The Prevalence and Associated Factors of Occupational Stress in Healthcare Providers in Saudi Arabia.

Background: Occupational stress is a negative physical and emotional response to job requirements, which might be caused by various factors that can harm the emotional and physical well-being of the employee. We aimed to investigate the factors and conditions associated with occupational stress. Study Design: The study was cross-sectional, conducted with the Perceived Stress Scale ten item version. Results: The majority of the participants reported moderate stress 223 (71%) and a small proportion (n=38, 12.2%) a high stress level. Several factors associated with higher risk of stress level for example being single were associated with higher risk of stress level in 135 (74.6%), moderate and high stress level was also reported in the group without enough income, 96 (75%) and 20 (15.6%), respectively. Conclusion: A group of sociodemographic factors were consistently associated with occupational stress, including gender, income, comorbidity and marital status. However, some factors remained complex and multifaceted. Recommendation: It is important to focus on reducing stress levels for all employees, regardless of their work experience or income. To prevent losing control of the healthcare worker's stress and to prevent an escalation to anxiety or depression, stress-management programs are necessary, specifically for those who are experiencing high stress levels.

Acetylene Tunes Microbial Growth During Aerobic Cometabolism of Trichloroethene.

Microbial aerobic cometabolism is a possible treatment approach for large, dilute trichloroethene (TCE) plumes at groundwater contaminated sites. Rapid microbial growth and bioclogging pose a persistent problem in bioremediation schemes. Bioclogging reduces soil porosity and permeability, which negatively affects substrate distribution and contaminant treatment efficacy while also increasing the operation and maintenance costs of bioremediation. In this study, we evaluated the ability of acetylene, an oxygenase enzyme-specific inhibitor, to decrease biomass production while maintaining aerobic TCE cometabolism capacity upon removal of acetylene. We first exposed propane-metabolizing cultures (pure and mixed) to 5% acetylene (v v-1) for 1, 2, 4, and 8 d and we then verified TCE aerobic cometabolic activity. Exposure to acetylene overall decreased biomass production and TCE degradation rates while retaining the TCE degradation capacity. In the mixed culture, exposure to acetylene for 1-8 d showed minimal effects on the composition and relative abundance of TCE cometabolizing bacterial taxa. TCE aerobic cometabolism and incubation conditions exerted more notable effects on microbial ecology than did acetylene. Acetylene appears to be a viable approach to control biomass production that may lessen the likelihood of bioclogging during TCE cometabolism. The findings from this study may lead to advancements in aerobic cometabolism remediation technologies for dilute plumes.

High Efficacy Two-Stage Metal Treatment Incorporating Basic Oxygen Furnace Slag and Microbiological Sulfate Reduction.

Lignocellulosic sulfate-reducing biochemical reactors (SRBRs) can be implemented as passive treatment for mining-influenced water (MIW) mitigating the potentially deleterious effects of MIW acidic pH, and high concentrations of metal(loid)s and SO42-. In this study, a novel two-stage treatment for MIW was designed, where basic oxygen furnace slag (slag stage) and microbial SO42- reduction (SRBR stage) were incorporated in series. The SRBRs contained spent brewing grains or sugarcane bagasse as sources of lignocellulose. The slag reactor removed >99% of the metal(loid) concentration present in the MIW (130 ± 40 mg L-1) and increased MIW pH from 2.6 ± 0.2 to 12 ± 0.3. The alkaline effluent pH of the slag reactor was mitigated by remixing slag effluent with acidic MIW before SRBR treatment. The SRBR stage removed the bulk of SO42- from MIW, additional metal(loid)s, and yielded a circumneutral effluent pH. Cadmium, copper, and zinc showed high removal rates in SRBRs (≥96%) and likely precipitated as sulfide minerals. The microbial communities developed in SRBRs were enriched in hydrolytic, fermentative, and sulfate-reducing taxa. However, the SRBRs developed distinct community compositions due to the different lignocellulose sources employed. Overall, this study underscores the potential of a two-stage treatment employing steel slag and SRBRs for full-scale implementation at mining sites.

