Characterisation of M2 muscarinic acetylcholine receptor signalling in dental pulp stem cells

Cholinergic signalling is hypothesised to occur in stem cells, and there is evidence that mesenchymal stem cells (MSCs) express a functional cholinergic system. Expression of functional acetylcholine receptors (AChRs) have been reported in several types of MSC, which suggests that MSCs have non-neuronal cholinoceptive properties that may play a role in their regenerative potential. However, this remains relatively unexplored, particularly, in Dental pulp stem cells (DPSCs). This project commenced by reviewing AChRs in MSCs, highlighting DPSCs characteristics, and then investigated the presence of functional AChRs and their role in modulating DPSCs regenerative potential. This study commenced by identifying gene expression of both classes of AChRs, the muscarinic (mAChRs) and the nicotinic (nAChRs), in DPSCs. Protein expression of detected AChRs was assessed via western blotting and immunofluorescence. Functionality of expressed AChRs was assessed using an array of AChRs agonists and antagonists and DPSCs viable count was measured via MTT assay. Subtype selective agonist was used to study the role of the targeted AChR and its influence on DPSCs regenerative potential. Proliferation of DPSCs in response to that stimulation was assessed via measuring viable cell count using MTT assay, Cell Counting Kit-8 (CCK-8), and cell cycle analysis. Survival of DPSCs was assessed via detecting proliferation recovery, measuring Lactate dehydrogenase (LDH) levels, and detecting Annexin V/Propidium iodide staining. Stemness potential of DPSCs was assessed via detecting gene expression of MSCs stemness markers and pluripotency markers. Migration of DPSCs was investigated using a wound healing assays. Osteogenic differentiation of DPSCs was assessed via phenotypic mineralisation stains. Gene expression of cell cycle markers, stemness markers, osteogenic markers were assessed via Real-time polymerase chain reaction (q-PCR). Whole RNA sequencing (RNA-seq) was undertaking to measure transcriptome changes and enriched signalling pathways. Follow-up analysis was undertaking via measuring the phosphorylation and transcripts levels of ERK1 and ERK2 of the Mitogen-activated protein kinase (MAPK) pathway. The results showed transcripts expression for the M2, M3 and M5 mAChRs, and expression of subunits that support the formation of α7 and α4β2-nAChRs. Subtype selective agonists/antagonists results suggest DPSCs to express functional M2 mAChR, α7 nAChRs, and α4β2-nAChRs. This was based on the ability of the agonists to influence DPSCs viable count and the subtype selective antagonist to cancel that effect. The project then focussed on mAChRs and protein expression of M2, M3 and M5 mAChRs were detected. The subsequent work focused on investigating the role of the M2 mAChRs in modulating the function of DPSCs via activating this receptor through its selective agonist Arecaidine propargyl ester (APE). Activation of the M2 mAChR inhibited DPSCs proliferation, in a reversable manner, without affecting DPSCs viability or survival. Further evidence showed that the M2 mAChR inhibits DPSCs proliferation by arresting cell cycle progression. This was further corroborated via expression analysis of key genes involved in the regulating cell cycle. The results also showed that M2 mAChR activation inhibited DPSCs migration and differentiation potential but did not interfere with DPSCs stemness. This was further corroborated via expression analysis of key genes involved in stemness and osteogenesis. The data obtained suggests that M2 mAChR activation induce DPSCs to go into a quiescent state. The RNA-seq results showed that DPSCs responded differently to M2 mAChR activation 4 and 24 hours post activation, with different sets of differentially expressed genes (DEGs). The analysis of the enriched pathways suggested that M2 mAChR activation regulates cellular processes involved in metabolism, growth, adhesion, and response to stimuli. These processes function in proliferation, migration, and cell cycle through several metabolic pathways associated with response to cellular and oxidative stress. Follow up analysis showed upregulation of ERK1 and ERK2 phosphorylation and transcripts, which are downstream effectors of the MAPK pathway. The data obtained suggests that the transcriptomic data support the observed inhibitory effect of the M2 mAChR on DPSCs functions and highlights the many downstream effectors involved in the M2 mAChR downstream signalling. In conclusion, this thesis presents evidence for the expression of a functional M2 mAChR in DPSCs, indicating the involvement of ACh signalling in modulating DPSCs behaviour. It also provides a promising route ultimately to pharmacologically control the regenerative output of DPSCs

