Converging alfalfa (Medicago sativa L.) and petroleum hydrocarbon acclimated ACC-deaminase containing bacteria for phytoremediation of petroleum hydrocarbon contaminated soil.

Plant assisted bioremediation of petroleum hydrocarbon contaminated soil is considered an effective green technology whereby accelerated degradation occurs due to converged effect of microorganisms and plants. However, survival and growth of microbes and plants under stress conditions is challenging task for success of the technology. In this study, plant growth promoting bacteria containing 1-aminocyclopropane-1-carboxylate (ACC)-deaminase activity and tolerance to petroleum hydrocarbon contamination were used in association with alfalfa for bioremediation of petroleum hydrocarbon contaminated soil. Eight pre-isolated bacterial isolates from soil having previous history of petroleum contamination were used in convergence with alfalfa on sand soil which was artificially contaminated (10 g crude oil per kg-1 of coarse textured soil). Combined effect of bacteria and plants on the degradation of petroleum hydrocarbons under controlled conditions of light and temperature was observed for a period of 60 days. The results of the study revealed that four bacterial isolates Bacillus subtilis strain PM32Y, Bacillus cereus strain WZ3S1, Bacillus sp. strain SM73 and Bacillus sp. strain WZ3S3 in association with alfalfa significantly degraded petroleum hydrocarbons. The most significant biodegradation (47%) of petroleum hydrocarbons was recorded in the experimental unit receiving PM32Y inoculation in association with alfalfa. Biodegradation of petroleum hydrocarbons was 33% with alone inoculation (without alfalfa) of PM32Y. The study revealed that combined use of bacteria and alfalfa plant is more efficient than alone application of either bacteria or plants for degradation of petroleum hydrocarbons.

This study provides the evidence for phytoremediation and significant degradation of petroleum hydrocarbons by using plant growth promoting bacteria (PGPB), containing 1-aminocyclopropane-1-carboxylate deaminase (ACC-deaminase) in association with alfalfa (Medicago sativa L.). The most significant biodegradation of petroleum hydrocarbons was recorded with a new combination of Bacillus subtilis strain PM32Y in association with alfalfa.

Concurrent Killian-Jamieson and Zenker's Diverticula.

Pharyngoesophageal diverticula are rare causes of dysphagia. Zenker's diverticulum is the most common type, followed by Killian-Jamieson diverticulum. A 44-year-old male presented to our clinic with a longstanding history of dysphagia and globus sensation. Bilateral pharyngoesophageal diverticula were confirmed by imaging CT and esophagogastroscopy. He underwent transcervical resection, and a right Killian-Jamieson diverticulum was observed during surgery. The left diverticulum was found to originate above the cricopharyngeus muscle and was labeled as Zenker's diverticulum. Bilateral pharyngoesophageal diverticula are rare, and physicians should be aware of the variable clinical presentations and management options for pharyngoesophageal diverticula.

An AI-Inspired Spatio-Temporal Neural Network for EEG-Based Emotional Status.

The accurate identification of the human emotional status is crucial for an efficient human-robot interaction (HRI). As such, we have witnessed extensive research efforts made in developing robust and accurate brain-computer interfacing models based on diverse biosignals. In particular, previous research has shown that an Electroencephalogram (EEG) can provide deep insight into the state of emotion. Recently, various handcrafted and deep neural network (DNN) models were proposed by researchers for extracting emotion-relevant features, which offer limited robustness to noise that leads to reduced precision and increased computational complexity. The DNN models developed to date were shown to be efficient in extracting robust features relevant to emotion classification; however, their massive feature dimensionality problem leads to a high computational load. In this paper, we propose a bag-of-hybrid-deep-features (BoHDF) extraction model for classifying EEG signals into their respective emotion class. The invariance and robustness of the BoHDF is further enhanced by transforming EEG signals into 2D spectrograms before the feature extraction stage. Such a time-frequency representation fits well with the time-varying behavior of EEG patterns. Here, we propose to combine the deep features from the GoogLeNet fully connected layer (one of the simplest DNN models) together with the OMTLBP_SMC texture-based features, which we recently developed, followed by a K-nearest neighbor (KNN) clustering algorithm. The proposed model, when evaluated on the DEAP and SEED databases, achieves a 93.83 and 96.95% recognition accuracy, respectively. The experimental results using the proposed BoHDF-based algorithm show an improved performance in comparison to previously reported works with similar setups.