Phosphorus removal by steel slag from tile drainage water: Lab and field evaluations.

Basic oxygen furnace (BOF) and blast furnace (BF) steel slags are well suited for phosphorous (P) removal from nonpoint sources such as agricultural runoff. However, the reported mechanism(s) of removal varies from study to study which complicates implementation for unique environmental conditions that may interfere with the removal mechanism(s). This work compared laboratory column experiments and field filter experiments to provide insights on the influence of relevant field conditions (water alkalinity, slag grain size distribution, BF:BOF slag ratio, and water stagnation) on P removal by BF and BOF steel slag mixtures. Alkalinity was the most influential variable in lab-scale slag columns that received 250 mg/L alkalinity water and achieved complete P removal throughout the 3-h experiment, while identical columns receiving 500 mg/L alkalinity water averaged 52% P removal and only 14% removal after 2.5 h. Batch regeneration and adsorption experiments were conducted on the exhumed BOF/BF slag mixture from the field filter to evaluate strategies for increasing field P removal capacity. The adsorption capacity of steel slags was effectively regenerated by 0.01 M Al2(SO4)3, which allowed for an additional 34% P removal in batch adsorption tests. The acid neutralization capacity of slag samples was effectively regenerated by 1 M NaOH, which allowed previously expended slag to reach a pH of 9.7 even in high alkalinity test water. The results presented here show that BF slag and Al2(SO4)3 regeneration of BF slag is best suited for high alkalinity influent conditions and removes P through adsorption while BOF slag and NaOH regeneration perform best under low alkalinity conditions and removes P through mineral precipitation.

Ammonium nitrate explosion at the main port in Beirut (Lebanon) and air pollution: an analysis of the spatiotemporal distribution of nitrogen dioxide.

An explosion of the ammonium nitrate (AN) stored at Beirut Port devastated the city on Tuesday 4 August 2020. Such an explosion produces pollutants such as nitrogen oxides (NO x ). The most common NO x is nitrogen dioxide (NO2), which is present in the atmosphere due to natural and anthropogenic processes. The presence of NO2 is used as indicator of air pollution. However, the specific contribution of NO2 to air quality is uncertain due to the presence of other constituents, especially particulate matter (PM10). Research has shown that extended exposure to NO2 may result in serious health effects. This study investigated the impact of the explosion on NO2 levels in the atmosphere above Beirut and the surrounding area. NO2 data from the Sentinel-5P program were used to map the levels of NO2. Furthermore, ground-monitoring data were used to assess the levels of PM10 and ozone (O3) due to the evident association between these constituents and NO2. Results showed that NO2 levels were higher than before the blast. However, 7 days after the explosion, NO2 levels had returned to normal, while the levels of PM10 and O3 remained normal following the explosion. However, a slight increase in the daily average atmospheric pressure was noticed after the explosion, which was attributed to the decomposition of ammonium nitrate.

Giant Third-Order Nonlinear Response of Mixed Perovskite Nanocrystals.

Mixed (FAPbI3)0.92(MAPbBr3)0.08 perovskite thin films exhibit strong nonlinear optical responses, rendering them promising candidates for applications in photonics and optical communications. In this work, we present a systematic study on the ultrafast third-order nonlinear optical processes in mixed perovskite nanocrystals (NCs) by exploring the generation of third harmonic radiation and giant two-photon absorption-based photoluminescence (PL) when excited by femtosecond laser pulses of a 1030 nm central wavelength. A comparative analysis of the coherent third harmonic generation in the thin-film-containing perovskite nanocrystals has shown a 40× enhancement of the third harmonic signal compared to the signal generated in the pure quartz substrate. The cubic dependence of the third-nonlinear optical response of the (FAPbI3)0.92(MAPbBr3)0.08 perovskites on the intensity of the driving radiation was identified using broadband 38 femtosecond driving pulses. The positive nonlinear refractive index (γ = +1.4 × 10-12 cm2·W-1) is found to play an important role in improving the phase-matching conditions of the interacting pulses by generating a strong third order harmonic. The giant two-photon absorption (TPA)-assisted PL peak was monitored and a blue shift of the PL was obtained in the higher intensity range of the laser pulses, with the absorption coefficient ß estimated to be~+7.0 cm·MW-1 at a 1030 nm laser wavelength.

