Mindfulness-based intervention as a symptom management strategy in patients with end-stage renal disease: A controlled clinical trial.

AIM: The study's purpose was to examine the effect of mindfulness-based intervention (MBI) on physical and psychological symptoms in patients with end-stage renal disease (ESRD) in Jordan. METHODS: A repeated-measure randomized control study was conducted in a haemodialysis unit in Jordan between April 2023 and July 2023. Participants (N = 61) were selected using convenience sampling and then randomly assigned into experimental and control groups. The experimental group performed 30-min MBI, three times a week for 8 weeks during haemodialysis sessions. The Depression, Anxiety and Stress Scale-21 and the Patient Health Questionnaire-15 were used to measure the outcomes at baseline, after 5 weeks of the intervention and at the end of the intervention. RESULTS: Mixed-model repeated-measure ANOVAs revealed that the experimental group showed significantly lower levels of stress, depression and physical symptoms than the control group over time. Within-subject repeated-measure ANOVAs revealed that, in the experimental group, physical symptoms improve significantly over the three points of time. However, significant reductions in psychological symptoms occurred 5 weeks after initiating the intervention, but there was no further significant improvement at the end of the intervention. CONCLUSION: The study supports the integration of MBI as a symptom management strategy into nursing care plans of patients with ESRD. TRIAL REGISTRATION: Clinical trial.gov; registration ID: NCT06064708.

Evaluation of resuscitation systems in the Democratic Republic of Congo: A narrative review.

Introduction: Limited data exists regarding cardiovascular diseases (CVDs) and related emergencies such as out-of-hospital cardiac arrest (OHCA) in low- and middle-income countries (LMICs). The recent burden of disease report indicates a rising prevalence of CVDs in these settings like the Democratic Republic of Congo (DRC), likely associated with acute complications. Achieving improved outcomes necessitates resilient healthcare systems, including adequate emergency care and resuscitation systems. This study aims to characterize the current state of resuscitation systems in the DRC, contributing to the discourse on the burden of CVDs in LMICs and advocating for context-appropriate interventions to develop and reinforce these systems. Methods: A narrative review utilizing the modified survival framework of the Global Resuscitation Alliance was conducted. It encompassed the country's CVD epidemiological data, healthcare components, and emergency care system. Results: Analysis of limited available data revealed an underdeveloped and inadequately resourced healthcare system in the country, particularly its early-stage emergency care component. While specific data on out-of-hospital cardiac arrests were lacking, crucial components of the survival chain necessary for improved post-arrest outcomes were found to be largely deficient. Community-based first aid knowledge and practice were inadequate, the availability of automated external defibrillators (AEDs) and integrated ambulance services were either absent or insufficiently developed, and facility-based resuscitation capacity was predominantly in its infancy. Nonetheless, optimism is warranted due to recent government decisions to increase total health expenditure and progressively implement Universal Health Coverage. Conclusion: Resuscitation systems in the DRC are largely non-existent, reflecting the country's underdeveloped healthcare system, particularly in emergency care. Urgent action is needed to develop and reinforce context-appropriate resuscitation systems to address the growing burden of CVD-related emergencies in LMICs.

ZnO-NPs/AC composite antibacterial agents with N-halamine glycinate functionalized silica-mesoporous silica coating for water disinfection.

This work deals with the synthesis, structural characterization and applications of N-halamine glycinate functionalized silica-mesoporous silica coated ZnO-NPs/AC composite for water disinfection. Several nanocomposite materials were obtained: ZnO-NPs/AC, ZnO-NPs/AC@SiO2, ZnO-NPs/AC@SiO2@mSiO2, ZnO-NPs@SiO2@mSiO2-Gly and ZnO-NPs@SiO2@mSiO2-N-halamine-Gly. These nanocomposite materials were fully characterized via different physiochemical techniques including: FTIR, TGA, XPS, XRD, SEM, TEM and BET. XRD indicated a predominance of crystalline pattern of ZnO-NPs impregnated into activated carbon (AC) and their silica and m-mesoporous silica coating precursors. The FTIR spectra confirmed an immense combination between ZnO-NPs and AC of ZnO-NPs/AC nanocomposite as well as its interactions with coated silica precursors. SEM, TEM images illustrated that the fabricated ZnO-NPs/AC nanocomposites are well coated with silica-mesoporous silica functionalized N-halamine. The distinctive surface area has decreased from 800 m2/g for pristine AC to 772 m2/g for ZnO-NPs/AC and to 282 m2/g for ZnO-NPs/AC@SiO2 and to 139 m2/g for ZnO-NPs/AC@SiO2@mSiO2 and to 15.4 m2/g for ZnO-NPs@SiO2@mSiO2-N-Gly. All those nanocomposites showed good efficacy against all four bacterial species, with higher inhibition zones for the 2 g-positive bacteria than that of the 2 g-negative ones. The ZnO@SiO2@mSiO2-N-halamine-Gly exhibited the high zone inhibition against all tested bacteria except for E. Coli.

