Political Advertising In Kuwait - A Functional Discourse Analysis

Most political advertising studies focus on the U.S. or other western democracies like the U.K. and other European countries. In general, political advertising studies focused on the content of political advertising especially on the subject of issues vs. images in advertising. In addition, many studies of political advertising content focus on the topic of negative advertising. The practice of political advertising has been found to vary depending on the political and media structure within a country as well as cultural and legal elements. Therefore, the gap in the literature about the practice of political advertising in the Middle-East is worth examining as it is reasonable to expect different in the use of issue vs. image appeals and in terms of the use of negative advertising. This dissertation focuses on political advertisement content in Kuwait as one of the developing democracies in the Middle-East. One of the important cultural and political elements of Kuwaiti politics is the non-secular nature of the country according to the Kuwaiti constitution. The interest of the study is to explore the content appeals used in political advertising in Kuwait and compare it to relevant literature that examines advertising in the U.S and other parts of the world. In addition, comparisons of advertisements\u27 content between winners and losers in elections will be made to explore possible differences. Because of lack of previous studies about Kuwait, interviews with parliament members, candidates, campaign managers and advertising practitioners were done to give context and better understanding of the ads. Findings of both the qualitative and the quantitative parts of the study indicate unique practice of political advertising in Kuwait including lack of negative advertisements, which is a significant characteristic of political advertisement world wide. In addition, contrary to experts\u27 suggestions in the interviews, political advertisements in Kuwait uses more character based discourse than policy based discourse

Comparative study assessing a group of COPD patients according to the new combined (ABCD) assessment tool in Al-Yarmouk Teaching Hospital

List of abbreviations DLCO : diffusion capacity of Carbon monoxide GOLD : global initiative of chronic obstructive pulmonary disease FEV1 : forced expiratory volume in first second FVC : forced vital capacity ICS : inhaled corticosteroid LABA : long acting beta agonist LAMA : long acting anti muscarinic mMRC modified medical research council SABA : short acting beta agonist SAMA : short acting anti muscarinic ABSTRACT Background: COPD is one of the commonest respiratory illnesses that lead great morbidity and disability and one of the leading causes of mortality worldwide, also it is a growing field of researches regarding reclassification and treatment review there are several methods of classification of COPD patients: GOLD system and the newer ABCD assessment tool which is the main field of this research. Objective: The aim of the study is to evaluate the patients with COPD using the new ABCD assessment tool and comparing it with GOLD classification system in the way of early detection and diagnosis of COPD. Patients and methods: A cross-sectional study was conducted at Al-Yarmouk Teaching Hospital - Department of Respiratory medicine involving 110 COPD patient evaluated depending on history , physical examination , radiological imaging , spirometry and six minute walk test. Then the patients had been grouped according to GOLD and ABCD classification systems then comparism between two modalities had been done. Results: The study involved 110 patients aged between 42 and 81 years old ; 92 male and 18 female, male : female ratio 5:1. We assess the patients according to GOLD module, then the patient had been redistributed according  to ABCD assessment tool using FEV1, dyspnea scale utilizing mMRC , and number of exacerbation per year reveal the following: No  patient (0%) GOLD 1, 36 patient (32.7%) GOLD2, 42 patient (38.2%) GOLD3, and 32 patient (29.1%) GOLD 4 ; while  redistributing the patients according to ABCD module reveals the following: Twenty seven patient (24.5%) were class A, 10 patients (9%) were class B , 6 patients (5.5%) class C  and 67 patient (61%) of class D ; so there is a significant difference between the different categories of ABCD assessment tool as compared to GOLD groups due to the impact of dyspnea scale and number of exacerbations on the reclassification. Conclusions: ABCD assessment tool may be more accurate and practical than GOLD classification ; ABCD assessment tool can be of benefit in early detection and management of early COPD cases more than the GOLD system. Recommendations: utilization of ABCD assessment tool in early detection , diagnosis , and follow up of patients with COPD

FUTURE CARDIAC EVENTS IN NORMALLY DIAGNOSED GATED MYOCARDIAL PERFUSION SPECT (GSPECT)

