A Qualitative Survey Study in Managing Patient Obesity for Exploring Self Efficacy among Saudi General Practitioners

This study aimed at investigate the management of obesity patients for exploring the self-efficacy among Saudi general practitioners in a qualitative survey methodology, by conducting interviews that were recorded digitally and transcribed verbatim by a professional transcription service. DE identified data were transferred into NVivo 10 for data organisation and coding. Data were analysed independently by the researchers and coded using social cognitive theory as a guiding framework. Twenty GPs recruited via a snowball sampling strategy to deliver a pilot of an obesity management program (“The Change Program”) participated in semi structured interviews before commencing the pilot. Of the 20 participating GPs (twelve  males and eight female), ages ranged between 33 and 55, and years working in general practice ranged between 5 and 25. The Interviews were face-to-face and were conducted in June and July of 2017. The study concluded that shifting the frame away from weight loss per se and towards these other goals might therefore allow for a more authentic GP-patient interaction and increase the self-efficacy of both GP and patient for healthy lifestyle changes

Kristalna struktura i optička svojstva sustava Bi-Sb-Te-Se

The quaternary systems of Bi-Sb-Te-Se were synthesized by direct fusion technique. Thin films of these compounds were prepared by thermal evaporation under vacuum of 10−4 Pa. The structural properties of these compounds in powder and thin film forms were investigated by X-ray diffraction. The optical constants (absorption coefficient and band gap) of the thin films were determined by measurements of IR absorbance in the region 2.5 – 10 µm. Analysis of the optical absorption spectra revealed the existence of two direct energy gaps.Sintetizirali smo sustave Bi-Sb-Te-Se sa četiri sastavnice izravnom metodom staljivanja. Tanke slojeve tih spojeva pripremali smo isparavanjem u vakuumu (na 10−4 Pa). Primjenom rendgenske difrakcije odredili smo strukturna svojstva praha i tankih slojeva tih spojeva. Optičke konstante tankih slojeva (koeficijent apsorpcije i procijep med–u vrpcama) odredili smo mjerenjem apsorpcije u području 2.5 – 10 µm. Analiza optičkih apsorpcijskih spektara pokazuje dva izravna procijepa

Kristalna struktura i optička svojstva sustava Bi-Sb-Te-Se

The quaternary systems of Bi-Sb-Te-Se were synthesized by direct fusion technique. Thin films of these compounds were prepared by thermal evaporation under vacuum of 10−4 Pa. The structural properties of these compounds in powder and thin film forms were investigated by X-ray diffraction. The optical constants (absorption coefficient and band gap) of the thin films were determined by measurements of IR absorbance in the region 2.5 – 10 µm. Analysis of the optical absorption spectra revealed the existence of two direct energy gaps.Sintetizirali smo sustave Bi-Sb-Te-Se sa četiri sastavnice izravnom metodom staljivanja. Tanke slojeve tih spojeva pripremali smo isparavanjem u vakuumu (na 10−4 Pa). Primjenom rendgenske difrakcije odredili smo strukturna svojstva praha i tankih slojeva tih spojeva. Optičke konstante tankih slojeva (koeficijent apsorpcije i procijep med–u vrpcama) odredili smo mjerenjem apsorpcije u području 2.5 – 10 µm. Analiza optičkih apsorpcijskih spektara pokazuje dva izravna procijepa

Present status and sustainable utilization of hydrothermal geothermal resources in Tianjin, China: a critical review

Tianjin, as one of the pioneering and most prominent cities in China, has a long history of harnessing geothermal energy. The geothermal resource available in Tianjin is primarily characterized as a low- to medium-temperature hydrothermal geothermal resource. This manuscript introduces the ongoing status and potential of geothermal utilization in China, with a particular focus on the characteristics and utilization status of geothermal resources in Tianjin, China. Moreover, the relevant strategies and challenges for cost-efficient sustainable utilization of Tianjin geothermal resources are identified. The formation parameters of heat storage characteristics of Tianjin geothermal resources are also discussed. In addition, the key paths, guidelines and challenges on how to solve the obstacles related to the geothermal resources development in Tianjin are also suggested. The summarized results indicate that the geothermal reservoirs exploited in Tianjin vary greatly, which include sandstone of Neogene Minghuazhen formation, Guantao formation, Ordovician and Cambrian and carbonate of Proterozoic Wumishan formation. Most of the exploitative geothermal resources (146 geothermal wells) in Tianjin have mainly been produced from the Wumishan formation of the Jixian system and the Guantao formation of the Neogene system. The current production capacity has been doubled, and a two-stage cascade utilization system has been established, incorporating geothermal power generation and geothermal heating. The geothermal utilization share in Tianjin is estimated to be 81.66% for heating, 16.6% for domestic hot water and 1.35% for bathing. In conclusion, notwithstanding the diversity of geothermal resources in Tianjin, it is difficult to guarantee the sustainable development and utilization of geothermal resources in Tianjin due to the unreasonable layout of geothermal wells, imbalance of production and reinjection. Hence, the integration of distributed temperature sensing and distributed strain sensing monitoring demonstrates significant promise and effectiveness in tracking water circulation and detecting flow localization problems as dynamic monitoring processes and smart thermal response tests should be recommended and established as a substantial feature required in the future utilization and development of geothermal resources in Tianjin