Deep brain stimulation in children and youth: perspectives of patients and caregivers gleaned through Twitter.

OBJECTIVE: This study aims to glean patient and caregiver perspectives surrounding deep brain stimulation (DBS) in children and youth through an analysis of patterns of social media usage. METHODS: The authors performed a comprehensive search of the Twitter Application Programming Interface (API) database for all tweets about DBS use in children and youth, with no date restriction. Data pertaining to each tweet were extracted for analysis. Results were analyzed using qualitative and quantitative methodologies. These included thematic analysis of tweets, accounts, and descriptive statistics. Sentiment analysis of extracted tweets was also performed. A multivariable regression model was used to identify predictors of higher engagement metrics (likes, retweets, and quotes). RESULTS: A comprehensive search of the Twitter database yielded 877 tweets from 816 unique accounts meeting study inclusion criteria. Most tweets were from patients or caregivers, researchers, or news media outlets. The most common themes among analyzed tweets were research discussing novel findings (45.2%) or personal experiences of patients or caregivers (27.4%). Sentiment analysis showed that 54.5% of tweets were positive, 35.1% were neutral, and 10.4% were negative. The presence of pictures or videos increased the tweet engagement count by an average of 10.5 (95% CI 7.3-13.6). Tweets about personal patient experiences (ß = 6, 95% CI 0.95-12) and tweets tagging other accounts (ß = 3.2, 95% CI 0.63-5.8) were also significantly associated with higher engagement metrics. CONCLUSIONS: The current study is the first to assess patient and caregiver perspectives surrounding pediatric DBS through a comprehensive analysis of social media usage. Given the nascent field, social media presents an opportunity to share experiences and promote patient and healthcare professional education surrounding pediatric DBS.

A Comprehensive Collection and Analysis Model for the Drone Forensics Field.

Unmanned aerial vehicles (UAVs) are adaptable and rapid mobile boards that can be applied to several purposes, especially in smart cities. These involve traffic observation, environmental monitoring, and public safety. The need to realize effective drone forensic processes has mainly been reinforced by drone-based evidence. Drone-based evidence collection and preservation entails accumulating and collecting digital evidence from the drone of the victim for subsequent analysis and presentation. Digital evidence must, however, be collected and analyzed in a forensically sound manner using the appropriate collection and analysis methodologies and tools to preserve the integrity of the evidence. For this purpose, various collection and analysis models have been proposed for drone forensics based on the existing literature; several models are inclined towards specific scenarios and drone systems. As a result, the literature lacks a suitable and standardized drone-based collection and analysis model devoid of commonalities, which can solve future problems that may arise in the drone forensics field. Therefore, this paper has three contributions: (a) studies the machine learning existing in the literature in the context of handling drone data to discover criminal actions, (b) highlights the existing forensic models proposed for drone forensics, and (c) proposes a novel comprehensive collection and analysis forensic model (CCAFM) applicable to the drone forensics field using the design science research approach. The proposed CCAFM consists of three main processes: (1) acquisition and preservation, (2) reconstruction and analysis, and (3) post-investigation process. CCAFM contextually leverages the initially proposed models herein incorporated in this study. CCAFM allows digital forensic investigators to collect, protect, rebuild, and examine volatile and nonvolatile items from the suspected drone based on scientific forensic techniques. Therefore, it enables sharing of knowledge on drone forensic investigation among practitioners working in the forensics domain.

Assessment of the ability, perception, and readiness of nurses to manage tracheostomy-related complications in Riyadh City: a cross-sectional study.

