Context: The COVID-19 pandemic has changed the structure of the healthcare system. As a response to the pandemic, the ministry of health applied many changes to the primary healthcare system. These ...changes created new challenges for healthcare workers (HCWs). Aims: To identify the roles and challenges of practitioners in primary healthcare (PHC) centers during COVID-19 in Al-Baha city, Saudi Arabia, in 2022. Methods and Materials: An analytical cross-sectional study was carried out in 2022 in Al-Baha city, Saudi Arabia. An electronic online questionnaire was distributed formally to HCWs in PHC centers. All primary HCWs during the COVID-19 pandemic in Al-Baha city, Saudi Arabia, were included. Results: A total of 424 responses were analyzed. Half (50.7%) of the participants had fieldwork roles during the pandemic. The two most commonly agreed-upon challenges were stress (78.7%) and worry about getting infected (79.8%). The majority (74.4%) of the participants' roles involved direct contact with suspected COVID-19 cases, whereas 50.9% involved direct contact with confirmed COVID-19 cases. Direct contact with confirmed cases showed a significant association with worrying about getting infected (P = 0.019). Conclusions: Workload, overtime, conflict ambiguity, fear of getting and transmitting the infection, stress, and lack of personal protective equipment were challenges faced by the primary HCWs, which negatively impacted the quality of delivered services and mental health. We recommend facilitating access of primary HCWs to psychiatric clinics to improve stress and help cope with new roles during the pandemics and changes in the healthcare system.
The aim was to estimate the psychometric properties of the COVID-19-related distress scale in our society, as well as verifying the global structure of the COVID-19-related distress scale through ...exploratory factor analysis and the confirmatory factor analysis model for the dimensions prepared in the light of previous studies and the general factor model.
The study follows the design of the exploratory cross-sectional studies by applying a scale electronically using the Google Forms tool. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach's alpha reliability coefficient, and test-retest methods were used to evaluate reliability.
In the analysis made for internal consistency in the reliability study of the scale, the Cronbach's alpha reliability coefficients were determined as α = 0.93 for the physical dimension subscale, 0.90 for the psychological and emotional dimension, 0.92 for cognitive dimension, 0.91 for the social dimension, 0.92 for behavioral dimension, 0.87 for living Dimension and 0.94 for the whole scale. The total number of items on the scale is 62. It is clear that the items of the scale explained 55.49 % of the variance of the correlation matrix between the items, which indicates that the scale has an appropriate degree to extract the variance that explains COVID-19-related distress. The fit indices were found to be Chi square = 862.30 (p < .001), degree of freedom = 210 (χ2 = 862.30; df = 210, χ2/df = 4.10), root mean square error of approximation (RMSEA) = 0.07 (p < .05) standardized root mean- square residual (SRMR) = 0.05, comparative fit index (CFI) = 0.92, non-normed fit index (NNFI) = 0.95, goodness of fit index (GFI) = 0.95, and adjusted goodness of fit index (AGFI) = 0.94.
The COVID-19-related distress scale is an easy to administer, valid, and reliable instrument to assess COVID-19-related distress. This instrument can be a helpful tool informing us about distress related to COVID-19 and hence may prevent adverse long-term consequences arising due to pandemic.
The aim of this study was to evaluate the accuracy of the degree of fracture reduction after open reduction and internal fixation of Zygomaticomaxillary Complex (ZMC) fractures in the Saudi ...population of the Al-Baha region, using Gillies approach. Further comparison with preoperative and postoperative standardized computed tomography (CT) views with the calculation of residual deformity percentage, which remained after the ZMC rehabilitation.
A 5-year retrospective CT-based study on preoperative and postoperative axial CT scans of 46 male patients with ZMC fractures. The CT measurements were made (in millimeters) at the fracture site of maximum displacement through the anterior orbital rim and orbital floor, posterolateral wall of the maxillary sinus, zygomatic arch, and zygomaticofrontal suture. For the zygomatic arch, measurements were made (in mm) by drawing a tangent to the fractured arch segments and dropping a perpendicular to the inward displaced fractured arch. The total difference in all measured parts between preoperative and postoperative displacement was calculated in percentages.
Upon comparison of preoperative and postoperative zygomaticomaxillary complex CTs, three-point fixation at the regions of infraorbital rim, frontozygomatic suture, and posterolateral wall of the maxilla results in a reduction of the fracture sites in the range of 72.85% to 85%. Maximum reduction was noted at the zygomatic arch, that is, 85%, and minimum at the infraorbital rim, that is, 72.85%. The reduction obtained at all four sites was statistically significant, with
values ranging from .011 to .039.
