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 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.

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.

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.

Computer Networks and Communications, Computer Science Applications, Politics, Social class, Media studies, and Sociology

Otolaryngology, tonsillectomy, post-tonsillectomy complication, surgical emphysema, gag-reflex, facial emphysema, respiratory tract diseases, and respiratory system

Subcutaneous facial emphysema is a rare complication of tonsillectomy that can lead to infection, upper airway obstruction or invasion into the thorax. The latter can cause pneumomediastinum or pneumothorax, with possible subsequent cardiorespiratory function impairment. Although multiple causes are suggested in the literature, the main causative factor is still unclear. Moreover, the rationale for its management is inconsistent and the outcomes are unpredictable. We report a case of a 14-year-old pediatric male patient, known to have a hypersensitive gag reflex, who developed post-tonsillectomy cervicofacial subcutaneous emphysema; management has achieved complete clinical resolution after two weeks of complication onset. Additionally, we present a literature review that showcases the potential causes and management of subcutaneous emphysema.

Dermatology, Allergy/Immunology, chronic idiopathic urticaria, antihistamines, leukotriene receptor antagonists, montelukast, singulair, immune system diseases, and respiratory tract diseases

Introduction Chronic urticaria (CU) is a common disorder that can significantly affect the quality of life. The goal of treatment is complete symptomatic relief. Conventional therapy, with antihistamines, is not always effective in all patients. Leukotrienes are believed to be involved in the pathogenesis of urticaria. Leukotriene receptor antagonists (LTRAs), such as montelukast, have been suggested as useful agents in patients with chronic idiopathic urticaria. Our objective is to document the efficacy of montelukast in our patients. Materials and methods Patients who received montelukast were identified from clinic letters. Data including clinical features were collected and analyzed. The main endpoint was adequate disease control. Results A total of nine patients who met the inclusion criteria were included in this study. Four patients reported having a good response to montelukast and three patients reported full control of the disease. Conclusion These findings suggest that leukotriene antagonists, such as montelukast, are effective as an add-on therapy to anti-histamines and their use in histamine resistant patients is justifiable.

Genetics, Molecular Biology, Biochemistry, and Biotechnology

Genetics, Molecular Biology, Biochemistry, and Biotechnology

strength, plyometric training, function performance, resisted sprint training, young football players, Medicine, Article, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, human activities, and education

The main objectives of this study were to evaluate the short-term effects of resisted sprint and plyometric training on sprint performance together with lower limb physiological and functional performance in collegiate football players. Ninety collegiate football players participated in this three-arm, parallel group randomized controlled trial study. Participants were randomly divided into a control group and two experimental groups: resisted sprint training (RST) (n = 30), plyometric training (PT) (n = 30), and a control group (n = 30). Participants received their respective training program for six weeks on alternate days. The primary outcome measures were a knee extensor strength test (measured by an ISOMOVE dynamometer), a sprint test and a single leg triple hop test. Measurements were taken at baseline and after 6 weeks post-training. Participants, caregivers, and those assigning the outcomes were blinded to the group assignment. A mixed design analysis of variance was used to compare between groups, within-group and the interaction between time and group. A within-group analysis revealed a significant difference (p <
0.05) when compared to the baseline with the 6 weeks post-intervention scores for all the outcomes including STN (RST: d = 1.63
PT: d = 2.38
Control: d = 2.26), ST (RST: d = 1.21
PT: d = 1.36
Control: d = 0.38), and SLTHT (RST: d = 0.76
PT: d = 0.61
Control: d = 0.18). A sub-group analysis demonstrated an increase in strength in the plyometric training group (95% CI 14.73 to 15.09, p = 0.00), an increase in the single leg triple hop test in the resisted sprint training group (95% CI 516.41 to 538.4, p = 0.05), and the sprint test was also improved in both experimental groups (95% CI 8.54 to 8.82, p = 0.00). Our findings suggest that, during a short-term training period, RST or PT training are equally capable of enhancing the neuromechanical capacities of collegiate football players. No adverse events were reported by the participants.

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.

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

Education, Creativity, media_common.quotation_subject, media_common, Curriculum, Mathematics education, Well-being, Psychology, Mindfulness, and ComputingMilieux_COMPUTERSANDEDUCATION

Taking a whole-child approach to schooling, the authors address how creativity and mindfulness are connected and suggest practical ways that teachers can integrate them into the curriculum.

