Long term sleep disturbances in Tunisian COVID-19 patients discharged from hospital: a cohort study

Background: A spectrum of long-term COVID19 effects have been reported. Much less data areavailable about how COVID19 will affect sleep over time in recovered patients. We Assessed the long-term impact of COVID 19 infection on sleep. Methodology:A prospective cohort study including 84 Tunisian COVID19 patients discharged fromhospital. Patients were asked about the period before SARS COV2 related hospital stay, and the 6-9 month-period after hospital discharge, using several self- reported evaluation scales (Pittsburgh Sleep Quality Inde, the Insomnia Severity Index, Epworth Sleepiness Scale, Patient Health Questionnaire (PHQ)-9 and the EuroQol five-dimension five-level questionnaire). Result(s): The mean age was 57,59 years with 46 men and 38 women. As compared with baseline statue of patients, all assessed outcomes were significantly impaired (VAS pain: 1,71+/-1,1 Vs 3,8+/-2,84;PSQI: 3,25+/-2,4 VS 6,39+/-4,73;ESS: 1,94+/-2,44 VS 3,59+/-4,53;ISI: 1,95+/-2,76 VS 6,07+/-5,96, and PHQ-9: 1,45+/-2,74 VS 7,47 +/- 6,61;p=0.0001). The percentage of poor sleepers (PSQI global score higher than 5) and patients with insomnia had significantly increased from 15,5% to 48,8% and from 1,2 to 11%, respectively (p=0.0001). The percentage of patients experiencingdepression symptoms has also doubled (25% to 58,3%), while severe pain was reported by more than one out of five patients against only 1,2% at baseline. The post-COVID -19 PSQI was significantly correlated with body mass index (r=0,328, p=0,003);the post-COVID-19 VAS pain (r=0,479, p=0,0001) as well as the post-COVID-19 PHQ-9 scale (r=0,712, p=0,0001). Conclusion(s): Sleep disturbances, depression symptoms as well as chronic pain are highly prevalent in long-term follow-up period in hospitalized COVID19 survivors therefore,they should be systematically screened.

IoT-Based Remote Health Monitoring System Employing Smart Sensors for Asthma Patients during COVID-19 Pandemic (preprint)

COVID19 and asthma are respiratory diseases that can be life threatening in uncontrolled circumstances and require continuous monitoring. A poverty stricken South Asian country like Bangladesh has been bearing the brunt of the COVID19 pandemic since its beginning. The majority of the country's population resides in rural areas, where proper healthcare is difficult to access. This emphasizes the necessity of telemedicine, implementing the concept of the Internet of Things (IoT), which is still under development in Bangladesh. This paper demonstrates how the current challenges in the healthcare system are resolvable through the design of a remote health and environment monitoring system, specifically for asthma patients who are at an increased risk of COVID19. Since on-time treatment is essential, this system will allow doctors and medical staff to receive patient information in real time and deliver their services immediately to the patient regardless of their location. The proposed system consists of various sensors collecting heart rate, body temperature, ambient temperature, humidity, and air quality data and processing them through the Arduino Microcontroller. It is integrated with a mobile application. All this data is sent to the mobile application via a Bluetooth module and updated every few seconds so that the medical staff can instantly track patients' conditions and emergencies. The developed prototype is portable and easily usable by anyone. The system has been applied to five people of different ages and medical histories over a particular period. Upon analyzing all their data, it became clear which participants were particularly vulnerable to health deterioration and needed constant observation. Through this research, awareness about asthmatic symptoms will improve and help prevent their severity through effective treatment anytime, anywhere.