Gillies temporal approach and three-point fixation at the regions of the infraorbital rim, frontozygomatic suture, and posterolateral wall of the maxilla results in satisfactory treatment of ZMC fractures and improves patients oral health and quality of life.
Endoplasmic Reticulum (ER) stress, caused by the accumulation of misfolded proteins in the ER, elicits a homeostatic mechanism known as the Unfolded Protein Response (UPR). The UPR reprograms gene ...expression to promote adaptation to chronic ER stress. The UPR comprises an acute phase involving inhibition of bulk protein synthesis and a chronic phase of transcriptional induction coupled with the partial recovery of protein synthesis. However, the role of transcriptional regulation in the acute phase of the UPR is not well understood. Here we analyzed the fate of newly synthesized mRNA encoding the protective and homeostatic transcription factor X-box binding protein 1 (XBP1) during this acute phase. We have previously shown that global translational repression induced by the acute UPR was characterized by decreased translation and increased stability of XBP1 mRNA. We demonstrate here that this stabilization is independent of new transcription. In contrast, we show XBP1 mRNA newly synthesized during the acute phase accumulates with long poly(A) tails and escapes translational repression. Inhibition of newly synthesized RNA polyadenylation during the acute phase decreased cell survival with no effect in unstressed cells. Furthermore, during the chronic phase of the UPR, levels of XBP1 mRNA with long poly(A) tails decreased in a manner consistent with co-translational deadenylation. Finally, additional pro-survival, transcriptionally-induced mRNAs show similar regulation, supporting the broad significance of the pre-steady state UPR in translational control during ER stress. We conclude that the biphasic regulation of poly(A) tail length during the UPR represents a previously unrecognized pro-survival mechanism of mammalian gene regulation.
The Hand in Distal Arthrogryposis Alzahrani, Mohammed A.; Farr, Sebastian
The Journal of hand surgery (American ed.),
20/May , Letnik:
47, Številka:
5
Journal Article
Recenzirano
Distal arthrogryposis is the second most common type of arthrogryposis after amyoplasia and is defined as arthrogryposis that affects hands and feet; it is mostly inherited in an autosomal-dominant ...fashion. This review discusses up-to-date background information, clinical features, and treatment of distal arthrogryposis in hands concentrating on camptodactyly, thumb-in-palm deformity, and windblown hand deformity, which are the most common and functionally limiting deformities. Treating these deformities should be individualized and follow a multidisciplinary approach. Most deformities can be initially treated nonoperatively, and if not responsive, operative treatment may be pursued to improve function. Surgery primarily aims to release soft-tissue contractures, rebalance muscle forces, and may need bony correction based on the deficits of each case. Current literature suggests that early treatment leads to better outcomes. However, reported cases are scarce, and no consensus or gold standard for treatment exists. Therefore, long-term (multicenter) studies are needed to assess outcomes and standardize the treatment of such deformities whenever possible.
Nowadays, people over the world face severe water scarcity despite the presence of several water sources. Adsorption is considered as the most efficient technique for the treatment of water ...containing biological, organic, and inorganic contaminants. For this purpose, materials from various origins (clay minerals, modified clays, zeolites, activated carbon, polymeric resins, etc.) have been considered as adsorbent for contaminants. Despite their cheapness and valuable properties, the use of clay minerals as adsorbent for wastewater treatment is limited due to many factors (low surface area, regeneration, and recovery limit, etc.). However, clay mineral can be used to enhance the performance of polymeric materials. The combination of clay minerals and polymers produces clay-polymers nanocomposites (CPNs) with advanced properties useful for pollutants removal. CPNs received a lot of attention for their efficient removal rate of various organic and inorganic contaminants via flocculation and adsorption ability. Three main classes of CPNs were developed (exfoliated nanocomposites (NCs), intercalated nanocomposites, and phase-separated microcomposites). The improved materials can be explored as novel and cost-effective adsorbents for the removal of organic and inorganic pollutants from water/wastewater. The literature reported the ability of CPNs to remove various pollutants such as bacteria, metals, phenol, tannic acid, pesticides, dyes, etc. CPNs showed higher adsorption capacity and efficient water treatment compared to the individual components. Moreover, CPNs offered better regeneration than clay materials. The present paper summarizes the different types of clay-polymers nanocomposites and their effective removal of different contaminants from water. Based on various criteria, CPNs future as promising adsorbent for water treatment is discussed.
