Satisfaction survey on the critical care response team services in a teaching hospital

Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC), National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT).Methods: Our hospital has 900 beds. A self-administered survey was given onsite to all ward nurses. Survey items were identified, discussed, reviewed, piloted, and finalized over a 3-month period in a focus group discussion format during three CCRT core group meetings. Responses were anonymous and collected by the nurses onsite.Results: The total number of returned and analyzed surveys was 274 (98.6%). Ninety-seven percent agreed that CCRT staff arrived in a timely manner. Ninety-four percent reported that CCRT staff helped in managing sick patients and ~70% reported that it strengthened team dynamics. Only 50% of the nurses felt CCRT staff improved competence at the bedside. The overall satisfaction was 100%; none of the nurses were dissatisfied with the team.Conclusion: The CCRT helped manage sick patients in the wards. However, CRRT staff should remember to involve and communicate with the team initiator and the patient’s physician to optimize patient health care.Keywords: rapid response team, medical emergency team, critical care response team, satisfactio

Acute renal failure and severe rhabdomyolysis in a patient with resistant thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disorder. This paper describes the case of a 39-year-old Sudanese male who presented to the emergency room with fever, jaundice, decreased level of consciousness, and worsening kidney function for 7 days, a high lactate dehydrogenase level (1947), severe thrombocytopenia (platelets 8), and numerous schistocytes in the peripheral blood smear. The patient was admitted with a diagnosis of TTP for plasma exchange. Fourteen days later, his creatinine kinase (CK) level rose to >50,000 IU; rhabdomyolysis was suggested. Continuous venovenous hemodialysis (CVVHD) was started. The patient’s CK level remained high, despite CVVHD, until the 6th day, after which this parameter gradually started to decrease. This report highlights a resistant case of TTP that presented with concomitant severe rhabdomyolysis, which demanded aggressive, continuous intervention

Evaluation and Comparison of Efficacy of Gluma® and D/Sense® Desensitizer in the Treatment of Root Sensitivity Induced by Non-Surgical Periodontal Therapy

BACKGROUND: Dentinal hypersensitivity is one of the most common sequels of non-surgical periodontal therapy. Resulted discomfort may restrain patients from oral hygiene maintenance, thus affects the long-term success of periodontal therapy. So, it becomes a prime concern of the clinician to manage the post-operative hypersensitivity. AIM: This clinical investigation aimed to evaluate and compare the efficacy of D/Sense® and Gluma® in preventing post-operative sensitivity after non-surgical periodontal therapy. MATERIAL AND METHODS: The present randomised, double-blind, split-mouth study was conducted on forty-five (22 male, 23 female) systemically healthy patients, with the mean age of 40 ± 17.5 years. Visual Analogue scale was used to evaluate root sensitivity after application of tactile and cold stimuli at baseline, 1, 2, 4 and 6 weeks after scaling and root planing. After scaling and root planning, the sites were randomly divided into different groups for the application of desensitising agents. Collected data were analysed by using, analysis of variance (ANOVA) for inter-group and paired t-test for intra-group comparisons. RESULTS: No adverse or side effects were reported by any of the patients throughout the study period. Gluma® showed a statistically significant reduction in the VAS score for root sensitivity as compared to D/Sense®, at 1, 2- and 4-weeks follow-up period (p < 0.05). Whereas, at 6th-week follow-up, both the solution showed almost similar score for root hypersensitivity. Intragroup comparison for D/Sense® revealed a significant difference in scores from baseline to all intervals (p < 0.05), except baseline to 6 weeks (p > 0.05). Whereas Gluma® showed a significant difference in scores from baseline to 2nd-week follow-up (p < 0.05). CONCLUSION: The result of the present investigation revealed that application of Gluma® resulted in better control on iatrogenic root hypersensitivity as compared to the D/Sense® during the initial follow-up period

From Compressive Sensing to Machine Learning in Smart Grids

Traditional power grids are a single-layered physical system, while smart grids are an extension of traditional power grids that are cyber-physical networks, and the main difference is smart grids include an information layer. There is a huge amount of information being managed within recent smart grids, and the decentralized power generation adds an extra level of uncertainty to smart grids. The standard methods of monitoring and security available cannot work as expected when collecting and analyzing the large amount of data presented from different parameters in the power network. Compressive sensing is a signal processing tool that is used to monitor single and simultaneous fault locations in smart distribution and transmission networks, to detect harmonic distortions, and to recognize patterns of partial discharge. Compressive sensing reduces the measurement cost and the management cost since it can detect or rebuild a signal from very few samples. In this thesis, we propose to design and implement the fault detection via a feedforward neural network using similar regularizations as in compressive sensing. We shall use the adaptivity of neural networks to tackle with state changes in the smart grid, proving the scalability and the decentralized capability of a neural network for fault detection in the grid. Two codes have been created against two different databases, and it was found that indeed, a feedforward autoencoder would be great at fault detection, however, many things should be considered prior to implementing it on a large scale. The most important part of any autoencoder generation is a good dataset