Electrochemistry, Catalysis, Materials science, Solid state electrolyte, Plastic crystal, Ionic liquid, chemistry.chemical_compound, chemistry, and Chemical engineering

Computer Science Applications, Education, Education and technology, Educational technology, Sociology, Aesthetics, Creativity, media_common.quotation_subject, and media_common

This article is part of an ongoing series by the authors and the Deep Play Research Group, which focuses on the intersection of creativity and technology in education. In this article, Dr. Anthony Brandt, professor of composition and theory at Rice University shares his thoughts about the study of creativity. He uses his experiences as a musician and composer to highlight the important role that creativity plays in our lives, providing examples that illustrate multiple understandings of creativity. His work with neuroscientist David Eagleman is highlighted and serves to illustrate how our understanding of the brain has influenced our knowledge about the way that humans have evolved to engage in creative acts. Dr. Brandt shares his excitement about opportunities that the future will bring as researchers collaborate with scientists and use ground-breaking technological advancements to study creativity. He further offers implications for education and technology.

General Agricultural and Biological Sciences, Quality of life, Odds, Cross-sectional study, Polycystic ovary, Binge-eating disorder, medicine.disease, medicine, Internal medicine, medicine.medical_specialty, business.industry, business, Population, education.field_of_study, education, Infertility, Logistic regression, Original Article, Polycystic ovary syndrome, Binge eating disorder, Health related quality of life, Depression disorder, Riyadh, lcsh:Biology (General), lcsh:QH301-705.5, endocrine system diseases, and female genital diseases and pregnancy complications

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.

Occupational asthma is usually characterized by airway hyperresponsiveness, airway obstruction, and airway inflammation that usually result from exposure to specific irritants in the workplace and is not usually associated with any evidence of exacerbation outside the workplace. Occupational asthma can be associated with complicated long-term outcomes because affected patients are not usually aware of the hazards of the condition. Therefore, applying adequate diagnostic and management approaches is essential to enhance the outcomes among high-risk workers. In the present literature review, we have discussed the causes, diagnosis, and management of occupational asthma based on the evidence obtained from the current studies in the literature. Our findings indicated the presence of various environmental triggers that can lead to the development of asthma in the workplace, including HMW and LMW compounds. The diagnosis of asthma is based on obtaining a thorough personal and clinical history from the affected patient. However, such approaches have been reported to have low specificity rates, and therefore, the diagnosis should be established by other measures as lung function tests. The management of asthma is hugely dependent on the clinical phenotypes of occupational asthma. Nevertheless, applying adequate interventions can significantly enhance the outcomes in the affected patients, in addition to the other measures that have been adequately discussed in the manuscript.

Clinical Neurology and Neurology

Education

Ocean Engineering

General Medicine, Surgery, Case Report, Acute gastric volvulus, Organoaxial volvulus, Borchardt's triad, and Gastric gangrene

Introduction and importance Gastric volvulus is the abnormal gastric rotation upon itself. It carries a considerable risk for gastric strangulation which may lead to gangrene and perforation, which can be fatal. It commonly presents with non-specific and vague abdominal symptoms making prompt diagnosis and management imperative. This is a case report describing a case of acute organo-axial gastric volvulus. Case presentation A 74-year-old female, with no comorbidities, presented to our department with non-specific abdominal symptoms. Gastric outlet obstruction was suspected. The patient was reviewed by the gastroenterologist and was offered an urgent upper endoscopy. The upper endoscopy findings described a gastric volvulus, and a Computed Tomography (CT) scan was done to confirm the diagnosis. The patient underwent exploratory/diagnostic laparoscopy and successful reduction and fixation followed. There was no evidence of tissue compromise or ischemia. The patient was discharged on post-operative day 4 following an unremarkable postoperative course. Clinical discussion Acute gastric volvulus is a surgical emergency which can be associated with a high morbidity and mortality, if complications occur. The most important factor in diagnosing acute volvulus of the stomach is a high index of suspicion of the clinical symptoms and should be confirmed by imaging. Contrast enhanced computed tomography (CT) scan is the preferred imaging modality. Urgent surgical intervention is needed to prevent potentially fatal complications. Conclusion Acute Gastric Volvulus is rare and carries the risk of significant morbidity and mortality. Prompt recognition and treatment is required to prevent complications.
Highlights • Acute gastric volvulus is a rare potentially life-threatening condition. • Prompt diagnosis and treatment is vital to improve patient outcome. • Contrast enhanced Computed Tomography is the preferred imaging modality used to confirm the diagnosis of gastric volvulus. • Surgical repair is the treatment of choice.

