Mental health, learning behaviour and perceived fatigue among university students during the COVID-19 outbreak: a cross-sectional multicentric study in the UAE.

BACKGROUND: The rapid shift to online education due to COVID-19 quarantine challenged students' ability to accept pure online learning without negative consequences for their physical, emotional and mental health. Some educational institutions introduced new strategies to reduce the psychosocial burden associated with online learning during home confinement. Thus, the primary aims were to determine the consequences of COVID-19 for the psychological well-being and fatigue levels of higher education students and to explore the effects of a new academic assessment approach in reducing home confinement stress. METHOD: A cross-sectional online survey was conducted among students, from 30 August to 30 September 2020, of 7 disciplines in all 16 higher colleges of technology in the United Arab Emirates (UAE). The Mental Well-being and Learning Behaviours Scale and the modified Copenhagen Burnout Inventory were used to evaluate students' psychological well-being and fatigue levels. A Welch t-test and Welch ANOVA were performed to determine the differences in perceived psychological well-being associated with students' characteristics. Second, Kruskal_Wallis and Mann_Whitney were performed to determine the differences in fatigue level based on students' characteristics. RESULTS: One thousand four hundred students participated. The majority were female (78.5%) and aged from 21-25 years (58.1%). Around 14% of respondents were married with children. Nearly 40% were satisfied with the new assessment approach introduced during the COVID pandemic and 45.5% perceived it as having reduced their home confinement stress. The mean psychological distress score of 3.00 (SD ± 0.71) indicates a moderate impact of COVID-19 on psychological well-being. Students' psychological distress was positively correlated with fatigue level (0.256, p < 0.001) and negatively correlated with the perceived impact of the new assessment approach on student lifestyle (- 0.133, p < 0.001), physical health (- 0.149, p < 0.001) and coping with stress (- 0.125, p < 0.001). Male students experienced significantly lower fatigue and better psychological well-being than female students. CONCLUSION: The study reveals that new assessment approaches which emerged during home confinement reduced students' perception of stress and of impaired lifestyle. However, students still had a considerable burden of psychological distress, requiring further preventive measures to maintain their psychological well-being during future outbreak events. Educational institutions should consider additional strategies to improve students' preparedness for online teaching, which could help maintain their psychological well-being.

The impact of somatic and cognitive depressive symptoms on medical prognosis in patients with end-stage renal disease.

PURPOSE: To determine whether somatic or cognitive depressive symptoms affect hospitalization and death in patients with end-stage renal disease. DESIGN AND METHOD: In an observational retrospective design, the patients (n = 190) completed the Beck Depression Inventory-II at baseline and were followed for 5 years to collect data all-cause mortality and hospitalization. FINDINGS: High somatic (53.7%, n = 102) and cognitive (52.1%, n = 99) depressive symptoms scores significantly associated with mortality (38% vs. 19%; hazard ratio [HR] = 2; 95% CI, 1.1-3.7; p = 0.02) and hospitalization (62.5% vs. 49.4%; HR = 1.6; 95% CI, 1.0-2.6; p = 0.03), respectively. PRACTICE IMPLICATIONS: In the context of diagnosing and intervening, awareness of depressive symptoms dimensionality is crucial.

Factors Influencing the Choice of Radiology Subspecialty Among Radiology Trainees in Saudi Arabia.

Background Differential choices of radiology subspecialties by radiology trainees can cause shortages in some subspecialties. The objective of the current study was to evaluate the relative preference of different radiology subspecialties and the influencing factors among radiology trainees in Saudi Arabia.  Methods An online questionnaire was developed based on previous publications and was used to collect the data from radiology trainees in Saudi Arabia during August 2018. The relative importance of potential personal and work-related factors was assessed using Likert-scaled responses. Results A total of 105 radiology trainees were included in the current analysis. Approximately 64.8% of the trainees were males. A total of eight subspecialties were reported, with the most frequent being interventional radiology (20%), neuroradiology (19%), abdominal/gastrointestinal (15.2%), and musculoskeletal (14.3%). Personal factors that were reported as extremely or very important included strong personal interest (84.8%), successful/enjoyable rotation during training (84.8%), and intellectual challenge (76.2%). Work-related factors that were reported as extremely or very important included direct impact on patient care (84.8%), advanced or a variety of imaging modalities (81%), direct professional contact (77.1%), and favorable/flexibility of working hours and on-call commitments (77.1%). The subspecialty of interventional radiology was more frequently chosen by male trainees (p = 0.006), while the gynecological/breast subspecialty was exclusively chosen by female trainees (p < 0.001). Conclusion In addition to gender-specific differences, we are reporting several important personal and professional factors that influence the choice of radiology subspecialty. These findings can potentially help the directors of radiology training in making evidence-based modifications to their residency programs to ensure the maintenance of a sufficient radiology workforce.

