A COMPUTATIONAL MODEL RELATING TISSUE OXYGEN CONSUMPTION TO OXYGEN DELIVERY IN A KROGH CYLINDER MODEL OF SKELETAL MUSCLE

Oxygen transport from a capillary to skeletal muscle tissue is a complex process that involves convective and diffusive mechanisms to deliver adequate oxygen to meet tissue metabolic activities. Typically, oxygen uptake in tissue is set by oxygen demand, which is set by metabolic activity. The relationship between the oxygen consumption (VO2) of an isolated perfused tissue and the rate of delivery of oxygen (QO2) to the tissue has been a subject of interest to many investigators over the past century. Experiments have shown that there is a critical value of QO2 below which tissue VO2 begins to decline. The Michaelis-Menten kinetics model for oxygen-dependent oxygen consumption is investigated as a modeling assumption in a computational study of oxygen transport from capillaries to skeletal muscle tissue using the Krogh cylinder model. The work presented in this thesis extends Schumacker and Samsel’s computational model to include the more accurate Michaelis-Menten kinetic description of the oxygen tension (PO2) dependence of VO2, using the parameter km, the PO2 for half-maximal VO2. This study aims to predict the relationship between oxygen consumption and oxygen delivery by considering the oxygen transport processes at the microvascular level. The dependence of oxygen consumption on oxygen delivery, critical oxygen extraction, critical oxygen delivery, and tissue oxygen tension profiles were examined as a function of km. The critical oxygen delivery was found to depend on km, increasing nonlinearly as km increases. The fractional oxygen extraction at the critical QO2 varied inversely with km. The venous oxygen partial pressure (PvO2) also varied with km. Finally, the predicted radial profile of tissue oxygen tension at the critical QO2 depended on km. At lower critical oxygen delivery and at lower km, the critical radial distance at which tissue oxygen partial pressure was found to be km occurred closer to the end of the capillary. The present results suggest that the value of km influences the relationship between tissue oxygen consumption and oxygen supply as the oxygen delivery is reduced to the critical point. Ultimately, km becomes the fundamental parameter that specifies how oxygen consumption depends on oxygen tension instead of the critical mitochondrial oxygen tension

Early Childhood Mathematics Curriculum in the light of the standards of the National Council of Mathematics Teachers

This study aims at exploring the preschool mathematics curriculum in light of the National Council of Teachers of Mathematics Standards. The study researched a sample of (140) preschool educators. An analysis of the mathematical content of preschool Self-Learning curriculum was conducted, and Saudi preschool educators were surveyed, in terms of their educational practices, and the processes used in teaching mathematics in their classes In accordance with the U.S. national standards for mathematicians, it means the methods in which children interact with sports content or content, namely (problem solving- communication- logical thinking - representation - Connection), where the study showed that the reality of the components of the mathematics curriculum applied in kindergartens within Saudi Arabia achieved these standards at these levels was The application of representation, communication and connectivity are the most achieved in the self-learning curriculum units with ratios of (86.4%, 83%, 82%), respectively, while problem-solving and logical thinking have reached the minimum use in the classroom, indicating that these processes are the least interested in application from the sample point of view, with 80%, respectively, using them (80%, 67.80%), despite the critical importance of these two processes specifically in building mathematical concepts as they focus on the ability of the child to be focused on the ability of the child. To use his accumulated sports skills to meet challenges such as predicting and examining hypotheses in order to find a scientific solution to the sports situation

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

Comparison of total endoscopic thyroidectomy with conventional open thyroidectomy for treatment of papillary thyroid cancer

BackgroundRecent advance of endoscopic techniques has allowed surgeons to perform thyroidectomy via an incision placement at hidden places which lead to better cosmetic acceptability compared with conventional open thyroidectomy.AimsThis study was conducted to summarize the current evidence that compare open thyroidectomy with endoscopic ‎thyroidectomy in treatment of papillary thyroid cancer‎.‎Methods An electronic literature review, including PubMed, Google Scholar, and EBSCO that examining randomized trials of endoscopic thyroidectomy (ET), conventional open thyroidectomy (COT), and management of papillary thyroid carcinoma was carried out.Results The review included 8 randomized studies that compare total endoscopic thyroidectomy versus conventional open thyroidectomy in treatment of papillary thyroid cancer. The findings showed endoscopic thyroidectomy had statically significant cosmetic appearance, less amount of blood loss and occurrence of transient hypocalcaemia than conventional open thyroidectomy in form of cosmetic outcome, amount lower blood loss.ConclusionThe current review showed that, ET has a better cosmetic outcome and lower blood loss compared with COT. While COT was associated with significantly low operation time, hospital stay, drainage time, amount of drainage fluid and transient recurrent laryngeal nerve (RLN) palsy

Community Perception and Attitude towards COVID-19 Vaccination for Children in Saudi Arabia

