Domiciliary monitoring to predict exacerbations of COPD

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a common, longterm condition that is usually caused by cigarette smoking. In addition to daily symptoms and limitation in activities, patients are prone to chest infections ('exacerbations'). These are a significant problem: unpleasant for patients, and sometimes severe enough to cause hospital admission and death. Reducing the impact of exacerbations is very important. Previous studies have shown that earlier treatment of exacerbations results in faster recovery, and reduced risk of hospital admission. Helping patients to better detect exacerbations early is therefore important. This PhD focuses on measuring overnight heart rate and oxygen saturation, which we hypothesised would provide the best chance of detecting COPD exacerbations earlier than changes in symptoms. // Aim: To evaluate the potential of monitoring physiological variables to provide earlier detection of exacerbations of COPD. // Methods: Firstly, a systematic review was conducted to assess the existing literature on predicting exacerbations of COPD by monitoring physiological variables. Next, two clinical tele-health datasets were accessed, from two different NHS services in London, to report the impact of false alarms on tele-health service, and to examine the feasibility of using downloadable data from home non-invasive ventilation to detect exacerbations resulting in hospitalisation. National and international surveys were conducted to explore the techniques that have been used by healthcare providers on how to customise tele-health alarm limits for each individual, and to explore healthcare providers’ perceptions of tele-health for COPD. These preliminary projects enabled me to formulate my research question and main PhD hypothesis, tested using a prospective randomised controlled trial. Patients were randomised into two groups (one measured physiology only in the morning versus overnight continuous measurement) and patients were monitored for up to six months or the first exacerbation, whichever was sooner. Patients’ acceptance of continuous overnight monitoring was assessed at the end of the study. // Results: Existing studies that used physiological variables were small and heterogeneous using different variables and different protocols. The majority of medical alarms received by tele-health teams are false. Most patients reported a positive acceptance of being monitored overnight. Continuous overnight monitoring identified changes at exacerbation earlier than once-daily monitoring, and earlier than symptoms. Changes in physiological variables were correlated with changes in symptoms during non-stable phases. There is widespread UK national and international use of tele-health monitoring physiological variables in COPD without sufficient evidence base. // Conclusion: Monitoring physiological parameters may be useful in assisting earlier detection of COPD exacerbations but further, robust studies are required to confirm this. A particular challenge is how to set alarm limits for individual patients given the heterogeneity inherent in COPD and COPD exacerbations

Moderating role of government support on relationship between cultural dimensions and Saudi women’s leadership effectiveness

The underrepresentation of women in academic and administrative leadership roles is a global phenomenon. This study aimed to investigate the important factors that influence the effectiveness of women leadership in the context of Saudi universities. There are still many obstacles faced by academic women leaders in universities. Women leadership effectiveness is still a significant problem that affects higher education institutions and the community of KSA. Thus, this research investigated the impact of gender egalitarianism, assertiveness, and future orientation on women leadership effectiveness in the public universities by taking government support as a moderating variable. The population of this study, consisting of 2800 female leaders, were divided into five groups based on the geographic regions (East, West, Middle, North and South). This study used the geographical clusters sampling to select the universities, and random sampling to select women leaders from each geographical cluster. 500 questionnaires were distributed among the employees working in the higher education sector of KSA. 271 questionnaires were returned and were usable for analysis with a response rate of 54%. This study employed the Structural Equations Modeling Approach by using the Partial Least Squares (PLS) to analyse the data. The results revealed that gender egalitarianism, assertiveness and future orientation have significant positive impacts on leadership effectiveness. The value of this study lies in finding government support as a significant moderating variable for assertiveness and future orientation to enhance women leadership effectiveness in Saudi universities. Future studies may adopt and examine different variables like motivation, organizational, cultural and other variables to understand leadership effectiveness at the organization level. The higher education sector of any country is considered as an important sector which needs female leaders besides the male to concentrate on achieving their goals successfully

KACST Arabic Text Classification Project: Overview and Preliminary Results

Electronically formatted Arabic free-texts can be found in abundance these days on the World Wide Web, often linked to commercial enterprises and/or government organizations. Vast tracts of knowledge and relations lie hidden within these texts, knowledge that can be exploited once the correct intelligent tools have been identified and applied. For example, text mining may help with text classification and categorization. Text classification aims to automatically assign text to a predefined category based on identifiable linguistic features. Such a process has different useful applications including, but not restricted to, E-Mail spam detection, web pages content filtering, and automatic message routing. In this paper an overview of King Abdulaziz City for Science and Technology (KACST) Arabic Text Classification Project will be illustrated along with some preliminary results. This project will contribute to the better understanding and elaboration of Arabic text classification techniques

Undergraduate students' perceptions of the use of simulation software through online learning in colleges of engineering during the covid-19 pandemic: A case study at al-Balqa applied university, Jordan.