The Role of Extracellular Vesicles as Modulators of the Tumor Microenvironment, Metastasis and Drug Resistance in Colorectal Cancer.

Colorectal cancer (CRC) is one of the most common cancers worldwide, with high morbidity and mortality rates. A number of factors including modulation of the tumor microenvironment, high metastatic capability, and resistance to treatment have been associated with CRC disease progression. Recent studies have documented that tumor-derived extracellular vesicles (EVs) play a significant role in intercellular communication in CRC via transfer of cargo lipids, proteins, DNA and RNAs to the recipient tumor cells. This transfer influences a number of immune-related pathways leading to activation/differentiation/expression of immune cells and modulation of the tumor microenvironment that plays a significant role in CRC progression, metastasis, and drug resistance. Furthermore, tumor-derived EVs are secreted in large amounts in biological fluids of CRC patients and as such the expression analysis of EV cargoes have been associated with prognosis or response to therapy and may be a source of therapeutic targets. This review aims to provide a comprehensive insight into the role of EVs in the modulation of the tumor microenvironment and its effects on CRC progression, metastasis, and drug resistance. On the other hand, the potential role of CRC derived EVs as a source of biomarkers of response and therapeutic targets will be discussed in detail to understand the dynamic role of EVs in CRC diagnosis, treatment, and management

Genital-Sparing Cystectomy versus Standard Urethral-Sparing Cystectomy Followed with Orthotopic Neobladder in Women with Bladder Cancer: Incidence and Causes of Hypercontinence with an Ultrastructure Study of Urethral Smooth Muscles

BACKGROUND: Bladder cancer in women is an indication for radical cystectomy (RC) when the tumour is confined muscle-invasive bladder cancer (MIBC) of T2 N0M0, or high risk progressive non-muscle invasive bladder cancer (NMIBC). Radical cystectomy is either genital-sparing cystectomy (GSC) or standard urethra-sparing cystectomy (USC) that is followed with orthotopic ileal neobladder (ONB). Post-operative chronic retention “Hypercontinence†had been reported in different series following URS or GSC and ONB. In long-term follow-up, we evaluated the functional outcome of women who developed hypercontinence after USC or GSC and ONB. AIM: An ultrastructure study of female urethral smooth muscle was done to elucidate the underlying causes of hypercontinence. MATERIAL AND METHODS: Retrospective study was conducted on 71 women who underwent RC and ONB, 45women had undergone USC, and 26 women had GSC, follow-up ranged from 5 to 15 years. Ultrastructure studies were done on 5 urethral biopsy specimens from 5 women who had hypercontinence, and 4 biopsies were from a normal control. RESULTS: Follow-up showed that women who had undergone USC and ONB, 28.88% developed hypercontinence, where in the series of GSC and ONB three women out of 26 developed hypercontinence (7.80%). Three women who had hypercontinence following USC and ONB, they developed stones in the ileal pouch. Ultrastructure study of urethral smooth muscles in women who had hypercontinence showed organized collagen fibrils, absent myelin sheath, and non-detected lymphatic vessels. Normal urethra showed collagen fibrils within the interstitial matrix, preserved myelin sheath of nerve fibres, the presence of lymphatic vessels in the matrix. CONCLUSION: The present study shoes that GSC with ONB leads to the minimal incidence of hypercontinence (7.80%), while standard USC lead to higher incidence (28.88%). Ultrastructure changes of the female urethra who had hypercontinence were fibrotic changes, loss of myelin sheath and minimal vascularity, their findings explains the underlying cause of hypercontinence and support the technique of GSC rather than the standard USC

Potential Utilization of Alternative Construction Materials in Qatar, in lieu of Conventional Washed Sand

