Turnover among foreign nurses in Saudi Arabia

Background: Globally, nursing turnover has become a contemporary concern that significantly influences the financial proficiency of healthcare systems. Not only costs, but healthcare accessibility and quality also reverberate the consequence of the phenomenon.Design and methods:  The study explores the factors that attribute to turnover among foreign registered nurses working in Saudi Arabia. A quantitative-based cross-sectional descriptive study design that uses survey data to make statistical inferences about foreign nurse turnover in Saudi Arabia, was conducted to ascertain factors influencing the termination of foreign nurses working with the Ministry of Health (MOH) hospitals.Results: Factors influencing turnover were categorized into 9 dimensions, professional growth and development, leadership style, management, wage and benefits, workload, interpersonal relationship, housing facilities and services, hospital facilities and intent to stay and turn-over intention, of which the professional growth (4.1±0.7) and development had the highest mean agreement scores (4.0±1.1), whereas housing (2.3±1.3) and hospital facilities (2.1±1.0) showed the lowest mean scores. Conclusions: Wage benefits and workload factors were found to be the most significant causes of expatriate nursing turnover, closely followed by inadequate housing and hospital facilities. Recommendations from nursing staff on how to improve retention were also noted

The Effectivity of Himmati to Improve the Arabic Reading Skills Through the Online ATQ Program

This article aimed to verify the effectivity of Himmati to improve the Arabic reading skills of beginners. The target population here was all of the beginners in Indonesia as well as some other countries in Southeast Asia. While the accessible population was the beginners in MAN 4 Banyuwangi, Indonesia among the new students of 2020/2021. Based on the experiment results on 21 samples who participated in the online ATQ program using Himmati, which were analyzed with the paired-sample t-test, it was found a value of sig. (2-tailed) 0,000 ttable 2,086. It showed that there was difference in the Arabic reading skills for beginners between pretest and post-test scores. Because the post-test score 87,19 > pretest score 80,38.  So it can be concluded that Himmati is effective as a textbook to improve the Arabic reading skills for beginners in MAN 4 Banyuwangi. Thus, Himmati can be recommended as a textbook to be used by more beginners to improve the Arabic reading skills

Study of the Effect of Berry Paper Mulberry on Optical Properties of Poly Methyl Methacrylate

In this work, study the optical properties of composites consisting of poly Methyl Methacrylate and Berry Paper Mulberry. The samples of composites were prepared using casting method .The Berry Paper Mulberry (BPM) was added by different concentrations are (0, 2, 4 and 6)wt.%. The optical properties of composites have been studied in the wavelength range (200-800)nm. The absorption coefficient ,energy gap, refractive index, extinction coefficient and dielectric constants have been determined. The results show that the optical constants change with increase of BPM concentrations

Synthesis of GNAT PA3944 Substrate Analogs

The Gcn5-related N-acetyltransferase (GNAT) superfamily is responsible for diverse biological functions and is critically important in cellular and metabolic processes in all kingdoms of life. GNATs transfer an acetyl-group from an active donor, typically acetyl-coenzyme A (AcCoA), to a primary amine of an acceptor substrate. Members of this family are well known for their roles in aminoglycoside antibiotic resistance, histone modification, protein acetylation, xenobiotic metabolism, and other cellular processes.1, 2 A small subset of bacterial GNAT enzymes have been studied and characterized both structurally and functionally, but the function of the vast majority remains unknown. Most of the reported 3D crystallographic structures of GNATs contain no acceptor substrate bound in their active sites. We previously screened the PA3944 protein against a panel of potential substrates and found the enzyme exhibited the highest activity toward aspartame, polymyxin B and colistin (polymyxin E).3 Our project involves the synthesis of molecular analogs of previously identified functionally relevant acceptor substrates that will be co-crystallized with GNAT-PA3944, in particular simplified derivatives of polymyxin B including NANMO and AAB, and we have shown that NANMO is as efficient as polymyxin B as a substrate. The ligand-bound crystallographic structures will provide insight into the structural features of the active site that are involved in substrate recognition and advance our understanding of types of substrates recognized by this enzyme of unknown function. Syntheses of NANMO and AAB will be described, along with modeling and substrate efficiency

In Silico Binding of 2-Aminocyclobutanones to SARS-CoV-2 Nsp13 Helicase and Demonstration of Antiviral Activity

The landscape of viral strains and lineages of SARS-CoV-2 keeps changing and is currently dominated by Delta and Omicron variants. Members of the latest Omicron variants, including BA.1, are showing a high level of immune evasion, and Omicron has become a prominent variant circulating globally. In our search for versatile medicinal chemistry scaffolds, we prepared a library of substituted α-aminocyclobutanones from an α-aminocyclobutanone synthon (11). We performed an in silico screen of this actual chemical library as well as other virtual 2-aminocyclobutanone analogs against seven SARS-CoV-2 nonstructural proteins to identify potential drug leads against SARS-CoV-2, and more broadly against coronavirus antiviral targets. Several of these analogs were initially identified as in silico hits against SARS-CoV-2 nonstructural protein 13 (Nsp13) helicase through molecular docking and dynamics simulations. Antiviral activity of the original hits as well as α-aminocyclobutanone analogs that were predicted to bind more tightly to SARS-CoV-2 Nsp13 helicase are reported. We now report cyclobutanone derivatives that exhibit anti-SARS-CoV-2 activity. Furthermore, the Nsp13 helicase enzyme has been the target of relatively few target-based drug discovery efforts, in part due to a very late release of a high-resolution structure accompanied by a limited understanding of its protein biochemistry. In general, antiviral agents initially efficacious against wild-type SARS-CoV-2 strains have lower activities against variants due to heavy viral loads and greater turnover rates, but the inhibitors we are reporting have higher activities against the later variants than the wild-type (10–20X). We speculate this could be due to Nsp13 helicase being a critical bottleneck in faster replication rates of the new variants, so targeting this enzyme affects these variants to an even greater extent. This work calls attention to cyclobutanones as a useful medicinal chemistry scaffold, and the need for additional focus on the discovery of Nsp13 helicase inhibitors to combat the aggressive and immune-evading variants of concern (VOCs)

