Simulation Use in Respiratory Therapy Programs in Saudi Arabia: Results of a National Survey

Hajed M Al-Otaibi,1,2 Nabeela Abdullah Al-Abdullah,3 Abdulrahman A Naqru,4 Mohammed A Boukhari,5 Ahmed M Almohaimeed,2 Abdulaziz J Alzhrani6 1Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 2Respiratory Therapy Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Public Health, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia; 4Respiratory Therapy Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 5Respiratory Therapy Department, Andalusia Group Hospital, Jeddah, Saudi Arabia; 6Respiratory Therapy Department, Bugshan Hospital, Jeddah, Saudi ArabiaCorrespondence: Hajed M Al-Otaibi, Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589, Saudi Arabia, Email [email protected]: The use of simulation-based methods for teaching and learning in the education of health professions is increasing, but its prevalence in Saudi Arabia among respiratory therapy programs has yet to be investigated. The purpose of this study is to identify the use of simulation-based learning (SBL) in respiratory therapy programs in Saudi Arabia.Methods: A cross-sectional study was performed by sending Google forms survey via Email to directors of respiratory therapy programs in Saudi Arabia (N=16) to evaluate how each one used simulations as an educational tool.Results: The survey was returned with a total response of 12 out of all 16 program that were initially contacted (75% response rate). Among the respondents, approximately 75% of the programs are using SBL, while high-fidelity simulation is used by all programs. The present data show that 67% of the respiratory therapy programs has a space for simulation within the department, while 33% utilizes institutional simulation centers. For short simulation scenarios, debriefing is not conducted in 67% of the programs. There is acceptance by program directors that simulation hours should be counted towards clinical hours. About 67% of respondent programs have mandatory simulation learning activities, and 100% agree that simulations should be used more. However, lack of training and shortage of staff are among barriers to increase the use of SBL.Conclusion: SBL is commonly used and relatively varied among respiratory therapy programs. However, it requires some improvements in several aspects, including the use of debriefing and increasing the number of properly trained staff.Keywords: respiratory therapy, simulation, debriefing, medical education, Saudi Arabi

Utilization of Renewable Energy for Power Sector in Yemen: Current Status and Potential Capabilities

A severe energy crisis has plagued Yemen for decades, and most of the population lack access to electricity. This has harmed the country’s economic, social, and industrial growth. Yemen generates electricity mainly from fossil fuels, despite having a high potential for renewable energy. Unfortunately, the situation has recently been compounded by the country’s continuing war, which has been ongoing since early 2015. It has impacted the country’s energy infrastructure negatively, resulting in power outages. Therefore, this paper aims to provide an updated perspective on Yemen’s current energy crisis and explain its key issues and potential solutions. Besides, it examines the potential, development, and current state of renewable energy sources, such as solar, wind, geothermal, and biomass. Based on the findings, Yemen is one of the world’s wealthiest countries in terms of sunlight and wind speed, and these two resources are abundant in all regions of the country. In addition, this paper sheds light on the solar energy revolution that has arisen since the war started due to the complete outage of the national electricity. Within a few years, solar energy in Yemen has increased its capacity by 50 times and has recently become the primary source of electricity for most Yemenis. Furthermore, the paper discusses the difficulties and challenges that face the implementation of renewable energy investment projects. Numerous recommendations for potential improvements in Yemen’s widespread use of renewable energy are also provided in this paper. All of the ideas presented in this paper are hoped to increase the efforts to grow renewable energy production in Yemen, thereby solving the issues of energy poverty and reducing environmental effects. The presented analysis can be used as a scientific reference for researchers and industrial companies looking for suitable solutions to advance Yemen’s renewable energy

Immigrants and health system challenges to TB control in Oman

<p>Abstract</p> <p>Background</p> <p>During the past three decades, Oman has made significant progress in controlling TB within it's borders. However, the national TB control program elimination target has yet to be reached. This study aims to explore the perceived roles played by the immigrant population and the private health sector in relation to TB control in Oman.</p> <p>Methods</p> <p>We conducted seventeen interviews with different health care providers. The verbatim transcripts were processed using content analysis.</p> <p>Results</p> <p>Three main themes emerged. Firstly the threat of repatriation faced by underprivileged expatriates, secondly the criticized and forgotten private health sector as a key player and thirdly the user and provider barriers faced by Omani patients in the Omani public health system.</p> <p>Conclusions</p> <p>The study has identified some of the challenges and barriers to TB control in Oman. These challenges are mainly related to unintended negative consequences arising from the current repatriation policy of immigrants and to and the lack of involvement of the private sector in TB control. TB control strategies designed to address these challenges are needed, for Oman to reach its TB elimination targets.</p