Natural sand that has been washed is an essential material used in infrastructure development and construction projects of all sizes. Due to the depletion of natural sand sources in Qatar, there has arisen a need to develop alternate materials to replace it. Substitutes such as wadi gravel, marine sand and manufactured sand, including crushed imported limestone, recycled sand and crushed gabbro have been considered and explored. Consequently, a proposal to encourage local washed sand producers to incorporate varying proportions of these alternate materials into the various material demands was considered by the Public Works Department, depending on the application in either structural and/or precast members. This paper primarily focuses on providing an overview of some of the available alternate materials to washed sand that could be utilized without affecting the physical, mechanical, or strength properties of concrete, precast, and other construction materials that use washed sand, while at the same time providing a long-lasting, durable and economically beneficial alternative material to the national economy

Sanguinarine Induces Apoptosis Pathway in Multiple Myeloma Cell Lines via Inhibition of the JaK2/STAT3 Signaling.

Sanguinarine (SNG), a benzophenanthridine alkaloid, has displayed various anticancer abilities in several vivo and studies. However, the anticancer potential of SNG is yet to be established in multiple myeloma (MM), a mostly incurable malignancy of plasma cells. In this study, we aimed to investigate the potential anti-proliferative and pro-apoptotic activities of SNG in a panel of MM cell lines (U266, IM9, MM1S, and RPMI-8226). SNG treatment of MM cells resulted in a dose-dependent decrease in cell viability through mitochondrial membrane potential loss and activation of caspase 3, 9, and cleavage of PARP. Pre-treatment of MM cells with a universal caspase inhibitor, Z-VAD-FMK, prevented SNG mediated loss of cell viability, apoptosis, and caspase activation, confirming that SNG-mediated apoptosis is caspase-dependent. The SNG-mediated apoptosis appears to be resulted from suppression of the constitutively active STAT3 with a concomitant increase in expression of protein tyrosine phosphatase (SHP-1). SNG treatment of MM cells leads to down-regulation of the anti-apoptotic proteins including cyclin D, Bcl-2, Bclxl, and XIAP. In addition, it also upregulates pro-apoptotic protein, Bax. SNG mediated cellular DNA damage in MM cell lines by induction of oxidative stress through the generation of reactive oxygen species and depletion of glutathione. Finally, the subtoxic concentration of SNG enhanced the cytotoxic effects of anticancer drugs bortezomib (BTZ) by suppressing the viability of MM cells via induction of caspase-mediated apoptosis. Altogether our findings demonstrate that SNG induces mitochondrial and caspase-dependent apoptosis, generates oxidative stress, and suppresses MM cell lines proliferation. In addition, co-treatment of MM cell lines with sub-toxic doses of SNG and BTZ potentiated the cytotoxic activity. These results would suggest that SNG could be developed into therapeutic agent either alone or in combination with other anticancer drugs in MM

Hand hygiene knowledge and attitude of medical students in western Saudi Arabia

Background The practice of hand hygiene (HH) has prime importance among Health Care Professionals (HCPs) and non-compliance could cause adverse consequences. By keeping the importance of HH in mind, this study aims at investigating the knowledge and attitudes towards HH among medical students and interns at King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA). Methods The study includes 453 medical students and interns (189 males & 264 females). This study was completed in three months; from September to November 2017. The World Health Organization (WHO) HH questionnaire was used and data were analyzed on SPSS-21. Results Two-third of the participants 292 (64.2%) had formal training in HH in the last three years. Almost half of the participants 254 (56.1%) had correct knowledge regarding the major course of transmission of potentially detrimental microbes among patients in the healthcare premises. Just 124 (27.4%) of the respondents had the correct knowledge about the most common basis of germs accountable for healthcare-related infections. Females had significantly better knowledge than males regarding the type of HH technique needed before palpation of the abdomen (177(54%) Vs. 151(46%); P < 0.002), before an injection (175(54.5%) Vs. 146(45.5%); P < 0.007), after emptying a bedpan (207(64.7%) Vs. 113(35.3%); P < 0.001), following discarding examination gloves (256(60.4% Vs. 168(39.6%); P < 0.001] and after exposure to blood (200(64.1%) Vs. 112(35.%); P < 0.001). Female participants had better knowledge than males regarding the type of HH actions. Females also had a significantly better attitude towards the importance of HH than males (240(62.5%) Vs. 144(37.5%); P < 0.001). Conclusion The majority of the participants’ knowledge regarding HH was not up to the mark; however, female students had better knowledge compared to male students. The medical students and interns’ knowledge and positive attitude towards HH can play a pivotal role in preventing HCPs associated infections and it would overall decrease the infection-related burden on the hospital and governmental budgets. It is suggested that multi-dimensional plans are required to change this low compliance to a higher rate