Factors Associated With The Covid-19 Infection Severity In Patients With Mental Disorders

Introduction: Recent research showed that persons with mental disorders may represent a population at increased risk for coronavirus disease (COVID-19) infection with more adverse outcomes. Objective(s): We aimed to analyze clinical profile of psychiatric inpatients during their infection with COVID-19, and to explore factors associated with the disease progression. Method(s): Weanalyzed retrospectively the medical records of 32 psychiatric inpatients, hospitalized in psychiatry "B" department at Hedi Chaker hospital (Sfax, Tunisia), and who contracted the COVID-19 infection. We used "Charlson Comorbidity Index Score" (CCIS), predicting 10-year survival in patients with multiple comorbidities. Result(s): Somatic history was reported in 50% of patients. The CCIS ranged between 0 and 4. Psychiatric diagnosis was schizophrenia in 81.3% and bipolar disorder in 18.7% of cases. The clinical symptoms reported were fever (50%), dry cough (75%);dyspnea (34.4%). Biological assessment showed a lymphopenia in 40.6% and a high C-Reactive Protein (CRP) in 53.1%. Among our patients, 37,5% needed oxygen, and 25% were transferred to the intensive care unit. The COVID-19 complications were mostly bacterial pulmonary superinfections (21.9%) and pulmonary embolism (9.4%). Only three (9.4%) patients died from the virus. Patients with medical history were more likely to need oxygen (p<0.001). Clinical and paraclinical parameters associated with oxygen need were: fever (p<0.001);dyspnea (p<0.001);lymphopenia (p<0.001);high CRP (p=0.001). Patients presenting pulmonary superinfection or embolism were more likely to require oxygen (p=0.006 and p=0.044 respectively). Conclusion(s): This study highlighted factors that may worsen the COVID-19 infection evolution, and which require special attention, in order to improve the prognosis of this disease.

Bidirectional Associations Between Covid-19 Infection And Mental Disorders

Introduction: The COVID-19 pandemic brought unbearable psychological pressure to people worldwide, because of serious threats to one's physical health and life. From early stages of this pandemic, concerns have been raised about its effect on mental health. However, we still know little whether pre-existing psychiatric disorder (PD) affects the susceptibility and evolution of this infection. Objective(s): We aimed to assess the interactions between COVID- 19 infection and PD. Method(s): We conducted a litterature review through pubmed database, using the keywords :COVID 19, psychiatry, mental disorders, schizophrenia , anxiety , depression , insomnia. Result(s): On one hand, prior surveys suggested that the infection is associated with increased incidence of a first psychiatric symptom. Mental health disturbances mostly include anxiety, depression, sleep disturbances, cognitive impairment and posttraumatic stress disorder. On the other hand, recent studies showed that patients with pre-existing mental disorders were associated with high susceptibility to be infected, increased risk of intensive care unit admission and a high mortality. The susceptibility to contracting COVID-19 was associated with preexisting mood disorders, anxiety, and attention-deficit hyperactivity disorder. Infection severity was associated with preexisting or subsequent mood disorders and sleep disturbances;or a pre-extisting schizophrenia. Mortality is increased in patients diagnosed with schizophrenia. Conclusion(s): The complicated interactions between COVID-19 infection and PD have several implications. Enhanced psychiatric follow-up should be considered for survivors of COVID-19. Besides, early detection and intervention for PD are needed to control morbidity and mortality induced by the COVID-19 infection.

Qualite de vie professionnelle et resilience chez les professionnels de sante en Tunisie au cours de la pandemie a COVID-19

During the COVID-19 pandemic, repeated exposure of health care workers to unpre-dictable challenges in practice can affect their professional quality of life. The objectives of this study were to assess professional quality of life among healthcare workers during the COVID-19 pandemic and to investigate the relationships between professional quality of life and resi-lience. We conducted a cross-sectional, descriptive, and analytical study, carried out in October and November 2020, among 250 health professionals, practicing in Tunisia. Data were collec-ted through an online questionnaire distributed on social networks. We used the "Professional Quality of Life Scale-5" to assess professional quality of life and the "Brief Resilience Scale"to assess resilience. Compassion satisfaction was low to moderate in 77.6% of participants. Most participants (90.4%) had moderate burnout. Compassion fatigue was low to moderate in 98% of cases. Healthcare professionals with higher resilience scores had significantly higher compassion satisfaction scores, and significantly lower burnout and compassion fatigue scores. In addition, higher burnout scores were associated with significantly lower compassion satisfac-tion scores and significantly higher compassion fatigue scores. These associations were found after multivariate analysis using multiple linear regression. Our results highlight the altered professional quality of life among healthcare workers during the COVID-19 pandemic. Imme-diate interventions are essential to improve psychological resilience and build health systems capacity.

