A systematic review of the efficiency of radiation protection training in raising awareness of medical staff working in catheterisation laboratory

The purpose of this study is to conduct a systematic review of the efficiency of radiation protection (RP) training in minimising the radiation dose to both medical staff and patients. The literature search for the relevant articles was performed using five different databases which included Scopus, Science Direct, PubMed, Medline and ProQuest. The search covered English language publications in the period between 2000 and 2014. The search was also limited to peer-reviewed articles on human subjects and reporting patient doses, staff doses or both before and after RP training. The dose reductions were compared using percentage calculations. Ten articles met the inclusion criteria and were included in the study. Seven of these studies showed the value of the RP training by measuring the patient dose and the fluoroscopy time (FT) pre- and post-training, whereas the remaining two of the three studies focused on the occupational doses only and one reported patient and staff doses as well as the FT. After receiving training, a reduction was found in patient doses and FT with a mean and standard deviation of 49% ± 0.15 and 12% ± 0.15, respectively. Additionally, the analysis displayed an occupational dose reduction by a mean and standard deviation of 72% ± 0.14 after receiving training. This review shows the necessity and efficacy of RP training in order to provide a safer environment when utilising the fluoroscopic image-guided machines by medical staff working in the catheterisation laboratory

A reinforcement learning recommender system using bi-clustering and Markov Decision Process

Collaborative filtering (CF) recommender systems are static in nature and does not adapt well with changing user preferences. User preferences may change after interaction with a system or after buying a product. Conventional CF clustering algorithms only identifies the distribution of patterns and hidden correlations globally. However, the impossibility of discovering local patterns by these algorithms, headed to the popularization of bi-clustering algorithms. Bi-clustering algorithms can analyze all dataset dimensions simultaneously and consequently, discover local patterns that deliver a better understanding of the underlying hidden correlations. In this paper, we modelled the recommendation problem as a sequential decision-making problem using Markov Decision Processes (MDP). To perform state representation for MDP, we first converted user-item votings matrix to a binary matrix. Then we performed bi-clustering on this binary matrix to determine a subset of similar rows and columns. A bi-cluster merging algorithm is designed to merge similar and overlapping bi-clusters. These bi-clusters are then mapped to a squared grid (SG). RL is applied on this SG to determine best policy to give recommendation to users. Start state is determined using Improved Triangle Similarity (ITR similarity measure. Reward function is computed as grid state overlapping in terms of users and items in current and prospective next state. A thorough comparative analysis was conducted, encompassing a diverse array of methodologies, including RL-based, pure Collaborative Filtering (CF), and clustering methods. The results demonstrate that our proposed method outperforms its competitors in terms of precision, recall, and optimal policy learning

Diode laser photoacoustic spectroscopy of CO2, H2S and O2 in a differential Helmholtz resonator for trace gas analysis in the biosciences and petrochemistry

Photoacoustic spectroscopy in a differential Helmholtz resonator has been employed with near-IR and red diode lasers for the detection of CO2, H2S and O2 in 1 bar of air/N2 and natural gas, in static and flow cell measurements. With the red distributed feedback (DFB) diode laser, O2 can be detected at 764.3 nm with a noise equivalent detection limit of 0.60 mbar (600 ppmv) in 1 bar of air (35-mW laser, 1-s integration), corresponding to a normalised absorption coefficient α = 2.2 × 10−8 cm−1 W s1/2. Within the tuning range of the near-IR DFB diode laser (6357–6378 cm−1), CO2 and H2S absorption features can be accessed, with a noise equivalent detection limit of 0.160 mbar (160 ppmv) CO2 in 1 bar N2 (30-mW laser, 1-s integration), corresponding to a normalised absorption coefficient α = 8.3 × 10−9 cm−1 W s1/2. Due to stronger absorptions, the noise equivalent detection limit of H2S in 1 bar N2 is 0.022 mbar (22 ppmv) at 1-s integration time. Similar detection limits apply to trace impurities in 1 bar natural gas. Detection limits scale linearly with laser power and with the square root of integration time. At 16-s total measurement time to obtain a spectrum, a noise equivalent detection limit of 40 ppmv CO2 is obtained after a spectral line fitting procedure, for example. Possible interferences due to weak water and methane absorptions have been discussed and shown to be either negligible or easy to correct. The setup has been used for simultaneous in situ monitoring of O2, CO2 and H2S in the cysteine metabolism of microbes (E. coli), and for the analysis of CO2 and H2S impurities in natural gas. Due to the inherent signal amplification and noise cancellation, photoacoustic spectroscopy in a differential Helmholtz resonator has a great potential for trace gas analysis, with possible applications including safety monitoring of toxic gases and applications in the biosciences and for natural gas analysis in petrochemistry

Work-Related Musculoskeletal Symptoms in Otorhinolaryngology-Head and Neck Surgery Residents