Academic Occupational Bullying at King Saud University : Implications and Suggested Measures to Combat it التنمر المهني الأكاديمي بجامعة الملك سعود: الآثار والإجراءات المقترحة لمكافحته

الملخص: هدفت الدراسة إلى التعرف على آثار التنمر المهني، والإجراءات المقترحة لمكافحته من وجهة نظر الأكاديميين بجامعة الملك سعود، والكشف عن وجود فروق ذات دلالة إحصائية في استجابة العينة على تساؤلي الدراسة وفق متغيري الجنس والرتبة العلمية. وقد تكونت عينة الدراسـة من 361 أكاديميا من الذكور والإناث من مختلف التخصصات، حيث تم اختيارهم بالطريقة العشوائية الطبقية من مجتمع الدراسة، وقد استخدمت الباحثة المنهج الوصفي التحليلي، ولتحقيق أهداف الدراسة صممت الباحثة استبانة، تكونت من (27) فقرة، كما استخدمت الدراسة للمعالجة الإحصائية للبيانات، المتوسطات الحسابية والانحرافات المعيارية، واختبار (ت)، وتحليل التباين الأحادي، وأظهرت نتائج الدراسة أن محور آثار التنمر المهني قد حصل على درجة موافقة كبيرة من الأكاديميين بالجامعة، وكان من هذه الآثار التي نالت على درجة موافقة كبيرة جدا: غياب روح العمل الجماعي، تراجع الروح المعنوية، وغياب علاقات الألفة والتواد بين زملاء العمل، بينما حصل محور الإجراءات المقترحة لمكافحة التنمر المهني على درجة موافقة كبيرة جدا من الأكاديميين بالجامعة، ومن هذه الإجراءات التي حصلت على درجة موافقة كبيرة جدا، وضع سياسة لمكافحة التنمر المهني بالجامعة، وضع إدارة الجامعة إطار لتغيير ثقافة التساهل مع التنمر والتغاضي عنه في بيئة العمل، وإدراك الأكاديميين بالجامعة لسياسة مكافحة التنمر وقواعدها المكتوبة. كما أظهرت نتائج الدراسة عدم وجود فروق ذات دلالة إحصائية وفق متغيري الجنس والرتبة العلمية. Abstract: The study aimed to identify the Implications of Occupational bullying, and the Suggested measures to combat it from the academics\u27 point of view at King Saud University, and to reveal the presence of statistically significant differences in the sample\u27s response to the two questions of the study according to the variables of gender and academic rank. The study sample consisted of (361) male and female academics from various disciplines, who were chosen by random stratified method from the study population. For the statistical treatment of the data, the Study used arithmetic averages and standard deviations, t-test, and one-way analysis of variance, and the results of the study showed that the domain of the Implications of occupational bullying has obtained a great degree of approval from academics at the university, and among these Implications that obtained a very large degree of approval: the absence of teamwork spirit, declining morale , and the absence of familiarity and affection between co-workers, while the domain of the Suggested measures to combat occupational bullying obtained a very large degree of approval from the university’s academics, and among these measures, which obtained a very large degree of approval, the development of a policy to combat occupational bullying at the university, the university administration set a framework for changing the culture of Tolerating and condoning bullying in the work environment, university academics\u27 awareness of anti-bullying policy and its written rules. The results of the study also showed that there were no statistically significant differences according to the variables of gender and academic rank