Comprehensive Highlights of the Universal Efforts towards the Development of COVID-19 Vaccine.

The world has taken proactive measures to combat the pandemic since the coronavirus disease 2019 (COVID-19) outbreak, which was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). These measures range from increasing the production of personal protective equipment (PPE) and highlighting the value of social distancing to the emergency use authorization (EUA) of therapeutic drugs or antibodies and their appropriate use; nonetheless, the disease is still spreading quickly and is ruining people's social lives, the economy, and public health. As a result, effective vaccines are critical for bringing the pandemic to an end and restoring normalcy in society. Several potential COVID-19 vaccines are now being researched, developed, tested, and reviewed. Since the end of June 2022, several vaccines have been provisionally approved, whereas others are about to be approved. In the upcoming years, a large number of new medications that are presently undergoing clinical testing are anticipated to hit the market. To illustrate the advantages and disadvantages of their technique, to emphasize the additives and delivery methods used in their creation, and to project potential future growth, this study explores these vaccines and the related research endeavors, including conventional and prospective approaches.

Perceived stigma among Tunisian healthcare workers during the COVID-19 pandemic.

BACKGROUND AND OBJECTIVES: Stigma was a major issue during the COVID-19 pandemic. It posed a serious threat to the lives of healthcare workers (HCWs) who were expected to experience higher levels of stigma and increased psychological distress. This is the first survey to investigate forms and correlates of perceived stigma in Tunisian HCWs during the COVID-19 pandemic. METHODS: A cross-sectional web-based survey was conducted between October 8th and November 10th 2020, among 250 Tunisian HCWs. Data were collected using an online questionnaire using the Google Forms® platform. We used a self-reported instrument measuring COVID-19-related stigma, and the Multidimensional Scale of Perceived Social Support (MSPSS) to measure the perceived adequacy of social support from three sources: family, friends, and significant other. RESULTS: The mean stigma score was 18.6±8. Participants sometimes to often experienced stigma in their relationships with friends (22%), neighbors (27.2%), parents (22,4%), and in social activities (30.8%). This stigma was perceived mainly through avoidance (68.4%), and rarely through verbal (6%) or physical aggression (1.2%). The mean MSPSS total score was 5.26±1.24. In multivariate analysis, depression history (P<0.001), long working experience (P<0.001), having presented ageusia/anosmia (P=0.007) and lower total social support scale (P<0.001) were significantly associated with higher perceived stigma score. CONCLUSION: Our findings showed that HCWs perceived stigma in professional, societal and familial domains. Social support from family, friends and others seemed to protect against perceived stigma. Proper health education targeting the public appears to be an effective method to prevent social harassment of both HCWs and COVID-19 survivors.

Professional quality of life and resilience strategies among Tunisian healthcare workers during the COVID-19 pandemic

During the COVID-19 pandemic, repeated exposure of health care workers to unpredictable challenges in practice can affect their professional quality of life. The objectives of this study were to assess professional quality of life among healthcare workers during the COVID-19 pandemic and to investigate the relationships between professional quality of life and resilience. We conducted a cross-sectional, descriptive, and analytical study, carried out in October and November 2020, among 250 health professionals, practicing in Tunisia. Data were collected through an online questionnaire distributed on social networks. We used the “Professional Quality of Life Scale-5” to assess professional quality of life and the “Brief Resilience Scale” to assess resilience. Compassion satisfaction was low to moderate in 77.6% of participants. Most participants (90.4%) had moderate burnout. Compassion fatigue was low to moderate in 98% of cases. Healthcare professionals with higher resilience scores had significantly higher compassion satisfaction scores, and significantly lower burnout and compassion fatigue scores. In addition, higher burnout scores were associated with significantly lower compassion satisfaction scores and significantly higher compassion fatigue scores. These associations were found after multivariate analysis using multiple linear regression. Our results highlight the altered professional quality of life among healthcare workers during the COVID-19 pandemic. Immediate interventions are essential to improve psychological resilience and build health systems capacity. © 2022 Elsevier Masson SAS

High Seroprevalence of SARS-CoV-2 IgG and RNA among Asymptomatic Blood Donors in Makkah Region, Saudi Arabia.

