed cytoalbuminic dissociation. Antibodies against ganglioside complex were elevated. Diagnosis of sero-negative MFS was made, and intravenous immunoglobulin (IVIG) was started. He improved remarkably within two days.Conclusion: MFS is immune-mediated entity which is usually triggered by upper respiratory tract infection but in rare cases it can be consequence of pneumonia including VAP. Further research is needed to establish link between MFS and VAP.Keywords: Guillain-Barré syndrome, Miller Fisher syndrome, ventilator-associated pneumonia, Pseudomonas aeruginosa

Human papillomavirus, Female schoolteachers, Unawareness, HPV vaccine, HPV vaccine uptake, HPV transmission routes, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270, Infectious Diseases, Public Health, Environmental and Occupational Health, General Medicine, Viral infection, Medicine, business.industry, business, Reproductive tract, Future studies, Logistic regression, HPV infection, medicine.disease, Demography, Family income, and Cervical cancer

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.

Psychiatry and Mental health and Developmental and Educational Psychology

General Medicine, Otorhinolaryngology, and Surgery

Computer Science Applications and Education

Physical and Theoretical Chemistry

Management of Technology and Innovation, Physics and Astronomy (miscellaneous), and Engineering (miscellaneous)

Pharmacology, Immunology, and Immunology and Allergy

Education, Situated, Educational technology, Sociology, Emerging technologies, Engineering ethics, Enthusiasm, media_common.quotation_subject, media_common, Curriculum, Conceptual model, Common ground, Creativity, and ComputingMilieux_COMPUTERSANDEDUCATION

Internationally, creativity is a widely discussed construct that is pivotal to educational practice and curriculum. It is often situated alongside technology as a key component of education futures. Despite the enthusiasm for integrating creativity with technologies in classrooms, there is a lack of common ground within and between disciplines and research about how creativity relates to technology in teaching and learning—especially in the uncertain space of classroom implementation. This article provides a critical thematic review of international literature on creativity and technology in the context of educational practice. We identify four essential domains that emerge from the literature and represent these in a conceptual model, based around: (1) Learning in regard to creativity, (2) Meanings of creativity, (3) Discourses that surround creativity, and (4) the Futures or impacts on creativity and education. Each of these clusters is contextualized in regard to emerging technologies and the developing scope of twenty-first century skills in classroom implementation. We offer conclusions and implications for research and practice.

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, RC963-969, and Original Article

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.

Infectious Diseases, Public Health, Environmental and Occupational Health, General Medicine, Intensive care, Retrospective cohort study, Cohort study, Medicine, business.industry, business, Extracorporeal membrane oxygenation, medicine.medical_treatment, Procalcitonin, Intensive care unit, law.invention, law, Comorbidity, medicine.disease, Emergency medicine, medicine.medical_specialty, Univariate analysis, Children, SARS-CoV-2, Mortality, lcsh:Infectious and parasitic diseases, lcsh:RC109-216, lcsh:Public aspects of medicine, lcsh:RA1-1270, and Article

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.

Infectious Diseases, Virology, Medicine, business.industry, business, Retrospective cohort study, Public health, medicine.medical_specialty, Procalcitonin, Asymptomatic, medicine.symptom, Coronavirus, medicine.disease_cause, Epidemiology, Internal medicine, Disease, Viral shedding, Short Communication, Short Communications, , epidemiology, , and

Clinical presentation of coronavirus disease‐2019 (COVID‐19) ranges from asymptomatic to severe and life‐threatening. National‐level registries found that children, generally, have less severe disease when compared with adults. However, most asymptomatically infected children will not present to hospital and may be missed. We aimed to describe the clinical characteristics in pediatric COVID‐19 patients in Kuwait, and to estimate the potential duration of viral shedding. A retrospective cohort study was performed in Jaber Alahmad Hospital (JAH) from February 29 to April 30, 2020. During the study period and as part of the public health measures, all severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐infected patients from 1 month to 18 years old, regardless of symptoms, were hospitalized at JAH, and were included. Polymerase chain reaction (PCR) negativity was defined as having two consecutive negative PCR results from a respiratory specimen. Descriptive statistics and multivariable regression analyses were performed. We found that 67.9% (95% CI, 59.4%–75.3%) of 134 SARS‐CoV‐2‐infected children were asymptomatic. Median PCR positivity was 15 days and did not vary with symptoms. Among patients who had laboratory investigations and chest imaging, symptomatic infection was associated with elevated C‐reactive protein and procalcitonin, and radiographic pneumonia. Asymptomatic SARS‐CoV‐2 infection is very common in children. Among symptomatic patients, the disease seems to be mild. Children exhibit substantial duration of viral shedding, regardless of symptoms.