Estrogen : molecular mechanisms of antidiabetic action

The pathogenesis of metabolic syndrome is multifactorial and hormones play an essential role in its development. Estrogen loss in postmenopausal women has been linked to several features of metabolic syndrome, while estrogen replacement therapy reverses these pathological and metabolic features. However, estrogen replacement therapy is associated with adverse effects including breast cancer and coagulopathy. Therefore, identification of the molecular mechanisms of estrogen’s beneficial effects would give the possibility to target them directly and to prevent the undesirable side effects. In this study, administration of 17β-estradiol (E2) in a perimenopausal mouse model maintained on a high fat diet (HFD) for 10 months results in improved glycemic control and body weight reduction, in association with multiple molecular mechanisms in the visceral adipose tissue (Paper 1) and liver (Paper 2) without suppression of inflammatory mediators in these organs (Paper 3). In visceral adipose tissue, E2 administration results in an anti-obesogenic effect and a reduction of adipocyte size in parallel with molecular mechanisms, including the activation of the lipolytic enzyme pnpla2, the suppression of lipogenic gene expression possibly through downregulating the expression levels of the nuclear receptor nr2c2/tr4, and the induction of brown adipose tissue-specific gene expression via E2-dependent alterations in methylation levels (Paper 1). In liver, E2 treatment induces activation of hepatic AMPK, which results in the suppression of hepatic lipogenesis via inhibition of NR2C2/TR4, and in the inhibition of gluconeogenesis through suppression of transcript levels of the gluconeogenic g6pc; E2 treatment also normalizes hepatic triglycerides through the suppression of lipogenesis and the activation of triglyceride mobilization; the summative effect of these events results in improvements in hepatic insulin signaling (Paper 2). E2 induces increased expression levels of pro-inflammatory mediators in the visceral adipose, which does not impact upon the positive actions of E2 on body weight, fasting blood glucose levels, and glycemic control (Paper 3). The reductions induced by E2 in the plasma levels of adiponectin, and in its mRNA levels in adipose tissue, could explain the continued elevated expression levels of these mediators. Tracing the events of metabolic pathogenesis due to ovariectomy-related estrogen loss in an ovariectomized mouse model shows that estrogen signaling appears to suppress features of hepatic insulin resistance resulting from short-term HFD exposure by opposing the continuous accumulation of hepatic triglycerides, and via reduced expression levels of gluconeogenic genes (Paper 4). Ovariectomy resulted in weight gain, elevation of fasting blood glucose levels, increased hepatic triglycerides and increases in expression levels of nr2r2/tr4 and the pro-inflammatory tlr2, independently of dietary intervention. In conclusion, the current study highlights significant molecular mechanisms responsible for the effects of estrogen in relation to features of metabolic syndrome, giving the possibility to target them directly and to prevent the undesirable side effects of systemic E2 treatment

Contemporary Endodontic Sealers

Endodontic treatment over goes multiple phases to ensure long term successful outcome. Starting with an accurate diagnosis and treatment planning, through proper debridement and disinfection of the root canal system. Finally maintaining a sterile environment of the pulpal space, by filing its root’s with an inert biocompatible material and securing it with a final restoration, a process known as obturation. Accordingly, quality of the seal was shown to be an influencing factor in the long term success of an endodontic treatment, as root canal obturation act as a barrier isolating both periapical tissue and radicular space from ingress of microbial contaminant, and promotes healing as it entombs any remaining pulpal or microbial irritants. (1)(2) Traditionally, root canal obturation consist of a core material most typically gutta-percha (GP), and some sort of an endodontic sealant to produce a homogenous filling. (3) These Sealers play a major role in obturation by overcoming the physical limitation of the core material, they help to seal minor anomalies, accessory canals and foramina, and fill any voids between root canal walls and core material. (4)  Sealers also facilitate placement of core material. (5)(6) While the broader objective of these sealers is to ban microbial ingress, some sort of micro leakage does occur in almost all types of sealant used. (7) Apart from antimicrobial activities, ideal properties desired in an endodontic sealer were outlined by Grossman. These sealers must be biocompatible or at least non-toxic, insoluble in tissue fluids but dissolve in retreatment solvent, and must display excellent sealing ability. Other include; appropriate adhesion to dentinal walls, bacteriostatic, dimensionally stable, provide adequate working time, radiopaque, and must not stain the tooth. (8) Unfortunately, no available sealer displays all of these properties yet. (9) In light of this, selection of any type of an endodontic sealer could therefore affect treatment outcome. (10-13) Root canal sealers are available in various quantities and have been grouped in a number of arrangement according to either their chemical composition, usage, or tissue absorbance (14) This paper will touch upon conventional ones and will attempt to introduce contemporary and new ones

العوامل المؤثرة في تقبل الفصول الافتراضية لدى طلبة كلية التربية الأساسية بالكويت في ضوء نموذج قبول التقنية TAM - Factors influencing the acceptance of virtual classes among students of the Faculty of Basic Education in Kuwait in light of the TAM technology acceptance model