The gold-standard approach for diagnosing and confirming Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection is reverse transcription-polymerase chain reaction (RT-PCR). This method, however, is inefficient in detecting previous or dormant viral infections. The presence of antigen-specific antibodies is the fingerprint and cardinal sign for diagnosis and determination of exposure to infectious agents including Corona virus disease-2019 (COVID-19). This cross-sectional study examined the presence of SARS-CoV-2 spike-specific immunoglobulin G (IgG) among asymptomatic blood donors in Makkah region. A total of 4368 asymptomatic blood donors were enrolled. They were screened for spike-specific IgG using ELISA and COVID-19 RNA by real-time PCR. COVID-19 IgG was detected among 2248 subjects (51.5%) while COVID-19-RNA was detected among 473 (10.8%) subjects. The IgG frequency was significantly higher among males and non-Saudi residents (p < 0.001 each) with no significant variation in IgG positivity among blood donors with different blood groups. In addition, COVID-19 RNA frequency was significantly higher among donors below 40-years old (p = 0.047, χ2 = 3.95), and non-Saudi residents (p = 0.001, χ2 = 304.5). The COVID-19 IgG levels were significantly higher among the RNA-positive donors (p = 001), and non-Saudi residents (p = 0.041), with no variations with age or blood group (p > 0.05). This study reveals a very high prevalence of COVID-19 IgG and RNA among asymptomatic blood donors in Makkah, Saudi Arabia indicating a high exposure rate of the general population to COVID-19; particularly foreign residents. It sheds light on the spread on COVID-19 among apparently healthy individuals at the beginning of the pandemic and could help in designing various control measures to minimize viral spread.

IoT-Based Remote Health Monitoring System Employing Smart Sensors for Asthma Patients during COVID-19 Pandemic

COVID-19 and asthma are respiratory diseases that can be life-threatening in uncontrolled circumstances and require continuous monitoring. A poverty-stricken South Asian country like Bangladesh has been bearing the brunt of the COVID-19 pandemic since its beginning. The majority of the country’s population resides in rural areas, where proper healthcare is difficult to access. This emphasizes the necessity of telemedicine, implementing the concept of the Internet of Things (IoT), which is still under development in Bangladesh. This paper demonstrates how the current challenges in the healthcare system are resolvable through the design of a remote health and environment monitoring system, specifically for asthma patients who are at an increased risk of COVID-19. Since on-time treatment is essential, this system will allow doctors and medical staff to receive patient information in real time and deliver their services immediately to the patient regardless of their location. The proposed system consists of various sensors collecting heart rate, body temperature, ambient temperature, humidity, and air quality data and processing them through the Arduino Microcontroller. It is integrated with a mobile application. All this data is sent to the mobile application via a Bluetooth module and updated every few seconds so that the medical staff can instantly track patients’ conditions and emergencies. The developed prototype is portable and easily usable by anyone. The system has been applied to five people of different ages and medical histories over a particular period. Upon analyzing all their data, it became clear which participants were particularly vulnerable to health deterioration and needed constant observation. Through this research, awareness about asthmatic symptoms will improve and help prevent their severity through effective treatment anytime, anywhere.

Users' satisfaction levels about mHealth applications in post-Covid-19 times in Saudi Arabia.

PURPOSE: This study aims to investigate the users' satisfaction levels about mHealth applications and their intentions to use them in future (in post-Covid-19 times) in Saudi Arabia. METHODS: A cross-sectional survey design was adopted in this study. The mHealth App Usability Questionnaire (MAUQ)22 was used in this study. An online version of the survey was created using Google Surveys, and a link for the survey was generated. As the objective of this study is to assess the users' satisfaction levels about mHealth applications and their intentions to use them in future (in post-Covid-19 times) in Saudi Arabia, all individuals who used or using mHealth applications will be included in this study. At the end of the survey time period, 318 responses were received. RESULTS: Items including 'easy to learn using the app' (mean rating = 3.9), 'easy to find information on the application'(mean rating = 3.9), 'interface of the app' (mean rating = 3.8) were rated to be highly effective by the participants.). However, ability to recover from mistakes while using the applications (mean rating = 2.9), inconsistency in navigation (mean rating = 2.9), and lack of all necessary functions (mean rating = 2.3) were few issues identified. No statistically significant difference of opinions was observed in relation to all sub-scales of usability factor. CONCLUSION: Although the satisfaction levels are good with respect to mHealth applications, the sudden rise in the mHealth users can be partly linked to the several psychological issues such as anxiety and depression among people and also because of restricted access during the pandemic.