General Medicine

citizen science, urban ecology, biodiversity, amphibian, conservation planning, urbanization, Biology (General), QH301-705.5, Nature and Landscape Conservation, Agricultural and Biological Sciences (miscellaneous), Ecological Modelling, and Ecology

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.

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, QA75.5-76.95, Digital Health, Perspective, and General Medicine

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.

Pharmaceutical Science, Pharmacology, Original Article, Biomarkers, Breast cancer, Ceramide expression, Molecular subtypes, Saudi Arabia, Therapeutics. Pharmacology, RM1-950, and lipids (amino acids, peptides, and proteins)

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.

Case Report, AcademicSubjects/MED00910, jscrep/0160, and Surgery

Gallstone ileus (GSI) is an uncommon entity that causes obstruction of the intestinal lumen due to gallstones. It affects mainly the elderly with multiple comorbidities, leading to a high mortality rate. In this case, an 81-year-old woman was admitted due to GSI. She had a recurrence after 5 days of the index surgery. Recurrent intestinal obstruction due to GSI during the same hospitalization despite complete clearance of the small bowel from stones is rare. Through our case, we will discuss management along with a review of the current evidence.

Infectious Diseases, Virology, Throat, medicine.anatomical_structure, medicine, Virus, Antigen, Respiratory system, Respiratory tract, Serotype, business.industry, business, Antigen test, and Reverse transcription polymerase chain reaction

Human orthopneumovirus, formerly known as respiratory syncytial virus (RSV), is a frequent cause of hospitalization among infants due to respiratory tract infection. Fast, reliable, and easy to perform tests are needed to optimize treatment and to identify children that should be contact isolated to avoid nosocomial outbreaks. We prospectively tested 200 respiratory samples with a new assay (ImmuView RSV Antigen Test, SSI Diagnostica) and compared the results to the Alere BinaxNOW RSV Card by using our laboratory-developed real-time reverse transcription polymerase chain reaction (PCR) as reference. In addition, 300 retrospectively collected respiratory samples were included in the study. The sensitivities of both antigen kits were very low (

General Dentistry, Education, Family medicine, medicine.medical_specialty, medicine, Patient care, Job satisfaction, Internal medicine, Dental clinic, Positive attitude, Teamwork, media_common.quotation_subject, media_common, Endocrinology, Mean age, Female students, Patient safety, business.industry, business, and education

OBJECTIVE To evaluate awareness and attitudes of dental students and interns about patient safety culture in Dammam, Saudi Arabia. MATERIALS AND METHODS This cross-sectional study was conducted on 272 undergraduate dental students and interns using the Safety Attitudes Questionnaire (SAQ) from November 2019 to January 2020. The SAQ consists of six domains: teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions. The score of SAQ ranges from 0 to 100, and a cut-off ≥75 is considered a positive attitude of patient safety. RESULTS The study included 47.1% of males and 52.9% of females with a mean age of 22.58 ± 1.3 years. Few participants (9.9%) showed a positive attitude of patient safety culture. Nearly one-third of participants (35.7%) attended a course on patient safety and 31.6% reported experiencing adverse events by them or their families. Out of six domains, job satisfaction showed the highest mean score (70.25) and 75.4% of participants felt proud to practise in the dental clinic. Female students demonstrated a significantly higher mean score of stress recognition (64.28 ± 18.98) than male students (56.98 ± 22.53) (P 0.004). The mean SAQ score increased significantly from fourth year students to interns (P

Computer Science Applications, Education, Educational technology, 2019-20 coronavirus outbreak, Cognitive science, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Gray (unit), Creativity, media_common.quotation_subject, media_common, Psychology, Evolutionary psychology, Coronavirus disease 2019 (COVID-19), and Column: Rethinking Technology & Creativity in the 21st Century

Physical and Theoretical Chemistry, General Physics and Astronomy, Ionic bonding, Plastic crystal, Imide, chemistry.chemical_compound, chemistry, Ionic liquid, Dicyanamide, Polymer chemistry, Alkyl, chemistry.chemical_classification, Hexafluorophosphate, Lithium, and chemistry.chemical_element