Students at Al-Balqa' Applied University, Jordan, are being interviewed about their experiences with online simulation software during the Covid-19 pandemic. In this study, a descriptive method was employed. 667 undergraduate students were asked to fill out a 25-item questionnaire. During the Covid-19 epidemic, undergraduate students showed a modest level of proficiency in using simulation software via online instruction, according to the study's findings. Al-Balqa' Applied University undergraduate students' perspectives vary according to gender (in favor of females) and discipline, according to the findings (in favor of the Electrical engineering discipline.). Academic evaluation, on the other hand, does not show any statistically significant differences amongst pupils. As a result, there appears to be no statistically significant difference in academic evaluation across pupils (GPA). It's important to do more research like this one on simulation software implementation in higher education institutions, according to this study

A Pragmatic Study of Speech Acts in Thoreau’s Inspiration

يتعامل هذا البحث مع تشخيص أنواع أفعال الكلام في قصيدة الالهام لهنري ديفيد ثوريا. تعد هذه الدراسة دراسة نوعية حيث أنها تحاول التثبت من كل أنواع أفعال الكلام الممكن ايجادها في القصيدة حسب تصنيف سيرل. سجل فعلا الكلام التوكيدي والتصريحي اعلى مستوى تمثيل يبلغ 12 (44%). بينما سجل الفعل الكلامي التعبيري فارقا محلوظا بمستوى تمثيل بلغ 2 (7%). اما بالنسبة لفعلي الكلام العمدي، فهو لم يسجل إلا تكرارا واحدا بنسبة تمثيل بلغت (3%). بينما سجل كل نوع من أفعال الكلام مستوى معينا من التمثيل، لا يوجد لفعل الكلام الإرشادي إذ إن غياب هذا الفعل يشير إلى أن طبيعة الأفكار التي وردت في قصيد الإلهام لثوريا التي لا تتوافق مع طبيعة فعل الكلام.This paper deals with identifying the speech act types in Henery David Thoreau’s Inspiration. This study is basically qualitative as it tries to define the different categories of speech acts according to Searle’s classification. representatives and declarative speech acts score the highest percentage of flouting i.e., 12 (44%). Expressive speech act signifies a considerable difference as it scores i.e., 2 (7%). For commissive speech acts, the level of its representation in Thoreau’s Inspiration scores only one occurrence (3%). As each speech act score certain level of representation, directive speech acts could not be identified through Thoreau’s Inspiration. The study tries to show one feature of Thoreau’s poetry which is variety of speech act types that enables him to express abstract themes and conceptions. Whereas, the absences of directive speech acts indicate that the nature of themes and ideas expressed in Thoreau’s Inspiration does not agree the nature of that speech act

Transcriptome profile of early responsive genes in susceptible barley during Rhynchosporium secalis infection

Scald caused by Rhynchosporium secalis, is an economically important disease found worldwide. In order to profile genes and pathways responding to R. seclais infection, leaf transcriptomes before and after fungus inoculation in susceptible barley were compared using cDNA-AFLP technique. Transcriptional changes of 144 expressed sequence tags (ESTs) were observed, of which 18 have no previously described function. Functional annotation of the transcripts revealed a wide range of pathways including cell wall fortification, cytoskeleton construction and metabolic processes at different time points. Furthermore, the results of RT-PCR analysis on candidate genes, ABC transporters and lycine-specific demethylase were consistent with the cDNA-AFLP data in their expression patterns. Taken together, our data suggest that susceptible barley reprograms metabolic and biological processes to initiate a suitable response R. secalis infection

Application of oxygen saturation variability analysis for the detection of exacerbation in individuals with COPD: A proof-of-concept study

BACKGROUND: Individuals with chronic obstructive pulmonary disease (COPD) commonly experience exacerbations, which may require hospital admission. Early detection of exacerbations, and therefore early treatment, could be crucial in preventing admission and improving outcomes. Our previous research has demonstrated that the pattern analysis of peripheral oxygen saturation (Sp O2 ) fluctuations provides novel insights into the engagement of the respiratory control system in response to physiological stress (hypoxia). Therefore, this pilot study tested the hypothesis that the pattern of Sp O2 variations in overnight recordings of individuals with COPD would distinguish between stable and exacerbation phases of the disease. METHODS: Overnight pulse oximetry data from 11 individuals with COPD, who exhibited exacerbation after a period of stable disease, were examined. Stable phase recordings were conducted overnight and one night prior to exacerbation recordings were also analyzed. Pattern analysis of Sp O2 variations was carried examined using sample entropy (for assessment of irregularity), the multiscale entropy (complexity), and detrended fluctuation analysis (self-similarity). RESULTS: Sp O2 variations displayed a complex pattern in both stable and exacerbation phases of COPD. During an exacerbation, Sp O2 entropy increased (p = 0.029) and long-term fractal-like exponent (α2) decreased (p = 0.002) while the mean and standard deviation of Sp O2 time series remained unchanged. Through ROC analyses, Sp O2 entropy and α2 were both able to classify the COPD phases into either stable or exacerbation phase. With the best positive predictor value (PPV) for sample entropy (PPV = 70%) and a cut-off value of 0.454. While the best negative predictor value (NPV) was α2 (NPV = 78%) with a cut-off value of 1.00. CONCLUSION: Alterations in Sp O2 entropy and the fractal-like exponent have the potential to detect exacerbations in COPD. Further research is warranted to examine if Sp O2 variability analysis could be used as a novel objective method of detecting exacerbations

