Maintaining Oxygenation Successfully with High Flow Nasal Cannula during Diagnostic Bronchoscopy on a Postoperative Lung Transplant Patient in the Intensive Care

Bronchoscopy is an important diagnostic and therapeutic intervention for a variety of patients displaying pulmonary pathology. The heterogeneity of the patients undergoing bronchoscopy affords a challenge for providing minimal and safe respiratory support during anesthesia. Currently, options are intubation and general anesthesia versus frequently inadequate sedation or local anaesthesia with low flow oxygen through nasal prongs or mouthpiece. The advent of high flow nasal cannula allows the clinician to have a “middle man” that allows high flow oxygen delivery as well as a degree of respiratory support, which in some cases has been noted to be between 3 and 4 cm of continuous positive airway pressure-like effect. There are minimal data analyzing the use of high flow nasal cannula during anesthesia for bronchoscopy. We present a case report of orthotropic lung transplant recipient undergoing diagnostic bronchoscopy whilst being supported with high flow nasal oxygen in the intensive care unit

Impact of Online Education on the Academic Motivation for University Rural Youth in Egypt

This research aimed to 1) describe some indicators related to distance education among university rural youth, 2) measure the academic motivation of respondents, 3) identify factors related to the academic motivation of respondents, and 4) identify the impact of distance education on the academic motivation of young rural university. Data were collected via an electronic questionnaire form distributed to the students of the Faculty of Agriculture, Ain Shams University via WhatsApp groups; the rural students were urged to complete it. The number of completed forms was 416 during the period from June and July 2021. Frequencies, percentages and average, range, standard deviation, as well as correlation coefficient were used for data analysis and presentation. The results showed that the majority of respondents use the WhatsApp application (80%), the mobile internet package (54.6%), and the majority (51.9%) use online education for 2-3 hours per day. The results also showed that the average overall academic motivation of respondents was 109.76 ((which is approximately 78.4% of the overall scale). The results showed that there are significant correlations between the overall level of the students’ academic motivation with the variables of the overall level of electronic applications and smart devices used by respondents to access online learning and the total number of hours spent in online learning.  The results also showed the positive effect of online learning on academic motivation, according to 72.8% of respondents, where the motivation of internal organization had the greatest impact on online education according to 80.3% of respondents

The impact of acute lung injury, ECMO and transfusion on oxidative stress and plasma selenium levels in an ovine model

The purpose of this study was to determine the effects of smoke induced acute lung. injury (S-ALI), extracorporeal membrane oxygenation (ECMO) and transfusion on oxidative stress and plasma selenium levels. Forty ewes were divided into (i) healthy control (n = 4), (ii) S-ALI control (n = 7), (iii) ECMO control (n = 7), (iv) S-ALI + ECMO (n = 8) and (v) S-ALI + ECM + packed red blood cell (PRBC) transfusion (n = 14). Plasma thiobarbituric acid reactive substances (TBARS), selenium and glutathione peroxidase (GPx) activity were analysed at baseline, after smoke injury (or sham) and 0.25, 1, 2, 6, 7, 12 and 24 h after initiation of ECMO. Peak TBARS levels were similar across all groups. Plasma selenium decreased by 54% in S-ALI sheep (1.36 +/- 0.20 to 0.63 +/- 0.27 mu mol/L, p < 0.0001), and 72% in sheep with S-ALI + ECMO at 24 h (1.36 +/- 0.20 to 0.38 +/- 0.19, p < 0.0001). PRBC transfusion had no effect on TBARS, selenium levels or glutathione peroxidase activity in plasma. While ECMO independently increased TBARS in healthy sheep to levels which were similar to the S-ALI control, the addition of ECMO after S-ALI caused a negligible increase in TBARS. This suggests that the initial lung injury was the predominant feature in the TBARS response. In contrast, the addition of ECM in S-ALI sheep exacerbated reductions in plasma selenium beyond that of S-ALI or ECM alone. Clinical studies are needed to confirm the extent and duration of selenium loss associated with ECMO. Crown Copyright (C) 2015 Published by Elsevier GmbH. All rights reserved

Prevalence of anxiety and depressive symptoms in ulcerative colitis patients in Jordan and its relationship to patient-reported disease activity

Inflammatory bowel disease is associated with higher rates of anxiety and depression compared to the general population. We aimed to determine the prevalence of anxiety and depressive symptoms among patients with ulcerative colitis and correlation to disease activity. In this cross-sectional study, we collected data from 70 consecutive ulcerative colitis patients over one year at our inflammatory bowel disease outpatient clinic through an interview and a questionnaire containing patient demographics and disease characteristics. Anxiety and depressive symptoms were characterized using the Generalized Anxiety Disorder-7 questionnaire and Patient Health Questionnaire-9, respectively, with ulcerative colitis disease severity assessed by the Partial Mayo scoring system. The majority of our patients were females (68.6%) and the mean age was 39.3 years. Rates of anxiety and depressive symptoms among ulcerative colitis patients were 65.7% and 58.6%, respectively. Depressive symptoms were significantly associated with patient-reported disease activity (r = 0.361; p = 0.010). Significant percentages of ulcerative colitis patients were appreciated to have anxiety and depressive symptoms, and there was a correlation between patient-reported disease activity and depressive symptoms. At this high rate of prevalence, it is justified to screen patients for the presence of psychiatric comorbidities