Ionic liquids and plastic crystals based on pyrrolidinium cations are recognised for their advantageous properties such as high conductivity, low viscosity, and good electrochemical and thermal stability. The pyrrolidinium ring can be substituted with symmetric or asymmetric alkyl chain substituents to form a range of ionic liquids or plastic crystals depending on the anion. However, reports into the use of branched alkyl chains and how this influences the material properties are limited. Here, we report the synthesis of six salts – ionic liquids and organic ionic plastic crystals – where the typically used linear propyl chain substituent is replaced by the branched alternative, isopropyl, to form the cation [C(i3)mpyr]+, in combination with six different anions: dicyanamide, (fluorosulfonyl)(trifluoromethanesulfonyl)imide, bis(trifluoromethanesulfonyl)imide, bis(fluorosulfonyl)imide, tetrafluoroborate and hexafluorophosphate. The thermal and transport properties of these salts are compared to those of the analogous N-propyl-N-methylpyrrolidinium and N,N-diethylpyrrolidinium-based salts. Finally, a high lithium salt content ionic liquid electrolyte based on the bis(fluorosulfonyl)imide salt was developed. This electrolyte showed high coulombic efficiencies of lithium plating/stripping and high lithium ion transference number, making it a strong candidate for use in lithium metal batteries.

Psychology (miscellaneous), Social Sciences (miscellaneous), Clinical psychology, Autism spectrum disorder, medicine.disease, medicine, Increased risk, Logistic regression, Public health, medicine.medical_specialty, First trimester, Neurotypical, Computer-assisted web interviewing, Folic acid, business.industry, business, mental disorders, behavioral disciplines and activities, and genetic structures

This study assessed prenatal risk factors that contribute significantly to autism spectrum disorder (ASD). A total of 400 online questionnaires were sent to the mothers who had children not older than 12 years of age. Only 76.25% of the questionnaires were fully complete, with 160 of the 305 mothers had a child with ASD while 145 had a neurotypical child. The risk factors were analyzed using binary logistic regression. The results showed four factors that contributed significantly (p

Medicine, business.industry, business, and Environmental health

Medicine, business.industry, business, Demography, Bell Palsy, and Adult population

Case Report, Paraparesis, Guillain-Barré Syndrome, Demyelination, Postpartum Period, and Saudi Arabia

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.

Computer Science Applications, Education, Psychology, Educational technology, Creativity, media_common.quotation_subject, media_common, Conversation, Visual arts, and Column: Rethinking Technology & Creativity in the 21st Century

Visual Arts and Performing Arts, Developmental and Educational Psychology, Education, Embodied cognition, Psychology, Aesthetics, Creativity, media_common.quotation_subject, and media_common

Collaborative design, Design thinking, Educational technology, Psychology, Engineering ethics, Facilitation, Facilitator, Group dynamic, Debriefing, and Qualitative research

As design thinking expands into educational contexts, teams engaged in the process increasingly encounter situations that involve facilitating collaborative problem-solving. In design-focused workshops and other collaborative design activities, facilitators play a key role in supporting small group interactions in order to generate ideas, structure discussions, and guide the process. Yet despite this increased focus on collaborative design thinking, there is little research to inform either facilitator roles or facilitator practices in this process. We address this gap by presenting a qualitative study that thematically examines our experiences as university-based facilitators who supported a community-wide educational design event. Specifically, we served as facilitators in a collaborative, multi-stakeholder, educational design thinking workshop that sought innovations for a local high school improvement initiative. This research is a qualitative study of our own facilitation processes based on data generated through open-ended self-reflection questionnaires and facilitator planning and debriefing discussions. Our results demonstrate that design facilitation resonates with Thomas Kuhn’s (1977) notion of “essential tension.” Essential tension exists within multiple aspects of design thinking roles and practices—including processes, products, discussion flow, and group dynamics. We reflect on these findings and propose implications for design thinking facilitation in future research and practice.

Business administration, Business, and Organizational culture

Telefonaktiebolaget LM Ericsson (Ericsson) is a Swedish telecom company with branches all over the world. It is not a secret that a company with branches in several diverse cultures has to decide what extent the organization will go in adapting the host culture into the new branch. This essay will focus on Ericsson and a few cases on how well Ericsson decided to incorporate host cultures into their organization. The cases picked will mainly be in Asia due to the greater cultural difference between the Asian host culture and their European home culture.

