Health Sciences Students’ Attitude, Perception, and Experience of Using Educational Simulation in Saudi Arabia: A Cross-Sectional Study

Background: Simulation-based education (SBE) provides a safe, effective, and stimulating environment for training medical and healthcare students. This is especially valuable for skills that cannot be practiced on real patients due to ethical and practical reasons. We aimed to assess medical students’ attitude, perception, and experience of simulation-based medical education in Saudi Arabia. Method: A validated cross-sectional survey, using the KidSIM scale, was conducted to measure the level of perception and experience of students from different health sciences specialties toward integrating simulation as an educational tool. Participants responded to questions investigated the importance of simulation, opportunities for Inter-Professional Education (IPE), communication, roles and responsibilities, and situation awareness. Only students with previous experience of SBE were considered for participation. Result: This survey was completed by 246 participants, of whom 165 (67%) were male students and 228 (93%) were aged between the range of 18–30 years old. Of the respondents, 104 (67%) were respiratory care students, 90 (37%) were anesthesia technology students, and 45 (18%) were nursing students. Most of the participants had previous experience in IPE simulation activities (84%), and more than half of the students (54%) had a grade point average (GPA) ranging between 5.00 and 4.50. Overall, students had positive attitudes toward and beliefs about SBE, with a mean score of 129.76 ± 14.27, on the KidSIM scale, out of 150. Students’ GPA was significantly associated with a better perception to the relevance of simulation (p = 0.005), communication (p = 0.003), roles and responsibilities (p = 0.04), and situation awareness (p = 0.009). GPA is merely the sole predictor for positive attitude toward simulation with coefficient Beta value of 4.285 (p = 0.001). There were no significant correlations between other students’ characteristic variables (gender, specialty, study year, experience in IPE, and prior critical care experience). Conclusion: We found that health sciences students’ perception of SBE in Saudi Arabia is generally positive, and students’ performance is a significant determinant of the positive perception

Teaching faculty perceptions, attitudes, challenges, and satisfaction of online teaching during COVID-19 pandemic in Saudi Arabia: A national survey

Background: The COVID-19 pandemic and associated preventative measures introduced a shock to the teaching paradigm in Saudi Arabia and the world. While many studies have documented the challenges and perceptions of students during the COVID-19 pandemic, less attention has been given to higher education staff. The aim of the present investigation is to evaluate the staff’s perception and experiences of online teaching during the COVID-19 pandemic. Materials and methods: A validated survey was conducted between December 2021 and June 2022 in Saudi Arabian Universities to assess the status of online teaching during the COVID-19 pandemic among faculty members. The collected responses were exploratively and statistically analyzed. Results: A total of 1117 response was received. About 66% of the respondents were male and 90% of them hold postgraduate degree. Although rarely or occasionally teach online pre-COVID-19, only 33% of the respondents think the transition was difficult and 55% of them support the move. Most respondents received adequate training (68%) and tools (80%) and 88% of the respondents mentioned that they did not accrue additional workload in online study design. While the perception of online teaching was mostly positive (62%) with high satisfaction (71%). However, 25% of the respondents reported that a poor internet bandwidth was an obstacle and 20% was unable to track students’ engagement. Respondents with more years of experience, previous training, support, or perceived online transition as easy were also more likely to be satisfied with the process. Also, older respondents, those who support the transition and those with previous training were less likely to report barriers (all p < 0.001). Conclusion: The perception and experience of transition to online teaching during the COVID-19 pandemic in Saudi Arabia were positive. Low internet bandwidth and inability to track students’ limited effective online teaching. Work experience, previous training, and positive perception are the main factors that influence staff online teaching satisfaction

Intravitreal Bevacizumab Alone Vs Combined With Topical Timolol-Dorzolamide or Dorzolamide for Diabetic Macular Edema: A Systematic Review and Meta-Analysis