BACKGROUND: Nursing staff play a key role in the bedside management of tracheostomized patients in both intensive care units and general floors. Effective provision of postoperative care to these patients by nurses is critical. This study aimed to assess the readiness of nursing staff to manage tracheostomy-related complications in Riyadh, Saudi Arabia. METHODS: This cross-sectional study enrolled 395 nurses in Riyadh, Saudi Arabia. A self-administered questionnaire developed by the authors was distributed to nurses via an online survey. The questionnaire assessed nurses' socio-demographic characteristics and their knowledge and practices regarding tracheostomy indications, postoperative care, and management of its complications. RESULTS: Of respondents, approximately 59% (232/395) had poor knowledge regarding tracheostomy-related complications and indications, 39% (154/395) had moderate knowledge, and only 2%(9/395) had good knowledge. Several factors were associated with increased knowledge, including having a higher education degree, working in a tertiary/quaternary hospital, being a government employee, caring for tracheostomized patients, and attending courses or lectures on managing tracheostomized patients. CONCLUSIONS: Knowledge level and practices regarding tracheostomy-related complications and indications among nurses remain limited. In-service continuous professional development programs for nurses working in all hospital settings are strongly recommended. Further research is warranted to elicit the major factors contributing to inadequate knowledge and practices among nurses in Riyadh.

Efficacy of Tocilizumab in Management of COVID-19 Patients Admitted to Intensive Care Units: A Multicenter Retrospective Cohort Study.

Background and Objectives: Mortality and illness due to COVID-19 have been linked to a condition known as cytokine release syndrome (CRS) that is characterized by excessive production of inflammatory cytokines, particularly interleukin-6 (IL-6). Tocilizumab (TCZ), a recent IL-6 antagonist, has been redeployed as adjunctive treatment for CRS remission in COVID-19 patients. This study aimed to determine the efficacy of Tocilizumab on patients' survival and the length of stay in hospitalized COVID-19 patients admitted to the intensive care unit. Methods: Between January 2021 and June 2021, a multicenter retrospective cohort study was carried out in six tertiary care hospitals in Egypt's governorate of Giza. Based on the use of TCZ during ICU stay, eligible patients were divided into two groups (control vs. TCZ). In-hospital mortality was the main outcome. Results: A total of 740 patient data records were included in the analysis, where 630 patients followed the routine COVID-19 protocol, while 110 patients received TCZ, need to different respiratory support after hospitalization, and inflammatory mediators such as C-reactive protein (CRP), ferritin, and Lactate dehydrogenase (LDH) showed a statistically significant difference between the TCZ group and the control group. Regarding the primary outcome (discharged alive or death) and neither the secondary outcome (length of hospital stay), there is no statistically significant difference between patients treated with TCZ and the control group. Conclusions: Our cohort of patients with moderate to severe COVID-19 did not assert a reduction in the risk of mortality or the length of stay (LOS) after TCZ administration.

Bibliometric analysis of the top 100 most cited articles on craniosynostosis.

BACKGROUND: Craniosynostosis is the premature closure of cranial sutures and it continues to be a therapeutic challenge due to the diversity and complexity of the syndrome. Bibliometric analysis is a study of ranking citations and exploring the most impactful articles in a respective discipline. It also demonstrates the chronological trends of publications. METHODS: In May 2020, we performed a title-specific search of the Scopus database using "craniosynostosis" as our query term without publication date restrictions. The top 100 articles in craniosynostosis were retrieved and analyzed. RESULTS: The top 100 most-cited articles in craniosynostosis received a total 13,826 citations, and an average of 138 citations per paper. The publication dates ranged from 1920 to 2015, with a peak period of top publications between 1996 and 2005. The most common category is clinical, followed by neurogenetics. The top cited article received 540 citation counts and 19.29 citations per year. The USA was the most contributing country to the list. The Journal of Plastic and Reconstructive Surgery published the largest number of top cited articles. Neurosurgery as a specialty contributed to most articles in the list (27 articles). The institute who contributed the most was the Assistance Publique Hopitaux Paris. CONCLUSION: Bibliometric analysis in craniosynostosis revealed major trend changes of research over the years, with a focus on neurogenetics and the different types of surgical corrections. The current collection of highly cited publications may assist physicians in gaining a better understanding of the evidence-based approach in craniosynostosis.

Spheno-orbital juvenile psammomatoid ossifying fibroma: a case report and literature review.