IoT-Based Health Monitoring System Development and Analysis

This paper presents the design and implementation of a health monitoring system using the Internet of Things (IoT). In present days, with the expansion of innovations, specialists are always looking for innovative electronic devices for easier identification of irregularities within the body. IoT-enabled technologies enable the possibility of developing novel and noninvasive clinical support systems. This paper presents a health care monitoring system. In particular, COVID-19 patients, high blood pressure patients, diabetic patients, etc., in a rural area in a developing country, such as Bangladesh, do not have instant access to health or emergency clinics for testing. Buying individual instruments or continuous visitation to hospitals is also expensive for the regular population. The system we developed will measure a patient’s body temperature, heartbeat, and oxygen saturation (SpO2) levels in the blood and send the data to a mobile application using Bluetooth. The mobile application was created via the Massachusetts Institute of Technology (MIT) inventor app and will receive the data from the device over Bluetooth. The physical, logical, and application layers are the three layers that make up the system. The logical layer processes the data collected by the sensors in the physical layer. Media access management and intersensor communications are handled by the logical layer. Depending on the logical layer’s processed data, the application layer makes decisions. The main objective is to increase affordability for regular people. Besides sustainability in the context of finance, patients will have easy access to personal healthcare. This paper presents an IoT-based system that will simplify the utilization of an otherwise complicated medical device at a minimum cost while sitting at home. A 95 percent confidence interval with a 5 percent maximum relative error is applied to all measurements related to determining the patient’s health parameters. The use of these devices as support tools by the general public in a certain situation could have a big impact on their own lives.

Modelling the Effect of COVID-19 Lockdown on Air Pollution in Makkah Saudi Arabia with a Supervised Machine Learning Approach.

To reduce the spread of COVID-19, lockdowns were implemented in almost every single country in the world including Saudi Arabia. In this paper, the effect of COVID-19 lockdown on O3, NO2, and PM10 in Makkah was analysed using air quality and meteorology data from five sites. Two approaches were employed: (a) comparing raw measured concentrations for the lockdown period in 2019 and 2020; and (b) comparing weather-corrected concentrations estimated by the machine learning approach with observed concentrations during the lockdown period. According to the first approach, the average levels of PM10 and NO2 decreased by 12% and 58.66%, respectively, whereas the levels of O3 increased by 68.67%. According to the second approach, O3 levels increased by 21.96%, while the levels of NO2 and PM10 decreased by 13.40% and 9.66%, respectively. The machine learning approach after removing the effect of changes in weather conditions demonstrated relatively less reductions in the levels of NO2 and PM10 and a smaller increase in the levels of O3. This showed the importance of adjusting air pollutant levels for meteorological conditions. O3 levels increased due to its inverse correlation with NO2, which decreased during the lockdown period.

Qualité de vie professionnelle et résilience chez les professionnels de santé en Tunisie au cours de la pandémie à COVID-19 Professional quality of life and resilience strategies among Tunisian healthcare workers during the covid-19 pandemic

