THE EFFECTS OF CREDIT RISK, OPERATIONAL RISK AND LIQUIDITY RISK ON THE FINANCIAL PERFORMANCE OF INSURANCE COMPANIES LISTED AT KUWAIT STOCK EXCHANGE

This aim of this study to shed some light of the effect of risk factors on the financial performance of insurance companies listed at Kuwait stock exchange (KSE) over the period 2009-2017. The research uses credit, operational and liquidity risk as independent variables and return on assets (ROA) and return on equity (ROE) as dependent variables. Results obtained from this study showed that the financial performance of Kuwaiti insurance companies are mostly affected by operational risk and credit risk while liquidity risk does not have any statistical significant effect on their financial performance. JEL: L10; L25; G32; G22  Article visualizations

Disaster Management, Role Of Healthcare Administration, Nursing, Paramedics And Operating Room Technician

During crises like the COVID-19 epidemic, it is imperative to utilize all accessible resources in order to strengthen healthcare personnel. Several variables contribute to this process, such as choosing the groups of experts require, simplifying their licensing and credentialing procedures, determining suitable roles for them, and promoting their health and well-being. The dearth of educational initiatives is a significant problem contributing to the insufficient expertise of healthcare professionals in the realm of disaster preparedness. Therefore, it is imperative to incorporate emergency and disaster preparedness into the core medical school curricula and ongoing medical education programs offered by healthcare institutions. Extended periods of structured education, such as undergraduate and postgraduate degrees, are essential. It is recommended to conduct operational simulations that involve important personnel from many agencies. These simulations should prioritize organizational training rather than individual-based training

Development and validation of Arabic version of the Hospital Anxiety and Depression Scale

Introduction: The Hospital Anxiety and Depression Scale (HADS) is widely used to predict and diagnose hospital anxiety and depression. It has been translated and validated in many languages, but the existing Arabic version was not validated in hospitalized patients. The aim was to translate, culturally adapt, and validate the HADS Questionnaire into Arabic language for in-patient use, especially for surgical wards. Methods: A systematic translation process was used to translate the original English HADS into Arabic. After the pilot study, we validated our version in surgical patients at two tertiary care centers. We tested the reliability of our version using internal consistency. We examined the validity by assessing construct validity, concurrent validity (by testing the associations between HADS, Generalized Anxiety Disorder 7-item scale [GAD-7], and Major Depression Inventory [MDI]), and face validity. The questionnaire was administered before and after surgery to examine responsiveness. Results: A total of 110 patients (22 men, 88 women) were included in the study. Cronbach's αs for the HADS anxiety subscale were 0.83 (95% confidence interval: 0.79– 0.88) and for the HADS depression subscale were 0.77 (0.7–0.83). Nearly 36% of the patients reported symptoms indicative of borderline or case anxiety before surgery, which decreased to 25% 1 week after surgery. HADS anxiety score was strongly correlated with GAD-7, and HADS depression score was strongly associated with MDI. Patients with higher American Society of Anesthesiologists Physical Status and those who remained hospitalized for more than 5 days were more likely to report depression symptoms. Most patients found the HADS questions to be clear and easy to understand, and thought the questionnaire items covered all their problem areas regarding their hospital anxiety and depression. Conclusions: Our Arabic version of HADS is a reliable and valid tool to assess the mood states in hospitalized patients

Soluble ACE2 and angiotensin II levels are modulated in hypertensive COVID-19 patients treated with different antihypertension drugs.

This study examines the effect of antihypertensive drugs on ACE2 and Angiotensin II levels in hypertensive COVID-19 patients. Hypertension is a common comorbidity among severe COVID-19 patients. ACE2 expression can be modulated by antihypertensive drugs such as ACEis and ARBs, which may affect COVID-19's prognosis. BB and CCB reduce mortality, according to some evidence. Their effect on circulating levels of ACE2 and angiotensin II, as well as the severity of COVID-19, is less well studied. The clinical data were collected from 200 patients in four different antihypertensive medication classes (ACEi, ARB, BB, and CCB). Angiotensin II and ACE2 levels were determined using standard ELISA kits. ACE2, angiotensin II, and other clinical indices were evaluated by linear regression models. Patients on ACEi ( = 57), ARB ( = 68), BB ( = 15), or CCB ( = 30) in this study had mild ( = 76), moderate ( = 76), or severe ( = 52) COVID-19. ACE2 levels were higher in COVID-19 patients with severe disease ( = 0.04) than mild ( = 0.07) and moderate ( = 0.007). The length of hospital stay is correlated with ACE2 levels ( = 0.3,  = 0.003). Angiotensin II levels decreased with severity ( = 0.04). Higher ACE2 levels are associated with higher CRP and D-dimer levels. Elevated Angiotensin II was associated with low levels of CRP, D-dimer, and troponin. ACE2 levels increase with disease severity in patients taking an ARB ( = 0.01), patients taking ACEi, the degree of disease severity was associated with a decrease in angiotensin II. BB patients had the lowest disease severity. We found different levels of soluble ACE2, and angiotensin II are observed among COVID-19 patients taking different antihypertensive medications and exhibiting varying levels of disease severity. COVID-19 severity increases with elevated ACE2 levels and lower angiotensin II levels indicating that BB treatment reduces severity regardless of levels of ACE2 and angiotensin II.Open Access funding is provided by the Qatar National Library. This report was made possible by an RRC award [RRC-2-076] from the Qatar National Research Fund (a member of The Qatar Foundation). The statements made herein are solely the responsibility of the authors. We would like to acknowledge Qatar BioBank for helping with the logistics of the collected samples, Prof. Nahla Afifi, Dr. Marwa A. El Deeb, and Ms. Sidra Abdulshakoor. The publication of this paper is covered by Qatar National Library

