Improving Academic Writing in a Low-Resource Country: A Systematic Examination of Online Peer-Run Training.

Problem: Syrian medical research synthesis lags behind that of neighboring countries. The Syrian war has exacerbated the situation, creating obstacles such as destroyed infrastructure, inflated clinical workload, and deteriorated medical training. Poor scientific writing skills have ranked first among perceived obstacles that could be modified to improve Syrian research conduct at every academic level. However, limited access to personal and physical resources in conflict areas consistently hampers the implementation of standard professional-led interventions. Intervention: We designed a peer-run online academic writing and publishing workshop as a feasible, affordable, and sustainable training method to use in low-resource settings. This workshop covered the structure of scientific articles, academic writing basics, plagiarism, and the publication process. It was also supplemented by six practical assignments to exercise the learned skills. Context: The workshop targeted healthcare professionals and medicine, dentistry, and pharmacy trainees (undergraduate and postgraduate) at all Syrian universities. We employed a systematic design to evaluate the workshop's short- and long-term impact when using different instructional delivery methods and assignment formats. Participants were assigned in a stratified manner to four groups; two groups attended the workshop synchronously, and the other two groups attended asynchronously. One arm in each group underwent a supervised peer-review evaluation for the practical writing exercises (active), while the other arm in each group self-reviewed their work on the same exercises using exemplary solutions (passive). We assessed knowledge (30 questions), confidence in the learned skills (11 questions), and the need for further guidance in academic writing (1 question) before the workshop and one month and one year after it. Impact: One-hundred-twenty-one participants completed the workshop, showing improved knowledge, confidence, and need for guidance. At one-year follow-up, participants showed stability in these gains. Outcomes for the synchronous and asynchronous groups were similar. Completing practical assignments was associated with greater knowledge and confidence only in the active arms. Participants in the active arms engaging in the peer-review process showed greater knowledge increase and reported less need for guidance compared to those who did not engage in the peer-review. Lessons learned: Peer-run interventions can provide an effective, affordable alternative to improving scientific writing skills in settings with limited resources and expertise. Online academic writing training can show improvements regardless of method of attendance (i.e., synchronous versus asynchronous). Participation in supplementary practical exercises, especially when associated with peer-review, may improve knowledge and confidence.

Activated protein C resistance impact on Syrian candidates for in vitro fertilisation and the benefit of anticoagulation therapy: a retrospective cohort study.

Activated protein C resistance (APCR) is a common thrombophilia, caused mainly by a mutation. The impact of APCR on the efficacy of In Vitro Fertilization (IVF) are still unclear, and no solid recommendations for its management were published. To investigate the effect of APCR on IVF outcomes and assess the efficacy of our management protocol, we retrospectively scanned the medical records of women who were tested with APCR assay in 2019 at our fertility centre. The 66 women (12%) positive for APCR had lower odds of reaching clinical pregnancies after IVF 0.18 [95% CI: 0.07-0.47] and fewer live births. The administration of low-molecular-weight heparin and aspirin associated with more implantation in treated compared to untreated APCR-positive women with an odds ratio of 43.2 [7.51-248.6]. In conclusion, APCR negatively affects the number of clinical pregnancies after IVF, but anticoagulation therapy can mitigate this effect and significantly increase clinical pregnancies.Impact StatementWhat is already known on this subject? The evidence about the impact of APCR on IVF outcomes is still inconclusive. According to the Canadian guideline, routine screening for thrombophilia in patients with recurrent pregnancy loss is not recommended. No clear recommendations regarding the management of APCR in the planning for IVF are yet available.What do the results of this study add? APCR significantly increases implantation failure among infertile women who conduct IVF. Management of APCR using LMWH and aspirin was effective in mitigating this effect and increasing successful implantation.What are the implications of these findings for clinical practice and/or further research? Our findings can support the recommendation to include APCR assay in the routine tests for infertile women conducting IVF, and suggest the combination between LMWH and aspirin as an effective therapy to increase successful implantation in APCR positive candidates. However, more controlled clinical trials are still needed to confirm our results.

Idiopathic endogenous lipid pneumonia: A case report of a young Syrian man.

Lipid pneumonia is pneumonia due to aspiration or inhalation of various oily or fatty substances. It can be divided into exogenous and endogenous depending on the source of the lipids. In endogenous lipid pneumonia (ELP), lipid accumulates in the intra alveoli as a result of obstruction, chronic lung infection/disease, or a lipid storage disorder. This study presents a case of a 47 year-old man with a history of smoking, surgically repaired ventricular septal defect, pulmonary stenosis, and no history of lipid intake. He complained of worsened exertional dyspnea and a chronic non-productive cough with no signs and symptoms of infection. The patient was diagnosed with idiopathic endogenous lipid pneumonia after excluding any inflammatory or systemic disease as a possible cause. Open lung biopsy showed lipid-laden macrophages. Corticosteroids were the mainstay therapy with no radiological improvement, eventually death occurred due to pulmonary embolism.