The clinical utility of forced oscillation technique during hospitalisation in patients with exacerbation of COPD

Background: Forced Oscillation Technique (FOT) is an innovative tool to measure within-breath reactance at 5 Hz (ΔXrs5Hz) but its feasibility and utility in acute exacerbations of COPD (AECOPD) is understudied. Methods: A prospective observational study was conducted in 82 COPD patients admitted due to AECOPD. FOT indices were measured and the association between these indices and spirometry, peak inspiratory flow rate, blood inflammatory biomarkers and patient-reported outcomes including assessment of dyspnoea, quality of life, anxiety and depression and frailty at admission and discharge were explored. Results: All patients were able to perform FOT in both sitting and supine position. The prevalence of expiratory flow limitation (EFL) in the upright position was 39% (32 out of 82) and increased to 50% (41 out of 82) in the supine position. EFL (measured by ΔXrs5Hz) and resistance at 5 Hz (Rrs5Hz) negatively correlated with forced expiratory volume in 1 s (FEV1); those with EFL had lower FEV1 (0.74±0.30 versus 0.94±0.36 L, p = 0.01) and forced vital capacity (1.7±0.55 versus 2.1±0.63 L, p = 0.009) and higher body mass index (27 (21-36) versus 23 (19-26) kg·m-2, p = 0.03) compared to those without EFL. During recovery from AECOPD, changes in EFL were observed in association with improvement in breathlessness. Conclusion: FOT was easily used to detect EFL during hospitalisation due to AECOPD. The prevalence of EFL increased when patients moved from a seated to a supine position and EFL was negatively correlated with airflow limitation. Improvements in EFL were associated with a reduction in breathlessness. FOT is of potential clinical value by providing a noninvasive, objective and effort-independent technique to measure lung function parameters during AECOPD requiring hospital admission

A Case Study of Princess Sumaya University for Technology (PSUT) Engineering Students’ Perceptions of Utilizing Simulation Software via Online Learning

The primary goal of this research has been to examine the perceptions related to the use of simulation software in the context of e-learning at Engineering PSUT in Jordan, which is acknowledged as one of the leading private universities in the country. The present study and a descriptive study utilized a 25-item survey given to 270 students. The research findings indicate that, according to the students’ subjective viewpoint, the effectiveness of simulation software in the context of online learning was observed to be significantly high. This observation is supported by an average score of 3.89 and a standard deviation of 0.959, indicating a relatively consistent perception among the participants. The study’s results indicate that there were no significant variations observed in terms of academic year, computer skills, student GPA or gender parameters. The research findings underscore the importance of incorporating simulation software in higher educational institutions to improve the teaching and learning experience

E-cigarette use among male smokers in Al-Ahsa, Kingdom of Saudi Arabia : a cross-sectional study

E-cigarette use is increasing globally. Recent evidence suggests that e-cigarettes contain harmful substances that could cause adverse health outcomes. This study investigated the prevalence and associated factors of e-cigarette use among male current smokers in Saudi Arabia. We conducted a cross-sectional survey of adult male current smokers in the Al-Ahsa province of Saudi Arabia. Data were collected using a structured questionnaire. We performed logistic regression analyses to investigate the factors associated with e-cigarette use among adult male current smokers. 325 current smokers participated in the study. A third of them (33.5%) were e-cigarette users. Almost all the study participants (97.0%) had heard about e-cigarettes. Participants who were occasional smokers (Odds Ratio (OR): 2.28; 95% Confidence Interval (CI): 1.17–4.41) and had good knowledge perception of e-cigarettes (OR 3.49; 95% CI: 2.07–5.90) had higher odds of using e-cigarettes when compared to regular smokers of conventional cigarettes and current smokers with poor knowledge perception of e-cigarettes, respectively. In contrast, private employees (OR: 0.25, 95% CI: 0.07–0.85), and business owners (OR: 0.09, 95% CI: 0.01–0.63) had lower odds of using e-cigarettes compared to unemployed individuals. Compared with non-e-cigarette users, the rate of conventional cigarette smoking per day was significantly lower among e-cigarette users. Use of e-cigarette (OR: 3.57, 95% CI: 2.14–5.98), believing that e-cigarette quitting is hard (OR: 2.02, 95% CI: 1.17–3.49) and trying to quit e-cigarettes (OR: 2.17, 95% CI: 1.1–4.25) were found to be significant predictors of good knowledge perception of e-cigarettes among the current smokers. The use and knowledge perception of e-cigarettes were higher among occasional conventional male cigarette smokers than regular male smokers in Al-Ahsa province. The use of e-cigarettes as smoking cessation aids should be examined further in the Saudi Arabian setting. © 2022 by the authors