Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study.

This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.

The development of an electrochemical immunosensor utilizing chicken IgY anti-spike antibody for the detection of SARS-CoV-2.

This paper introduces a novel approach for detecting the SARS-CoV-2 recombinant spike protein combining a label free electrochemical impedimetric immunosensor with the use of purified chicken IgY antibodies. The sensor employs three electrodes and is functionalized with an anti-S IgY antibody, ELISA and immunoblot assays confirmed the positive response of chicken immunized with SARS-CoV2 S antigen. The developed immunosensor is effective in detecting SARS-CoV-2 in nasopharyngeal clinical samples from suspected cases. The key advantage of this biosensor is its remarkable sensitivity, and its capability of detecting very low concentrations of the target analyte, with a detection limit of 5.65 pg/mL. This attribute makes it highly suitable for practical point-of-care (POC) applications, particularly in low analyte count clinical scenarios, without requiring amplification. Furthermore, the biosensor has a wide dynamic range of detection, spanning from 11.56 to 740 ng/mL, which makes it applicable for sample analysis in a typical clinical setting.

Racial Disparity Between the Post-Procedural Outcomes Among Patients With Peripheral Artery Disease: A Systematic Review and Meta-analysis.

The Racial disparity between the clinical outcomes post interventions among Peripheral Artery Disease (PAD) have not been well studied, with limited literature available. We conducted a meta-analysis to evaluate the post-procedure outcomes among PAD patients between Black and White race. We systematically searched all electronic databases from inception until first November 2022. The primary endpoint was major amputation within 30 days. Secondary endpoints were myocardial infarction (MI) within 30 days, mortality within 30 days, and all-cause mortality (ACM). A total of 136,395 patients were included in the analysis, with 117,177 patients of the White race and 19,218 patients of the Black race. The mean age of the patients in each group was (66.41 vs 62.75). Most common comorbidity among White and Black patients was diabetes mellitus (42.15% vs 55.90%), and hypertension (HTN) (39.53% vs 90.07%). The odds of major amputation within 30 days was significantly higher in Black patients compared to white patients (OR, 0.40 (95% CI: 0.19-0.84, P = 0.02), while the odds of MI was higher in White patients compared to Black race PAD patients (OR, 1.29, (95%CI:1.05-1.58), P < 0.02). There was no significant difference in ACM (OR, 0.97(95%CI: 0.64-1.47, P = 0.88), and mortality within 30 days (OR, 1.09(95%CI:0.77-1.53, P = 0.64) between both groups. To our knowledge, this is the first meta-analysis with the largest sample size thus far, highlighting that Black patients are at a higher risk for major amputation within 30 days compared to white patients although mortality remains comparable between the 2 races.

Deep learning models for detecting respiratory pathologies from raw lung auscultation sounds.

In recent years deep learning models improve the diagnosis performance of many diseases especially respiratory diseases. This paper will propose an evaluation for the performance of different deep learning models associated with the raw lung auscultation sounds in detecting respiratory pathologies to help in providing diagnostic of respiratory pathologies in digital recorded respiratory sounds. Also, we will find out the best deep learning model for this task. In this paper, three different deep learning models have been evaluated on non-augmented and augmented datasets, where two different datasets have been utilized to generate four different sub-datasets. The results show that all the proposed deep learning methods were successful and achieved high performance in classifying the raw lung sounds, the methods were applied on different datasets and used either augmentation or non-augmentation. Among all proposed deep learning models, the CNN-LSTM model was the best model in all datasets for both augmentation and non-augmentation cases. The accuracy of CNN-LSTM model using non-augmentation was 99.6%, 99.8%, 82.4%, and 99.4% for datasets 1, 2, 3, and 4, respectively, and using augmentation was 100%, 99.8%, 98.0%, and 99.5% for datasets 1, 2, 3, and 4, respectively. While the augmentation process successfully helps the deep learning models in enhancing their performance on the testing datasets with a notable value. Moreover, the hybrid model that combines both CNN and LSTM techniques performed better than models that are based only on one of these techniques, this mainly refers to the use of CNN for automatic deep features extraction from lung sound while LSTM is used for classification.

Oocyte metabolic function, lipid composition, and developmental potential are altered by diet in older mares.

Dietary supplementation is the most feasible method to improve oocyte function and developmental potential in vivo. During three experiments, oocytes were collected from maturing, dominant follicles of older mares to determine whether short-term dietary supplements can alter oocyte metabolic function, lipid composition, and developmental potential. Over approximately 8 weeks, control mares were fed hay (CON) or hay and grain products (COB). Treated mares received supplements designed for equine wellness and gastrointestinal health, flaxseed oil, and a proprietary blend of fatty acid and antioxidant support (reproductive support supplement (RSS)) intended to increase antioxidant activity and lipid oxidation. RSS was modified for individual experiments with additional antioxidants or altered concentrations of n-3 to n-6 fatty acids. Oocytes from mares supplemented with RSS when compared to COB had higher basal oxygen consumption, indicative of higher aerobic metabolism, and proportionately more aerobic to anaerobic metabolism. In the second experiment, oocytes collected from the same mares prior to (CON) and after approximately 8 weeks of RSS supplementation had significantly reduced oocyte lipid abundance. In the final experiment, COB was compared to RSS supplementation, including RSS modified to proportionately reduce n-3 fatty acids and increase n-6 fatty acids. The ability of sperm-injected oocytes to develop into blastocysts was higher for RSS, regardless of fatty acid content, than for COB. We demonstrated that short-term diet supplementation can directly affect oocyte function in older mares, resulting in oocytes with increased metabolic activity, reduced lipid content, and increased developmental potential.

