Strategic Spatial Planning Consideration in the Kingdom Vision 2030 and National Physical Planning Plan: Utilizing Content Analysis Methodology for Evaluation and Comparison

Urban and regional planning over the time pass through a lot of changes in the 20th century and have been impacted by economic, social and environmental problems. However, old traditional planning approaches were replaced by sustainable approaches to avoid the limitations and improve the results. One of these new approaches known as strategic spatial planning which defined as a long term perspective with clear methodology and strategic vison for critical and important issues in all aspects of economic, social and environment as well as involve stakeholders in this vision through focusing on spatial aspects to achieve sustainable development. The aim of this study is to analyze the content of vision 2030 for Saudi Arabia based on the perspective of spatial strategic planning and compare it with the content of urban national strategy through using same base line. The purpose of this comparison is to explore the achievement of spatial development considerations in the 2030 vision. The literatures review helps to identify the key aspects of strategic spatial planning (economic, social, environmental), as well as identify important considerations associated with each one of them. However, eight considerations were associated with the economical aspect and seven considerations were associated with the social aspect. While, there are five considerations associated with the environmental aspect. By applying content analyses approach; the quantitative analysis of repetitions of the spatial considerations was high in the urban strategy rather than vision 2030 in the overview context. Moreover, there is homogeneity for spatial considerations in the urban strategy with more clarity than vision 2030. Based on the repetitions of spatial considerations in 2030 vision; the vision is focusing more on the economical aspect, social aspect then environmental aspect

Repeatability and Diurnal Variation of Tear Ferning Test

This is a non-final version of an article published in final form in: Masmali, A. M., Al-Bahlal, J. M., El-Hiti, G. A., Akhtar, S., Purslow, C., Murphy, P. J., & Almubrad, T. (2015). Repeatability and Diurnal Variation of Tear Ferning Test: Eye & Contact Lens: Science & Clinical Practice, 41(5), 262–267. https://doi.org/10.1097/ICL.0000000000000116Objectives: To investigate tear ferning (TF) test repeatability between sessions by observing changes in the tear fern pattern during the day. Methods: Twenty-three healthy young adults (15 men and 8 women), ranging in age from 20 to 32 years (mean±SD: 22.9±3.3 years) without signs or symptoms of dry eye disease, ocular disease, or contact lens wear were enrolled in the study. Schirmer I, tear break-up time (TBUT) test, and McMonnies questionnaire were used to screen volunteers. Schirmer I and TBUT tests were applied to both eyes in each subject. Four samples of tear fluid were collected from the right eye of each subject using glass capillaries at set intervals during a single day (9 AM, 11 AM, 2 PM, and 4 PM). The TF patterns obtained from samples were classified according to the Masmali TF grading scale to increments of 0.1. Results: The median values obtained from the McMonnies, Schirmer, and TBUT tests were 4.0±2.0, 30.0±7.0 mm (OD), and 16.0±10.0 sec (OD), respectively. There were no statistically significant differences between the TF grades for tear samples collected at different times of the day (Wilks' Lambda, P=0.351). The majority (84.8%) of TF grades was between 0.0 and 1.5; the remaining 15.2% of subjects had TF between grades 1.6 and 1.9. The overall mean grade for the TF was 1.1±0.3. There were small insignificant correlations between TF grades and the McMonnies questionnaire (r=0.1.30) and TBUT (r=0.248) and a negligible correlation with Schirmer test (r=−0.046). Conclusions: The results found no significant differences within the TF for tear samples collected at different times of the day, suggesting that there is little diurnal variation evident.The authors extend their appreciation to the College of Applied Medical Sciences Research Center and the Deanship of Scientific Research at King Saud University for its funding of this research

Development and Validation of R-hf Risk Score in Acute Heart Failure Patients in the Middle East