Computer Science Applications, Music, Engineering (miscellaneous), Visual Arts and Performing Arts, Literal and figurative language, The arts, Bridging (networking), Psychology, Mathematics education, and Competence (human resources)

STEM education in the United States is often described as being in a downward spiral, when assessed by competency test scores and lack of student motivation for engaging STEM disciplines. The authors suggest this arises from an overly instrumental view of STEM. While STEAM has arisen as a pushback paradigm, the application of STEAM in schools is challenging, and educators are often unclear about connecting STEM and the arts. The authors suggest envisioning STEAM through natural disciplinary interconnections. They focus on the integration of language arts and figurative thinking to blur the boundaries of STEM and the arts, and offer examples of figurative language—such as metaphor, linguistic etymology and synecdoche—for framing STEM teaching and learning.

Computer Science Applications, Education, Craft, Sociology, Fandom, Conversation, media_common.quotation_subject, media_common, and Visual arts

Civil and Structural Engineering, Superplasticizer, Microstructure, Metallurgy, Materials science, Portland cement, law.invention, law, Raw material, Volcanic ash, Durability, Slag, visual_art.visual_art_medium, visual_art, and Saturation (chemistry)

Sustainable development in concrete technology can be achieved via conservation of primary materials and enhancement of the durability of concrete structures. Accordingly, in this study, self-compacting concrete (SCC) was developed economically, using sustainable materials such as volcanic ash (VA) and recycled coarse aggregates (RCA). The flow behavior, mechanical properties, and durability performance were evaluated and compared for the developed mixes. Six concrete mixes with different compositions, including the replacement of ordinary Portland cement and normal coarse aggregates (NCA) with 30% VA and 30% RCA, respectively, were prepared using the saturation dosages of superplasticizer (SP) and viscosity modifying admixture (VMA) obtained from the paste study. SCC could be developed with the selected compositions through a two-stage mixing method, and it was observed that the replacement of NCA with 30% RCA did not adversely affect the mechanical properties. A modification in the microstructure could be observed with the incorporation of SP, VA, and VMA. Further to this, the reduction in the durability properties with the incorporation of VA and RCA was compensated with a ternary mix containing ground granulated blast-furnace slag. In general, the SCC incorporating regional and local materials such as VA and RCA could be used, based on the durability indices developed through this study, and considered as a viable alternative to meet the raw material shortage in Kuwait.

Journal of Multidisciplinary Healthcare, internal jugular vein, high jugular bulb, facial nerve palsy, high jugular bulb dehiscence, headache, surgery, lcsh:Medicine (General), lcsh:R5-920, Case Report, General Medicine, and General Nursing

Fahd Alkhamis,1 Khalid Alhajri,1 Danah Aljaafari,1 Ali Alhashim,1 Adnan Alsamarah,2 Abdulaziz Sharydah,2 Osama Basheir,1 Feras AlSulaiman,1 Majed Alabdali1 1Department of Neurology, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Radiology, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Majed AlabdaliNeurology Departments, King Fahad Hospital of the University – Imam Abdulrahman Bin Faisal University, PO Box 40236, Dammam, 31952, Kingdom of Saudi ArabiaTel +966-534347474Email mmalabdali@iau.edu.saBackground: A high mega jugular Bulb is an enlarged and swollen upper portion of the internal jugular vein with a variation of its anatomical position among the population, mostly situated below the hypotympanum. Although most cases of jugular bulb diverticulum are asymptomatic, excessive pressure on the surrounding structures might cause various symptoms, most prominently vertigo, sensorineural hearing loss, or tinnitus.Case Report: A middle-aged male who was referred to the Department of Neurology with a recurrent complaint of left-sided facial weakness associated with headache and vertigo for a period of 24 months. His symptoms were episodic, furthermore exacerbated by visiting high altitude sites. Non-resolving with conventional medical treatment. After thorough investigation, including preoperative and postoperative audiograms, neuroimaging, including computed tomography as well as magnetic resonance angiography, he was diagnosed to have right-sided superior mega jugular bulb as a causative factor. After surgical management, the patient improved significantly. At his regular follow-up in our clinic there were no exacerbations of his symptoms.Conclusion: Among patients who present with recurrent non-resolving facial palsy in which no apparent causative factor is identified, high jugular bulb should be suspected and investigated. Comprehensive and detailed medical history is essential for raising the suspicion for the diagnosis. Such as the case presented eliciting high altitudes as the main precipitating factor. The diagnosis is clinically elusive, commonly obscured by other common diagnoses. Surgery is recommended if antihypertensive drugs do not show improvement.Keywords: internal jugular vein, high jugular bulb, facial nerve palsy, high jugular bulb dehiscence, headache, surgery