Smell loss associated with SARS-CoV-2 is not clinically different from other viruses: a multicenter cohort study.

BACKGROUND: Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms. METHODS: Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment. RESULTS: 188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores. CONCLUSION: Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.

Single incision laparoscopy versus conventional multiport laparoscopy for colorectal surgery: a systematic review and meta-analysis.

INTRODUCTION: There has been an increase in colorectal cancer resections worldwide and in the UK. Initially conducted as an open procedure, this was replaced with the conventional multiport technique. Laparoscopic colectomy became the standard surgical technique in 1991. With innovation in surgical technology, single incision laparoscopy (SIL) has attracted more attention as the possible next step in colorectal resection. The aim of this review was to compare outcomes between SIL and conventional laparoscopy (CL). METHODS: A literature search was carried out in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. The PubMed®, MEDLINE®, Embase®, Google Scholar™ and Cochrane Library databases were used to extract randomised controlled trials (RCTs) published between January 2000 and May 2021. Statistical analysis was performed with RevMan software. RESULTS: A total of 11 RCTs were extracted with 1,370 patients (686 SIL, 684 CL). There was no significant difference between SIL and CL for operative time (standardised mean difference [SMD]: 0.01, 95% confidence interval [CI]: -0.19 to 0.22, z=0.11, p=0.91), length of hospital stay (SMD: -0.10, 95% CI: 0.22 to 0.02, z=1.61, p=0.11) or overall complications (odds ratio [OR]: 0.99, 95% CI: 0.75 to 1.30, z=0.09, p=0.93). SIL had a shorter mean incision (SMD: -0.99, 95% CI: -1.35 to -0.62, z=5.25, p<0.00001). Patients undergoing SIL had a higher conversion rate to CL or an open approach (OR: 3.10, 95% CI: 0.95 to 10.14, z=1.87, p=0.06) but this just missed statistical significance. CONCLUSIONS: SIL can be considered a safe alternative to CL if performed by experienced surgeons.

Bioecology and breeding performance of cattle egret (Bubulcus ibis) in selected sites at Sharkia Governorate, Egypt.

Cattle egret Bubulcus ibis, feeds on insect pests in many agro-ecosystems. Thus, there is an urgent need to study the breeding chronology of cattle egret, in order to develop suitable protection programs for this beneficial bird to perform its role as abiological control agent in Egyptian agro-ecosystems. The study was conducted at Sharkia Governorate, Egypt, from December 2018 to December 2020; in different habitats (irrigation canals, drainage canals, garbage collection areas and Abbasa ponds). The mean clutch size ranged from 2-5 eggs/nest with an incubation period ranging between 21-25 days. The mean percentage of hatching success was 90.21%, while the total number of mortality eggs was 47 and the total egg hatching was 433. Also the total number of nests located nearby tree trunks were 73, while nests located in the core of the tree were 47 nests, and nests located at the peripherals were 15 nests.

The Prevalence of Video Game Addiction and Its Relation to Anxiety, Depression, and Attention Deficit Hyperactivity Disorder (ADHD) in Children and Adolescents in Saudi Arabia: A Cross-Sectional Study.