Ossifying fibroma (OF) is an uncommon benign fibro-osseous lesion. Based on its clinical, morphological, and radiological features, OF is further divided into cemento-ossifying fibroma (COF), juvenile psammomatoid ossifying fibroma (JPOF), and juvenile trabecular ossifying fibroma (JTOF). JPOF rarely involves the cranial base, with limited reports published on spheno-orbital JPOF. In this paper, we report a case of JPOF of the greater wing of the sphenoid bone and lateral orbital wall in an 11-year-old child and show a surgical video. Although rare, JPOF should be considered in the differential diagnosis of fibro-osseous lesions of the spheno-orbital region.

Online versus classroom teaching for medical students during COVID-19: measuring effectiveness and satisfaction.

BACKGROUND: The COVID-19 pandemic and physical distancing have had a significant impact on the conversion of traditional teaching methods to online teaching methods, which although not uncommon in medical schools, has to date only been used for some aspects of the teaching process. Thus, we aimed to measure the effectiveness of e-learning during the COVID-19 pandemic, as well as medical students' preferences regarding e-learning and classroom teaching, and the possibility of applying it post-pandemic. METHODS: A cross-sectional online survey of medical students (N = 376) in six medical schools was carried out after their second semester, from August 15 to 20, 2020. Ten parameters were measured for the effectiveness of e-learning based on a 5-point Likert-scale and five parameters were measured for satisfaction. RESULTS: e-learning was more or equally effective in four parameters such as assignment submission and meeting individual needs, but less effective in six parameters, including building skills and knowledge, and interaction level. Satisfaction was either high or neutral in all five parameters. CONCLUSIONS: Our findings have shown that e-learning can assist the teaching process in medical schools in some respects, but cannot be used for the entire teaching process.

Role of interleukin-1ß in nerve growth factor expression, neurogenesis and deep dyspareunia in endometriosis.

STUDY QUESTION: Does interleukin-1ß (IL-1ß) play a role in promoting nerve growth factor expression, neurogenesis and deep dyspareunia in endometriosis? SUMMARY ANSWER: IL-1ß directly stimulates nerve growth factor (NGF) expression in endometriosis and is associated with local neurogenesis around endometriosis and more severe deep dyspareunia. WHAT IS KNOWN ALREADY: Local nerve density around endometriosis (using the pan-neuronal marker PGP9.5) is associated with deep dyspareunia in endometriosis, mediated in part by NGF expression. STUDY DESIGN, SIZE, DURATION: This in vitro study included endometriotic tissue samples from 45 patients. PARTICIPANTS/MATERIALS, SETTING, METHODS: This study was conducted in a university hospital affiliated research institute and included 45 women with surgically excised deep uterosacral/rectovaginal endometriosis (DIE, n = 12), ovarian endometriomas (OMA, n = 14) or superficial peritoneal uterosacral/cul-de-sac endometriosis (SUP, n = 19). Immunolocalisation of IL-1ß, IL-1 receptor type 1 (IL-1R1), NGF and PGP9.5 in endometriotic tissues was examined by immunohistochemistry (IHC), and the intensity of IHC staining in the endometriotic epithelium and stroma was semi-quantitatively evaluated using the Histoscore method (H-score). For each case, deep dyspareunia was pre-operatively rated by the patient on an 11-point numeric rating scale (0-10). In addition, primary endometriosis stromal cells were isolated and cultured from surgically excised endometriosis. These cells were treated with IL-1ß alone or in combination of Anakinra (an inhibitor of IL-1R1), small inference RNA (siRNA) against IL-1R1, siRNA against c-FOS or NGF neutralising antibody. The mRNA and protein levels of target genes (NGF and c-FOS) were assessed by reverse-transcription qPCR and western blot/ELISA, respectively. Furthermore, immunofluorescent microscopy was used to examine the neurite growth of rat pheochromocytoma PC-12 cells, as an in vitro model of neurogenesis. MAIN RESULTS AND THE ROLE OF CHANCE: For IHC, IL-1ß expression in the endometriosis epithelium was significantly associated with more severe deep dyspareunia (r = 0.37, P = 0.02), higher nerve fibre bundle density around endometriosis (r = 0.42, P = 0.01) and greater NGF expression by the endometriosis epithelium (r = 0.42, P = 0.01) and stroma (r = 0.45, P = 0.01). In primary endometriosis stromal cells, treatment with exogenous IL-1ß significantly increased the mRNA and protein levels of NGF and c-FOS. Pre-treatment with Anakinra, siRNA against IL-1R1, or siRNA against c-FOS, each attenuated IL-1 ß-induced increases of NGF expression. In addition, supernatants from IL-1ß treated endometriosis stromal cells significantly stimulated PC-12 neurite growth compared to controls, and these effects could be attenuated by pre-treatment with NGF neutralising antibody or Anakinra. LARGE-SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: We did not have data from cultures of endometriosis glandular epithelium, due to the known difficulties with primary cultures of this cell type. WIDER IMPLICATIONS OF THE FINDINGS: Our study revealed a mechanism for deep dyspareunia in endometriosis, whereby IL-1ß stimulates NGF expression, promoting local neurogenesis around endometriosis, which in turn leads to tender pelvic anatomic sites and thus deep-hitting dyspareunia. There may also be potential for drug targeting of IL-1ß and/or NGF in the management of endometriosis-associated pain. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by grants from the Canadian Institutes of Health Research (MOP-142273 and PJT-156084). P.Y. is also supported by a Health Professional Investigator Award from the Michael Smith Foundation for Health Research. MB has financial affiliations with Abbvie and Allergan. Otherwise, there are no conflicts of interest to declare.