The Prevalence and Risk Factors of Trichosporonosis at King Abdulaziz University Hospital

Ghassan J Alboloshi,1 Asif A Jiman-Fatani,2,3 Dalya Attallah,3 Jawahir A Mokhtar,2– 4 Nabeela Abdullah Al-Abdullah,5,6 Khalil Alkuwaity,4,7 Reham Kaki,6,8 Mohammed W Al-Rabia,2 Abdelbagi Alfadil,2,9 Karem Ibrahem,2 Addisu D Teklemariam,10,11 Steve Harakeh12,13 1Department of Medical Laboratories, King Abdullah Medical Complex Jeddah, Ministry of Health, Jeddah, Saudi Arabia; 2Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Clinical and Molecular Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 4Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Public Health, College of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Infection Control and Environmental Health, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 7Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 8Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 9Center of Research Excellence for Drug Research and Pharmaceutical Industries, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 10Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 11Department of MIVP, College of Veterinary Medicine and Agriculture, Addis Ababa University, Addis Ababa, Ethiopia; 12King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; 13Yousef Abdul Latif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi ArabiaCorrespondence: Abdelbagi Alfadil, Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, P.O. Box 80205, King Abdulaziz University, 21589, Saudi Arabia, Tel +96612 6952000 Ext 21062, Email [email protected]: Fungal infections, especially those caused have emerged as a significant medical concern over the past three decades, particularly among immunocompromised patients. However, recent studies have highlighted the increasing prevalence of fungal infections resembling yeast other than Candida, such as trichosporonosis, especially among immunosuppressed individuals worldwide. Trichosporon has been identified as a significant contributor to superficial and invasive infections. Invasive trichosporonosis, primarily affecting immunocompromised patients, poses a significant threat with high mortality rates.Purpose: The current study aimed to explore the clinical epidemiology of Trichosporon spp at King Abdulaziz University Hospital (KAUH) in Saudi Arabia.Methods: This retrospective study aimed to assess the clinical epidemiology of Trichosporon spp. infections in microbiology cultures obtained from KAUH in Saudi Arabia. The study analyzed data from patients over a five-year period, focusing on demographic, clinical, and microbiological characteristics.Results: This study encompassed 21 participants, categorized into four distinct age groups. Moreover, this study indicated T. asahii as the predominant species isolated, accounting for 90.5% of infections, followed by T. mucoides (9.5%). ICU hospitalization, diabetes mellitus, taking immunosuppressive drugs, and antifungal drugs, and the use of invasive medical equipment were identified as prominent risk factors for trichosporonosis. Urinary tract infections were the most common clinical presentation, particularly among male and elderly patients. Mortality rates were high, especially among older individuals.Conclusion: This study contributes valuable epidemiological insights into trichosporonosis, highlighting the need for enhanced surveillance and preventive strategies in healthcare settings. Further research is warranted to optimize treatment approaches and infection control measures, ultimately reducing the burden of Trichosporon infections on patient outcomes.Keywords: fungal infection, trichosporonosis, Trichosporon spp, Trichosporon asahii, invasive, risk factor

Optimisation of biomass, exopolysaccharide and intracellular polysaccharide production from the mycelium of an identified Ganoderma lucidum strain QRS 5120 using response surface methodology