Objectives: The Rajan’s heart failure (R-hf) score was proposed to aid risk stratification in heart failure patients. The aim of this study was to validate R-hf risk score in patients with acute decompensated heart failure. Methods: R-hf risk score is derived from the product estimated glomerular filtration rate (mL/min), left ventricular ejection fraction (%), and hemoglobin levels (g/dL) divided by N-terminal pro-brain natriuretic peptide (pg/mL). This was a multinational, multicenter, prospective registry of heart failure from seven countries in the Middle East. Univariable and multivariable logistic regression was applied. Results: A total of 776 patients (mean age = 62.0±14.0 years, 62.4% males; mean left ventricular ejection fraction = 33.0±14.0%) were included. Of these, 459 (59.1%) presented with acute decompensated chronic heart failure. The R-hf risk score group (≤ 5) was marginally associated with a higher risk of all-cause cumulative mortality at three months (adjusted odds ratio (aOR) = 4.28; 95% CI: 0.90–20.30; p =0.067) and significantly at 12 months (aOR = 3.84; 95% CI: 1.23–12.00; p =0.021) when compared to those with the highest R score group (≥ 50). Conclusions: Lower R-hf risk scores are associated with increased risk of all-cause cumulative mortality at three and 12 months

Demystifying Smoker's Paradox: A Propensity Score-Weighted Analysis in Patients Hospitalized With Acute Heart Failure.

Background Smoker's paradox has been observed with several vascular disorders, yet there are limited data in patients with acute heart failure (HF). We examined the effects of smoking in patients with acute HF using data from a large multicenter registry. The objective was to determine if the design and analytic approach could explain the smoker's paradox in acute HF mortality. Methods and Results The data were sourced from the acute HF registry (Gulf CARE [Gulf Acute Heart Failure Registry]), a multicenter registry that recruited patients over 10 months admitted with a diagnosis of acute HF from 47 hospitals in 7 Middle Eastern countries. The association between smoking and mortality (in hospital) was examined using covariate adjustment, making use of mortality risk factors. A parallel analysis was performed using covariate balancing through propensity scores. Of 5005 patients hospitalized with acute HF, 1103 (22%) were current smokers. The in-hospital mortality rates were significantly lower in current smoker's before (odds ratio, 0.71; 95% CI, 0.52-0.96) and more so after (odds ratio, 0.47; 95% CI, 0.31-0.70) covariate adjustment. With the propensity score-derived covariate balance, the smoking effect became much less certain (odds ratio, 0.63; 95% CI, 0.36-1.11). Conclusions The current study illustrates the fact that the smoker's paradox is likely to be a result of residual confounding as covariate adjustment may not resolve this if there are many competing prognostic confounders. In this situation, propensity score methods for covariate balancing seem preferable. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01467973.Gulf CARE (Gulf Acute Heart Failure Registry) is an investigator- initiated study conducted under the auspices of the Gulf Heart Association and funded by Servier, Paris, France; and (for centers in Saudi Arabia), by the Saudi Heart Association (The Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia [research group number: RG -1436- 013]). This does not alter our adherence to policies on sharing data and materials; and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The publication of this article was funded by the Qatar National Library

Clinical outcomes of transcatheter aortic valve replacement stratified by left ventricular ejection fraction : a single centre pilot study

