Intraoperative use of processed electroencephalogram in a quaternary center: a quality improvement audit.

Although intraoperative electroencephalography (EEG) is not consensual among anesthesiologists, growing evidence supports its use to titrate anesthetic drugs, assess the level of arousal/consciousness, and detect ischemic cerebrovascular events; in addition, intraoperative EEG monitoring may decrease the incidence of postoperative neurocognitive disorders. Based on the known and potential benefits of intraoperative EEG monitoring, an educational program dedicated to staff anesthesiologists, residents of Anesthesiology and anesthesia technicians was started at Cleveland Clinic Abu Dhabi in May 2022 and completed in June 2022, aiming to have all patients undergoing general anesthesia with adequate brain monitoring and following international initiatives promoting perioperative brain health. All the surgical cases performed under General Anesthesia at 24 daily locations were prospectively inspected during 15 consecutive working days in March 2023. The use or absence of a processed EEG monitor was registered. Of 379 surgical cases distributed by 24 locations under General Anesthesia, 233 cases (61%) had processed EEG monitoring. The specialty with the highest use of EEG monitoring was Cardiothoracic Surgery, with 100% of cases, followed by interventional Cardiology (90%) and Vascular Surgery (75%). Otorhinolaryngology (29%), Gastrointestinal Endoscopy (25%), and Interventional Pulmonology (20%) were the areas with the lowest use of EEG monitoring. Of note, in the Neuroradiology suite, no processed EEG monitor was used in cases under General Anesthesia. We identified a reasonable use of EEG monitoring during general anesthesia, unfortunately not reaching our target of 100%. The educational and support program previously implemented within the Anesthesiology Institute needs to be continued and improved, including workshops, online discussions, and journal club sessions, to increase the use of EEG monitoring in underused areas.

Evaluating the knowledge, attitudes, and uptake of the influenza vaccine in healthcare professionals: A cross-sectional study from the United E

Background: Influenza, a yearly epidemic, can present with a wide array of symptoms ranging from mild rhinorrhoea and cough to life-threatening superadded bacterial infections. It affects the lives of around 12.5% of the world’s population every year and accounts for almost half a billion deaths. With growing populations, these numbers will follow a similar growth resulting in increased morbidity and mortality. Currently, the recommended method to prevent influenza is through the administration of a yearly vaccine that entails the suspected strains of the virus for the year and region. Objective: This study aims to explore the knowledge, attitudes, and practices of the health care professionals in the United Arab Emirates (UAE) regarding Influenza vaccination. Methods: A cross-sectional study, utilizing a self-administered questionnaire, was distributed amongst health care professionals in the four largest emirates in the UAE, via convenience sampling. 417 responses were completed and analysed using SPSS-24. Results: 54.1% (n=225) of participants continue going to work while being sick despite 67.6% (n=282) reporting they are aware of the recommendations published by the Centers for Disease Control and Prevention (CDC). Multiple linear regression showed that age and profession were the only significant predictor of influenza vaccine knowledge. 54.2% (n=226) of the participants reported receiving the vaccine; of those, only 38.9% (n=88) receive it annually. One of the most commonly reported barriers to taking the vaccine was the uncertainty of its effectiveness. Those using a reminder system were 2.044 times more likely to take the vaccine regularly. Conclusion: This study demonstrates that the attitudes and practices towards taking the influenza vaccine as recommended are suboptimal. Campaigns targeting health care professionals regarding the influenza vaccine and the CDC recommendations would perhaps positively skew the results in the future (AU)

IL-13 Augments Histone Demethylase JMJD2B/KDM4B Expression Levels, Activity, and Nuclear Translocation in Airway Fibroblasts in Asthma.

PURPOSE: Asthma is one of the most common obstructive pulmonary diseases worldwide. Epigenetic alterations, including DNA methylation and histone modifications, have been reported to contribute to asthma pathogenesis. Since the inflammation mediator and remodeling trigger, IL-13, is known to play a central role in the pathophysiology of asthma, this study was aimed to identify novel IL-13-regulated epigenetic modifiers in asthma that may contribute to subepithelial fibrosis. METHODS: Publicly available transcriptomic datasets from Gene Expression Omnibus (GEO) were used to identify differentially expressed genes on an epigenetic level upon IL-13 exposure in lung fibroblasts. Bronchial fibroblasts isolated from healthy and asthmatic individuals were assessed for the gene and protein expression levels of the identified gene at baseline and upon IL-13 treatment using qRT-PCR and western blotting, respectively. Its subcellular localization and tissue distribution were examined in bronchial fibroblasts as well as bronchial biopsies by immunofluorescence and immunohistochemical analysis, respectively. RESULTS: Bioinformatic analysis revealed the differential expression of the histone demethylase JMJD2B/KDM4B, a well-known epigenetic modulator that leads to the demethylation of different lysine residues on histones, in IL-13-treated lung fibroblasts. The baseline expression levels of JMJD2B were higher in asthmatic fibroblasts and in bronchial biopsies in comparison to healthy ones. There was also an increase in JMJD2B activity as evidenced by the demethylation of its downstream target, H3K36me3. Furthermore, IL-13 stimulation induced JMJD2B expression and further demethylation of H3K36me3 in asthmatic fibroblasts. This was accompanied by increased translocation of JMJD2B into the nucleus. CONCLUSION: This study highlights the novel pathological involvement of the histone demethylase JMJD2B/KDM4B in asthmatic airway fibroblasts that are regulated by IL-13. Clinical implications. Given that there is no single therapeutic medicine to effectively treat the various subtypes of asthma, this study provides promising insights into JMJD2B as a new therapeutic target that could potentially improve the treatment and management of asthma.

Evaluating the knowledge, attitudes, and uptake of the influenza vaccine in healthcare professionals: A cross-sectional study from the United Arab Emirates.

Background: Influenza, a yearly epidemic, can present with a wide array of symptoms ranging from mild rhinorrhoea and cough to life-threatening superadded bacterial infections. It affects the lives of around 12.5% of the world's population every year and accounts for almost half a billion deaths. With growing populations, these numbers will follow a similar growth resulting in increased morbidity and mortality. Currently, the recommended method to prevent influenza is through the administration of a yearly vaccine that entails the suspected strains of the virus for the year and region. Objective: This study aims to explore the knowledge, attitudes, and practices of the health care professionals in the United Arab Emirates (UAE) regarding Influenza vaccination. Methods: A cross-sectional study, utilizing a self-administered questionnaire, was distributed amongst health care professionals in the four largest emirates in the UAE, via convenience sampling. 417 responses were completed and analysed using SPSS-24. Results: 54.1% (n=225) of participants continue going to work while being sick despite 67.6% (n=282) reporting they are aware of the recommendations published by the Centers for Disease Control and Prevention (CDC). Multiple linear regression showed that age and profession were the only significant predictor of influenza vaccine knowledge. 54.2% (n=226) of the participants reported receiving the vaccine; of those, only 38.9% (n=88) receive it annually. One of the most commonly reported barriers to taking the vaccine was the uncertainty of its effectiveness. Those using a reminder system were 2.044 times more likely to take the vaccine regularly. Conclusion: This study demonstrates that the attitudes and practices towards taking the influenza vaccine as recommended are suboptimal. Campaigns targeting health care professionals regarding the influenza vaccine and the CDC recommendations would perhaps positively skew the results in the future.