Coronary heart disease (CHD) is a major cause of mortality and morbidity in Europe and USA and its management consumes a large proportion of national healthcare budgets. Many studies had tested the prognostic value of a normal myocardial perfusion scintigraphy; they concluded that a normal MPI study is associated with a very low rate of future cardiac events. In view of the above this study is designed to determine the risk of future cardiac events after normal MPS in local population. Methods: This was a retrospective observational registry performed in a single center in the Kingdom of Saudi Arabia. The data were collected from the nuclear medicine database identifying all the reported normal myocardial perfusion scans between January 2008 and December 2011 . Results: There were 290 patients identified with normal cardiac nuclear scans in the pre-specified time frame. Basic patient demographics were outlined and the patients’ charts were reviewed looking for any major cardiac events such as MI or sudden death. Mean follow up was 14.8 months. There were 2 patients that were admitted with NSTEMI and went on to have diagnostic angiograms. One of those two patients underwent percutaneous coronary intervention with stenting. The other patient had nonobstructive CAD and was advised for medical management only. These findings are consistent with a 0.7% risk of cardiac events after a negative scan Conclusion: The above findings demonstrate that the risk of major cardiac events after a negative nuclear cardiac scan is low and is in keeping with the international statistics available

FUTURE CARDIAC EVENTS IN NORMALLY DIAGNOSED GATED MYOCARDIAL PERFUSION SPECT (GSPECT)

Coronary heart disease (CHD) is a major cause of mortality and morbidity in Europe and USA and its management consumes a large proportion of national healthcare budgets. Many studies had tested the prognostic value of a normal myocardial perfusion scintigraphy; they concluded that a normal MPI study is associated with a very low rate of future cardiac events. In view of the above this study is designed to determine the risk of future cardiac events after normal MPS in local population. Methods: This was a retrospective observational registry performed in a single center in the Kingdom of Saudi Arabia. The data were collected from the nuclear medicine database identifying all the reported normal myocardial perfusion scans between January 2008 and December 2011 . Results: There were 290 patients identified with normal cardiac nuclear scans in the pre-specified time frame. Basic patient demographics were outlined and the patients’ charts were reviewed looking for any major cardiac events such as MI or sudden death. Mean follow up was 14.8 months. There were 2 patients that were admitted with NSTEMI and went on to have diagnostic angiograms. One of those two patients underwent percutaneous coronary intervention with stenting. The other patient had nonobstructive CAD and was advised for medical management only. These findings are consistent with a 0.7% risk of cardiac events after a negative scan Conclusion: The above findings demonstrate that the risk of major cardiac events after a negative nuclear cardiac scan is low and is in keeping with the international statistics available

Protein kinase B controls Mycobacterium tuberculosis growth via phosphorylation of the transcriptional regulator Lsr2 at threonine 112.

Mycobacterium tuberculosis (Mtb) is able to persist in the body through months of multi-drug therapy. Mycobacteria possess a wide range of regulatory proteins, including the protein kinase B (PknB) which controls peptidoglycan biosynthesis during growth. Here, we observed that depletion of PknB resulted in specific transcriptional changes that are likely caused by reduced phosphorylation of the H-NS-like regulator Lsr2 at threonine 112. The activity of PknB towards this phosphosite was confirmed with purified proteins, and this site was required for adaptation of Mtb to hypoxic conditions, and growth on solid media. Like H-NS, Lsr2 binds DNA in sequence-dependent and non-specific modes. PknB phosphorylation of Lsr2 reduced DNA binding, measured by fluorescence anisotropy and electrophoretic mobility shift assays, and our NMR structure of phosphomimetic T112D Lsr2 suggests that this may be due to increased dynamics of the DNA-binding domain. Conversely, the phosphoablative T112A Lsr2 had increased binding to certain DNA sites in ChIP-sequencing, and Mtb containing this variant showed transcriptional changes that correspond with the change in DNA binding. In summary, PknB controls Mtb growth and adaptations to the changing host environment by phosphorylating the global transcriptional regulator Lsr2