Background and objective Video games have become a popular source of entertainment among children and adolescents, not only targeting the young generation but also increasingly popular among older demographics as well. This study aimed to assess the association between video game addiction and depression, anxiety, and attention deficit hyperactivity disorder (ADHD) among children and adolescents in Saudi Arabia. Materials and methods This was a cross-sectional study involving Saudi adolescents aged 12-16 years. A self-administered online survey was distributed on social media (Twitter, WhatsApp, and Snapchat). The survey addressed sociodemographic characteristics (i.e., age, gender, area of residence city, etc.). Arabic versions of the Patient Health Questionnaire-9 (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (PHQ-GAD7), the ADHD Rating Scale-IV (ADHD-RS), and the seven-item Game Addiction Scale (GAS-7) questionnaires were distributed as well, including Arabic terms for depression, anxiety, and ADHD. Results A total of 393 surveys were completed (males: 58.3% vs. females: 41.7%). Of note, 63.1% of the respondents reported playing video games every day with an average of more than five hours of gaming time per day (25.2%). The prevalence of video game addiction was 62.1%. Independent risk factors of video game addiction included being young in age, playing video games every day, playing more than three hours per day, and playing multiplayer games. Furthermore, our findings suggest that a higher video game addiction score is correlated with higher scores in inattention, anxiety, and depression. Conclusion This study found a high prevalence of video game addiction among Saudi children and adolescents. Excessive video game playing negatively influences mental health and leads to issues including anxiety, depression, and ADHD. Also, younger males with an increased rate of regular playtime were more likely to exhibit video game addiction in comparison to the rest of the population. Further research is required to more comprehensively assess the prevalence rate of video game addiction and its effect on the mental health of the younger generation within the region.

Survey and population dynamics of land snails at Sharkia Governorate, Egypt.

Land snails are a destructive agricultural pest in economic crops, but the populations for that pest are highly influenced by temperature and humidity, therefore climatic changes affected their behavior, distribution and population dynamics, for these reasons researchers should follow up on the changes in their behavior, distribution, and population dynamics. In this study, a survey study was conducted to define land snail species existing at Sharkia Governorate, Egypt, from January 2019 to March 2022 in horticultural, vegetable, and field crops and study the population dynamics for the dominant land snail species. Results showed that there are six species of land snails, these species were, Monacha cartusiana, Succinea putris, Eobania vermiculata, Theba pisana, Helicella vestalis, and Cochlicella acuta. The population dynamics of two prevalent land snail species (M. cartusiana and S. putris), were conducted during two successive growing seasons, the Egyptian clover harbored the highest number of M. cartusiana followed by wheat, while the onion was the lowest one during the study period. In the same trends, the land snail S. putris recorded the highest numbers during the growing season of the Egyptian clover crop. Finally, it is concluded that the land snail M. cartusiana considered the first grade of infestation existed everywhere at Sharkia Governorate, and the population density of the land snail is increase gradually after winter till reach the maximum density in spring.

Hand hygiene practices for prevention of health care-associated infections associated with admitted infectious patients in the emergency department: a systematic review.

BACKGROUND: In most high-income countries, emergency departments (ED) represent the principal point of access forcer by critically ill or injured patients. Unlike inpatient units, ED healthcare workers (ED HCWs) have demonstrated relative lack of adherence to hand hygiene (HH) guidelines, commonly citing frequency of intervention and high rates of admission, which reflect severity of cases encountered. AIM: Assessment of studies on hand hygiene compliance (HHC) by ED HCWs conducted between 2010 and 2020, seeking to estimate HHC rates and intervention strategies utilised to improve HHC in EDs. METHODS: Searches conducted in Web of Science, EBSCO HOST (CINHAL & Medline), PubMed, Embase, and Cochrane for full studies published between 2010 and 2020 on the topic of HHC in the ED. RESULTS: One hundred twenty-nine eligible articles were identified of which 79 were excluded. Fifty-one underwent full-text screening before 20 studies were deemed relevant. Of the eligible studies, fifteen (75%) had, as the primary outcome, HHC according to the WHO-recommended 5-moments. Twelve studies (60%) implemented multimodal or single intervention strategies. Eight studies were ambiguous regarding the nature of the approach adopted. In the nine observational studies where HHC was documented, an overall post-intervention median HHC rate of 45% (range 8-89.7%). CONCLUSION: Multimodal approaches appear to have enhanced HHC moderately among ED HCWs. Elevated complexity associated with critically ill patients, and ED overcrowding, are contributing factors to relatively low compliance rates observed. Strategies to improve HHC rates may need to acknowledge, and cater for, the context of an unpredictable environment.

