Physicians' attitudes and knowledge toward artificial intelligence in medicine: Benefits and drawbacks.

The use of artificial intelligence (AI) in the medical field is increasing and is expected to shape future clinical practice and job security. Therefore, this study aimed to assess the opinions and attitudes of practicing physicians in Bahrain regarding the benefits and drawbacks of AI for their future daily practice. A cross-sectional survey of practicing physicians with a minimum of five years' experience across the main secondary and tertiary care hospitals in Bahrain was conducted. An online questionnaire was used to collect data on demographics, knowledge of AI, attitudes towards the use of AI in 10 tasks of daily clinical practice, and opinions on the benefits and drawbacks of AI. A total of 114 physicians participated in the survey. Among them, 43 (37.7%) were registered psychiatrists, 15 (13.2%) were pathologists, 17 (14.9%) were radiologists, and 39 (34.2%) were surgical specialists. The participants' attitudes were overall positive towards AI. Pathologists were particularly in favor of using AI to "Formulate personalized medication and/or treatment plans for patients" and to "Interview patients in a range of settings to obtain medical history." Most participants agreed that AI would reduce the time needed to establish a diagnosis and negatively affect employment rates. There were no correlations between the responses and the participants' age, gender, years of experience, or AI knowledge. This study demonstrates that the attitudes towards the use of AI in medicine among practicing physicians in Bahrain are similar to those of physicians in developed countries in that they are positive and welcoming of AI implementation in practice. However, the potential effects of AI on job security are a major concern.

Correction to: Lipid accumulation in prokaryotic microorganisms from arid habitats.

There is an error in the Original Publication of this paper for "Acknowledgements" section was missing.

Sphingomonas jeddahensis sp. nov., isolated from Saudi Arabian desert soil.

A novel Sphingomonas strain was isolated from a sample of desert soil collected near Jeddah in Saudi Arabia. A polyphasic approach was performed to characterize this strain, initially designated as G39T. Cells of strain G39T are motile, Gram-negative, catalase- and oxidase-positive. The strain is able to grow aerobically at 20-35 °C, pH 6.5-8 and tolerates up to 4 % (w/v) NaCl. Based on 16S rRNA gene sequence similarity, the closest relative type strains of G39T are Sphingomonas mucosissima DSM 17494T (98.6 %), S. dokdonensis DSM 21029T (98.4 %) and S. hankookensis DSM 23329T (97.4 %). Furthermore, the average nucleotide identities between the draft genome sequence of strain G39T and the genome sequences of all other available and related Sphingomonas species are significantly below the threshold of 94 %. The G+C content of the draft genome (3.12 Mbp) is 65.84 %. The prevalent (>5 %) cellular fatty acids of G39T were C18 : 1ω7c, C16 : 1ω7c and/or C16 : 1ω6c, C14 : 0 2-OH and C16 : 0. The only detectable respiratory quinone was ubiquinone-10 and the polar lipids profile is composed of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, sphingoglycolipid, as well as unidentified lipids, phospholipids and glycolipids. The results of the conducted polyphasic approach confirmed that this isolate represents a novel species of the genus Sphingomonas, for which the name Sphingomonas jeddahensis sp. nov. is proposed. The type strain of this species is G39T (=DSM 103790T=LMG 29955T).

Dietary exposure to acrylamide from cafeteria foods in Jeddah schools and associated risk assessment.