Managing adolescent pregnancy: The unique roles and challenges of private general practitioners in Malaysia.

INTRODUCTION: Managing adolescent pregnancy in the primary care setting is complex, as it requires doctors to navigate through a combination of medical, social, financial and legal needs. Objective: This study explores the perspectives of private general practitioners on their roles and challenges in managing adolescent pregnancy in Malaysia. METHODS: Nineteen private general practitioners in Selangor and Kuala Lumpur participated in in-depth interviews in 2015. A topic guide was used for interview navigation. Participants were asked to discuss their experiences and approaches in managing pregnant adolescents. We used purposive sampling to recruit consenting private general practitioners who had experience in managing adolescent pregnancy. The verbatim transcripts of the audio-recorded interviews were analyzed using thematic analysis. Data reached saturation at the nineteenth in-depth interview. Results: Two themes emerged. Under the theme 'inadvertent advocator,' participants described their tasks with regards to building trust, calming angry parents and delivering comprehensive counseling and care related to the sexual and reproductive health of adolescents, including requests for abortions. Theme two, 'challenges of private general practitioners,' refers mainly to personal and religious conflicts arising from a request for an abortion and deficiencies in support and multidisciplinary integration within their practice settings. CONCLUSION: General practitioners practicing in the private sector identify themselves as active players in supporting pregnant adolescents but face many challenges arising from the personal, religious, professional and community levels. Addressing these challenges is important for optimal care delivery to pregnant adolescents in this community.

Diels Alder-mediated release of gemcitabine from hybrid nanoparticles for enhanced pancreatic cancer therapy.

Hybrid nanoparticles (HNPs) have shown huge potential as drug delivery vehicles for pancreatic cancer. Currently, the first line treatment, gemcitabine, is only effective in 23.8% of patients. To improve this, a thermally activated system was developed by introducing a linker between HNPs and gemcitabine. Whereby, heat generation resulting from laser irradiation of the HNPs promoted linker breakdown resulting in prodrug liberation. In vitro evaluation in pancreatic adenocarcinoma cells, showed the prodrug was 4.3 times less cytotoxic than gemcitabine, but exhibited 11-fold improvement in cellular uptake. Heat activation of the formulation led to a 56% rise in cytotoxicity causing it to outperform gemcitabine by 26%. In vivo the formulation outperformed free gemcitabine with a 62% reduction in tumor weight in pancreatic xenografts. This HNP formulation is the first of its kind and has displayed superior anti-cancer activity as compared to the current first line drug gemcitabine after heat mediated controlled release.

Temperature-dependent IR and Raman studies of metal-organic frameworks [(CH3)2NH2][M(HCOO)3], M=Mg and Cd.

Two metal-organic frameworks of [(CH3)2NH2][M(HCOO)3], where M=Mg and Cd, have been investigated by temperature-dependent IR and Raman methods in order to determine the nature of the phase transition. Our results indicate that phase transition in the Mg-compound is driven by ordering of the dimethylammonium cations. Additional X-ray diffraction and spectroscopic studies on Cd-compound as the function of temperature reveal that this compound does not undergo any structural phase transition. We attribute this behavior to the large size of the cavity occupied by the dimethylammonium cations and thus weak hydrogen bonding between these cations and formate ions.

A new insight into the interaction of cisplatin with DNA: ROA spectroscopic studies on the therapeutic effect of the drug.

Raman optical activity (ROA) spectroscopy has been applied for the first time to study the interaction of cisplatin with DNA. The knowledge about the structure of DNA-metal ion cross-links and hence the mechanism of the drug action is fundamental for the development of new antitumor drugs. At the same time, there is an urgent need to search for new methods for monitoring of this effect at the therapeutic dose of a drug. We have demonstrated that ROA spectroscopy is a sensitive technique with the capability to follow the structural alteration of the whole DNA molecule upon drug binding via a direct observation of transformation undergoing within chiral sugar moieties. A ROA profile delivers clear evidence of a partial transition from the B-DNA to the A-form due to the formation of cisplatin-DNA cross-links.

Conformational space and photochemistry of alpha-terpinene.