Introduction: Vaccines are an important part of the COVID-19 pandemic response plan. This study was undertaken to find out the percentage of supporters in the Saudi population for COVID-19 vaccination among children, and to assess the study population’s perceptions towards COVID-19 vaccination among children. Material and Methods: This nationwide study adopted a cross-sectional survey of adult participants, conducted by trained medical students. The anonymous questionnaire was published on social media tools. Statistical analysis was conducted using two-tailed tests. Results: Six hundred and twenty (620) participants were recruited for this study. Nearly 17.0% of participants had a chronic health problem/comorbidity. About 28.7% of the study participants reported having COVID-19 infection. The COVID-19 vaccine was received among 94.7% of the study respondents. The majority of the vaccination supporters (89.0%) wanted to get the third dose. There was a statistically significant association between the participant’s attitudes towards getting vaccinated themselves, and their attitude towards children’s vaccination. Vaccine newness, as a reason for hesitating to get vaccinated, was most reported among non-vaccine supporters. False religious beliefs were found to significantly influence the opposing attitude towards children’s vaccination. Conclusion: Health professionals and policy makers should implement and support strategies to ensure children are vaccinated against COVID-19. They also need to educate parents and families regarding the importance of vaccination against COVID-19

The Right to Refuse: Understanding Healthcare Providers’ Perspectives on Patient Autonomy in Emergency Care

Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into the attitudes of these providers toward treatment refusal, unearthing the strategies they employ in navigating such challenging situations while actively working in prehospital emergency health services. Our findings showed that, as the participants’ age and experience increased, so did their inclination to respect patient autonomy and avoid persuading them to change their decision about treatment. It was noted that doctors, paramedics, and emergency medical technicians demonstrated a deeper understanding of patients’ rights than other medical specialists. However, even with this understanding, the prioritization of patients’ rights tended to diminish in life-threatening situations, giving rise to ethical dilemmas. This underlines the complexity of balancing the healthcare professionals’ responsibilities and the patients’ autonomy, which can generate ethically challenging scenarios for those working in emergency healthcare. By investigating these attitudes and experiences, this study seeks to foster a more profound understanding of the ethical quandaries faced by emergency healthcare providers. Our ultimate aim is to contribute to the development of effective strategies that support both patients and professionals in managing these tough circumstances

Prevalence of lower back pain and its associations with lifestyle behaviors among college students in Saudi Arabia

Abstract Background Lower back pain (LBP) is a common musculoskeletal disorder that may affect students’ daily lives. Recent psychological research showed a relevant connection between LBP and multidimensional health. However, the association between LBP and lifestyle behavior has not been established, and improving knowledge in this area may help develop preventive strategies and optimize college students’ quality of life. Methods A cross-sectional study of 1420 college students in Saudi Arabia was conducted, and participants who attended Saudi Universities were recruited from May 2021 to November 2021. An established validated online survey assessed LBP, sleep quality, time spent sedentary (sedentary duration), health responsibility, physical activity, nutrition, spiritual growth, interpersonal relationships, and stress management. Generalized Linear Regression was used to assess the associations between LBP severity and lifestyle behaviors after controlling for covariates. Results LBP was prevalent among college students from Saudi Arabia. Most of the sample were young (23.81 ± 6.02), and female (83.7%). There were significant differences between students with and without LBP regarding age, BMI, sex, marital status, pain severity, overall lifestyle behavior, health responsibility, physical activity, nutrition, stress management, and global sleep quality. After controlling for age, BMI, sex, and marital status, there were significant associations between pain severity and global sleep quality (ß=0.2, p < .001, CI: 16 to 0.24), and sedentary duration (ß=0.03, p = .01, CI:0.009 to 0.06). Conclusions This study helped define the prevalence of LBP in college students in Saudi Arabia and evaluated the association between LBP and lifestyle behaviors. The findings showed that students with higher levels of poor sleep quality or sedentary behavior had higher levels of pain. Promoting sleep quality and reducing sedentary behavior may help establish preventive strategies for LBP in college students

Physical, Optical, and Mechanical Properties of Ceramic Materials after Coffee Immersion and Evaluation of Cleaning Impact with Different Oral Hygiene Tools