Data,Algorithms,Big Data, ComputingMilieux_LEGALASPECTSOFCOMPUTING, and GeneralLiterature_MISCELLANEOUS

As members of the US Department of Commerce’s Data Advisory Council, we are all deeply committed to seeing government use data strategically and productively to improve our country. We have spent the last year examining ways to open up government data and push for more engagement with government data. My talk today is intended to challenge and provoke us to think more deeply about the mission that we’re committed to. I want to challenge some of the basic assumptions that we all hold dear and highlight how some of our values are in conflict. We all assume that our commitment to using data well is a commitment to using data for social good. But what if our passion project will increase inequality and hurt the people we’re trying to help? What if our efforts will do harm?...*D.S. Department of Commerce, Data Advisory Council: October 28, 2016 / This talk was written for a meeting of the Data Advisory Council. It is a crib; the actual talk probably came out slightly differently.*This study has been published with the approval of its writer.

Plastic waste, Marine litter, Qatar, and Material flow analysis

As the population continues to grow, the generation of waste and specifically plastic waste, has also increased significantly in the past decades both globally and regionally. However, little attention has been directed to this problem in the region. This study aims to delineate and map the status of the plastic waste problem in Qatar with a focus on the plastic inflow to the marine environment. A generic material flow diagram was built using a material flow analysis software named STAN, to depict the flow of the plastic waste. The study focuses on the plastic waste in the marine environment, depicting the different types, sizes and shapes of plastic particles, and the recovery and recycling efforts that have been made, in order to reduce plastic waste and minimize its risk on the environment.

Creativity, media_common.quotation_subject, media_common, Terrain, Visual arts, and Sociology

Medical education, Psychology, Online teaching, Article, and ComputingMilieux_COMPUTERSANDEDUCATION

Online education has grown rapidly in recent decades. The COVID-19 pandemic has brought the ubiquity of online learning to new levels, alongside renewed recognition of the need for high-quality online pedagogy. In an uncertain world, educators must be prepared to teach online and potentially shift modalities as needed. While this can be daunting, it helps to remember that online teaching emerges from the same teaching principles that exist in any setting—that good teaching is an act of design. This sense of pedagogical design is foregrounded in the need for careful front-end design of online learning spaces. In this chapter, I discuss keyframing points for online instructors to use in designing online learning. This includes practical information on designing for learning goals, including design-based projects, assessment strategies, and community building tips and ideas.

Fluent, Mindset, Engineering management, Sociology, and Online teaching

General Medicine

Purpose of the studyThis study aims at identifying the predominant learning approaches by Saudi medical students across Saudi Arabia and assess its possible associations with sociodemographic and educational characteristics.Study designA cross-sectional study design using the Approaches and Study Skills Inventory for Students questionnaire. The questionnaire gives rise to three possible learning approaches; deep, strategic and surface approaches. Bivariate analyses were performed through independent samples t-test and χ2 tests where appropriate. A multinominal regression analysis was performed to obtain risk estimates and 95% CIs.ResultsA total of 3767 students participated and were included in the analysis. The predominant learning approach was the deep approach, followed by the strategic and surface approaches (40.59%, 37.81% and 21.60%, respectively). Males and students belonging to private medical schools were more likely to adopt a strategic rather than a deep one (relative risk ratio (RRR) 1.22, 95% CI 1.06 to 1.42 and RRR 1.32, 95% CI 1.05 to 1.65, respectively). Students with an A grade point average (GPA) were less likely to adopt a surface approach, whereas those with a C GPA were more likely to adopt it (RRR=0.67, 95% CI 0.54 to 0.83 and RRR=1.29, 95% CI 1.02 to 1.61, respectively).ConclusionThe findings from this study show that medical students predominantly favour the deep learning approach. Results from this study encourage the continuous adaptation of clinical teaching in medical schools to optimise students’ learning experiences.