Continuous-mode acclimation and operation of lignocellulosic sulfate-reducing bioreactors for enhanced metal immobilization from acidic mining-influenced water.

Lignocellulosic sulfate-reducing bioreactors are an inexpensive passive approach for treatment of mining-influenced water (MIW). Typically, microbial community acclimation to MIW involves bioreactor batch-mode operation to initiate lignocellulose hydrolysis and fermentation and provide electron donors for sulfate-reducing bacteria. However, batch-mode operation could significantly prolong bioreactor start-up times (up to several months) and select for slow-growing microorganisms. In this study we assessed the feasibility of bioreactor continuous-mode acclimation to MIW (pH 2.5, 6.5 mM SO42-, 18 metal(loid)s) as an alternate start-up method. Results showed that bioreactors with spent brewing grains and sugarcane bagasse achieved acclimation in continuous mode at hydraulic retention times (HRTs) of 7-12-d within 16-22 days. During continuous-mode acclimation, extensive SO42- reduction (80 ± 20% -91 ± 3%) and > 98% metal(loid) removal was observed. Operation at a 3-d HRT further yielded a metal(loid) removal of 97.5 ± 1.3 -98.8 ± 0.9% until the end of operation. Sulfate-reducing microorganisms were detected closer to the influent in the spent brewing grains bioreactors, and closer to the effluent in the sugarcane bagasse bioreactors, giving insight as to where SO42- reduction was occurring. Results strongly support that a careful selection of lignocellulose and bioreactor operating parameters can bypass typical batch-mode acclimation, shortening bioreactor start-up times and promoting effective MIW metal(loid) immobilization and treatment.

Investigation and Optimization of Mxene Functionalized Mesoporous Titania Films as Efficient Photoelectrodes.

Three-dimensional mesoporous TiO2 scaffolds of anatase phase possess inherent eximious optical behavior that is beneficial for photoelectrodes used for solar energy conversion applications. In this regard; substantial efforts have been devoted to maximizing the UV and/or visible light absorption efficiency; and suppressing the annihilation of photogenerated charged species; in pristine mesoporous TiO2 structures for improved solar illumination conversion efficiency. This study provides fundamental insights into the use of Mxene functionalized mesoporous TiO2 as a photoelectrode. This novel combination of Mxene functionalized TiO2 electrodes with and without TiCl4 treatment was successfully optimized to intensify the process of photon absorption; charge segregation and photocurrent; resulting in superior photoelectrode performance. The photocurrent measurements of the prepared photoelectrodes were significantly enhanced with increased contents of Mxene due to improved absorption efficiency within the visible region; as verified by UV-Vis absorption spectroscopy. The anatase phase of TiO2 was significantly augmented due to increased contents of Mxene and postdeposition heat treatments; as evidenced by structural analysis. Consequently; an appreciable coverage of well-developed grains on the FTO surface was observed in SEM images. As such; these newly fabricated conductive mesoporous TiO2 photoelectrodes are potential candidates for photoinduced energy conversion and storage applications.

Enzyme Induced Biocementated Sand with High Strength at Low Carbonate Content.

Specimens of silica sand treated via enzyme induced carbonate precipitation (EICP) showed surprisingly high strength at a relatively low carbonate content when non-fat powdered milk was included in the treatment solution. EICP is a biologically-based soil improvement technique that uses free urease enzyme to catalyze the hydrolysis of urea in an aqueous solution, producing carbonate ions and alkalinity that in the presence of calcium cations leads to precipitation of calcium carbonate. The strength achieved at less than 1.4% carbonate content via a single cycle of treatment was unprecedented compared to results reported in the literature from both EICP and microbially induced carbonate precipitation (MICP). Scanning electron microscope images show that in the specimens treated with the solution containing powdered milk the carbonate precipitate was concentrated at interparticle contacts. The impact of these results include reductions in the concentration of substrate and enzyme required to achieve a target compressive strength, reduction in the undesirable ammonium chloride by-product, and, depending on the desired strength, reduction in the number of cycles of EICP treatment. These advantages enhance the potential for development of a sustainable method of soil improvement via hydrolysis of urea.