Rahaf A Hubayni,1,2 Jumanah Qedair,1,2 Ziad M Bukhari,3 Ali S Alsudais,1,2 Orjwan Salah Badghaish,1,2 Razan Osama Bawazir,1,2 Abdullah S AlQahtani,1– 3 Hashem Almarzouki1– 3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 2King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 3Ophthalmology Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaCorrespondence: Rahaf A Hubayni, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, Email [email protected]: Diabetic macular edema (DME) is a major cause of vision loss in diabetes. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of intravitreal bevacizumab (IVB) combined with topical timolol-dorzolamide versus dorzolamide alone in DME patients.Patients and Methods: A literature search was conducted across multiple databases until March 2024. Randomized controlled trials (RCTs) comparing IVB (1.25 mg, monthly) with topical dorzolamide-timolol (twice daily) or dorzolamide alone (twice daily) were included. Primary outcomes assessed were best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at various intervals.Results: Four RCTs involving 98 patients (150 eyes) were analyzed, with a mean age of 57.9 years and a female predominance (55.1%). The subgroup meta-analysis indicated a weighted mean difference (WMD) in BCVA of − 0.125 [95% CI: − 0.21 to − 0.041]. The IVB+D group showed no significant difference in WMD compared to the IVB and IVB+TD groups. IOP measurements revealed a WMD of − 1.244 mmHg [95% CI: − 2.548 mmHg to 0.06 mmHg], with a significant increase in the IVB group compared to the IVB+D and IVB+TD groups. CMT analysis showed a WMD of − 78.875 μm [95% CI: − 118.606 μm to − 39.145 μm], with no significant differences among groups.Conclusion: Concurrent IVB with topical timolol-dorzolamide or dorzolamide alone demonstrated similar efficacy in improving BCVA and CMT in DME patients. However, the IVB+TD combination resulted in a more significant reduction in IOP compared to IVB alone.Keywords: diabetic macular edema, intravitreal bevacizumab, anti-vascular endothelial growth factor, retinal disorders, timolol-dorzolamid

A smart decentralized identifiable distributed ledger technology‐based blockchain (DIDLT‐BC) model for cloud‐IoT security

The most important and difficult challenge the digital society has recently faced is ensuring data privacy and security in cloud‐based Internet of Things (IoT) technologies. As a result, many researchers believe that the blockchain's Distributed Ledger Technology (DLT) is a good choice for various clever applications. Nevertheless, it encountered constraints and difficulties with elevated computing expenses, temporal demands, operational intricacy, and diminished security. Therefore, the proposed work aims to develop a Decentralized Identifiable Distributed Ledger Technology‐Blockchain (DIDLT‐BC) framework that is intelligent and effective, requiring the least amount of computing complexity to ensure cloud IoT system safety. In this case, the Rabin algorithm produces the digital signature needed to start the transaction. The public and private keys are then created to verify the transactions. The block is then built using the DIDLT model, which includes the block header information, hash code, timestamp, nonce message, and transaction list. The primary purpose of the Blockchain Consent Algorithm (BCA) is to find solutions for numerous unreliable nodes with varying hash values. The novel contribution of this work is to incorporate the operations of Rabin digital data signature generation, DIDLT‐based blockchain construction, and BCA algorithms for ensuring overall data security in IoT networks. With proper digital signature generation, key generation, blockchain construction and validation operations, secured data storage and retrieval are enabled in the cloud‐IoT systems. By using this integrated DIDLT‐BCA model, the security performance of the proposed system is greatly improved with 98% security, less execution time of up to 150 ms, and reduced mining time of up to 0.98 s

The effect of cumulative night shift duties on insomnia, fatigue, and mental health in intensive care unit

Background: Night shift duties are crucial in the ICU to ensure care continuity, where critically ill patients require round-the-clock care. However, cumulative night shift duties may disturb circadian rhythm, insomnia, fatigue, and depression, and require further elucidation. Objectives: This study aims to examine the negative consequences of various night shift patterns on insomnia, fatigue, and mental health of ICU Workers. Methods: A cross-sectional study examined how cumulative night shift duty affects insomnia, fatigue, and mental health in critical care providers (CCPs). Results: A total of 1006 participants completed this study between June 2022 and March 2023, including 54.5 % males. About 35 % were between 20 and 30 years of age, and Respiratory Therapists accounted for approximately 46.5 % of the entire sample. Most of our respondents (476; 47 %) reported working night shifts, with a monthly range of 8–15 nights. The prevalence rates for moderate to severe clinical insomnia, fatigue, and moderate to severe depression were 42 %, 48 %, and 32 %, respectively. CCPs working 8–15 nights had a 2-fold risk of clinical insomnia than those working fewer than eight nights with (AOR) and 95 % (CI) of 2.12 and 1.41–3.20, while those working ≥16 nights per month had a greater incidence of clinical insomnia compared to those working <8 nights per month, AOR (CI): 3.09 (1.90–5.03). Only those working ≥16-night shifts per month had a substantially higher fatigue risk compared to those working < 8-night shifts per month, with an AOR (CI) of 1.92 (1.19–3.08). Working 8–15-night shifts per month increases depression risks by 34 % compared to the <8-night shifts group, AOR (CI): 1.34 (0.87–2.08). Those working ≥16-night shifts per month showed a higher depression risk than those working <8-night shifts, AOR (CI): 2.53 (1.53–4.19). Conclusion: A cumulative night shift above eight nights per month is linked with an increased risk of insomnia, fatigue, and depression. The risk of these conditions was significantly directly proportional to the number of night shifts performed per month