COVID-19 Fear and Anxiety among Patients with Chronic Heart Failure: A Cross Sectional Study.

Although the current management of COVID-19 is mainly focused on efficacious vaccine and infection control, the most common psychological reactions (such as fear and anxiety) associated with the COVID-19 pandemic have not been investigated and even neglected in patients with heart failure who are at greater risk for morbidity and mortality. We assessed COVID-19 related fear and anxiety among patients with heart failure and determined their associated factors. A cross sectional survey was conducted among 300 consecutive patients with heart failure during the period of March 2021−June 2021. Almost 50.7% of patients had fear of COVID-19 and 36.3% had coronavirus anxiety. Age > 55 was significantly associated with increased odds of fear (OR = 2.6) and anxiety (OR = 4.3). Patients with angina were more likely to have fear (OR = 3.0) and anxiety (OR = 2.2) and patients with chronic lung disease were more likely to have fear (OR = 3.0) and anxiety (OR = 3.3). Increased age, having angina, and having chronic lung disease were associated with increased odds of fear of COVID-19 and coronavirus anxiety. Psychological support needs to be integrated in patient care with special attention to physiological risk factors that are associated with COVID-19 comorbidities.

Rapid Enzymatically Reduction of Zincum Gluconicum for the Biomanufacturing of Zinc Oxide Nanoparticles by Mycoextracellular Filtrate of Penicillium Digitatum (Pdig-B3) as a Soft Green Technique.

Molds have been used as micro-biofactories for biomanufacturing of metal oxide nanoparticles (MetNps) since they are effortless, immaculate, safe, non-poisonous, vital-biocompatible, and environmentally acceptable. The present study aimed to explore the bioindustry, mold screening protocol, and characterization of zinc oxide nanoparticles (ZnONPs) using a diverse filamentous Green mold (FiGM) isolated from spoiled citrus fruits. Eight filamentous Penicillium Digitatum mold strains had been obtained and subjected to investigate the capability of ZnONPs biosynthesis by fungal extracellular free-cell filtrate. P. digitatum (P-digB3) obtained the peak of ZnONps (379 nm) detected by the UV-visible spectrophotometry and was found as a significantly optimum strain in the highest quantity (mean±SD: 0.0138±0.001 gm/100 ml) and the smallest average NPs size. The ZnONPs were characterized by UV-visible scanning spectrophotometry, Atomic Force Microscopy, X-RD, Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM). The final average size of ZnONPs was obtained at 65.46 nm with diversified shapes and dimensions. The present study concluded the high capabilities of fungi (FiGMs) as eco-friendly and cheap bio-nano factories to manufacture ZnONPs with great nano-level average size, which may consider new boost sources for use in many nano-sectors and applications.

The effect of slow deep breathing relaxation exercise on pain levels during and post chest tube removal after coronary artery bypass graft surgery.

Objectives: This study aimed to evaluate the effectiveness of slow deep breathing relaxation exercise (SDBRE) in reducing patients' pain levels during chest tube removal (CTR) post coronary artery bypass grafting (CABG) surgery. Methods: In 2019, fifty post-CABG patients were conveniently selected from a cardiac intensive care unit in Jordan's major referral heart institute. The patients were randomly assigned to either an intervention group or a control group. A total of 25 patients were assigned into the experimental group who received slow deep breathing relaxation Exercise (SDBRE) alongside the conventional care before CTR. The remaining 25 patients constituted the control group (50%) that had CTR following conventional care. The Visual Analogue Scale (VAS) was used to measure the participants' pain levels during three phases: before CTR (Time 1), 5-min post CTR (Time 2), and 15-min post CTR (Time 2) to compare the intervention effect between the two groups. Results: The data analysis findings for the control and intervention group of patients showed that there was a statistically significant decline in their pain level across time for both groups (H = 32.71, P < 0.01; H = 47.23, P < 0.01) respectively. The intervention group had significantly lower pain levels than the control group at Time 2 (3.50 [1.20, 5.30] vs. 7.90 [7.00, 9.00], P < 0.01) and Time 3 (0.00 [0.00, 1.30] vs. 3.60 [2.40, 4.10] P < 0.01). Conclusions: Using SDBRE during CTR is an effective technique for reducing pain which can minimize the need for analgesics and their associated adverse effects.