Biomimetic Hydrogel Composites for Soil Stabilization and Contaminant Mitigation.

We have developed a novel method to synthesize a hyper-branched biomimetic hydrogel network across a soil matrix to improve the mechanical strength of the loose soil and simultaneously mitigate potential contamination due to excessive ammonium. This method successfully yielded a hierarchical structure that possesses the water retention, ion absorption, and soil aggregation capabilities of plant root systems in a chemically controllable manner. Inspired by the robust organic-inorganic composites found in many living organisms, we have combined this hydrogel network with a calcite biomineralization process to stabilize soil. Our experiments demonstrate that poly(acrylic acid) (PAA) can work synergistically with enzyme-induced carbonate precipitation (EICP) to render a versatile, high-performance soil stabilization method. PAA-enhanced EICP provides multiple benefits including lengthening of water supply time, localization of cementation reactions, reduction of harmful byproduct ammonium, and achievement of ultrahigh soil strength. Soil crusts we have obtained can sustain up to 4.8 × 103 kPa pressure, a level comparable to cementitious materials. An ammonium removal rate of 96% has also been achieved. These results demonstrate the potential for hydrogel-assisted EICP to provide effective soil improvement and ammonium mitigation for wind erosion control and other applications.

Perceived stress and associated factors among medical students.

BACKGROUND: Stress and its psychological manifestations are currently a major source of concern. Medical education poses challenging and potentially threatening demands for students throughout the world. OBJECTIVES: To determine the prevalence and factors associated with perceived stress in medical students in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Fahad Medical City, Riyadh, Saudi Arabia. MATERIALS AND METHODS: This was a cross-sectional study on all medical students of batches 9, 10, and 11, which constituted all the enrolled students. Data were collected using a questionnaire based on the Kessler10 psychological distress instrument with a total score ranging from 10 to 50 points in addition to some sociodemographic characteristics. Appropriate statistical test procedures were used to study the magnitude of stress and its risk factors. RESULTS: Mean stress score of the eighty participants was 26.03 ± 9.7. Students with severe stress constituted 33.8%, and 30% were well. Severe stress was significantly associated with female gender and junior level. Nervousness, feeling hopeless, feeling restless, and depressed were the most important factors affecting students' stress scores. Factor analysis revealed three hidden factors for stress in this group, namely, depression, nervousness, and age. CONCLUSION: Stress in medical students is prevalent and significantly associated with the female gender and the junior level. Implementation of coping programs is necessary.

Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey.

BACKGROUND: In the past, diastolic hypertension was the main criterion for treatment, but currently, systolic pressure is the main criterion because it was thought that Isolated Diastolic Hypertension (IDH) is not associated with complications. Studies later revealed that IDH carries significant risks. Quantifying the magnitude and risk factors of IDH in the community is essential for all intervention strategies. AIMS: This study aims to determine the prevalence, risk factors, predictors, treatment modalities and lifestyle practices of IDH adult patients in the Kingdom of Saudi Arabia (KSA). STUDY DESIGN: Cross-sectional study. METHODS: A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample was carried out. Data were collected using questionnaires which included socio-demographics, blood pressure, biochemical, anthropometric measurements and lifestyle practices. Statistical analysis included calculating means and standard deviations, proportions, univariate and multiple logistic regression analysis. RESULTS: Of a total 4562 subjects, 180 (3.95%) suffered from IDH, which was significantly related to age, gender, employment, smoking, diabetes mellitus, obesity and hypercholesterolemia. More than 93% were using some form of treatment, with 77.2% on prescribed drugs, 63% using diet, and 23% using exercise. Significant predictors of IDH were retirement and hypercholesterolemia. CONCLUSION: IDH is associated with some sociodemographic characteristics and co-morbidity. Given the risk of cardiovascular disease associated with IDH, the findings of this study emphasize the need for diagnosing the disease in middle-aged persons focusing on the modifiable risk factors of IDH.