Tweaking Subtype Selectivity and Agonist Efficacy at (<i>S</i>)‑2-Amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)propionic acid (AMPA) Receptors in a Small Series of BnTetAMPA Analogues

A series of analogues of the (<i>S</i>)-2-Amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)­propionic acid (AMPA) receptor agonist BnTetAMPA (<b>5b</b>) were synthesized and characterized pharmacologically in radioligand binding assays at native and cloned AMPA receptors and functionally by two-electrode voltage clamp electrophysiology at the four homomeric AMPA receptors expressed in <i>Xenopus laevis</i> oocytes. The analogues <b>6</b> and <b>7</b> exhibit very different pharmacological profiles with binding affinity preference for the subtypes GluA1 and GluA3, respectively. X-ray crystal structures of three ligands (<b>6</b>, <b>7</b>, and <b>8</b>) in complex with the agonist binding domain (ABD) of GluA2 show that they induce full domain closure despite their low agonist efficacies. Trp767 in GluA2 ABD could be an important determinant for partial agonism of this compound series at AMPA receptors, since agonist efficacy also correlated with the location of the Trp767 side chain

Tweaking Subtype Selectivity and Agonist Efficacy at (<i>S</i>)‑2-Amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)propionic acid (AMPA) Receptors in a Small Series of BnTetAMPA Analogues

A series of analogues of the (<i>S</i>)-2-Amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)­propionic acid (AMPA) receptor agonist BnTetAMPA (<b>5b</b>) were synthesized and characterized pharmacologically in radioligand binding assays at native and cloned AMPA receptors and functionally by two-electrode voltage clamp electrophysiology at the four homomeric AMPA receptors expressed in <i>Xenopus laevis</i> oocytes. The analogues <b>6</b> and <b>7</b> exhibit very different pharmacological profiles with binding affinity preference for the subtypes GluA1 and GluA3, respectively. X-ray crystal structures of three ligands (<b>6</b>, <b>7</b>, and <b>8</b>) in complex with the agonist binding domain (ABD) of GluA2 show that they induce full domain closure despite their low agonist efficacies. Trp767 in GluA2 ABD could be an important determinant for partial agonism of this compound series at AMPA receptors, since agonist efficacy also correlated with the location of the Trp767 side chain

Self-reported long COVID-19 symptoms are rare among vaccinated healthcare workers

Introduction: COVID-19 pandemic adversely affected healthcare workers (HCWs). Here, we evaluate the occurence of long-COVID-19 symtoms among HCWs. Methods: This is a questionnaire-based study of HCWs who had COVID-19 in two medical centers in Saudi Arabia and were mostly vaccinated. Results: The study included 243 HCWs with a mean age (+ SD) of 36.1 (+ 7.6) years. Of them, 223 (91.8%) had three doses of COVID-19 vaccine, 12 (4.9%) had four doses, and 5 (2.1%) had two doses. The most common symptoms at the start of the illness were cough (180, 74.1%), shortness of breath (124, 51%), muscle ache (117, 48.1%), headache (113, 46.5%), sore throat (111, 45.7%), diarrhea (109, 44.9%) and loss of taste (108, 44.4%). Symptoms lasted for one week and 2 months and 3 months in 15 (6.2%). The main symptoms present> 3 months were hair loss (8, 3.3%), cough (5, 2.1%), and diarrhea (5, 2.1%). A binomial regression analysis showed no relationship between persistence of symptoms for> 3 months and other demographic or clinical symptoms characteristics. Conclusion: The study showed a low rate of the occurence of long-COVID> 3 months during the Omicron-wave among mostly vaccinated HCWs with no significant comorbidities. Furhter studies are needed to examine the effect of different vaccines on long-COVID-19 among HCWs

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population