To accurately rank various web services can be a very challenging task depending on the evaluation criteria used, however, it can play an important role in performing a better selection of web ...services afterward. This paper proposes an approach to evaluate trust prediction and confusion matrix to rank web services from throughput and response time. AdaBoostM1 and J48 classifiers are used as binary classifiers on a benchmark web services dataset. The trust score (TS) measuring method is proposed by using the confusion matrix to determine trust scores of all web services. Trust prediction is calculated using 5-Fold, 10-Fold, and 15-Fold cross-validation methods. The reported results showed that the web service 1 (WS1) was most trusted with (48.5294%) TS value, and web service 2 (WS2) was least trusted with (24.0196%) TS value by users. Correct prediction of trusted and untrusted users in web services invocation has improved the overall selection process in a pool of similar web services. Kappa statistics values are used for the evaluation of the proposed approach and for performance comparison of the two above-mentioned classifiers.
Background
Information technology has shifted paper-based documentation in the health care sector into a digital form, in which patient information is transferred electronically from one place to ...another. However, there remain challenges and issues to resolve in this domain owing to the lack of proper standards, the growth of new technologies (mobile devices, tablets, ubiquitous computing), and health care providers who are reluctant to share patient information. Therefore, a solid systematic literature review was performed to understand the use of this new technology in the health care sector. To the best of our knowledge, there is a lack of comprehensive systematic literature reviews that focus on Fast Health Interoperability Resources (FHIR)-based electronic health records (EHRs). In addition, FHIR is the latest standard, which is in an infancy stage of development. Therefore, this is a hot research topic with great potential for further research in this domain.
Objective
The main aim of this study was to explore and perform a systematic review of the literature related to FHIR, including the challenges, implementation, opportunities, and future FHIR applications.
Methods
In January 2020, we searched articles published from January 2012 to December 2019 via all major digital databases in the field of computer science and health care, including ACM, IEEE Explorer, Springer, Google Scholar, PubMed, and ScienceDirect. We identified 8181 scientific articles published in this field, 80 of which met our inclusion criteria for further consideration.
Results
The selected 80 scientific articles were reviewed systematically, and we identified open questions, challenges, implementation models, used resources, beneficiary applications, data migration approaches, and goals of FHIR.
Conclusions
The literature analysis performed in this systematic review highlights the important role of FHIR in the health care domain in the near future.
Background The practice of self-medication (SM) is the use of self-consuming medication without consulting healthcare which carries its own risks. SM patterns differ across populations and are ...influenced by several factors. This study aimed to assess the prevalence of SM practices in Al-Baha, Saudi Arabia, to identify the factors contributing to this practice and develop effective strategies to decrease its occurrence and associated risks. Methodology This cross-sectional study was conducted in Al Baha Province, Saudi Arabia, over two weeks in July 2023, with a sample of 580 participants. Eligible participants were males and females, both Saudi and non-Saudi, aged 18-65. The data were collected using a self-administered online questionnaire. Results Of all participants, 48.7% admitted taking medications without a healthcare practitioner's prescription in the last three months. Analgesics were the most common SM (29.1%), followed by vitamins and minerals (16.2%), and antipyretics (14.1%). The side effects experienced from SM included nausea (24.5%), headache (20.5%), and shortness of breath (8.7%). Regarding the source of medication, the majority (61.9%) obtained medications from a pharmacy and 14.6% used existing stock. Age was significantly associated with higher rates in the 18-29 and 40-49 age groups. Educational status was significantly associated with higher SM among graduates. Regarding reading medical instructions, 39.2% always read, 47.7% sometimes read, and 13.1% never read. Regarding antibiotic SM, 61 participants reported using over-the-counter (OTC) antibiotics. Common reasons for use included sore throat (27.8%) and common cold (19.6%). The most common reason for SM was to save time (25.9%), followed by avoiding crowds and long waits (17.1%). Conclusions A significant prevalence of SM practice concerning antibiotic misuse and sex differences with female dominance was detected. We recommend further public awareness activities from related organizations and more regulations for OTC prescription practices to ensure safe SM practices. In addition, further research is needed to explore SM patterns.
PDF