من أهم معايير نجاح استخدام التكنولوجيا في التعليم هو رضى المستفيدين منها وتقبلهم لها. لذا هدف هذا البحث إلى الكشف عن العوامل المؤثرة على تقبل الفصول الافتراضية لدى طلبة كلية التربية الأساسية في دولة الكويت في ضوء نموذج قبول التقنية TAM . ولتحقيق أهداف البحث واختبار فرضياته، تم استخدام المنهج المسحي، واختيار عينة قصدية بلغت ) 400 ( من طلبة كلية التربية الأساسية في الكويت خلال الفصل الأول من العام الجامعي 2018 - 2019م، وتمثلت أدوات البحث في إعداد وتصميم استبانة تكونت من ثلاثة أجزاء رئيسية، وبعد جمع بيانات البحث وتحليلها احصائياً أثبتت النتائج وجود علاقة إيجابية بين النية لاستخدام الفصول الافتراضية وعوامل الفائدة المحققة وسهولة استخدام تقنية التعليم المتاحة في الفصول الافتراضية لدى طلبة كلية التربية الأساسية في الكويت، وكذلك علاقة إيجابية بين العوامل المستقلة) الدعم الفني، التفاعل في التعليم، والكفاءة الذاتية (والفائدة المحققة، وسهولة استخدام تقنية التعليم المتاحة في الفصول الاف تراضية لديهم، وعلاقة إيجابية أيضاً بين العوامل المستقلة الدعم الفني، التفاعل في التعليم والكفاءة الذاتية( ونية الطلبة حول استخدام الفصول الافتراضية من خلال الفائدة المحققة وسهولة الاستخدام كعوامل وسيطة لدى الطلبة، إلا أنه لا يوجد تأثير لنوع جنس الطلبة في قبولهم لاستخدام التقنيات المتاحة في الفصول الافتراضية، ويوجد تأثير للخبرة في ذلك، وتم الانتهاء بذكر عدد من التوصيات التطبيقية لنتائج البحث. ***************************************************************************** The successful use of technology in education relies primarily on the satisfaction and acceptance of its beneficiaries. This research aims to reveal the factors influencing the understanding of students of Faculty of Education in Kuwait for the virtual classrooms in the light of their acceptance for the TAM Technique. Survey methodology and selection of 400 students from Faculty of Education in Kuwait as a sample during the first semester in the academic year 2018-2019 are two methods used to achieve the goals of the research and test its hypotheses. The research develops a questionnaires consists of three major parts. After collecting and analysing the data statistically ,the results proves that there is a positive relationship between the intent of using virtual classrooms, usefulness factors and the ease of using technical education in virtual classrooms for the students in Faculty of Education in Kuwait. The research also shows that there is a positive relationship betweet the independent factors such as (technical support, interactions in teaching and self-efficacy) and the usefulness and the ease of using technical education in virtual classrooms for the students. Another positive relationship is discussed by this research connects the independent factors (technical support , interactions in teaching and self-efficacy) , the students' intention of using the virtual classrooms through the usefulness and the ease of use as a feedstock for them. Besides , it is indicated that the gender of the students has no effection in their acceptance for using the information technology in virtual classrooms however the experience palys a vital role in that. The research concludes with a mention of some applied recommendations for the results of this research

Efficacy of calcium sodium phosphosilicate containing dentifrice in reducing dentin hypersensitivity compared to other dentifrices with dentin tubule occluding molecules: A systematic review

Purpose: To assess the effectiveness of calcium sodium phosphosilicate in reducing dentin hypersensitivity compared to other dentin tubule occluding molecules. Methods: A structured research question was formulated, and an electronic search of available literature was carried out via PubMed, Google Scholar, and Scopus. A hand search as well as a gray literature search were also carried out. The search produced a total of 67 articles. Of these, only eight articles were eligible to be included in our review. Risk of bias and study quality were checked using Cochrane tool. The review was registered in The International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42018096200. Results: The results show a reduction in dentin hypersensitivity with calcium sodium phosphosilicate compared to many other molecules. However, nanohydroxyapatite showed a better desensitizing effect compared to Novamin. Conclusion: According to the available evidence, 5 % calcium sodium phosphosilicate containing toothpaste is more effective reducing dentin hypersensitivity compared to many other dentinal tubule occluding molecules