Introduction: To define baseline echocardiographic, electrocardiographic (ECG) and computed tomographic (CT) findings of patients with heart failure undergoing transcatheter aortic valve replacement (TAVR) and analyze their overall procedural outcomes. Methods: Between 2018 and 2021, patients with severe aortic stenosis (AS) who performed transcatheter aortic valve replacement (TAVR) in Sabah Al Ahmad Cardiac Centre, Al Amiri Hospital were identified. A retrospective review of patients' parameters including pre-, intra-, and post-procedural data was conducted. Patients were grouped in 2 subgroups according to their EF: EF <40% (HFrEF) and EF ≥ 40%. The data included patients’ baseline characteristics, electrocardiographic and echocardiographic details along with pre-procedural CT assessment of aortic valve dimensions. Primary outcomes including post-operative disturbances, pacemaker implantation and in-hospital mortality following TAVR were additionally analyzed. Results: A total of 61 patients with severe AS underwent TAVR. The mean age was 73.5 ± 9, and 21 (34%) of the patients were males. The mean ejection fraction (EF) was 55.5 ± 9.7%. Of 61 patients, 12 (20%) were identified as heart failure with reduced EF (<40%). These patients were younger, more often males, and were more likely to have coronary artery disease (75% versus 53.1%). Left ventricular hypertrophy and diastolic dysfunction was documented in 75% and 58.3% of patients with heart failure with reduced ejection fraction (HFrEF) respectively. Post TAVR conduction disturbances, with the commonest being LBBB was observed in 41.7%. Permanent pacemaker was implanted in 3 of patients with HFrEF (25%). There were no significant differences between the two groups with regards to in hospital mortality (p = 0.618). Conclusion: Severe AS with EF <40% constitute a remarkable proportion of patients undergoing TAVR. Preliminary results of post-operative conduction disturbances and in hospital mortality in HFrEF patients were concluded to not differ from patients with LVEF ≥40%

Self-reported health status of older adults in Malaysia and Singapore: evidence from the 2007 Global Ageing Survey

The aim of this study is to investigate the correlates of self-reported health (SRH) among older adults in Malaysia and Singapore. The study uses data collected in the Global Ageing Study (GLAS) 2007, one of the largest surveys of its kind, specially designed to investigate attitudes towards later life, ageing and retirement. Data were collected from 1002 and 1004 respondents from Malaysia and Singapore respectively. The study found that Singaporeans report a healthier life than Malaysians. The two countries have consistent results with regard to the influences of selected covariates on individual health. Poorer health is more prevalent among people with lower education, among those widowed, divorced or separated, and those working in blue-collar occupations. Although social support is found to be an important determinant of SRH, the effects are partially confounded with other covariates. These findings enhance our knowledge about the health status of older people, and in turn will be useful for governments to ensure effective policy making

High Density Lipoprotein (HDL) Promotes Glucose Uptake in Adipocytes and Glycogen Synthesis in Muscle Cells

Background: High density lipoprotein (HDL) was reported to decrease plasma glucose and promote insulin secretion in type 2 diabetes patients. This investigation was designed to determine the effects and mechanisms of HDL on glucose uptake in adipocytes and glycogen synthesis in muscle cells. Methods and Results: Actions of HDL on glucose uptake and GLUT4 translocation were assessed with 1- [ 3 H]-2deoxyglucose and plasma membrane lawn, respectively, in 3T3-L1 adipocytes. Glycogen analysis was performed with amyloglucosidase and glucose oxidase-peroxidase methods in normal and palmitate-treated L6 cells. Small interfering RNA was used to observe role of scavenger receptor type I (SR-BI) in glucose uptake of HDL. Corresponding signaling molecules were detected by immunoblotting. HDL stimulated glucose uptake in a time- and concentration-dependent manner in 3T3-L1 adipocytes. GLUT4 translocation was significantly increased by HDL. Glycogen deposition got enhanced in L6 muscle cells paralleling with elevated glycogen synthase kinase3 (GSK3) phosphorylation. Meanwhile, increased phosphorylations of Akt-Ser473 and AMP activated protein kinase (AMPK) a were detected in 3T3-L1 adipocytes. Glucose uptake and Akt-Ser473 activation but not AMPK-a were diminished in SR-BI knock-down 3T3-L1 cells. Conclusions: HDL stimulates glucose uptake in 3T3-L1 adipocytes through enhancing GLUT4 translocation by mechanisms involving PI3K/Akt via SR-BI and AMPK signaling pathways, and increases glycogen deposition in L6 muscle cells throug

Farnesoid X Receptor Induces Murine Scavenger Receptor Class B Type I via Intron Binding