Wild-cultivated medicinal mushroom Ganoderma lucidum was morphologically identified and sequenced using phylogenetic software. In submerged-liquid fermentation (SLF), biomass, exopolysaccharide (EPS) and intracellular polysaccharide (IPS) production of the identified G. lucidum was optimised based on initial pH, starting glucose concentration and agitation rate parameters using response surface methodology (RSM). Molecularly, the G. lucidum strain QRS 5120 generated 637 base pairs, which was commensurate with related Ganoderma species. In RSM, by applying central composite design (CCD), a polynomial model was fitted to the experimental data and was found to be significant in all parameters investigated. The strongest effect (p lt 0.0001) was observed for initial pH for biomass, EPS and IPS production, while agitation showed a significant value (p lt 0.005) for biomass. By applying the optimized conditions, the model was validated and generated 5.12 g/L of biomass (initial pH 4.01, 32.09 g/L of glucose and 102 rpm), 2.49 g/L EPS (initial pH 4, 24.25 g/L of glucose and 110 rpm) and 1.52 g/L of IPS (and initial pH 4, 40.43 g/L of glucose, 103 rpm) in 500 mL shake flask fermentation. The optimized parameters can be upscaled for efficient biomass, EPS and IPS production using G. lucidum

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was USD 92 492 million using approach 1 and USD 73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was USD 95 004 million using approach 1 and USD 75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.publishedVersio

Maternal hypoxia decreases capillary supply and increases metabolic inefficiency leading to divergence in myocardial oxygen supply and demand

Maternal hypoxia is associated with a decrease in left ventricular capillary density while cardiac performance is preserved, implying a mismatch between metabolism and diffusive exchange. We hypothesised this requires a switch in substrate metabolism to maximise efficiency of ATP production from limited oxygen availability. Rat pups from pregnant females exposed to hypoxia (FIO2=0.12) at days 10-20 of pregnancy were grown to adulthood and working hearts perfused ex vivo. 14 C-labelled glucose and 3 H-palmitate were provided as substrates and metabolism quantified from recovery of 14CO2 and 3 H2O, respectively. Hearts of male offspring subjected to Maternal Hypoxia showed a 20% decrease in cardiac output (P<0.05), despite recording a 2-fold increase in glucose oxidation (P<0.01) and 2.5-fold increase (P<0.01) in palmitate oxidation. Addition of insulin to Maternal Hypoxic hearts, further increased glucose oxidation (P<0.01) and suppressed palmitate oxidation (P<0.05), suggesting preservation in insulin signalling in the heart. In vitro enzyme activity measurements showed that Maternal Hypoxia increased both total and the active component of cardiac pyruvate dehydrogenase (both P<0.01), although pyruvate dehydrogenase sensitivity to insulin was lost (NS), while citrate synthase activity declined by 30% (P<0.001) and acetyl-CoA carboxylase activity was unchanged by Maternal Hypoxia, indicating realignment of the metabolic machinery to optimise oxygen utilisation. Capillary density was quantified and oxygen diffusion characteristics examined, with calculated capillary domain area increased by 30% (P<0.001). Calculated metabolic efficiency decreased 4-fold (P<0.01) for Maternal Hypoxia hearts. Paradoxically, the decline in citrate synthase activity and increased metabolism suggest that the scope of individual mitochondria had declined, rendering the myocardium potentially more sensitive to metabolic stress. However, decreasing citrate synthase may be essential to preserve local PO2, minimising regions of hypoxia and hence maximising the area of myocardium able to preserve cardiac output following maternal hypoxia

Distribution and variability of deformed wing virus of honeybees (Apis mellifera L.) in the Middle East and North Africa

Three hundred and eleven honeybee samples from 12 countries in the Middle East and North Africa (MENA) (Jordan, Lebanon, Syria, Iraq, Egypt, Libya, Tunisia, Algeria, Morocco, Yemen, Palestine, and Sudan) were analyzed for the presence of deformed wing virus (DWV). The prevalence of DWV throughout the MENA region was pervasive, but variable. The highest prevalence was found in Lebanon and Syria, with prevalence dropping in Palestine, Jordan, and Egypt before increasing slightly moving westwards to Algeria and Morocco Phylogenetic analysis of a 194 nucleotide section of the DWV Lp gene did not identify any significant phylogenetic resolution among the samples, although the sequences did show consistent regional clustering, including an interesting geographic gradient from Morocco through North Africa to Jordan and Syria. The sequences revealed several clear variability hotspots in the deduced amino acid sequence, which furthermore showed some patterns of regional identity. Furthermore, the sequence variants from the Middle East and North Africa appear more numerous and diverse than those from Europe