Effect of interactive vs. passive virtual reality on pain threshold and tolerance.

OBJECTIVES: Scientific evidence suggests that virtual reality (VR) could potentially help patients tolerate painful medical procedures and conditions. The aim of this study was to evaluate the efficacy of virtual reality on pain tolerance and threshold. METHODS: A within-subjects experimental study design was conducted on 53 female students at Qassim University in Saudi Arabia. Each participant completed three rounds of assessment: one baseline (no VR) and two VR immersion (passive and interactive) in random order sequence. During each round, participants submerged their non-dominant hand into an ice bath; pain threshold and tolerance were measured as outcomes and analyzed using repeated measures ANOVA. RESULTS: Participants had both higher pain threshold and tolerance during interactive and passive VR rounds in comparison to the non-VR baseline assessment (p<0.05). Participants had greater pain tolerance during the interactive VR condition compared to the passive VR condition (p<0.001). CONCLUSIONS: VR experiences increase pain threshold and tolerance with minimal side effects, and the larger effects were demonstrated using interactive games. Interactive VR gaming should be considered and tested as a treatment for pain.

EndMT Regulation by Small RNAs in Diabetes-Associated Fibrotic Conditions: Potential Link With Oxidative Stress.

Diabetes-associated complications, such as retinopathy, nephropathy, cardiomyopathy, and atherosclerosis, the main consequences of long-term hyperglycemia, often lead to organ dysfunction, disability, and increased mortality. A common denominator of these complications is the myofibroblast-driven excessive deposition of extracellular matrix proteins. Although fibroblast appears to be the primary source of myofibroblasts, other cells, including endothelial cells, can generate myofibroblasts through a process known as endothelial to mesenchymal transition (EndMT). During EndMT, endothelial cells lose their typical phenotype to acquire mesenchymal features, characterized by the development of invasive and migratory abilities as well as the expression of typical mesenchymal products such as α-smooth muscle actin and type I collagen. EndMT is involved in many chronic and fibrotic diseases and appears to be regulated by complex molecular mechanisms and different signaling pathways. Recent evidence suggests that small RNAs, in particular microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), are crucial mediators of EndMT. Furthermore, EndMT and miRNAs are both affected by oxidative stress, another key player in the pathophysiology of diabetic fibrotic complications. In this review, we provide an overview of the primary redox signals underpinning the diabetic-associated fibrotic process. Then, we discuss the current knowledge on the role of small RNAs in the regulation of EndMT in diabetic retinopathy, nephropathy, cardiomyopathy, and atherosclerosis and highlight potential links between oxidative stress and the dyad small RNAs-EndMT in driving these pathological states.

Equine maternal aging affects oocyte lipid content, metabolic function and developmental potential.

Advanced maternal age is associated with a decline in fertility and oocyte quality. We used novel metabolic microsensors to assess effects of mare age on single oocyte and embryo metabolic function, which has not yet been similarly investigated in mammalian species. We hypothesized that equine maternal aging affects the metabolic function of oocytes and in vitro-produced early embryos, oocyte mitochondrial DNA (mtDNA) copy number, and relative abundance of metabolites involved in energy metabolism in oocytes and cumulus cells. Samples were collected from preovulatory follicles from young (≤14 years) and old (≥20 years) mares. Relative abundance of metabolites in metaphase II oocytes (MII) and their respective cumulus cells, detected by liquid and gas chromatography coupled to mass spectrometry, revealed that free fatty acids were less abundant in oocytes and more abundant in cumulus cells from old vs young mares. Quantification of aerobic and anaerobic metabolism, respectively measured as oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) in a microchamber containing oxygen and pH microsensors, demonstrated reduced metabolic function and capacity in oocytes and day-2 embryos originating from oocytes of old when compared to young mares. In mature oocytes, mtDNA was quantified by real-time PCR and was not different between the age groups and not indicative of mitochondrial function. Significantly more sperm-injected oocytes from young than old mares resulted in blastocysts. Our results demonstrate a decline in oocyte and embryo metabolic activity that potentially contributes to the impaired developmental competence and fertility in aged females.

Day Surgery Conversion: Rate and Possible Causes in King Fahad Specialist Hospital, Buraydah, Saudi Arabia.