Farnesoid X receptor (FXR) is a nuclear receptor and a key regulator of liver cholesterol and triglyceride homeostasis. Scavenger receptor class B type I (SR-BI) is critical for reverse cholesterol transport (RCT) by transporting high-density lipoprotein (HDL) into liver. FXR induces SR-BI, however, the underlying molecular mechanism of this induction is not known. The current study confirmed induction of SR-BI mRNA by activated FXR in mouse livers, a human hepatoma cell line, and primary human hepatocytes. Genome-wide FXR binding analysis in mouse livers identified 4 putative FXR response elements in the form of inverse repeat separated by one nucleotide (IR1) at the first intron and 1 IR1 at the downstream of the mouse Sr-bi gene. ChIP-qPCR analysis revealed FXR binding to only the intronic IR1s, but not the downstream one. Luciferase assays and site-directed mutagenesis further showed that 3 out of 4 IR1s were able to activate gene transcription. A 16-week high-fat diet (HFD) feeding in mice increased hepatic Sr-bi gene expression in a FXR-dependent manner. In addition, FXR bound to the 3 bona fide IR1s in vivo, which was increased following HFD feeding. Serum total and HDL cholesterol levels were increased in FXR knockout mice fed the HFD, compared to wild-type mice. In conclusion, the Sr-bi/SR-BI gene is confirmed as a FXR target gene in both mice and humans, and at least in mice, induction of Sr-bi by FXR is via binding to intronic IR1s. This study suggests that FXR may serve as a promising molecular target for increasing reverse cholesterol transport

Vitamin D supplementation for the prevention of type 2 diabetes in overweight adults: study protocol for a randomized controlled trial

Despite Australia's sunny climate, low vitamin D levels are increasingly prevalent. Sun exposure is limited by long working hours, an increase in time spent indoors, and sun protection practices, and there is limited dietary vitamin D fortification. While the importance of vitamin D for bone mineralization is well known, its role as a protective agent against chronic diseases, such as type 2 diabetes and cardiovascular disease, is less understood. Observational and limited intervention studies suggest that vitamin D might improve insulin sensitivity and secretion, mainly via its anti-inflammatory properties, thereby decreasing the risk of development and progression of type 2 diabetes. The primary aim of this trial is to investigate whether improved plasma concentrations of 25-hydroxyvitamin D (25(OH)D), obtained through vitamin D supplementation, will increase insulin sensitivity and insulin secretion. A secondary aim is to determine whether these relationships are mediated by a reduction in underlying subclinical inflammation associated with obesity.Fifty overweight but otherwise healthy nondiabetic adults between 18 and 60 years old, with low vitamin D levels (25(OH)D < 50 nmol/l), will be randomly assigned to intervention or placebo. At baseline, participants will undergo a medical review and anthropometric measurements, including dual X-ray absorptiometry, an intravenous glucose tolerance test, muscle and fat biopsies, a hyperinsulinemic euglycemic clamp, and questionnaires assessing diet, physical activity, sun exposure, back and knee pain, and depression. The intervention group will receive a first dose of 100,000 IU followed by 4,000 IU vitamin D (cholecalciferol) daily, while the placebo group will receive apparently identical capsules, both for a period of 16 weeks. All measurements will be repeated at follow-up, with the primary outcome measure expressed as a change from baseline in insulin sensitivity and secretion for the intervention group compared with the placebo group. Secondary outcome measures will compare changes in anthropometry, cardiovascular risk factors, and inflammatory markers.The trial will provide much needed clinical evidence on the impact of vitamin D supplementation on insulin resistance and secretion and its underlying mechanisms, which are relevant for the prevention and management of type 2 diabetes.Clinicaltrials.gov ID: NCT02112721 .Barbora de Courten, Aya Mousa, Negar Naderpoor, Helena Teede, Maximilian P J de Courten and Robert Scrag