Knowledge and awareness of plantar fasciitis in the Saudi population.

OBJECTIVE: To evaluate and assess the knowledge and awareness level of lay people about plantar fasciitis (PF). METHODS: The cross-sectional study was conducted at a shopping mall in Riyadh, Saudi Arabia, from May to July 2017, and comprised random individuals busy shopping in the area. Data was collected through a self-administered questionnaire. , and was analysed using SPSS 22. . RESULTS: Of the 176 subjects, 101(57.4%) were females and 75(42.6%) were males. The age range was 18-55 years, and 153(87%) belonged to urban population. Overall, 60(34%) subjects had never heard of plantar fasciitis. Also, 148(84%) subjects thought that specialised medical shoes can be used as possible treatment for plantar fasciitis (p<0.001).Females had significantly higher knowledge regarding plantar fasciitis than males (p=0.009). CONCLUSIONS: Over 30% subjects did not have any knowledge about plantar fasciitis.

Multiple Sclerosis Patients Knowledge in Saudi Arabia.

OBJECTIVE: To assess Multiple Sclerosis (MS) patients` knowledge in Saudi Arabia (SA) and in which aspect of the disease do patient need more awareness. METHODS: A cross-sectional web-based survey has been conducted between June and August 2017. It consisted of 2 parts: sociodemographic and 23 multiple choice questions chosen from the previously validated MS Knowledge Questionnaire (MSKQ). The survey has been sent to 500 MS patients. RESULTS: A total of 218 MS patients filled the questionnaire where only 200 included in the study. Female MS patient represents 66% of all the participants. More than half of the patients had achieved their bachelor degree. The total mean of the correct answer for both male and female found to be 58.98% (+/-SD 15.06%). Most patients were aware that MS is a disease of central nervous system (93%), autoimmune disease (79%), not contagious (90%), or inherited (64.5%). However, few patients were aware that there is no single test to diagnose MS (28.5%), and intravenous injection of contrast during MRI reveals new lesions (18.5%). Only (37%) knew what is `Relapsing-remitting` MS. The MS knowledge is positively correlated with the educational level. CONCLUSION: Patients with MS in SA have less knowledge in the disease`s types, workups, and treatment efficacy. While in contrast, they have more awareness of the disease`s pathophysiology. Patient`s awareness programs should aid more knowledge among MS patients in SA.

Neurosurgical Assessment of Metrics Including Judgment and Dexterity Using the Virtual Reality Simulator NeuroTouch (NAJD Metrics).