Combining spectral domain optical coherence tomography of retinal nerve fiber layer and noncontact tonometry in mass glaucoma screening during the World Glaucoma Week.

PURPOSE: This study reports the combination of noncontact tonometry and spectral domain optical coherence tomography (SD-OCT) in mass glaucoma screening in the Lebanese population. METHODS: This cross-sectional study included Lebanese individuals who participated in a glaucoma screening campaign in March 2018 and March 2019 for World Glaucoma Week. Intraocular pressure (IOP) was measured by noncontact tonometry. Optic nerve head (ONH) and retinal nerve fiber layer (RNFL) scans were obtained using SD-OCT. Glaucoma suspects were defined as individuals having an IOP above 21mmHg in at least one eye and/or RNFL thinning in either the superior or the inferior quadrant. RESULTS: Among the 1116 individuals who were examined, 15.5% were found to be glaucoma suspects based upon their IOP readings, 15.5% based on OCT, and 3.0% based on both criteria combined. The mean vertical and horizontal disc diameter was 1.75±0.23mm and 1.57±0.22mm, respectively. Eyes that were suspects by OCT with normal IOP had thinner corneas when compared to eyes with normal OCT and high IOP (512.25µm vs. 559.12µm, P<0.0001). CONCLUSION: SD-OCT can be an easy and relatively fast component of mass glaucoma screening in addition to IOP measurement. Further studies are needed to establish this combination as a valid glaucoma screening method.

Mortality Rate, Demographics, and Clinical Attributes of Patients Dying in the Intensive Care Unit of a Comprehensive Cancer Center in Jordan: A Descriptive Study.

Very little is known about the provision of or the need for palliative care in the Middle East, including Jordan. This study investigated the mortality rate, demographics, and clinical attributes of patients with cancer who had died in the intensive care unit (ICU) of a national cancer center over a 3-year period in Jordan. We reviewed the records of 661 patients who had died and found that the majority of the people were terminally ill at the time of admission (had metastatic cancer, multisystem organ dysfunction, and seriously ill). This approach differs from the usual practice worldwide in which it is uncommon to admit patients with cancer to the ICU at the end of life. Improving end-of-life care in the ICUs in Jordan requires further exploration of the cultural context in which end-of-life care practice occurs in Jordan and developing a palliative care approach that fit with the Islamic and Arabic culture.

Vaginal collagen I and III changes after carbon dioxide laser application in postmenopausal women with the genitourinary syndrome: a pilot study.

OBJECTIVE: The aim of the study was to evaluate the clinical response and collagen remodeling in the vaginal wall after three sessions of carbon dioxide (CO2) laser application. METHODS: Fourteen postmenopausal women with vulvovaginal atrophy, aged 45-65 years and sexually active, were evaluated with clinical questionnaires, gynecological examinations and histological techniques before and after 20 weeks of treatment (ClinicalTrials.gov NCT03939078). Treatment consisted of 3-monthly sessions of the CO2 laser. Clinical questionnaires included the Vaginal Health Index, the Female Sexual Function Index and the International Consultation on Incontinence Questionnaires Short Form. Biopsies were taken from the lateral vaginal wall at week 0 (left wall) and week 20 (right wall). Tissue samples were stained with hematoxylin and eosin, Periodic Acid-Schiff, Picrosirius Red Stain and Orcein dyes. Immunohistochemical study was used to quantify collagens I and III in the samples. RESULTS: The mean age was 54.4 ± 4.5 years, and the average time of amenorrhea was 7.6 ± 5.1 years. The Female Sexual Function Index and the Vaginal Health Index Score values increased while the International Consultation on Incontinence Questionnaire Short Form score decreased after the programmed treatment. There was no significant change in vaginal pH. Histological studies showed increases in the total and superficial epithelial cell layers, and type III collagen fibers (from 10.86 ± 7.66 to 16.87 ± 3.96, p < 0.05), and immunohistochemical studies confirmed the significant increase in collagen III. CONCLUSION: Histological findings revealed epithelial atrophy reversal and collagen remodeling of the vaginal wall. Immunohistochemical analysis showed an increase in collagen type III fibers.