BACKGROUND: Acrylamide (AA) is a carcinogenic and genotoxic food contaminant produced at high temperatures in foods that are rich in carbohydrates. Foods sold in schools in Jeddah, Saudi Arabia, are among such carbohydrate-rich foods produced at high cooking temperatures. It is crucial to determine the importance of AA exposure with respect to cafeteria foods and assess the associated risks. RESULTS: The highest mean AA level was measured in chocolate pies (439 µg kg-1 ), followed by custard pies (435 µg kg-1 ) and cheese pies (432 µg kg-1 ). The average and 95th percentile values of AA exposure were 0.51 and 1.17 [µg kg-1 body weight (BW) school day-1 ]. The average exposure significantly decreased with an increase in age, from 0.65 (µg kg-1 BW school day-1 ) in primary school students to 0.37 in secondary school students. Cheese and chocolate pies are the main contributors in AA intake. The contributions of cheese and chocolate pies to the average exposure among primary, middle and secondary school students were 23.1%, 24.7% and 29.4% and 16.9%, 12.1% and 11.9%, respectively. Other products with significant contributions included cheese sandwiches (10.8%, 8.9% and 12.7%), plain cookies (7.7%, 5.6% and 6.7%) and custard pies (7.7%, 4.8% and 8.9%). Other cafeteria products contributed to AA exposure at much lower percentages. CONCLUSION: The calculated margins of exposure (MOEs) for the average [356 and 614 for both benchmark dose lower confidence limit (BMDL) 0.18 and 0.31 mg kg-1 BW day-1 ] and 95th percentile AA exposure values (154 and 265 for both BMDL 0.18 and 0.31 mg kg-1 BW day-1 ) suggest that there is a health concern with respect to school-aged students. © 2017 Society of Chemical Industry.

Lipid accumulation in prokaryotic microorganisms from arid habitats.

This review shall provide support for the suitability of arid environments as preferred location to search for unknown lipid-accumulative bacteria. Bacterial lipids are attracting more and more attention as sustainable replacement for mineral oil in fuel and plastic production. The development of prokaryotic microorganisms in arid desert habitats is affected by its harsh living conditions. Drought, nutrient limitation, strong radiation, and extreme temperatures necessitate effective adaption mechanisms. Accumulation of storage lipids as energy reserve and source of metabolic water represents a common adaption in desert animals and presumably in desert bacteria and archaea as well. Comparison of corresponding literature resulted in several bacterial species from desert habitats, which had already been described as lipid-accumulative elsewhere. Based on the gathered information, literature on microbial communities in hot desert, cold desert, and humid soil were analyzed on its content of lipid-accumulative bacteria. With more than 50% of the total community size in single studies, hot deserts appear to be more favorable for lipid-accumulative species then humid soil (≤20%) and cold deserts (≤17%). Low bacterial lipid accumulation in cold deserts is assumed to result from the influence of low temperatures on fatty acids and the increased necessity of permanent adaption methods.

Analysis and optimization of triacylglycerol synthesis in novel oleaginous Rhodococcus and Streptomyces strains isolated from desert soil.

As oleaginous microorganisms represent an upcoming novel feedstock for the biotechnological production of lipids or lipid-derived biofuels, we searched for novel, lipid-producing strains in desert soil. This was encouraged by the hypothesis that neutral lipids represent an ideal storage compound, especially under arid conditions, as several animals are known to outlast long periods in absence of drinking water by metabolizing their body fat. Ten lipid-accumulating bacterial strains, affiliated to the genera Bacillus, Cupriavidus, Nocardia, Rhodococcus and Streptomyces, were isolated from arid desert soil due to their ability to synthesize poly(ß-hydroxybutyrate), triacylglycerols or wax esters. Particularly two Streptomyces sp. strains and one Rhodococcus sp. strain accumulate significant amounts of TAG under storage conditions under optimized cultivation conditions. Rhodococcus sp. A27 and Streptomyces sp. G49 synthesized approx. 30% (w/w) fatty acids from fructose or cellobiose, respectively, while Streptomyces isolate G25 reached a cellular fatty acid content of nearly 50% (w/w) when cultivated with cellobiose. The stored triacylglycerols were composed of 30-40% branched fatty acids, such as anteiso-pentadecanoic or iso-hexadecanoic acid. To date, this represents by far the highest lipid content described for streptomycetes. A biotechnological production of such lipids using (hemi)cellulose-derived raw material could be used to obtain sustainable biodiesel with a high proportion of branched-chain fatty acids to improve its cold-flow properties and oxidative stability.

Measurement of Impairment among Children with Attention Deficit Hyperactivity Disorder as Part of Evaluating Treatment Outcome.