Use and outcomes of antihypertensive medication treatment in the US hypertensive population: A gender comparison

Background: Although effective antihypertensive medications have existed for decades, only about half of the hypertensive individuals are considered to have controlled blood pressure. Limited research studies have investigated gender disparity in the utilization and effectiveness of antihypertensive medications treatment. To examine the gender difference in antihypertensive medications’ use and the effect of using antihypertensive medication treatment on blood pressure control among the U.S. adult with hypertension. Methods: Analysis of National Health and Nutrition Examination Survey (NHANES) data from (1999-2012) including individuals≥18 years old with hypertension. Study variables included gender, age, race/ethnicity, obesity, smoking, comorbidities, treatment medication type, and continuity of care. We used multivariate logistic regression in STATA V14. The data is presented as adjusted odds ratios (ORs) and 95% confidence interval (CI). Results: Of the 15719 participants, 52% were female. 49% of the antihypertensive medication users had their blood pressure under control (95% CI). In the adjusted logistic regression analysis, use of antihypertensive medications was found to be 12% greater in females as compared to males (OR=1.12; CI=1.02-1.22; P<0.05). No association between gender and blood pressure control was found. Blood pressure control was less likely achieved among 50 years or younger individuals, Blacks and Hispanics, obese, and those taking calcium channel blocker (CCB). Conclusion: Hypertensive females are more likely than males to use antihypertensive medications. The effectiveness of treatment to control blood pressure is equal across males and females. Our findings have implications for practitioners to account gender-specific approaches when discussing adherence to hypertension medication treatment with their patients

Who, What, When, Where, Why? Comparing Multiple Approaches to the Cross-Lingual 5W Task

Cross-lingual tasks are especially difficult due to the compounding effect of errors in language processing and errors in machine translation (MT). In this paper, we present an error analysis of a new cross-lingual task: the 5W task, a sentence-level understanding task which seeks to return the English 5W's (Who, What, When, Where and Why) corresponding to a Chinese sentence. We analyze systems that we developed, identifying specific problems in language processing and MT that cause errors. The best cross-lingual 5W system was still 19% worse than the best monolingual 5W system, which shows that MT significantly degrades sentence-level understanding. Neither source-language nor target-language analysis was able to circumvent problems in MT, although each approach had advantages relative to the other. A detailed error analysis across multiple systems suggests directions for future research on the problem

Sodomy of Adolescent Males Presented to Pediatric Psychiatric Outpatient Clinic: A Case Series

Traditional Arab culture hides male sexual abuse and considers it a shame. Instead of treating male victims of sexual assault, they are often stigmatized as homosexual individuals. Moreover, guardians of sexually abused boys are also negatively affected. They have to choose between reporting abuse to a legal authority with the risk of labeling their child or keeping a close eye on them to prevent further abuse. However, reporting abuse to healthcare authorities does take place. Disclosing sexual abuse in the privacy of a psychiatric clinic is often the only way for victims to be successfully treated for the psychological effects of such abuse

Evaluating the Impact of a Collaborative Care Model in Diabetes Management in a Primary Healthcare Setting in Qatar Using Real-World Data

Objectives: To evaluate the impact of Collaborative Care Model (CCM) on diabetes-related outcomes among patients with diabetes attending a primary care setting. Methods: A multiple-time series, retrospective, observational study with a control group among patients with diabetes followed-up at Qatar Petroleum Diabetes Clinic. The impact of CCM on glycemic control, blood pressure, lipid profile, and anthropometrics was evaluated at baseline and up to 17 months of follow-up. Quantitative data were analyzed descriptively and inferentially using SPSS. Results: CCM significantly improved (p<0.05) the mean values (baseline vs. 17 months) of glycated hemoglobin A1c (6.9% vs. 6.5%), random blood glucose (194.38 mg/dL vs. 141.23 mg/dL), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), weight (78.52 Kg vs. 77.85 Kg), and body mass index (30.41 Kg/m2 vs. 30.17 Kg/m2) over 17-months within the intervention group; whereas, no significant changes occurred within the control group. Similarly, the between group comparisons demonstrated the superiority of CCM over usual care in improving several clinical outcomes. Conclusion: Inefficiencies in delivering diabetes care can be circumvented by the integration of CCM. The implementation of CCM in a primary healthcare setting improved several diabetes-related outcomes over 17-months