The effect of intraoperative glycemic control on surgical site infections among diabetic patients undergoing coronary artery bypass graft (CABG) surgery.

OBJECTIVE: Perioperative poor glycemic control in diabetic patients undergoing Coronary Artery Bypass Graft (CABG) surgery has been associated with infectious complications, particularly surgical site infections that are linked with adverse health surgical outcomes. The purpose of this study was to investigate the effect of two different intraoperative glycemic control protocol, tight and conventional, on thirty-day postoperative surgical site infection (SSI) rates among diabetic patients undergoing CABG surgery. DESIGN: A randomized controlled trial (RCT) design was employed in the study, with a convenience sample of 144 adult patients who were scheduled to undergo coronary artery bypass grafting surgery. SETTING: A main referral heart institute in Amman, Jordan. PARTICIPANTS: Subjects were randomly assigned to either the tight glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 110-149 mg/dl via continuous intravenous insulin infusion, or the conventional glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 150-180 mg/dl via continuous intravenous insulin infusion. The postoperative SSIs among both groups were evaluated and compared by independent blinded physicians. RESULTS: The primary findings of this study indicated no statistically significant difference between the two treatment groups in terms of SSI rates and their potential adverse surgical outcomes (p = 0.512). CONCLUSION: Nurses should consider the glycemic stability and glycemic control approach to minimize adverse surgical outcomes post CABG surgery. Healthcare providers should also carefully consider diabetic patients who have undergone CABG surgery and are at risk of developing postoperative SSIs. CLINICALTRIALSGOV IDENTIFIER: NCT04451655 was retrospectively registered in 30/06/2020.

Assessing the Degree of Gastroesophageal Reflux Disease (GERD) Knowledge Among the Riyadh Population.

Background Gastroesophageal reflux disease (GERD) is a chronic disease mainly characterized by heartburn and acid regurgitation. To our knowledge, there have been a limited number of studies in Saudi Arabia looking at the knowledge level among the general population regarding this disease and its associated factors. Therefore, this study aims to identify the knowledge level of the disease and its associated factors, assess the prevalence of GERD among the Riyadh general population, and assess the need for educational programs for GERD. Methodology A cross-sectional study was conducted among the general public in Riyadh, Saudi Arabia. The degree of GERD knowledge was assessed by translating and editing Jorgen Urnes' 24-item questionnaire into Arabic. In addition, six questions related to the symptoms and complications of GERD were added. Convenience sampling was done by using a Google form to distribute the questionnaire. The questionnaire assesses GERD knowledge by asking about the signs, symptoms, risk factors, predisposing factors, and management of GERD. Statistical analysis was performed using R v. 3.6.3 (https://cran.r-project.org/bin/windows/base/old/3.6.3/). Counts and percentages were used to summarize the distribution of categorical variables. Results The questionnaire was completed by 664 respondents (48.2% males and 51.8% females). The average age of the included respondents was 34.1 ± 12.8 years and Saudis represented 97% of the included respondents. The majority of the respondents had heard of GERD (83%). The average number of correct answers was 12.7 ± 6.1. In total, 40 respondents did not answer any questions correctly. Approximately one-third of respondents answered >50% of the questions correctly (n = 250, 37.6%). Approximately half of the respondents identified all risk factors for GERD. Other common risk factors identified included caffeine (23.6%), fast food (26.8%), and smoking (17.6%). Slightly more than a quarter of the respondents reported being diagnosed with GERD (28.8%). Knowledge was significantly higher among respondents who had received a diagnosis of GERD. A statistically significant positive association was observed between age and knowledge (r = 0.19, p < 0.001). Conclusion The study shows a relatively good knowledge level compared to previously reported figures in Saudi Arabia and worldwide. Educational programs for GERD should be increased in Saudi Arabia and more health conferences and teaching school students of the disease should be highlighted to increase the general knowledge of this disease in the Kingdom of Saudi Arabia (KSA).