Résumé La pandémie à COVID-19 a mis à rude épreuve les systèmes de santé partout dans le monde. L’exposition répétée des professionnels de la santé à des défis imprévisibles dans la pratique pourrait retentir sur leur qualité de vie professionnelle.Les objectifs de cette étude étaient d’évaluer la qualité de vie professionnelle chez les professionnels de santé au cours de la pandémie du COVID-19 et d’étudier la nature des liens entre les différentes composantes de la qualité de vie professionnelle et la résilience. Notre étude est de type transversal, descriptif et analytique. Elle a été réalisée aux mois d’octobre et novembre 2020, auprès de 250 professionnels de santé, exerçant en Tunisie. Les données ont été collectées au moyen d’un questionnaire en ligne diffusé sur les réseaux sociaux. Nous avons utilisé l’échelle « The Professional Quality of Life Scale–5 » pour évaluer la qualité de vie professionnelle et l’échelle « Brief Resilience Scale » pour évaluer la résilience. La satisfaction de compassion était faible à moyenne chez 77,6% des participants. La plupart des participants (90,4%) présentaient un burnout moyen. La fatigue de compassion était faible ou moyenne chez 98% des participants. Les professionnels de santé ayant des scores plus élevés de résilience avaient des scores de satisfaction de compassion significativement plus élevés, et des scores de burnout et d’usure de compassion significativement moins élevés. Ces mêmes associations ont été retrouvées après analyse multivariée par régression linéaire multiple.Nos résultats mettent en exergue l’altération de la qualité de vie professionnelle chez les professionnels de santé au cours de la pandémie du COVID-19. Des interventions immédiates sont essentielles pour améliorer la résilience psychologique et renforcer les capacités des systèmes de santé.

Source Apportionment of Atmospheric PM10 in Makkah Saudi Arabia by Modelling Its Ion and Trace Element Contents with Positive Matrix Factorization and Generalised Additive Model.

In this paper, the emission sources of PM10 are characterised by analysing its trace elements (TE) and ions contents. PM10 samples were collected for a year (2019-2020) at five sites and analysed. PM10 speciated data were analysed using graphical visualization, correlation analysis, generalised additive model (GAM), and positive matrix factorization (PMF). Annual average PM10 concentrations (µg/m3) were 304.68 ± 155.56 at Aziziyah, 219.59 ± 87.29 at Misfalah, 173.90 ± 103.08 at Abdeyah, 168.81 ± 82.50 at Askan, and 157.60 ± 80.10 at Sanaiyah in Makkah, which exceeded WHO (15 µg/m3), USEPA (50 µg/m3), and the Saudi Arabia national (80 µg/m3) annual air quality standards. A GAM model was developed using PM10 as a response and ions and TEs as predictors. Among the predictors Mg, Ca, Cr, Al, and Pb were highly significant (p < 0.01), Se, Cl, and NO2 were significant (p < 0.05), and PO4 and SO4 were significant (p < 0.1). The model showed R-squared (adj) 0.85 and deviance explained 88.1%. PMF identified four main emission sources of PM10 in Makkah: (1) Road traffic emissions (explained 51% variance); (2) Industrial emissions and mineral dust (explained 27.5% variance); (3) Restaurant and dwelling emissions (explained 13.6% variance); and (4) Fossil fuel combustion (explained 7.9% variance).

Knowledge and attitude of Saudi Arabian citizens towards telemedicine during the COVID-19 pandemic.

BACKGROUND: The objective of this study was to investigate the knowledge and attitudes of Saudi Arabian citizens towards telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A cross-sectional survey was designed to carry out this study. The electronic survey, prepared using Google Forms, was distributed to 1500 randomly selected citizens of Saudi Arabia. A total of 330 participants completed and returned the questionnaire. Basic statistics were used to describe the data. RESULTS: The majority of the respondents (73.9%) were female. More than half of them (54.8%) were >35 y of age and had graduate or postgraduate degrees (65.5%). A total of 96.7% of the respondents were Saudis. Most of the participants (70.0%) were familiar with the term 'telemedicine' and thought that telemedicine (92.1%) could reduce transportation costs. Of the respondents, 58.8% had not seen a telemedicine system before and 67.0% indicated that they had not previously used telemedicine services. A total of 87.3% of the participants agreed or strongly agreed that telemedicine was a useful tool during the COVID-19 pandemic. Also, more than half of the participants agreed or strongly agreed that telemedicine facilitates the diagnosis of people (58.8%), increases communication (58.2%), reduces clinic visits (85.9%) and performs tasks quickly (70.3%). Also, 51.5% of the respondents disagreed or strongly disagreed that telemedicine affects patient privacy. CONCLUSIONS: The outcomes indicated that most of the participants had a positive attitude towards the use of telemedicine as a response to the COVID-19 pandemic in Saudi Arabia. They believed that telemedicine saves time, labour and costs and is an effective tool to treat coronavirus patients at a safe distance. However, the government should develop programs to raise awareness in the population about the use of telemedicine for the treatment of various diseases that afflict the Saudi Arabian people. Likewise, a legal framework must be implemented to protect the privacy of patients and healthcare providers.