Cyclobutanone Inhibitor of Cobalt-Functionalized Metallo-γ-Lactonase AiiA with Cyclobutanone Ring Opening in the Active Site

An α-amido cyclobutanone possessing a C10 hydrocarbon tail was designed as a potential transition-state mimetic for the quorum-quenching metallo-γ-lactonase autoinducer inactivator A (AiiA) with the support of in-house modeling techniques and found to be a competitive inhibitor of dicobalt(II) AiiA with an inhibition constant of Ki = 0.007 ± 0.002 mM. The catalytic mechanism of AiiA was further explored using our product-based transition-state modeling (PBTSM) computational approach, providing substrate-intermediate models arising during enzyme turnover and further insight into substrate–enzyme interactions governing native substrate catalysis. These interactions were targeted in the docking of cyclobutanone hydrates into the active site of AiiA. The X-ray crystal structure of dicobalt(II) AiiA cocrystallized with this cyclobutanone inhibitor unexpectedly revealed an N-(2-oxocyclobutyl)decanamide ring-opened acyclic product bound to the enzyme active site (PDB 7L5F). The C10 alkyl chain and its interaction with the hydrophobic phenylalanine clamp region of AiiA adjacent to the active site enabled atomic placement of the ligand atoms, including the C10 alkyl chain. A mechanistic hypothesis for the ring opening is proposed involving a radical-mediated process

Gcn5-Related N-Acetyltransferases (GNATs) With a Catalytic Serine Residue Can Play Ping-Pong Too

Enzymes in the Gcn5-related N-acetyltransferase (GNAT) superfamily are widespread and critically involved in multiple cellular processes ranging from antibiotic resistance to histone modification. While acetyl transfer is the most widely catalyzed reaction, recent studies have revealed that these enzymes are also capable of performing succinylation, condensation, decarboxylation, and methylcarbamoylation reactions. The canonical chemical mechanism attributed to GNATs is a general acid/base mechanism; however, mounting evidence has cast doubt on the applicability of this mechanism to all GNATs. This study shows that the Pseudomonas aeruginosa PA3944 enzyme uses a nucleophilic serine residue and a hybrid ping-pong mechanism for catalysis instead of a general acid/base mechanism. To simplify this enzyme’s kinetic characterization, we synthesized a polymyxin B substrate analog and performed molecular docking experiments. We performed site-directed mutagenesis of key active site residues (S148 and E102) and determined the structure of the E102A mutant. We found that the serine residue is essential for catalysis toward the synthetic substrate analog and polymyxin B, but the glutamate residue is more likely important for substrate recognition or stabilization. Our results challenge the current paradigm of GNAT mechanisms and show that this common enzyme scaffold utilizes different active site residues to accomplish a diversity of catalytic reactions

Satisfaction of adult and pediatric neurologists and neurosurgeons using telehealth during the COVID-19 pandemic in Saudi Arabia: a cross-sectional study

ObjectivesTelehealth has become increasingly important in achieving universal health coverage. It offers doctors and their patients' convenience, including providing quality care at reduced costs. During the coronavirus disease (COVID)-19 pandemic, telehealth has been a vital tool for remote healthcare services. This study aimed to assess the satisfaction of adult and pediatric neurologists and neurosurgeons using telehealth, during the COVID-19 pandemic in Saudi Arabia.MethodsThis study had 348 participants. It was conducted among adult and pediatric neurologists and neurosurgeons using telehealth technology at their clinics between February and June 2021. The self-administered questionnaire included sociodemographic data, behavior in using telehealth, and an assessment of satisfaction with telehealth; the SPSS Windows software version 26 was used to analyze the data.ResultsThe most common age group was 25–34 years (42.8%), with men dominating (68.4%). The mean satisfaction score was 25.9 (SD 3.91) out of 33 points, with 90.2% of respondents satisfied with telehealth and 9.8% dissatisfied. Working in an academic center or private hospital, being a first-time telehealth user, using messages as a telehealth method, and using telehealth daily were associated with increased satisfaction with telehealth use.ConclusionThe satisfaction of adult and pediatric neurologists and neurosurgeons with telehealth was high. Although physicians still preferred face-to-face interviews, they recognized the benefits of telehealth in strengthening the patient–provider relationship, improving productivity, and integrating into daily workflows. The satisfaction levels align with past studies, but physical examination needs should be considered. Telehealth is suitable for follow-up visits and varies across subspecialties

Association Between Lipid Profile and Diabetic Foot Ulcer

Diabetic foot ulcer is a serious disabling consequence of Diabetes Mellitus. They are characterized by the breakdown of skin and underlying tissues in the feet, and are a major cause of lower limb amputations. Various risk factors have been identified for the development of diabetic foot ulcers, including poor glycemic control, peripheral neuropathy, peripheral arterial disease, and impaired wound healing. it is considered that the lipid profile is one of many factors that contribute to the formation and progression of diabetic foot ulcers. To stratify the incidence of diabetic foot ulcers (DFUs), biomarkers are required. The aim of this review is to assess the relationship between the risk of DFU and lipid profile in diabetic patients

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London