Advances in computer-based technology has created a significant opportunity for implementing new training paradigms in neurosurgery focused on improving skill acquisition, enhancing procedural outcome, and surgical skills assessment. NeuroTouch is a computer-based virtual reality system that can generate output data known as metrics from operator performance during simulated brain tumor resection. These measures of quantitative assessment are used to track and compare psychomotor performance during simulated operative procedures. Data output from the NeuroTouch system is recorded in a comma-separated values file. Data mining from this file and subsequent metrics development requires the use of sophisticated software and engineering expertise. In this article, we introduce a system to extract a series of new metrics using the same data file using Excel software. Based on the data contained in the NeuroTouch comma-separated values file, 13 novel NeuroTouch metrics were developed and classified. Tier 1 metrics include blood loss, tumor percentage resected, and total simulated normal brain volume removed. Tier 2 metrics include total instrument tip path length, maximum force applied, sum of forces utilized, and average forces utilized by the simulated ultrasonic aspirator and suction instrument along with pedal activation frequency of the ultrasonic aspirator. Advanced tier 2 metrics include instrument tips average separation distance, efficiency index, ultrasonic aspirator path length index, coordination index, and ultrasonic aspirator bimanual forces ratio. This system of data extraction provides researchers expedited access for analyzing the data files available for NeuroTouch platform to assess the multiple psychomotor and cognitive neurosurgical skills involved in complex surgical procedures.

Regulation of root growth and elongation in wheat.

Currently, the control of rhizosphere selection on farms has been applied to achieve enhancements in phenotype, extending from improvements in single root characteristics to the dynamic nature of entire crop systems. Several specific signals, regulatory elements, and mechanisms that regulate the initiation, morphogenesis, and growth of new lateral or adventitious root species have been identified, but much more work remains. Today, phenotyping technology drives the development of root traits. Available models for simulation can support all phenotyping decisions (root trait improvement). The detection and use of markers for quantitative trait loci (QTLs) are effective for enhancing selection efficiency and increasing reproductive genetic gains. Furthermore, QTLs may help wheat breeders select the appropriate roots for efficient nutrient acquisition. Single-nucleotide polymorphisms (SNPs) or alignment of sequences can only be helpful when they are associated with phenotypic variation for root development and elongation. Here, we focus on major root development processes and detail important new insights recently generated regarding the wheat genome. The first part of this review paper discusses the root morphology, apical meristem, transcriptional control, auxin distribution, phenotyping of the root system, and simulation models. In the second part, the molecular genetics of the wheat root system, SNPs, TFs, and QTLs related to root development as well as genome editing (GE) techniques for the improvement of root traits in wheat are discussed. Finally, we address the effect of omics strategies on root biomass production and summarize existing knowledge of the main molecular mechanisms involved in wheat root development and elongation.

Nerve Bundle Density and Expression of NGF and IL-1ß Are Intra-Individually Heterogenous in Subtypes of Endometriosis.

Endometriosis is a gynecological disorder associated with local inflammation and neuroproliferation. Increased nerve bundle density has been attributed to increased expression of nerve growth factor (NGF) and interleukin-1ß (IL-1ß). Immunohistochemical analysis was carried out on 12 patients presenting with all three anatomic subtypes of endometriosis (deep, superficial peritoneal, endometrioma) at surgery, with at least two surgically excised subtypes available for analysis. Immunolocalization for nerve bundle density around endometriosis using protein gene product 9.5 (PGP9.5), as well as NGF and IL-1ß histoscores in endometriosis epithelium/stroma, was performed to evaluate differences in scores between lesions and anatomic subtypes per patient. Intra-individual heterogeneity in scores across lesions was assessed using the coefficient of variation (CV). The degree of score variability between subtypes was evaluated using the percentage difference between mean scores from one subtype to another subtype for each marker. PGP9.5 nerve bundle density was heterogenous across multiple subtypes of endometriosis, ranging from 50.0% to 173.2%, where most patients (8/12) showed CV ≥ 100%. The percentage difference in scores showed that PGP9.5 nerve bundle density and NGF and IL-1ß expression were heterogenous between anatomic subtypes within the same patient. Based on these observations of intra-individual heterogeneity, we conclude that markers of neuroproliferation in endometriosis should be stratified by anatomic subtype in future studies of clinical correlation.

Assessment of nursing knowledge and practice toward prevention of acquired infections in the emergency department of King Faisal Medical Complex in Taif.