Multiple Long-Term Conditions and Disability are Independently Associated with Higher Risk of Fall Among Community Adults: a Cross-Sectional Study

Aqeel M Alenazi,1 Norah A Alhwoaimel,1 Bader A Alqahtani,1 Mohammed M Alshehri,2 Ahmed S Alhowimel,1 Kamlesh Khunti,3 Mohammed S Alghamdi4 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 2Department of Physical Therapy, Jazan University, Jazan, Saudi Arabia; 3Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, UK; 4Department of Medical Rehabilitation Sciences, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Aqeel M Alenazi, Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alt-Kharj, 11942, Saudi Arabia, Tel +966115886354, Email [email protected]; [email protected]: Previous studies have suggested an association between falls and the presence of Multiple Long-Term Conditions (MLTC) or disabilities. However, there is limited understanding of how these factors independently or collectively contribute to the risk of falls and fear of falling among community-dwelling adults.Objective: This study examined the independent association between MLTC and the presence of disability with the risk of falls among community adults.Methods: A cross-sectional study included 324 adults (age ≥ 50). Demographic and clinical data included age, sex, body mass index (BMI), MLTC (≥ two chronic diseases) risk of fall (ie, history of fall in the previous 12-months, number of falls, and recurrent falls). The Barthel Index and Falls Efficacy Scale-International (FES-I) were used to assess disability and fear of fall, respectively.Results: MLTC (Odds Ratio (OR) 2.50, 95% Confidence Interval (CI) [1.26, 4.95], p=0.009), and disability (OR 1.71, 95% CI [1.04, 2.79], p = 0.034) were independently associated with history of falls. MLTC (Incidence Rate Ratio (IRR) 2.87, 95% CI [1.93, 4.29], p < 0.001) and disability (IRR 1.86 95% CI [1.46, 2.36], p < 0.001) were independently associated with an increased number of falls. MLTC (OR 4.50, 95% CI [1.78, 11.36], p = 0.001) and disability (OR 2.82, 95% CI [1.58, 5.05], p < 0.001) were independently associated with recurrent falls. MLTC (B = 6.45, p < 0.001) and disability (B = 3.05, p = 0.025) were independently associated with increased fear of falling.Conclusion: This study indicated that both MLTC and disability are independently associated with falls, number of falls and fear of falling in this population.Keywords: falling, disabilities, impairments, functional limitations, multiple chronic diseases, multimorbidity, Saud

A population-based study of 15,000 people on Knowledge and awareness of lung cancer symptoms and risk factors in Saudi Arabia

Background: Lung cancer is currently the most fatal form of cancer worldwide, ranking as the fourth most prevalent type in Saudi Arabia, particularly among males. This trend is expected to increase with growing population, lifestyle changes, and aging population. Understanding the awareness of the Saudi population regarding the risk factors and symptoms of lung cancer is necessary to attenuate the predicted increase in cases. / Method: A cross-sectional, population-based survey was performed using a previously validated questionnaire (Lung CAM). Multiple linear regression analysis was used to assess variables associated with deficiency in knowledge and awareness of risk factors and symptoms of lung cancer. / Results: Majority of the 15,099 respondents were male (65%), aged between 18 and 30 years (53%), 50% of which were educated up to a bachelor’s degree level. Overall awareness of lung cancer signs and symptoms was 53%, with painful cough and coughing up blood being the best-known symptoms. Conversely, persistent shoulder pain (44%) and clubbing fingers (47%) were the least known lung cancer symptoms. Also, 60% of the respondents showed low confidence in identifying the signs and symptoms of lung cancer. The overall awareness of the risk factors for lung cancer development was 74%, with first-hand (74%) and second-hand (68%) smoking being the most known risk factors. However, only ≤ 62% know the other non-smoking risk factors. Awareness of the risk factors and symptoms of lung cancer depended on age, gender, education, marital and employment status (p < 0.001). / Conclusion: Public awareness of the risk factors and symptoms of lung cancer in Saudi Arabia is inadequate and heavily dependent on education and socio-economic status. Awareness can be improved through campaigns to raise awareness about other lesser-known lung cancer risk factors and symptoms