General Nursing, Community-based care, Health care, business.industry, business, Teamwork, media_common.quotation_subject, media_common, Learning experience, Nursing, Health professions, Emergency department, Psychology, Interprofessional education, and Motivational interviewing

Background/Purpose: An innovative care coordination program was developed to enhance wellness among low-income older adults living in subsidized apartment buildings and to provide rich interprofessional education experiences for health professions students. Method: Program effectiveness for the residents was measured through an evaluation of participation, services used, and healthcare utilization. Educational effectiveness was measured through a change in health concepts and perceptions of interprofessional practice. Findings: Health care utilization among participating residents showed an 8.6% reduction in emergency department visits and 9.8% reduction in hospital admissions. Students demonstrated improved knowledge in motivational interviewing (p = .02); diabetes (p = .02); hypertension (p≤.01); and frailty (p≤.01). Changes in students perception of interprofessional practice were significant in two areas; Teamwork and Collaboration (p≥.00); and Person Centeredness (p = .00). Discussion: This care coordination model may be an effective approach to reduce care resource utilization among medically complex lower income older adults and provides a rich interprofessional learning experience for students.

Library and Information Sciences, Computer Science Applications, Information Systems, Legitimacy, Law and economics, and Sociology

This paper is based upon the closing keynote presentation that was given by danah boyd at the inaugural NISO Plus conference held from February 23–25, 2020 in Baltimore, MD (USA). It focuses on how data are used, and how they can be manipulated to meet specific objectives – both good and bad. The paper reinforces the importance of understanding the biases and limitations of any data set. Topics covered include data quality, data voids, data infrastructures, alternative facts, and agnotology. The paper stresses that data become legitimate because we collectively believe that those data are sound, valid, and fit for use. This not only means that there is power in collecting and disseminating data, but also that there is power in interpreting and manipulating the data. The struggle over data’s legitimacy says more about our society – and our values – than it says about the data itself.

General Dentistry

General Medicine, Otorhinolaryngology, and Surgery

General Pharmacology, Toxicology and Pharmaceutics and Pharmacy

AcademicSubjects/MED00910, jscrep/070, and Case Report

The frontal sinus is the most common site for paranasal mucoceles, resulting in potentially threatening intraorbital or intracranial complications. Surgical drainage of mucoceles is the mainstay of treatment, which can be achieved usually through open or endoscopic transnasal approaches. Transorbital endoscopic surgery is a relatively novel approach to selective skull base lesions with limited data in the literature. It could be utilized as a safe and effective alternative approach in managing frontal sinus lesions when the endoscopic transnasal access alone is insufficient or inadequate. Here, we present a case of an isolated lateral left frontal mucocele that was managed successfully using an endoscopic transorbital approach alone with complete resolution of symptoms during a 10-month follow-up period.

General Medicine

Computer Science Applications and Education

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 amongst 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 a 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 were 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 known to be epilepsy-related loci were identified for the first time in our population, in addition to several potential new loci have been identified which may be prioritized for further investigation.

Physics - Fluid Dynamics and Physics::Fluid Dynamics

This study aims to quantify how turbulence in a channel flow mixes momentum in the mean sense. We applied the macroscopic forcing method to direct numerical simulation (DNS) of a turbulent channel flow at Re$_\tau$=180 using two different forcing strategies that are designed to separately assess the anisotropy and nonlocality of momentum mixing. In the first strategy, the leading term of the Kramers-Moyal expansion of the eddy viscosity operator is quantified where the macroscopic forcing is employed to reveal all 81 tensorial coefficients that essentially represent the local-limit eddy viscosity. The results indicate: (1) eddy viscosity has significant anisotropy, (2) Reynolds stresses are generated by both mean strain rate and mean rotation rate tensors, and (3) the local-limit eddy viscosity generates asymmetric Reynolds stress tensors. In the second strategy, the eddy viscosity operator is considered as an integration kernel representing the nonlocal influence of mean gradients on the Reynolds stresses. Considering the average of this kernel in the homogeneous directions, the macroscopic forcing is designed to reveal the nonlocal effects in the wall-normal direction for all 9 components of the Reynolds stresses. Our results indicate that while the shear component of the Reynolds stress is reasonably controlled by the local mean gradients, other components of the Reynolds stress are highly nonlocal. These two analyses provide accurate verification data for quantitative testing of anisotropy and nonlocality effects in turbulence closure models.
Comment: 39 pages, 24 figures

Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270, Public Health, Environmental and Occupational Health, Community and Home Care, Original Research, COVID-19, Parkinson’s disease, SARS-CoV-2, neurological, and ACE2

BackgroundCOVID-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 enzyme2 (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. PD is also been associated with certain post-viral infections apart from COVID-19, such as HSV, Influenzavirus A, Measles virus, Cytomegalovirus, and Mumps.ObjectiveIn this systematic review, we aim to provide a thorough analysis of associations between COVID-19 and neurological outcomes for patients with PD.MethodsUsing PRISMA statement 2020, a systematic review was conducted to isolate confirmed COVID-19 patients and analyze the PD-associated neurological outcomes. A systematic literature search was conducted 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 to include the studies and ensure that the clinical outcome measures were addressed.ResultsOf the 355 records 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 two of the included studies. Increased mortality rates were identified for hospitalized patients due to COVID-19 and PD as compared to other patient groups, albeit with limited generalizability due to high bias of included studies.ConclusionPatients with PD may experience substantial worsening of motor and non-motor 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.

Family medicine, medicine.medical_specialty, medicine, business.industry, business, and Sleep medicine