This study aimed to evaluate the effect of three oral hygiene tools, a regular toothbrush, an electronic toothbrush, and mouthwash, on the color stability of three different computer-aided design (CAD) and computer-aided manufactured (CAM) ceramic blocks. Feldspathic ceramic (Vita Triluxe Forte), hybrid resin ceramic (Vita Enamic), and lithium disilicate glass-ceramic (IPS e.max CAD) were used in this study. A CAD/CAM system and 81 (27 of each material) samples of ceramic blocks were used. All samples were immersed in black coffee for 15 days, and the coffee was changed twice per day. Using a spectrophotometer probe, samples on a grey background were scanned, and physical properties like surface hardness and depth were measured using interferometry and a 3D non-contact surface metrology. After 30 days of application of oral hygiene tools, instruments were used to measure various physical, mechanical, and optical properties. Vita Triluxe had the highest average color variation values (&Delta;E00) after 15 and 30 days of immersion in coffee in both regular and electronic toothbrushes. Moreover, IPS e.max CAD had the least &Delta;E00 values with no significant differences among the groups. The surface roughness (Ra) of the Vita Enamic ceramic increased when using a regular toothbrush, and the surface height (Rz) for the Vita Enamic ceramic increased when an electronic toothbrush was used. IPS e.max CAD had the greatest modules of elasticity forces, and Vita Triluxe Forte had the lowest when used with a regular toothbrush. The &Delta;E00 values of the tested materials were minimally increased or decreased after 30 days of cleaning, and all were clinically acceptable. Ra and Rz were the highest for Vita Enamic in comparison to the other groups. The highest percentage in IPS e.max CAD was associated with a type 1 fracture, whereas type 3 was predominantly observed with Vita Enamic, and type 2 in the Vita Triluxe group without significant differences

Awareness about folic acid intake amongst Saudi women of child bearing age in the Aseer region in prevention of neural tube defects in fetus

Background: Folic acid deficiency during pregnancy can lead to critical anomalies called neural tube defects (NTDs) in fetus. Though its prevalence is low (0.5 to 2 per 1000 births) yet efforts must be made to prevent its occurrence. Thus, objective of this study was to speculate the level of awareness of folic acid intake amongst Saudi women of child bearing age in the Aseer region in prevention of NTDs and to propose measures to prevent its occurrence. Method: A descriptive cross-sectional study was carried out on 700 women of child bearing age residing in various areas of Aseer Province. A self designed questionnaire form aiming to assess the awareness of folic acid was distributed to the participants and their responses were analysed. Results: Most of the women resided in villages/small town (54.1%) and were married (66.6%), educated up to graduation level (50.9%), non working (55.4%), non smokers (97.3%) and had monthly family income of less than 5000 Saudi Riyals indicating a relatively lower economic status. Only 18% women were aware that folic acid deficiency during pregnancy could lead to NTDs. Hardly 9.1% women were aware that folic acid should be taken 3 months before the pregnancy and during first 3 months of pregnancy. At the time of study although 53.9 % of study subject women were consuming folic acid supplements because of pregnancy, however 51.3 % women expressed their unwillingness to do so in future if they ever conceived. Conclusion: Awareness about folic acid intake amongst Saudi women of child bearing age in the Aseer region in prevention of NTDs in fetus was found to be low. Therefore formulating better health education strategies, support from healthcare staff, strengthening health care programs and frequent health visits/surveys are the proposed measures to ensure a higher level of awareness on the issue

MmpL3 Inhibition as a Promising Approach to Develop Novel Therapies against Tuberculosis: A Spotlight on SQ109, Clinical Studies, and Patents Literature

Tuberculosis (TB) is accountable for considerable global morbidity and mortality. Effective TB therapy with multiple drugs completes in about six months. The longer duration of TB therapy challenges patient compliance and contributes to treatment collapse and drug resistance (DR) progress. Therefore, new medications with an innovative mechanism of action are desperately required to shorten the TB therapy’s duration and effective TB control. The mycobacterial membrane protein Large 3 (MmpL3) is a novel, mycobacteria-conserved and recognized promiscuous drug target used in the development of better treatments for multi-drug resistance TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). This article spotlights MmpL3, the clinical studies of its inhibitor (SQ109), and the patent literature. The literature on MmpL3 inhibitors was searched on PubMed and freely available patent databases (Espacenet, USPTO, and PatentScope). SQ109, an analog of ethambutol (EMB), is an established MmpL3 inhibitor and has completed Phase 2b-3 clinical trials. Infectex and Sequella are developing orally active SQ109 in partnership to treat MDR pulmonary TB. SQ109 has demonstrated activity against drug-sensitive (DS) and drug-resistant (DR) Mycobacterium tuberculosis (Mtb) and a synergistic effect with isoniazid (INH), rifampicin (RIF), clofazimine (CFZ), and bedaquiline (BNQ). The combination of SQ109, clofazimine, bedaquiline, and pyrazinamide (PZA) has been patented due to its excellent anti-TB activity against MDR-TB, XDR-TB, and latent-TB. The combinations of SQ109 with other anti-TB drugs (chloroquine, hydroxychloroquine, and sutezolid) have also been claimed in the patent literature. SQ109 is more potent than EMB and could substitute EMB in the intensive stage of TB treatment with the three- or four-drug combination. Developing MmpL3 inhibitors is a promising approach to fighting the challenges associated with DS-TB and DR-TB. The authors foresee MmpL3 inhibitors such as SQ109 as future drugs for TB treatment