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine among Program’s Residents in Tabuk, Saudi Arabia

BACKGROUND: Complementary and alternative medicine (CAM) focuses on stimulating the body’s ability to heal itself through energy alignment, herbal supplementation, and other balancing techniques. AIM: The objective of the study was to investigate and compare the Knowledge Attitude Practice (KAP) of CAM among program’s residents in Tabuk region. METHODS: A cross-sectional CAP study was conducted among program’s residents in Tabuk region. All program’s residents of all specialties in Tabuk region were included in the study. Data were collected by predesigned electronic questionnaire covering the needed items. Collected data were coded and analyzed using SPSS Inc., Chicago, Illinois, USA. The Chi-square test was used as a test of significance and p = 0.05 or less was considered statistically significant. RESULTS: Most (95.8%) of the participants have heard about CAM, 25% have used CAM in treatment before, and 72.3% of them reported beneficial outcome, 25.7% strongly agree and 48.6% agree that CAM is a useful complement to pharmacological medicine, 38.2% believed that the results of CAM are usually due to the placebo effect, and 52.1% recommended using CAM. On the other hand, 79.9% have knowledge about acupuncture, 54.9% spiritual healing and herbal medicine, 43.1% massage, 41% yoga, 70.8% bloodletting cupping, and 56.3% about cauterization. More than third (38.2%) of the participants agreed that the use of herbal products is a valid form of drugs which can be used for the treatment of variety of diseases, 48.6% agreed that CAM is a useful complement to pharmacological medicine, while 36.1% strongly agreed that CAM treatments are not tested in a scientifically recognized manner. CONCLUSION: In our study, the majority of program’s residents in Tabuk region agree that CAM is a useful complement to pharmacological medicine and recommended using CAM while reasonable percentage of them believed that the results of CAM are usually due to the placebo effect

Assessment of Knowledge Among the Physicians Regarding Dental Screening Prior to Chemotherapy and Radiotherapy

Objective: To evaluate the physicians\u27 knowledge regarding the referral for dental screening prior to chemotherapy and radiotherapy. Material and Methods: We conducted a cross-sectional study using simple random sampling among 468 physicians from various specialties with diverse experience levels from different regions in Saudi Arabia. A self-reporting questionnaire was distributed among the physicians, which consisted of questions assessing the physicians\u27 knowledge about oral health and complications in patients prior to chemotherapy and radiotherapy. Statistical analysis was done after the data was collected employing SPSS, and p<0.05 was taken as significant. Results: Residents were more as expected (39.3%), followed by specialists (2.31%). The majority had a practice experience for more than five years (67.8%). The scores for the knowledge assessment showed that 51.3%, nearly half of the participants, had lower scores. The scores were statistically significant (p<0.05). Conclusion: General physicians and specialists should be aware of the dental complications and associated diseases in patients with malignancies and those undergoing chemo and radiotherapy. It is proposed that more awareness should be raised among physicians to rectify this lapse

A lightweight and robust authentication scheme for the healthcare system using public cloud server