Alpha-terpinene is a natural product that is isolated from a variety of plant sources and is used in the pharmaceutical and perfume industries. In the atmosphere, under the influence of sunlight, alpha-terpinene undergoes a series of photochemical transformations and contributes to the formation of the secondary organic aerosols. In the present work, alpha-terpinene has been isolated in low-temperature xenon and argon matrices, and its structure and photochemistry were characterized with the aid of FTIR spectroscopy and DFT calculations. The theory predicts three conformers resulting from the rotation of the exocyclic CH(CH(3))(2) framework, that is, Trans (T) and Gauche (G+ and G-) forms. The two Gauche conformers were estimated to be higher in energy, by ca. 1.75 kJ mol(-1), than the most stable Trans form. The signatures of all three conformers were found to be present in the experimental low-temperature matrix spectra with the T form dominating in diluted matrices. The conformational ratio was found to shift in favor of the G+/G- forms upon annealing of the matrices as well as in the neat alpha-terpinene liquid. UV-C (lambda > 235 nm) irradiation of matrix-isolated alpha-terpinene led to its isomerization into an open-ring species, which is produced in the Z configuration and in the conformations that require the smallest structural rearrangements of both the reagent and matrix.

Promoting the use of crumb rubber concrete in developing countries.

The use of accumulated waste materials in third world countries is still in its early phases. It will take courage for contractors and others in the construction industry to recycle selected types of waste materials in the concrete mixes. This paper addresses the recycling of rubber tires accumulated every year in Jordan to be used in concrete mixes. The main objectives of this research were to provide more scientific evidence to support the use of legislation or incentive-based schemes to promote the reuse of accumulated waste tires. This research focused on using crumb tires as a replacement for a percentage of the local fine aggregates used in the concrete mixes in Jordan. Different concrete specimens were prepared and tested in terms of uniaxial compression and splitting tension. The main variable in the mixture was the volumetric percentage of crumb tires used in the mix. The test results showed that even though the compressive strength is reduced when using the crumb tires, it can meet the strength requirements of light weight concrete. In addition, test results and observations indicated that the addition of crumb rubber to the mix has a limited effect toward reducing the workability of the mixtures. The mechanical test results demonstrated that the tested specimens of the crumb rubber concrete remained relatively intact after failure compared to the conventional concrete specimens. It is also concluded that modified concrete would contribute to the disposal of the non-decaying scrap tires, since the amount being accumulated in third world countries is creating a challenge for proper disposal. Thus, obliging authorities to invest in facilitating the use of waste tires in concrete, a fundamental material to the booming construction industry in theses countries, serves two purposes.

Broadband observations of the naked-eye gamma-ray burst GRB 080319B.

Long-duration gamma-ray bursts (GRBs) release copious amounts of energy across the entire electromagnetic spectrum, and so provide a window into the process of black hole formation from the collapse of massive stars. Previous early optical observations of even the most exceptional GRBs (990123 and 030329) lacked both the temporal resolution to probe the optical flash in detail and the accuracy needed to trace the transition from the prompt emission within the outflow to external shocks caused by interaction with the progenitor environment. Here we report observations of the extraordinarily bright prompt optical and gamma-ray emission of GRB 080319B that provide diagnostics within seconds of its formation, followed by broadband observations of the afterglow decay that continued for weeks. We show that the prompt emission stems from a single physical region, implying an extremely relativistic outflow that propagates within the narrow inner core of a two-component jet.

Workspace zone differentiation and visualization for virtual humans.

Human performance measures such as discomfort and joint displacement play an important role in product design. The virtual human Santos, a new generation of virtual humans developed at the University of Iowa, goes directly to the computer-aided design model to evaluate a design, saving time and money. This paper presents an optimization-based workspace zone differentiation and visualization. Around the workspace of virtual humans, a volume is discretized to small zones and the posture prediction on each central point of the zone will determine whether the points are outside the workspace as well as the values of different objective functions. Visualization of zone differentiation is accomplished by showing different colours based on values of human performance measures on points that are located inside the workspace. The proposed method can subsequently help ergonomic design. For example, in a vehicle's interior, the controls should not only lie inside the workspace, but also in the zone that encloses the most comfortable points. Using the palette of colours inside the workspace as a visual guide, a designer can obtain a reading of the discomfort level of product users.

'A phase II study of oral uracil/ftorafur (UFT) plus leucovorin combined with oxaliplatin (TEGAFOX) as first-line treatment in patients with metastatic colorectal cancer'.