Ophthalmology, General Medicine, Neuromyelitis optica, medicine.disease, medicine, Aquaporin 4, Small Cell Lung Carcinoma, business.industry, business, Spectrum disorder, Immunoglobulin G, biology.protein, biology, Pathology, and medicine.medical_specialty

Computer Science Applications, Education, Computer science, Knowledge management, business.industry, business, and Decision support system

Stalking, Risk area, Physical assault, Workplace violence, Medicine, business.industry, business, Response rate (survey), Christian ministry, Family medicine, medicine.medical_specialty, Arabic, language.human_language, language, and Healthcare providers

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 0.15�0.92). 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 0.03�0.75). 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.

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.

Brief Communication, Psychiatry and Mental health, Clinical Neurology, Betacoronavirus, biology.organism_classification, biology, Pandemic, 2019-20 coronavirus outbreak, Intensive care medicine, medicine.medical_specialty, medicine, Epilepsy, medicine.disease, business.industry, business, Disease management, MEDLINE, Coronavirus Infections, and Coronavirus disease 2019 (COVID-19)

Drug Discovery, Pharmaceutical Science, Molecular Medicine, Medicine, business.industry, business, Global health, Authorization, Coronavirus disease 2019 (COVID-19), Food and drug administration, Drug, media_common.quotation_subject, media_common, Adverse effect, Intensive care medicine, medicine.medical_specialty, Pandemic, belantamab mafodotin-blmf, 64Cu-DOTATATE, drugs, FDA, 68Ga-PSMA-11, lumasiran, lcsh:Medicine, lcsh:R, lcsh:Pharmacy and materia medica, lcsh:RS1-441, Setmelanotide, Oligonucleotides, Peptides, Viltolarsen, and Review

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.
This work was funded in part by the following: the National Research Foundation (NRF) and the University of KwaZulu-Natal (South Africa); MINECO, (RTI2018-093831-B-100), and the Generalitat de Catalunya (2017 SGR 1439) (Spain).

Artificial intelligence, business.industry, business, Semantic similarity, Computer science, Architecture, Conversation, media_common.quotation_subject, media_common, Descriptive knowledge, Recommender system, Natural language processing, computer.software_genre, computer, Dialog system, Pattern matching, Certification, and ComputingMilieux_THECOMPUTINGPROFESSION

In our modern day and age, students with different abilities tend to undertake professional examinations (PEs) to obtain certifications that would prove their knowledge and expertise in their respective fields. This will help them when seeking a career boost in various domains. However, a challenging point arises in which many students express a lack of awareness about which PEs to consider, and which PE is best suited to their professional needs. In this research, a solution is proposed to overcome this challenge by designing and developing a web-based recommendation system based on a textual Conversational Agent (CA) called the Conversational Agent for Professional Examinations (CAPEs) Advisory. The CAPEs Advisory provides smart recommendations for better exam pathways that would suit the student’s various types of knowledge and skill level at University. The proposed architecture for the CAPEs Advisory uses Natural Language Processing (NLP) techniques by applying both Pattern Matching (PM) and a semantic similarity algorithm to extract keywords from the user’s utterances to match patterns in the scripted conversation. An evaluation methodology and experiments have been designed and conducted by using subjective and objective methods to evaluate the CAPEs Advisory components. The results showed a statistically significant impact on the effectiveness of the CAPEs Advisory engine in recognizing 97.36% of the utterances. In addition, the results show that the CAPEs Advisory is effective as a Professional Examinations Advisory with the majority user satisfaction being 83.3%.

architectural heritage, historicist reconstruction, cultural continuity, environmental sustainability, energy efficiency, lcsh:Environmental effects of industries and plants, lcsh:TD194-195, lcsh:Renewable energy sources, lcsh:TJ807-830, lcsh:Environmental sciences, lcsh:GE1-350, Management, Monitoring, Policy and Law, Renewable Energy, Sustainability and the Environment, Geography, Planning and Development, Environmental ethics, Architectural heritage, Political science, Cultural continuity, Sustainability, Cultural heritage management, Historicism, Middle East, Local community, and Ethnography

Although attempts for formulating sustainable approaches in heritage management have been ongoing since the 1980s, sustainability dimensions in the context of &lsquo
reconstruction&rsquo
have remained an unexplored research area. By investigating the case of the ruined Khaz&rsquo
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 &lsquo
cultural continuity&rsquo
and &lsquo
environmental protection&rsquo
pillars of sustainability in reconstruction planning. By employing rapid ethnographic surveying and case study methods, we first investigate the approach to &lsquo
from the State&rsquo
s stance and through local community perceptions. Albeit with nuances, the surveying revealed a preference for historicist reconstruction. However, the Khaz&rsquo
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.