Tight glycaemic control and surgical site infections post cardiac surgery: a systematic review.

OBJECTIVE: Surgical site infection (SSI) is one of the most serious potential complications post cardiac surgery among patients with diabetes and has a number of adverse health outcomes. The literature shows discrepancies regarding the effect of different glycaemic control protocols on reducing adverse health outcomes including SSIs. The aim of this study was to conduct a systematic review that investigated the effect of the optimal range of tight glycaemic control protocols using a continuous insulin infusion on reducing the incidence of SSIs in adult patients with diabetes undergoing cardiac surgery. METHOD: A systematic review was conducted following the PRISMA statement and guidelines. Search terms were used to identify research studies published between 2000 and 2019 across five key databases, including CINAHL, Medline, PubMed, Cochrane Database and Google Scholar. RESULTS: A total of 12 studies met the review inclusion criteria. The reviewed literature tended to support the implementation of a tight glycaemic control protocol, particularly in the postoperative phase, that demonstrated fewer potential complications associated with cardiac surgery. On the other hand, the literature also supported the application of a moderate glycaemic control protocol in the intraoperative phase to obtain better glycaemic stability with fewer potential complications among those patients with diabetes undergoing cardiac surgery. CONCLUSION: This analysis concludes that tight glycaemic control is more effective than moderate glycaemic control intraoperatively in terms of glycaemic stability among patients with diabetes undergoing cardiac surgery. Results also emphasised the importance of time-based protocol implementation to ensure better health outcomes and better quality of care for patients.

Robust Three-Microphone Speech Source Localization Using Randomized Singular Value Decomposition.

Direction-of-arrival (DOA) estimation is a fundamental technique in array signal processing due to its wide applications in beamforming, speech enhancement and many other assistive speech processing technologies. In this paper, we devise a novel DOA technique based on randomized singular value decomposition (RSVD) to improve the performance of non-uniform non-linear microphone arrays (NUNLA). The accurate and efficient singular value decomposition of large data matrices is computationally challenging, and randomization provides an effective tool for performing matrix approximation, therefore, the developed DOA estimation utilizes a modified dictionary-based RSVD method for localizing single speech sources under low signal-to-noise ratios (SNR). Unlike previous methods developed for uniform linear microphone arrays, the proposed approach with L-shaped three microphone setup has no 'left-right' ambiguity. We present the performance of our proposed method in comparison to other techniques. The demonstrated experiments shows at-least 20% performance improvement using simulated data and 25% performance improvement using real data when compared with similar DoA estimation techniques for NUNLA. The proposed method exploits frame-based online time delay of arrival (TDOA) measurements which facilitates the proposed algorithm to run on real-time devices. We also show an efficient real-time implementation of the proposed method on a Pixel 3 Android smartphone using its built-in three microphones for hearing aid applications.

Smartphone-based single-channel speech enhancement application for hearing aids.

This work presents a single-channel speech enhancement (SE) framework based on the super-Gaussian extension of the joint maximum a posteriori (SGJMAP) estimation rule. The developed SE algorithm is an open-source research smartphone-based application for hearing improvement studies. In this algorithm, the SGJMAP-based estimation for noisy speech mixture is smoothed along the frequency axis by a Mel filter-bank, resulting in a Mel-warped frequency-domain SGJMAP estimation. The impulse response of this Mel-warped estimation is obtained by applying a Mel-warped inverse discrete cosine transform (Mel-IDCT). This helps in filtering out the background noise and enhancing the speech signal. The proposed application is implemented on an iPhone (Apple, Cupertino, CA) to operate in real time and tested with normal-hearing (NH) and hearing-impaired (HI) listeners with different types of hearing aids through wireless connectivity. The objective speech quality and intelligibility test results are used to compare the performance of the proposed algorithm to existing conventional single-channel SE methods. Additionally, test results from NH and HI listeners show substantial improvement in speech recognition with the developed method in simulated real-world noisy conditions at different signal-to-noise ratio levels.