The Risk of Nosocomial Transmission of Rift Valley Fever.

In 2000, we investigated the Rift Valley fever (RVF) outbreak on the Arabian Peninsula-the first outside Africa-and the risk of nosocomial transmission. In a cross-sectional design, during the peak of the epidemic at its epicenter, we found four (0.6%) of 703 healthcare workers (HCWs) IgM seropositive but all with only community-associated exposures. Standard precautions are sufficient for HCWs exposed to known RVF patients, in contrast to other viral hemorrhagic fevers (VHF) such as Ebola virus disease (EVD) in which the route of transmission differs. Suspected VHF in which the etiology is uncertain should be initially managed with the most cautious infection control measures.

Do routinely measured risk factors for obesity explain the sex gap in its prevalence? Observations from Saudi Arabia.

BACKGROUND: The prevalence of adult obesity is higher in women than men in most countries. However, the pathways that link female sex with excess obesity are still not fully understood. We examine whether socioeconomic and behavioural factors may mediate the association between sex and obesity in the Saudi Arabian setting where there is female excess in obesity. METHODS: We performed a mediation analysis using a cross-sectional, national household survey from Saudi Arabia with 4758 participants (51% female). A series of multivariable regression models were fitted to test if socioeconomic position, physical activity, sedentary behaviour, diet, and smoking mediate the association between sex and obesity (BMI >=30). The findings were confirmed using causal mediation analysis. RESULTS: Women in this sample were roughly twice as likely as men to be obese (crude OR 1.9; 95% CI 1.6-2.3). The odds ratio remained significantly higher for women compared to men in models testing for mediation (OR range 1.95-2.06). Our data suggest that indicators of socio-economic position, physical activity, sedentary behaviour, diet, and smoking do not mediate the sex differences in obesity. CONCLUSIONS: Our analysis shows that most commonly measured risk factors for obesity do not explain the sex differences in its prevalence in the Saudi context. Further research is needed to understand what might explain the female excess in obesity prevalence. We discuss how data related to the lived experience of Saudi men and women may tap into underlying mechanisms by which the sex difference in obesity prevalence are produced.

Role and challenges of simulation in undergraduate curriculum.

RATIONALE: Medical simulation is relatively a novel technology widely utilized for teaching and assessing students clinical skills. Students and faculty face many challenges when simulation sessions are introduced into undergraduate curriculum. OBJECTIVES: The aim of this study is to obtain the opinion of undergraduate medical students and our faculty regarding the role of simulation in undergraduate curriculum, the simulation modalities used, and the perceived barriers in implementing simulation sessions. METHODS: A self-administered pilot tested questionnaire with 18 items using a 5-point Likert scale was distributed to undergraduate male (n = 125) and female students (n = 70) as well as to the faculty members (n = 14) at King Fahad Medical City, King Saud Bin Abdul Aziz University of Health Sciences, Saudi Arabia, to respond. Survey elements addressed the role of simulation, simulation modalities used, and perceived challenges to implementation of simulation sessions. RESULT: Various learning outcomes are achieved and improved through the technology enhanced simulation sessions such as communication skills, diagnostic skills, procedural skills, self-confidence, and integration of basic and clinical sciences. The use of high fidelity simulators, simulated patients and task trainers was more desirable by our students and faculty for teaching and learning as well as an evaluation tool. According to most of the students', institutional support in terms of resources, staff and duration of sessions was adequate. However, motivation to participate in the sessions and provision of adequate feedback by the staff was a constraint. CONCLUSION: The use of simulation laboratory is of great benefit to the students and a great teaching tool for the staff to ensure students learn various skills.

Anthropometric risk factors and predictors of hypertension among Saudi adult population - a national survey.