Understanding the Impact of Digital Health Strategies During the COVID-19 Outbreak in Saudi Arabia.

BACKGROUND: The impact of COVID-19 has been analyzed from various aspects on the health care services management, accessibility and delivery of health care services. However, the COVID-19 pandemic has led to disruptions in health care services, which led to the increase in adoption of digital health technologies, mostly arising out of need and necessity. OBJECTIVE: Focusing on the prevailing situations (increasing reliance on digital health services), this study investigates the impact of digital health technologies from the perspectives of policymakers and citizens. METHODS: A mixed-methods approach was adopted. Twenty-seven semi-structured online interviews were conducted with experts and policymakers for assessing the impact from policymakers' perspectives. An online survey questionnaire instrument was used to collect the responses from 1698 Saudi Arabian citizens in relation to the various aspects of digital health applications. RESULTS: Health care expenditures increased during the COVID-19 outbreak, resulting in launch of various digital health applications. While policymakers defended their stand in improving health care services and accessibility; citizens reflected inability to book medicines/personal medical equipment online (Mean=2.4) and suffered a lack of personalized care (Mean=2.9) through digital health applications. Moreover, disparities exist between the population groups with respect to the accessibility, utilization, and perceptions of digital health technologies. CONCLUSION: Policymakers have to consider and address these differences in formulating digital health policies and implementing them.

Vacuum-Assisted Osmotic Dehydration of Autumn Olive Berries: Modeling of Mass Transfer Kinetics and Quality Assessment.

Autumn olive fruits were osmo-dehydrated in sucrose solution at 70 °C under vacuum and atmospheric pressure. The mass transfer kinetics data were applied to the models of Azuara, Crank, Page, and Peleg. The Peleg model was the best-fitted model to predict the water loss and solid gain of both treatments. The vacuum application decreased the effective diffusivities from 2.19 × 10-10 to 1.55 × 10-10 m2·s-1 for water loss and from 0.72 × 10-10 to 0.62 × 10-10 m2·s-1 for sugar gain. During the osmotic dehydration processes, the water activity decreased and stabilized after 5 h, while the bulk densities increased from 1.04 × 103 to 1.26 × 103 kg/m3. Titratable acidity gradually reduced from 1.14 to 0.31% in the atmospheric pressure system and from 1.14 to 0.51% in the vacuum system. pH increased significantly in both systems. Good retention of lycopene was observed even after 10 h of treatments. For the color parameters, the lightness decreased and stabilized after 30 min. In comparison, the redness and yellowness increased in the first 30 min and gradually decreased towards the initial levels in the fresh fruit.

Gig Health vs eHealth: Future Prospects in Saudi Arabian Health-Care System.

INTRODUCTION: The number of gig workers has been rising across the world, reflecting the growing trend toward the gig economy, which is already functioning in various sectors, such as transport(eg, Uber), technology (eg, Appen), and others (eg, Upwork). However, application of gig economy in health care is underresearched, especially in areas of eHealth that can facilitate various online activities and be outsourced. PURPOSE: The purpose of this study was to investigate the gig economy and eHealth in terms of prospects for future health care in Saudi Arabia. METHODS: Analysis of data collected using online semistructured interviews with 19 experts, including executives from ministries of health and information and communications, physicians, and health-care administrative managers was conducted and new empirical insights are offered. RESULTS: A lack of legal and regulatory frameworks and integrating gig culture into the eHealth system were identified to be the major challenges. Improved operational efficiency of health care, reduced costs, and positive societal impact were identified to be the opportunities and benefits of using the gig economy and eHealth in Saudi Arabia. A strategic framework and an effective regulatory framework are essential for integrating the gig economy into the eHealth system in Saudi Arabia and improving future health care by adopting innovative artificial intelligence and machine-learning technologies. CONCLUSION: eHealth has major scope for future health-care operations in Saudi Arabia and use of the gig economy in eHealth may lead to effective management of eHealth operations. More studies are required to evaluate the idea of integrating the gig economy and eHealth and analyze its impact.