This phase II trial was performed to evaluate the efficacy and tolerability of a new combination of Uracil/Ftorafur (UFT)/leucovorin (LV) and oxaliplatin in patients (pts) with metastatic colorectal cancer (MCRC) who had not received prior chemotherapy for metastatic disease. Between February 2002 and October 2002, 64 patients received UFT 300 mg m(-2) day(-1) and LV 90 mg day(-1) from day 1 to day 14 combined with oxaliplatin 130 mg m(-2) on day 1, every 3 weeks. All patients were evaluable for safety analysis and 58 of 64 patients were eligible for efficacy. Responses were reviewed by an independent review committee. Of the 58 per-protocol defined assessable patients, 1 complete response and 20 partial responses were observed yielding a response rate of 34% (95% CI: 22-47). The median response duration was 8.74 months (range 1.6-14). The median time to progression and the median survival were 5.88 months (95% CI: 4.34-8.21) and 18.2 months (95% CI: 10-20.7), respectively. Diarrhoea and peripheral neuropathy were the most frequent and predictable toxicities. These events were reversible, noncumulative and manageable. Grade 3 diarrhoea occurred in only 11% of the patients. No grade 4 gastrointestinal toxicity was reported in the study. The incidence of grade 3/4 (National Cancer Institute Common Toxicity Criteria 2: NCI-CTC 2) peripheral neuropathy was 15%. Haematological toxicity was of mild to moderate intensity with 10% of the patients with Grade 3/4 neutropenia without any episode of complication. The TEGAFOX regimen, a new combination using UFT/LV and oxaliplatin every 3 weeks is feasible on an outpatient basis. The combination is safe and active and may offer a promising alternative to the intravenous route. Nevertheless this efficacy results should be confirmed by randomized phase III trials.

Predictive factors for hematopoietic engraftment after autologous peripheral blood stem cell transplantation for AL amyloidosis.

Treatment of patients with AL amyloidosis with high-dose melphalan and autologous peripheral blood stem cells (PBSC) produces hematologic remissions in approximately 40% of evaluable patients, accompanied by improvements in organ disease and quality of life. These patients, who frequently have amyloid deposits in bone marrow blood vessels and interstitium and impaired function of kidneys, liver, spleen, and heart, represent an unusual population for stem cell transplantation, with unique problems. To identify factors influencing engraftment rates after chemotherapy and autologous granulocyte colony-stimulating factor (G-CSF)-mobilized PBSC reinfusion, we studied a group of 225 patients. The median time to neutrophil engraftment was 10 days (range, 8-17 days). In a multivariate analysis, the factors positively affecting the rate of neutrophil engraftment were CD34+ stem cell dose, female gender, and minimal prior alkylator therapy. The median time to platelet engraftment was 13 days (range, 7-52 days). Factors positively affecting platelet engraftment, in addition to CD34+ cell dose, included preserved renal function and the absence of neutropenic fever. The conditioning dose of intravenous melphalan was not found to be an independent predictive factor for hematopoietic recovery. Thus, in this patient population, organ function and host and hematopoietic factors influence engraftment after PBSC rescue.

Effects of surface roughness on self- and transport diffusion in porous media in the Knudsen regime.

The effect of surface roughness on Knudsen diffusion in nanoporous media is investigated by means of dynamic Monte Carlo simulations in three-dimensional rough fractal pores. These simulations yield new insight and explain a number of apparent inconsistencies by revealing a striking difference between the roughness dependence of transport diffusion and gradientless (self- or tracer) diffusion. Both analytical and simulation results show a significant roughness dependence of self-diffusion in the Knudsen regime. Transport diffusion, on the other hand, is roughness independent, as the fluxes do not depend on the detailed residence time and molecular trajectories.

Interpretive management: what general managers can learn from design.

The past two decades have seen a dramatic acceleration in the pace of marketplace change. Companies have abandoned the old hierarchical model, with its clean functional divisions and clear lines of authority, and adopted flatter, less bureaucratic structures. But if most organizations have begun to adapt to the uncertainty of rapid change, most managers have not. They remain locked into the mechanical mind-set of the industrial age--that is, they assume that any management challenge can be translated into a clearly defined problem for which an optimal solution can be found. That approach works in stable markets and even in markets that change in predictable ways. Today's markets, however, are increasingly unstable and unpredictable. Managers can never know precisely what they're trying to achieve or how best to achieve it. They can't even define the problem, much less engineer a solution. The challenges facing the general manager in these circumstances, the authors argue, resemble those typically confronted by design managers. In the unpredictable world of research and design, neither the flow of the development process nor its end point can be defined at the outset. Rather than the traditional analytical approach to management, the design world requires an interpretive one. And that approach is equally well suited to rapidly changing, unpredictable markets. The authors describe how companies such as Levi Strauss & Company and Chiron Corporation have stayed at the top of their industries by adopting just such an interpretive approach to management.