UNLABELLED: This cross-sectional study aimed at determining the anthropometric predictors of hypertension among adults in Saudi Arabia. Multi-stage stratified sampling was used to select 4758 adult participants. The average of three blood pressure measurements using an automatic sphygmomanometer was considered the real blood pressure. Anthropometric measurements and socio-demographics were obtained from participants. The overall prevalence of hypertension was 25.5%. Hypertension was significantly positively associated with selected anthropometric measurements. Selected anthropometric measures were significant predictors of systolic and diastolic blood pressures except for hip measurements. Waist for height ratio was a significant predictor for isolated diastolic hypertension and combined systolic and diastolic hypertension. Waist circumference was the significant predictor for isolated systolic hypertension. Body mass index was a significant predictor for the combined systolic diastolic type. Waist for Hip Ratio was not a significant predictor for any of the hypertension subtypes. CONCLUSION: Waist for height ratio is the most important predictor for blood pressure level and hypertension disease.

Gender differences in learning styles and academic performance of medical students in Saudi Arabia.

RATIONALE: Teachers at medical school are often faced with challenges of improving student satisfaction with the learning environment. On the other hand, education in the medical field is very competitive and medical students are exposed to diverse methods of teaching. Students adapt specific learning styles to keep pace with the information delivered to them in their institutions. OBJECTIVE: The aim of this study is to know the differences in learning styles between male and female students, and the effect it has on academic performance. METHOD: The VARK Questionnaire version 7.0 (Visual, Aural, Read/Write and Kinesthetic) was administered to the fourth year and fifth year medical students at King Saud Bin Abdul Aziz University for Health Sciences, Faculty of Medicine at King Fahad Medical City, Saudi Arabia for determining the preferred learning methods of students participating in this study. The learning styles were then compared to cumulative grade point average (GPA) obtained by the students. RESULT: The dominant learning style preference of students was multimodal. Among students who preferred unimodal preference, aural and kinesthetic preference was predominant for males and females. Moreover, Females had more diverse preferences than male students. Multimodal learners have higher cumulative GPAs when compared with the unimodal learners. CONCLUSION: This study revealed variation in learning style preferences among genders, and its implications on academic performance of medical students.

Academic and socio-demographic factors influencing students' performance in a new Saudi medical school.

OBJECTIVE: The objective of this study is to examine factors such as the students' demographic data, motivation, educational factors and socio-cultural factors, and identify whether these factors affect the academic performance of undergraduate medical students. METHODS: A cross-sectional study design utilising grade point averages (GPAs) of two cohorts of students in both levels of the pre-clinical phase. In addition, self-administered questionnaire was used to evaluate the effect of these factors on students with poor and good cumulative GPA. RESULTS: Academic performance was significantly affected with factors such as gender, marital status, interest and motivation, and the transportation used to reach the faculty. Students with a cumulative GPA of 3.0 or greater significantly differed than those with a GPA of less than 3.0 being higher in female students, in married students, students have interest to study medicine and type of transportation used to reach the college. Factors including age, motivation, learning resources, study time and type of transportation used have shown to create a significant difference in GPA between male and females. CONCLUSION: Factors such as age, gender, marital status, interest and motivation to enter medical school, learning resources, study time and the transportation used have been shown to significantly affect medical student's cumulative GPA as a whole batch as well as when they are tested for gender.

Comparative study of physical activity of hypertensives and normotensives: A cross-sectional study of adults in Saudi Arabia.

BACKGROUND: To formulate all intervention strategies for hypertension in the community, it is essential to quantify the magnitude of the disease and its risk factors. The patterns of physical activity have not been studied in terms of their being a risk factor or a predictor of hypertension in Saudi Arabia. MATERIALS AND METHODS: This was a community-based cross-sectional study using the STEP-wise approach of adults and a multistage, stratified, cluster random sample. Data were collected using a questionnaire which included sociodemographics, blood pressure, patterns, levels and duration of physical activity. RESULTS: Of a total of 4758, 1213 (25.5%) were hypertensives. Hypertension was significantly negatively associated with total levels and duration of physical activity in leisure, transport, and work. Significant predictors of hypertension included lower levels of work involving a moderate physical activity for 10 min, walking/cycling for 10 min continuously, and vigorous activity during leisure time. CONCLUSIONS: Hypertension is prevalent among adults; physical inactivity is a significant risk factor and predictor. Targeting this modifiable risk factor can help in prevention, early diagnosis, and control.