Introduction Day surgery is defined as the admission of a patient and discharge after the surgical procedure within the same day. It is becoming increasingly popular as it provides multiple advantages for the health care system and patients, including better resource utilization in the form of decreasing the cost, increasing the number of patients served, a reduction in the waiting list length, and preservation of hospital beds for complex advanced cases. Internationally, patients' admission rate after a planned day surgery was found at 1.5%. Etiologies for day surgery conversion vary among studies, 75% of which were labeled as potentially preventable. As patients are admitted, the benefits of day surgery decrease. Aim This study aimed to measure the unanticipated admission rate of day surgery while evaluating the reasons for admission in King Fahad Specialist Hospital, Buraydah, Qassim, Saudi Arabia. Materials and methods This is a retrospective review study in which all medical records of patients admitted and operated as day surgery from January 1, 2015 to February 28, 2021 in King Fahad Specialist Hospital in Buraydah, Qassim region in Saudi Arabia were evaluated. Variables collected included baseline characteristics such as age, gender, body mass index (BMI), chronic diseases, surgical history, operation name, complications, and causes of conversion. Results A total of 6,771 day surgery cases were found from January 1, 2015 to February 28, 2021. Of them, 231 cases were converted to inpatient admission, and the prevalence of conversion was 3.4%. The most common cause of conversion was pain (35.1%) followed by postoperative care (16%), need of antibiotics (12.1%), and bleeding (8.2%); most of these cases were associated with laparoscopic cholecystectomy. Furthermore, laparoscopic cholecystectomy (36.4%), hernia repair (12.1%), and pilonidal sinus excision were the most frequent surgical intervention. Conclusion The day surgery conversion rate was minimal in this study (3.4%). Pain, postoperative care, and the need for antibiotics were the most common reasons for conversion. Continuous monitoring of day surgery conversion rate and causes will all help the institution to gain the maximum benefits of day surgeries.

Design of a multi-sensor platform for integrating extracellular acidification rate with multi-metabolite flux measurement for small biological samples.

Rates of cellular oxygen consumption (OCR) and extracellular acidification (ECAR) are widely used proxies for mitochondrial oxidative phosphorylation (OXPHOS) and glycolytic rate in cell metabolism studies. However, ECAR can result from both oxidative metabolism (carbonic acid formation) and glycolysis (lactate release), potentially leading to erroneous conclusions about metabolic substrate utilization. Co-measurement of extracellular glucose and lactate flux along with OCR and ECAR can improve the accuracy and provide better insight into cellular metabolic processes but is currently not feasible with any commercially available instrumentation. Herein, we present a miniaturized multi-sensor platform capable of real-time monitoring of OCR and ECAR along with extracellular lactate and glucose flux for small biological samples such as single equine embryos. This multiplexed approach enables validation of ECAR resulting from OXPHOS versus glycolysis, and expression of metabolic flux ratios that provide further insight into cellular substrate utilization. We demonstrate expected shifts in embryo metabolism during development and in response to OXPHOS inhibition as a model system for monitoring metabolic plasticity in very small biological samples. Furthermore, we also present a preliminary interference analysis of the multi-sensor platform to allow better understanding of sensor interference in the proposed multi-sensor platform. The capability of the platform is illustrated with measurements of multi-metabolites of single-cell equine embryos for assisted reproduction technologies. However, this platform has a wide potential utility for analyzing small biological samples such as single cells and tumor biopsies for immunology and cancer research applications.

Relapse of Multiple Myeloma Presenting as Lower Lip Numbness.

Multiple myeloma (MM) is an uncommon malignancy characterised by the proliferation of clonal plasma cells. There are few published reports describing the extramedullary presentation of MM manifesting primarily in the head and neck region. In addition, the occurrence of an isolated relapse of MM in these sites is exceedingly rare. We report a 56-year-old female who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2010 with sudden-onset numbness of the lower lip. She had a history of MM in remission following chemotherapy and a bone marrow transplant. Clinical and radiographic examinations were indicative of a possible relapse of MM, which was subsequently confirmed by bone marrow aspiration and histopathological evaluation. This unique case highlights the unusual site of relapse of a haematolymphoid malignancy.

Is the Irish bedside best?

BACKGROUND: The use of the bedside to teach the art of clinical medicine is controversial. Rising student numbers can limit patient availability. Studies examining inpatient attitudes to bedside teaching are few. AIMS: We examined inpatients' attitudes to bedside teaching of undergraduate medical students. METHODS: The study was carried out in a 439-bed teaching hospital. A questionnaire, numerically scored (0-10), was prospectively administered to 102 consecutive patients involved in bedside teaching of undergraduate medical students. RESULTS: The results were available from 92 patients. Patients enjoyed the teaching process (mean score 9.13 +/- 1.16) and benefited from a better understanding of their illness (7.11 +/- 2.57). Patients appreciated their role in educating future doctors (mean score 9.52 +/- 1.11) but demonstrated less confidence in their personal contribution to the teaching process (7.81 +/- 1.89). CONCLUSIONS: Inpatients are very willing participants in bedside teaching of undergraduate medical students.