Bone registration method for robot assisted surgery: pedicle screw insertion.

A registration method that identifies bone geometry with respect to a robotic manipulator arm is presented. Although the method is generally applicable to many orthopaedic internal fixation procedures, it was only demonstrated for the insertion of pedicle screws in vertebral bodies for spine fixation. The method relies upon obtaining an impression of the vertebral bodies. Computerized tomography (CT) scans of both vertebrae and mould are reconstructed using a computer aided engineering (CAE) system. From the reconstructions, the surgeon is able to do preoperative planning including selection of pedicle screw diameter, direction of screw through pedicle, point of entry and length of engagement. The three-dimensional models are than meshed to determine positions of the surgeon's preoperative plan relative to the mould. Intra-operative positions are defined in space by a mechanical fixture rigidly attached to the mould and designed to allow a manipulator end-effector to recognize the global coordinates of the in vivo spine. The theory and methodology were validated using a five-axis manipulator arm. This initial presentation assumes and allows no relative motion between vertebrae in vivo.

Distribution of messenger RNAs for aldehyde dehydrogenase 1, aldehyde dehydrogenase 2, and aldehyde dehydrogenase 5 in human tissues.

BACKGROUND: The distribution of aldehyde dehydrogenases in human tissues is incompletely understood, in part because of technical limitations of gel electrophoretic and other enzyme assay methods used previously and because of the instability of the enzymes. Since these enzymes participate in detoxification of endogenous and exogenous compounds, including ethanol, their tissue distribution may be relevant to the toxicology of a number of substances and to the medical consequences of alcoholism. METHODS: The abundance of mRNA for aldehyde dehydrogenase 1 (ALDH1), aldehyde dehydrogenase 2 (ALDH2), and aldehyde dehydrogenase 5 (ALDH5) was determined by Northern blotting using poly A+ RNA from 16 adult human tissues and 5 fetal tissues. RESULTS: The highest levels of ALDH1 mRNA were found in liver, kidney, muscle, and pancreas. ALDH2 and ALDH5 were expressed in a larger number of tissues than ALDH1, with highest levels in liver, kidney, muscle, and heart. Fetal heart, brain, liver, lung, and kidney expressed ALDH2 and ALDH5, while ALDH1 was present mainly in fetal liver, kidney, and lung. CONCLUSIONS: The results are in general agreement with the distribution of enzymes studied in a limited number of tissues in the past, with the exception that the ALDH1 activity reported to exist in heart and brain may, in fact, be ALDH5. The only mRNA detected in placenta was that for ALDH5. This study extends the knowledge of the expression of these enzymes to several tissues not previously studied and establishes the tissue distribution of the new enzyme ALDH5.

The novel aldehyde dehydrogenase gene, ALDH5, encodes an active aldehyde dehydrogenase enzyme.

The mRNA for the novel aldehyde dehydrogenase 5 (ALDH5) gene was detected in HuH7 hepatoma cells. The cells also expressed cytosolic aldehyde dehydrogenase (ALDH1) mRNA, but no mitochondrial aldehyde dehydrogenase (ALDH2) mRNA. Extracts of the hepatoma cells contained an enzymatic activity with an isoelectric point similar to that of ALDH1. This enzyme activity was insensitive to inhibition by disulfiram, a potent inhibitor of ALDH1. The enzyme was active with short chain aldehydes (acetaldehyde and propionaldehyde) and NAD+, but not with NADP+, and the activity was higher in the mitochondrial pellet than other cell fractions. These studies demonstrate the expression of ALDH5 mRNA in a human hepatoma and suggest that the gene product is enzymatically active and probably resides in the mitochondria.

The effects of x-irradiation on mouse palatal epithelial chromosomes.

Low levels of X-ray exposure of mouse palatal epithelial cell cultures resulted in increased numbers of chromosomal aberrations. At the lowest level used (IR), aberrations occurred of the type produced by two breaks such as chromatid exchanges, dicentrics, and metacentrics.