UNLABELLED: This study assesses the impairment and treatment outcome of children with attention deficit hyperactivity disorder (ADHD) in an outpatient child psychiatry clinic, using multiple sources, including the Children Global Assessment Scale (C-GAS). METHODS: A total of 20 children, aged 4 to 16 years, were recruited serially in 2010 from the Child Psychiatric Unit of the Psychiatric Hospital, Manama, Bahrain. The children received a diagnosis of ADHD using the Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR). The children were assessed with the C-GAS by a blinded investigator, initially at the beginning of the treatment and then one year later. RESULTS: The parents of the patients reported improvement in all cases; the improvement in impairment after one year, assessed using the C-GAS, was significant for all of the cases (P = 0.001) and low for those with comorbidity (P = 0.07). CONCLUSION: Measurement of improvement using the C-GAS was a suitable method of collecting data, and hence should be included in routine clinical practice for both ADHD diagnosis and outcome measurement.

Estrogen-like effects in male goldfish co-exposed to fluoxetine and 17 alpha-ethinylestradiol.

The antidepressant fluoxetine (FLX) and the synthetic estrogen, 17 alpha-ethinylestradiol (EE2), are present in municipal sewage discharges. To better understand possible interactions between them, male goldfish were exposed to an ethanol control or to nominal concentrations of FLX (0.54 µg/L) and EE2 (5 ng/L) alone and in combination for 14 days. Real-time reverse-transcription polymerase chain reaction was used to assess effects on hepatic gene expression and liquid chromatography tandem mass spectrometry to analyze the plasma proteome. The results showed an increase in estrogen receptor alpha (esr1) and vitellogenin (vtg) gene expression by 1.9-2.4-fold in the FLX and EE2 groups, but this did not reach statistical significance. In contrast, co-exposure up regulated esr1 and vtg gene expression by 5.5- and 5.3-fold, respectively. Fluoxetine and EE2 alone did not affect estrogen receptor beta (esr2), but the co-exposure down regulated esr2 expression by 50%. There was a significant increase in the number of plasma proteins that were related to endocrine system disorders in the FLX and FLX plus EE2 groups. The level of VTG protein was increased in the plasma from goldfish exposed to EE2, FLX, and FLX plus EE2. Our study demonstrates that low concentrations of FLX and EE2 in a simple mixture produce strong estrogen-like effects in the male goldfish.

Dynamics of uptake and elimination of 17α-ethinylestradiol in male goldfish (Carassius auratus).

We used male goldfish (Carassius auratus) as a model species to determine the uptake, elimination, and bioaccumulation of 17α-ethinylestradiol (EE2). Goldfish were exposed to EE2 via two different routes: water (135ng/L±12.8 standard deviation) for 72h, and food (231ng/g±42 SD) for 120h. We observed a rapid uptake of EE2 in goldfish, reaching 8.4ng/g±1.2 dry weight (dw) after the first hour of exposure with an uptake rate coefficient (k1) of 45h(-1). The elimination rate coefficient (k2) was determined by a depuration experiment to be 0.0786h(-1). In the feeding experiment, EE2 concentrations increased rapidly, reaching an average of 1.4ng/g after 3h following the first dietary exposure with an estimated absorption efficiency (α) of 0.106. An average of 2.66ng/g±0.87 (n=8) was determined in the 24-72h samples, whereas EE2 concentrations in fish fell below our method detection limits (0.67ng/g) for all samples after 72h, suggesting efficient elimination over time. The bioconcentration factor (BCF) for EE2 reached a maximum of 377, similar to BCFs measured for other pharmaceuticals like fluoxetine and sertraline. Our kinetic data were also used to model various scenarios of EE2 uptake in the aquatic environment. To our knowledge, this is the first report to describe aqueous and dietary EE2 uptake and elimination in fish, as well as providing important data to model EE2 kinetics in fish.

The development of an optimized sample preparation for trace level detection of 17α-ethinylestradiol and estrone in whole fish tissue.