Perception and clinical practice regarding mucus clearance devices with chronic obstructive pulmonary disease: a cross-sectional study of healthcare providers in Saudi Arabia

OBJECTIVES: Clearing secretions from the airway can be difficult for people with chronic obstructive pulmonary disease (COPD). Mucus clearance devices (MCDs) are an option in disease management to help with this, but healthcare provider awareness and knowledge about them as well as current clinical practice in Saudi Arabia are not known. DESIGN: A cross-sectional online survey consisting of four themes; demographics, awareness, recommendations and clinical practice, for MCDs with COPD patients. SETTING: Saudi Arabia. PARTICIPANTS: 1188 healthcare providers including general practitioners, family physicians, pulmonologists, nursing staff, respiratory therapists and physiotherapists. PRIMARY OUTCOME MEASURES: Healthcare providers' level of awareness about MCDs, and the identification of current clinical practices of COPD care in Saudi Arabia. RESULTS: 1188 healthcare providers (44.4% female) completed the survey. Regarding devices, 54.2% were aware of the Flutter, 23.8% the Acapella and 5.4% the positive expiratory pressure mask. 40.7% of the respondents identified the Acapella, and 22.3% the Flutter as first choice for COPD management. 75% would usually or always consider their use in COPD patients reporting daily difficulty clearing mucus, whereas 55.9% would sometimes or usually consider the use of MCDs with COPD patients who produced and were able to clear mucus with cough. In clinical practice, 380 (32%) of the respondents would prescribe MCDs, 378 (31.8%) would give MCDs without prescriptions, 314 (26.4%) would not provide them at all and 116 (9.8%) would only advise patients about them. CONCLUSION: Healthcare providers are aware of the existence of MCDs and their benefits for sputum clearance and believe that MCDs are beneficial for sputum clearance in some COPD patients. TRIAL REGISTRATION NUMBER: ISRCTN44651852

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

National action plans for antimicrobial resistance and variations in surveillance data platforms

Objective To assess how national antimicrobial susceptibility data used to inform national action plans vary across surveillance platforms. Methods We identified available open-access, supranational, interactive surveillance platforms and cross-checked their data in accordance with the World Health Organization’s (WHO’s) Data Quality Assurance: module 1. We compared platform usability and completeness of time-matched data on the antimicrobial susceptibilities of four blood isolate species: Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Streptococcus pneumoniae from WHO’s Global Antimicrobial Resistance and Use Surveillance System, European Centre for Disease Control’s (ECDC’s) network and Pfizer’s Antimicrobial Testing Leadership and Surveillance database. Using Bland–Altman analysis, paired t-tests, and Wilcoxon signed-rank tests, we assessed susceptibility data and number of isolate concordances between platforms. Findings Of 71 countries actively submitting data to WHO, 28 also submit to Pfizer’s database; 19 to ECDC; and 16 to all three platforms. Limits of agreement between WHO’s and Pfizer’s platforms for organism–country susceptibility data ranged from −26% to 35%. While mean susceptibilities of WHO’s and ECDC‘s platforms did not differ (bias: 0%, 95% confidence interval: −2 to 2), concordance between organism–country susceptibility was low (limits of agreement −18% to 18%). Significant differences exist in isolate numbers reported between WHO–Pfizer (mean of difference: 674, P-value: <0.001, and WHO–ECDC (mean of difference: 192, P-value: 0.04) platforms. Conclusion The considerable heterogeneity of nationally submitted data to commonly used antimicrobial resistance surveillance platforms compromises their validity, thus undermining local and global antimicrobial resistance strategies. Hence, we need to understand and address surveillance platform variability and its underlying mechanisms