Objectives: Work-related musculoskeletal disorders in Saudi Arabia are not often reported in the literature. This study aimed to identify musculoskeletal symptoms among otorhinolaryngology residents in Saudi Arabia. Methods: This cross-sectional survey-based study was conducted in May 2018 and included residents registered in the Saudi Otorhinolaryngology-Head and Neck Surgery Board Training programme, Riyadh, Saudi Arabia. The Nordic Musculoskeletal Questionnaire was used to assess musculoskeletal symptoms in addition to demographic and occupational factors, including operating position and the average number of operating hours. Results: A total of 45 residents (response rate: 68.2%) completed the survey, including 33 males (73.3%) and 12 females (26.7%). Most residents (91.1%) reported at least one musculoskeletal symptom. The most commonly reported musculoskeletal over the previous 12 months were shoulder complaints (64.4%) followed by neck complaints (60%). In the short term (i.e. within seven days preceding the survey), neck complaints were more common than shoulder complaints (28.9% versus 20%). Lower back complaints were the most common cause of activity limitation (24.4%) followed by shoulder complaints (13.3%), while those with neck complaints reported it as a cause for visiting a physician (8.9%). Hip and thigh complaints were significantly more frequent among residents with operation times of eight hours or more compared to those who operating for less than eight hours (42.9% versus 5.9%; P = 0.021). Conclusion: A high incidence of shoulder, neck and lower back complaints was found in this study. Residency is an ideal time in an otorhinolaryngologist’s career to implement programmes in ergonomic best practices before bad habits are developed.Keywords: Otorhinolaryngology; Musculoskeletal Abnormalities; Symptoms and Signs; Workplace; Ergonomics; Saudi Arabia

Acute Appendicitis among Saudi and Non-Saudi Patients: A Cross-Sectional Based Study

Objective: We conduct this study to discuss the differences between Saudi and non- Saudi patients with acute appendicitis.Background: Acute appendicitis is one of emergency surgeries in developing and developed countries. Its symptoms are vomiting, lower abdominal pain and decreased appetite. Appendicitis needs urgent surgical prouder to avoid its perforation and associated complications which may lead to death. Method: We conduct cross-sectional based study in one of khamis Mushayt, Saudi Araba. 136 patients diagnosed with acute appendicitis were included and their medical records were reviewed after getting their informed consent.Results: We included 136 patients, 90 were non-Saudi and 46 were Saudi. There were no statistically differences in their diagnosis but the distribution of the diagnosis was different.Conclusion: Acute appendicitis was more prevalent among non-Saudi patients, the diagnosis between both was with no significant differences. Keywords: acute appendicitis, Saudi, non-Saudi, diagnosis, cross-sectional, Saudi Arabia and khamis Mushayt

Multidrug-Resistant Staphylococcus capitis: An Emerging Challenge in Clinical Settings Found in Adult Patients in Saudi Arabia

The study reveals crucial information on S. capitis, a potentially dangerous bacterium that can cause sepsis in hospitalized adult patients, including its frequency and patterns of drug resistance which could significantly contribute to the existing body of knowledge in this field. This retrospective study was conducted in the King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, from June 2019 to November 2022. The comprehensive data collection and analysis provide valuable information on the prevalence of S. capitis in different infection sites, antibiotic sensitivity profiles, and the association with patient demographics. A total of 219 S. capitis isolates from hospitalized patients with sepsis tested positive. Infection was most common in venous blood (139 patients, 63.5%), followed by central blood (24 patients, 11%). Other locations included venipuncture (48 patients, 21.9%) and cerebrospinal fluid (three patients, 1.4%). The results highlight the clinical significance of S. capitis as a major contributor to sepsis, especially in male patients, and emphasize the need for appropriate antibiotic selection for effective treatment. Furthermore, this study raises concerns about the high rates of methicillin resistance observed in S. capitis isolates, emphasizing the urgency in tackling antibiotic resistance and promoting judicious antibiotic prescription practices. Moreover, the identification of a decreased susceptibility to vancomycin as a potential explanation for its reduced effectiveness in treating S. capitis infections adds a crucial aspect to the discussion of treatment options and underscores the need for alternative therapeutic strategies

Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey

Background: As the global outbreak of COVID-19 continues to ravage the world, it is important to understand how frontline clinicians manage ventilatory support and the various limiting factors. / Methods: An online survey composed of 32 questions was developed and validated by an international expert panel. / Results: Overall, 502 respondents from 40 countries across six continents completed the survey. The mean number (±SD) of ICU beds was 64 ± 84. The most popular initial diagnostic tools used for treatment initiation were arterial blood gas (48%) and clinical presentation (37.5%), while the national COVID-19 guidelines were the most used (61.2%). High flow nasal cannula (HFNC) (53.8%), non-invasive ventilation (NIV) (47%), and invasive mechanical ventilation (IMV) (92%) were mostly used for mild, moderate, and severe COVID-19 cases, respectively. However, only 38.8%, 56.6% and 82.9% of the respondents had standard protocols for HFNC, NIV, and IMV, respectively. The most frequently used modes of IMV and NIV were volume control (VC) (36.1%) and continuous positive airway pressure/pressure support (CPAP/PS) (40.6%). About 54% of the respondents did not adhere to the recommended, regular ventilator check interval. The majority of the respondents (85.7%) used proning with IMV, with 48.4% using it for 12– 16 hours, and 46.2% had tried awake proning in combination with HFNC or NIV. Increased staff workload (45.02%), lack of trained staff (44.22%) and shortage of personal protective equipment (PPE) (42.63%) were the main barriers to COVID-19 management. / Conclusion: Our results show that general clinical practices involving ventilatory support were highly heterogeneous, with limited use of standard protocols and most frontline clinicians depending on isolated and varied management guidelines. We found increased staff workload, lack of trained staff and shortage of PPE to be the main limiting factors affecting global COVID-19 ventilatory support management

Overview on Juvenile Primary Fibromyalgia Syndrome

JPFS (juvenile primary fibromyalgia syndrome) is a musculoskeletal pain illness that affects children and adolescents. The intricacy of the clinical picture in JPFS has not been adequately characterized in the literature. JFMS symptoms are sometimes difficult to compare to adult fibromyalgia syndrome since many of them are "medically unexplained" and frequently overlap with other medical disorders.  The etiology of the illness is multifaceted, with impaired central pain processing being a significant contributor. Musculoskeletal pain that is severe and pervasive is the defining symptom. Other signs and symptoms include headaches, stiffness, subjective joint swelling, sleep and mood disorders, and headaches. Multiple sensitive spots might be found during a physical examination. The diagnosis has certain criteria and is clinical. Early detection and treatment are crucial. The gold standard of care combines a variety of modalities, but most significantly, exercise and cognitive behavioral therapy. The outlook varies, and symptoms might last well into adulthood. Discussing the epidemiology, etiology, pathophysiology, clinical symptoms, diagnosis, and management of JPFS is the goal of the review

Optimization of calcium carbonate precipitation during alpha-amylase enzyme-induced calcite precipitation (EICP)

The sand production during oil and gas extraction poses a severe challenge to the oil and gas companies as it causes erosion of pipelines and valves, damages the pumps, and ultimately decreases production. There are several solutions implemented to contain sand production including chemical and mechanical means. In recent times, extensive work has been done in geotechnical engineering on the application of enzyme-induced calcite precipitation (EICP) techniques for consolidating and increasing the shear strength of sandy soil. In this technique, calcite is precipitated in the loose sand through enzymatic activity to provide stiffness and strength to the loose sand. In this research, we investigated the process of EICP using a new enzyme named alpha-amylase. Different parameters were investigated to get the maximum calcite precipitation. The investigated parameters include enzyme concentration, enzyme volume, calcium chloride (CaCl2) concentration, temperature, the synergistic impact of magnesium chloride (MgCl2) and CaCl2, Xanthan Gum, and solution pH. The generated precipitate characteristics were evaluated using a variety of methods, including Thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). It was observed that the pH, temperature, and concentrations of salts significantly impact the precipitation. The precipitation was observed to be enzyme concentration-dependent and increase with an increase in enzyme concentration as long as a high salt concentration was available. Adding more volume of enzyme brought a slight change in precipitation% due to excessive enzymes with little or no substrate available. The optimum precipitation (87%) was yielded at 12 pH and with 2.5 g/L of Xanthan Gum as a stabilizer at a temperature of 75°C. The synergistic effect of both CaCl2 and MgCl2 yielded the highest CaCO3 precipitation (32.2%) at (0.6:0.4) molar ratio. The findings of this research exhibited the significant advantages and insights of alpha-amylase enzyme in EICP, enabling further investigation of two precipitation mechanisms (calcite precipitation and dolomite precipitation)

Laser Vaporization of Mouth Lesions, an Overview

Lasers are utilized in dentistry as a therapeutic tool or as an auxiliary tool. The major purpose of employing lasers in dentistry is to overcome the difficulties that are currently observed in traditional dental treatment treatments. The laser is used in hard tissue applications such as caries prevention, bleaching, restorative removal and curing, cavity preparation, dentinal hypersensitivity, growth modulation, and diagnostics, whereas soft tissue applications include wound healing, removal of hyperplastic tissue to uncover impacted or partially erupted teeth, photodynamic therapy for malignancies, and photo-stimulation of herpetic lesions. Lasers' capacity to perform minimally invasive operations with minimum patient discomfort has proven effective in the patient delivery system in dentistry practice. The availability of lasers with various wavelengths has produced a surgical panacea, and laser technology has replaced traditional surgical techniques in many oral surgical operations