Cloud computing is vital in various applications, such as healthcare, transportation, governance, and mobile computing. When using a public cloud server, it is mandatory to be secured from all known threats because a minor attacker’s disturbance severely threatens the whole system. A public cloud server is posed with numerous threats; an adversary can easily enter the server to access sensitive information, especially for the healthcare industry, which offers services to patients, researchers, labs, and hospitals in a flexible way with minimal operational costs. It is challenging to make it a reliable system and ensure the privacy and security of a cloud-enabled healthcare system. In this regard, numerous security mechanisms have been proposed in past decades. These protocols either suffer from replay attacks, are completed in three to four round trips or have maximum computation, which means the security doesn’t balance with performance. Thus, this work uses a fuzzy extractor method to propose a robust security method for a cloud-enabled healthcare system based on Elliptic Curve Cryptography (ECC). The proposed scheme’s security analysis has been examined formally with BAN logic, ROM and ProVerif and informally using pragmatic illustration and different attacks’ discussions. The proposed security mechanism is analyzed in terms of communication and computation costs. Upon comparing the proposed protocol with prior work, it has been demonstrated that our scheme is 33.91% better in communication costs and 35.39% superior to its competitors in computation costs

Men’s health in industries: Plastic plant pollution and prevalence of pre-diabetes and type 2 diabetes mellitus

Plastic production is prominently increasing and its pollution is an emerging environmental global health concern. This study aimed to investigate the occurrence of pre-diabetes and type 2 diabetes mellitus (T2DM) among nonsmoking plastic industry workers. Three hundred and forty volunteers male plastic industry workers were interviewed after medical history and examination; finally, 278 nonsmoking plastic industry workers were selected. The mean age for the participants was 38.03 ± 10.86 years and body mass index was 25.52 ± 3.15 (kg/m)2. The plastic industry workers had been exposed to plastic plant pollution for 8 hr daily, 6 days in a week. Subjects with glycated hemoglobin (HbA1c) less than 5.7% were considered non-diabetics; HbA1c 5.7%-6.4% were pre-diabetics; and subjects with HbA1c greater than 6.4% were considered diabetics. In plastic industry workers, the prevalence of pre-diabetes was 176 (63.30%) and T2DM was 66 (23.74%); however, 36 (12.95%) plastic plant workers were normal. The prevalence of pre-diabetes and T2DM among plastic industry workers was significantly increased with duration of working exposure in plastic industry ( p = .0001). Exposure to plastic plant pollution is associated with the prevalence of pre-diabetes and T2DM among plastic industry workers. The prevalence was associated with the duration of working exposure in plastic industry. The occupational and environmental health executives must take priority steps to minimize the plastic plant pollution from plastic industries to reduce the occurrence of pre-diabetes and T2DM among the plastic industrial workers and save the men\u27s health in industries

Social and Economic Factors that Influence Health Outcomes in Family Medicine

Over the last twenty years, the social determinants of health (SDOH) have gained more and more attention in the public health community. SDOH are non-medical elements that may be significantly impacted by social policies and have an impact on health. The increasing variety that exists within our societies makes it absolutely necessary for us to incorporate into undergraduate medical education social determinants of health such as racial factors, financial instability, partner violence, insufficient accessibility to transportation, and inadequate social supports, as well as the crucial role of health education.  Nonetheless, a growing body of research indicates that a variety of health outcomes are fundamentally caused by socioeconomic variables including wealth, income, and education together. In this review we highlight the influence of socio-economic factors on health outcomes, approaches to incorporate social determinants of health in family medicine practice, and we also talk about challenges and solutions in addressing social determinants in family medicine. The objective of this research was to assess the impact of social determinants of health on family medicine practice in which socioeconomic determinants of health might have an effect on health outcomes and healthcare delivery within the context of a family medicine clinical environment

Assessment of Primary Healthcare Physicians’ Awareness about Shingles in Al-Qassim Province: A Cross-sectional Study