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The role of Lsr2 phosphorylation in regulation of mycobacterial growth and gene expression

One-fourth of the world population is estimated to have latent tuberculosis infection associated with dormant Mycobacterium tuberculosis bacilli, which are more resistant to antimicrobial treatment and can resuscitate, resulting in the development of active tuberculosis. M. tuberculosis has a wide range of regulatory proteins that control growth, including the protein kinase B (PknB) that controls peptidoglycan biosynthesis and growth by phosphorylating several substrates. Lsr2 is one of the substrates of PknB that is highly conserved in mycobacteria. Lsr2 is DNA-binding protein that controls gene transcription and protects the nucleoid from damage.This project was focused on the investigation of Lsr2 phosphorylation and the role of Lsr2 in DNA binding, and regulation of gene expression in mycobacterial growth and dormancy.Recombinant M. tuberculosis Lsr2 and its phosphomimetic form (Lsr2T112D) were purified and used for kinase assay, DNA binding experiments, and generation of polyclonal antibodies. Mass-spectrometry confirmed that recombinant PknB phosphorylated recombinant Lsr2 in vitro at threonine 8, threonine 21, threonine 31 and threonine 112. Phosphoablative forms of Lsr2 were generated and used for complementation of lsr2 deletion mutants of Mycobacterium. smegmatis and M, tuberculosis. In M. smegmatis, none of the individual phosphoablative mutants (T8A, T22A, or T112A) complemented the defect in colony morphology. In M. tuberculosis, T8A, T22A, and T31A variants complemented the growth defect on solid medium, but T112A did not. Full-length Lsr2 showed non-specific binding to various DNA fragments, and this binding was completely abolished by PknB-mediated phosphorylation. Lsr2T112D showed reduced binding to DNA. Consequently, different DNA binding patterns in M. tuberculosis expressing Lsr2WT, and phosphoablative Lsr2T112A would result in alteration of gene expression of target genes.Finally, Lsr2 from Mycobacterium marinum was also investigated in this project. I found that M. marinum lsr2 was essential for the growth of this bacterium since the gene could be only deleted from the strain containing a second copy of lsr2. M. marinum Lsr2 is missing the terminal threonine (T112) and serine 113 was not phosphorylated by PknB in vivo or in vitro, suggesting that DNA binding by M. marinum Lsr2 is regulated by a different mechanism. These findings suggest that PknB controls mycobacterial biology by phosphorylating the global transcriptional regulator Lsr2.</div

Molecular detection of virulence genes in pseudomonas aeruginosa isolated from different clinical infections

Objective: To isolate pseudomonas aeruginosa from different clinical specimens, and to detect virulence factors. Method: The cross-sectional study was conducted at Al-Zharr Hospital and private clinics in Kut city of Wasit province in Iraq from October 15, 2021, to April 30, 2022, and comprised samples obtained from different patient sites, such as wound swabs, ear swabs, urine samples, burn swabs and respiratory tract swabs. The samples were subjected to molecular testing using, among other tools, polymerase chain reaction. The isolates were cultured on different media, such as blood agar, MacConkey agar and cetrimide agar, and were further diagnosed by biochemical testing. Data was analysed using SPSS 20. Results:Of the 212 samples, there were 70(33%) wound swabs, 53(25%) ear swabs, 41(19.3%) urine samples, 33(15.6%) burn swabs and 15(7%) respiratory tract swabs. Pseudomonas aeruginosa was identified in 54(25.47%) isolates via culture-based characterisation. All 54(100%) isolates were positive for mexR and toxA on polymerase chain reaction, 44(81.48%) were positive for exoU gene, 43(79.62%) for exoT gene, 36 (66.66) for exoT gen, 35(64.81%) for plcH, gene and 14(25.92 %) for exoS gene. Conclusions: Wound swabs were found to be the most common site for pseudomonas aeruginosa, followed by ear swabs and urine samples. Keywords: Pseudomonas aeruginosa, Virulence, Agar, Cetrimonium, Virulence, Burns, Polymerase chain reaction, DNA