Background: Hospital-acquired infections constitute a significant source of morbidity and mortality for both patients and healthcare professionals. Nursing professionals constitute an integral component of any quality-related program in a hospital, given their oversight and provision of nearly all healthcare services. Nurses' knowledge and attitudes play a significant role in healthcare delivery. Within Saudi Arabia, the prevalence of hospital-acquired infections in hospital settings has prompted a growing emphasis on evaluating nursing knowledge and adherence to practice standards aimed at hospital-acquired infection prevention. Methods: This single-center cross-sectional study was conducted at the emergency department of King Faisal Medical Complex, Taif, between October and December 2022, involving 168 nurses. The study utilized a pre-validated structured online questionnaire comprising three sections: demographics, knowledge assessment, and practice evaluation. Knowledge and practice levels were categorized as good, moderate, and poor using quartiles. Results: The study encompassed 168 nurses employed in the emergency department of the hospital, revealing their proficiency in standard practices for preventing hospital-acquired infections. Notably, 63.8% of participants demonstrated a commendable "Good" level of knowledge, while 10.6% exhibited a "Moderate" level and 25.5% manifested a "Poor" level in terms of knowledge. Similarly, concerning practice levels, 56.4% showcased a commendable "Good" practice level, 22.3% maintained a "Moderate" practice level, and 21.3% presented a "Poor" practice level. Chi-square analysis unveiled a significant association between age and knowledge levels (p = 0.000). In addition, age (p = 0.000) and years of clinical experience (p = 0.000) were significantly linked to nurses' practice levels The nurses aged 40-50 years (82%) and those with 10-15 years of clinical experience (83.3%) showed good levels of knowledge and practice, respectively. Overall, most of the nurses demonstrated effective knowledge and compliance with infection prevention practices. Conclusion: Sociodemographic factors such as age and clinical experience exert a notable impact on nurses' knowledge and practices regarding hospital-acquired infections.

Clinical Presentations and Risk Factors of Gastrointestinal Bleeding in the Emergency Department: A Multicenter Retrospective Study.

BACKGROUND AND AIMS: Gastrointestinal bleeding is a major healthcare burden and is associated with significant morbidity and mortality. This study aimed to assess the prevalence, clinical presentation, and risk factors of patients presenting with gastrointestinal bleeding in the emergency department. MATERIALS AND METHODS: This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms. RESULTS: A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52% and upper gastrointestinal in 48% of patients. CONCLUSIONS: Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.

Spontaneous epiglottic abscess: pathophysiology and airway management options.

Laryngeal abscesses are rare in the modern antibiotic era. This report presents a novel case of an epiglottic abscess in a patient with diabetes who developed respiratory distress and was managed by awake intubation in the emergency room followed by transoral incision and drainage of the abscess and tracheostomy. Full recovery after 1 week of intravenous antibiotic treatment was observed. Surgical intervention is necessary for treatment and culture-directed antimicrobial therapy. Poorly controlled diabetes is a newly described risk factor for spontaneous epiglottic abscess development.

A Framework for Prediction of Oncogenomic Progression Aiding Personalized Treatment of Gastric Cancer.

Mutations in genes can alter their DNA patterns, and by recognizing these mutations, many carcinomas can be diagnosed in the progression stages. The human body contains many hidden and enigmatic features that humankind has not yet fully understood. A total of 7539 neoplasm cases were reported from 1 January 2021 to 31 December 2021. Of these, 3156 were seen in males (41.9%) and 4383 (58.1%) in female patients. Several machine learning and deep learning frameworks are already implemented to detect mutations, but these techniques lack generalized datasets and need to be optimized for better results. Deep learning-based neural networks provide the computational power to calculate the complex structures of gastric carcinoma-driven gene mutations. This study proposes deep learning approaches such as long and short-term memory, gated recurrent units and bi-LSTM to help in identifying the progression of gastric carcinoma in an optimized manner. This study includes 61 carcinogenic driver genes whose mutations can cause gastric cancer. The mutation information was downloaded from intOGen.org and normal gene sequences were downloaded from asia.ensembl.org, as explained in the data collection section. The proposed deep learning models are validated using the self-consistency test (SCT), 10-fold cross-validation test (FCVT), and independent set test (IST); the IST prediction metrics of accuracy, sensitivity, specificity, MCC and AUC of LSTM, Bi-LSTM, and GRU are 97.18%, 98.35%, 96.01%, 0.94, 0.98; 99.46%, 98.93%, 100%, 0.989, 1.00; 99.46%, 98.93%, 100%, 0.989 and 1.00, respectively.