Background: Despite the significant public health implications of shingles (Herpes Zoster), there is a paucity of research examining the awareness levels among primary healthcare physicians, particularly in specific regions such as Al-Qassim Province. Understanding the awareness gaps is crucial for designing targeted interventions that enhance early detection, prevention, and management of shingles. Methods: A descriptive, correlational cross-sectional design was employed for this study. The study was conducted at primary health care centers in Al-Qassim Province. Participants were be selected during the period from January to March 2023. Population of the current study were primary healthcare physicians in Al-Qassim Province, KSA. Study participants were selected by non-probability convenient sampling technique. Study instrument consists of two domains. First is sociodemographic characteristics of participants. Second is KAP assessment regarding shingles. Results: The study included 252 participants. The mean age among study participants was 34.58 + 8.53 years with median age of 31 years. More than half of study participants were males (n= 154, 61.1%) and half of study participants were general practitioners (n= 127, 50.4%). Majority of study participants were Family Medicine practitioners (n= 228, 90.5%). More than half of study participants were Saudi (n= 150, 59.5%). In addition, more than half of study participants had 1-5 years of experience (n= 131, 52%). Notably, 60 participants acknowledge the common occurrence of Shingles while 166 recognize the possibility of multiple occurrences. A significant proportion, 188 participants, are aware of Shingles' transmissibility, and 240 participants understand that older individuals and those with comorbid conditions face a higher risk. Additionally, 231 participants acknowledge the serious impact of Shingles on daily life, with 185 considering the potential need for hospital admission. Most of study participants believed that rash (n= 130, 51.6%) and post-herpatic neuralgia (n= 116, 46%) are the most common complications of shingles. Moreover, more than half of study participants reported that pain associated with shingles is moderate and has a duration of few weeks (n= 144, 57.1%). Furthermore, more than half of study participants said that polymerase chain reaction (PCR) test is the diagnostic tool for herpes zoster (n= 132, 52.4%). Noteworthy results include a significant association between age and awareness, with the younger age group (25-35) showing higher awareness compared to older age groups (36-45 and 46-60). Proficiency level also demonstrates a substantial impact, as specialists and consultants exhibit higher awareness compared to general practitioners and residents. Nationality is another significant factor, with Saudis having higher awareness than non-Saudis. Experience plays a role, with those having more than 10 years of experience demonstrating greater awareness. Conclusion: Awareness increased with younger age, competency, Saudi nationality, and professional experience. Shingles' frequency, transmissibility, and impact on susceptible populations were well-known, demonstrating sophisticated views about the illness. These findings show that demographically appropriate education will enhance public health and patient care in the region

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

Perspectives, practices, and challenges of online teaching during COVID-19 pandemic: A multinational survey

The result of the movement restrictions during the COVID-19 pandemic was an impromptu and abrupt switch from in-person to online teaching. Most focus has been on the perception and experience of students during the process. The aim of this international survey is to assess staffs' perspectives and challenges of online teaching during the COVID-19 lockdown. Cross-sectional research using a validated online survey was carried out in seven countries (Brazil, Saudi Arabia, Jordan, Indonesia, India, the United Kingdom, and Egypt) between the months of December 2021 and August 2022, to explore the status of online teaching among faculty members during the COVID-19 pandemic. Variables and response are presented as percentages while logistic regression was used to assess the factors that predict levels of satisfaction and the challenges associated with online instruction. A total of 721 response were received from mainly male (53%) staffs. Most respondents are from Brazil (59%), hold a Doctorate degree (70%) and have over 10 years of working experience (62%). Although, 67% and 79% have relevant tools and received training for online teaching respectively, 44% report that online teaching required more preparation time than face-to-face. Although 41% of respondents were uncertain about the outcome of online teaching, 49% were satisfied with the process. Also, poor internet bandwidth (51%), inability to track students' engagement (18%) and Lack of technical skills (11.5%) were the three main observed limitations. Having little or no prior experience of online teaching before the COVID-19 pandemic [OR, 1.58 (95% CI, 1.35–1.85)], and not supporting the move to online teaching mode [OR, 0.56 (95% CI,0.48–0.64)] were two main factors independently linked with dissatisfaction with online teaching. While staffs who support the move to online teaching were twice likely to report no barriers [OR, 2.15 (95% CI, 1.61–2.86)]. Although, relevant tools and training were provided to support the move to online teaching during COVID-19 lockdown, barriers such as poor internet bandwidth, inability to track students’ engagement and lack of technical skills were main limitations observed internationally by teaching staffs. Addressing these barriers should be the focus of higher education institution in preparation for future disruptions to traditional teaching modes

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