The purpose of this study was to develop an optimized method for the extraction and determination of 17α-ethinylestradiol (EE2) and estrone (E1) in whole fish tissues at ng/g levels. The optimized procedure for sample preparation includes extraction of tissue by accelerated solvent extraction (ASE-200), lipid removal by gel permeation chromatography (GPC), and a cleanup step by acetonitrile precipitation followed by a hexane wash. Analysis was performed by gas chromatography/mass spectrometry (GC/MS) in negative chemical ionization (NCI) mode after samples were derivatized with pentafluorobenzoyl chloride (PFBCl). The method was developed using high lipid content wild fish that were exposed to the tested analytes. The whole procedure recoveries ranged from 74.5 to 93.7% with relative standard deviation (RSD) of 2.3-6.2% for EE2 and 64.8 to 91.6% with RSD of 9.46-0.18% for E1. The method detection limits were 0.67 ng/g for EE2 and 0.68 ng/g for E1 dry weight. The method was applied to determine EE2 levels in male goldfish (Carrasius auratus) after a 72 h dietary exposure. All samples contained EE2 averaging 1.7ng/g (±0.29 standard deviation, n=5). This is the first optimized protocol for EE2 extraction from whole fish tissue at environmentally relevant concentrations. Due to high sensitivity and recovery, the developed method will improve our knowledge about the environmental fate and uptake of synthetic steroidal estrogens in fish populations.

A method to estimate sediment ingestion by fish.

A method is proposed to use naturally occurring radionuclides of the (238)U decay series as mass balance tracers to estimate sediment ingestion by benthic fish. The mass balance tracer method can take two forms: one that does not account for tracers that would be ingested in invertebrate food items (simple mass balance tracer method) and one that does (adjusted mass balance tracer method). The contents of the gastrointestinal (GI) tracts from 17 Shorthead Redhorse Suckers (Moxostoma macrolepidotum) were analyzed using the proposed method to determine the proportion of sediment in the fish gut. The proportion of sediment in the GI tract samples was also determined using a method developed by Beyer et al. (1994), where the percent soil in wildlife is estimated from the acid insoluble residue (AIR) content of their scat and an assumed level of digestibility of their food (AIR method). The mean mass of sediment in the GI tracts of the 17 fish sampled, calculated using the simple mass balance tracer method, was observed to be 1.14g (standard deviation 0.99g) or approximately 46% (standard deviation 16%) of the dry weight of total GI tract contents. A mean of 0.97g (standard deviation 0.85g), or approximately 38% (standard deviation 13%) of the dry weight of total GI tract contents, was observed when the mass of sediment in the GI tract was calculated using the adjusted mass balance tracer method. When using the AIR method, the mean percentage of sediment in the GI tracts was observed to be 30% (standard deviation 16%). The findings in this study support the assertion that direct ingestion of sediment by benthic fish may be an important pathway for contaminants in aquatic food webs.

Bioaccumulation of the pharmaceutical 17alpha-ethinylestradiol in shorthead redhorse suckers (Moxostoma macrolepidotum) from the St. Clair River, Canada.

17alpha-ethynylestradiol (EE2), a synthetic estrogen prescribed as a contraceptive, was measured in Shorthead Redhorse Suckers (ShRHSs) (Moxostoma macrolepidotum) collected near a wastewater treatment plant (WWTP) in the St. Clair River (Ontario, Canada). We detected EE2 in 50% of the fish samples caught near the WWTP (Stag Island), which averaged 1.6+/-0.6ng/g (wet weight) in males and 1.43+/-0.96ng/g in females. No EE2 was detected in the samples from the reference site (Port Lambton) which was 26km further downstream of the Stag Island site. Only males from Stag Island had VTG induction, suggesting the Corunna WWTP effluent as a likely source of environmental estrogen. EE2 concentrations were correlated with total body lipid content (R(2)=0.512, p<0.01, n=10). Lipid normalized EE2 concentrations were correlated with delta(15)N (R(2)=0.436, p<0.05, n=10), suggesting higher EE2 exposures in carnivores. Our data support the hypothesis of EE2 bioaccumulation in wild fish.