Uncovering the effect of waterlogging stress on plant microbiome and disease development: current knowledge and future perspectives.

Waterlogging is a constant threat to crop productivity and ecological biodiversity. Plants face multiple challenges during waterlogging stress like metabolic reprogramming, hypoxia, nutritional depletion, reduction in gaseous exchange, pH modifications, microbiome alterations and disease promotion all of which threaten plants survival. Due to global warming and climatic change, the occurrence, frequency and severity of flooding has dramatically increased posing a severe threat to food security. Thus, developing innovative crop management technologies is critical for ensuring food security under changing climatic conditions. At present, the top priority among scientists is to find nature-based solutions to tackle abiotic or biotic stressors in sustainable agriculture in order to reduce climate change hazards to the environment. In this regard, utilizing plant beneficial microbiome is one of the viable nature based remedial tool for mitigating abiotic stressors like waterlogging. Beneficial microbiota provides plants multifaceted benefits which improves their growth and stress resilience. Plants recruit unique microbial communities to shield themselves against the deleterious effects of biotic and abiotic stress. In comparison to other stressors, there has been limited studies on how waterlogging stress affects plant microbiome structure and their functional traits. Therefore, it is important to understand and explore how waterlogging alters plant microbiome structure and its implications on plant survival. Here, we discussed the effect of waterlogging stress in plants and its microbiome. We also highlighted how waterlogging stress promotes pathogen occurrence and disease development in plants. Finally, we highlight the knowledge gaps and areas for future research directions on unwiring how waterlogging affects plant microbiome and its functional traits. This will pave the way for identifying resilient microbiota that can be engineered to promote their positive interactions with plants during waterlogging stress.

Saffron, a Potential Bridge between Nutrition and Disease Therapeutics: Global Health Challenges and Therapeutic Opportunities.

Plants are an important source of essential bioactive compounds that not only have a beneficial role in human health and nutrition but also act as drivers for shaping gut microbiome. However, the mechanism of their functional attributes is not fully understood despite their significance. One such important plant is Crocus sativus, also known as saffron, which possesses huge medicinal, nutritional, and industrial applications like food and cosmetics. The importance of this plant is grossly attributed to its incredible bioactive constituents such as crocins, crocetin, safranal, picrocrocin, and glycosides. These bioactive compounds possess a wide range of therapeutic activities against multiple human ailments. Since a huge number of studies have revealed negative unwanted side effects of modern-day drugs, the scientific communities at the global level are investigating a large number of medicinal plants to explore natural products as the best alternatives. Taken into consideration, the available research findings indicate that saffron has a huge scope to be further explored to establish alternative natural-product-based drugs for health benefits. In this review, we are providing an update on the role of bioactive compounds of saffron as therapeutic agents (human disorders and antimicrobial activity) and its nutritional values. We also highlighted the role of omics and metabolic engineering tools for increasing the content of key saffron bioactive molecules for its mass production. Finally, pre-clinical and clinical studies seem to be necessary to establish its therapeutic potential against human diseases.

Cardiovascular Disease and Stroke Risk Among Egyptian Resident Physicians: A Cross-Sectional Multicenter Study.

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of death worldwide and are considered silent killers that threaten different age groups. The stressful lifestyle of resident physicians might make them vulnerable to CVDs. Since 2021, Egypt has recently reported more frequent sudden deaths of junior physicians after long shifts. Many factors can be associated with this prevalence, such as diabetes mellitus, increased blood pressure, or a sedentary lifestyle. Therefore, this study aimed to estimate the risk of developing heart attack and stroke within 10 years among resident physicians in Egypt with the goal of informing health policymakers to improve the healthcare systems for Egyptian physicians. METHODS: This cross-sectional study was conducted at six university teaching hospitals around Egypt: Cairo, Al-Azhar, Zagazig, Menoufia, South Valley, and Sohag. Data were collected on the ground using a questionnaire developed from a validated tool, the QRISK3 calculator, developed by the National Health Service, and used to measure the development of CVDs and stroke over the next 10 years. RESULTS: Four hundred twenty-eight resident physicians filled out the study questionnaire, including 224 (52.3%) females. The mean age of the participants was 28.22 years (±2.54). The study revealed that 258 (60.3%), with a median (IQR) = 0.2% (0.1%-0.5%), of the resident physicians are at high risk of having a heart attack or stroke within 10 years. Migraine symptoms (n=65, 15.2%) and angina or heart attack in a first-degree relative (n=26, 6.1%) were the most reported risk factors. The risk was variable among the six university hospitals, with a significant P-value <0.001, where Menoufia University hospitals ranked first, followed by Zagazig University hospitals. However, the percentage of each specialty differs from others. The highest risk was among anesthesiology and ICU residents (n=18, 78.3%), followed by surgery residents (n=44, 62.9%). CONCLUSION: About 258 (60.3%) of the resident physicians are at risk of having a heart attack or stroke within 10 years. There is an urgent need to increase resident physicians' awareness about their heart attack and stroke risks and for health policymakers to ensure a better lifestyle and friendly training environment for resident physicians in Egypt.

Healthcare Professional's Knowledge of the Systemic ABCDE Approach: A Cross-Sectional Study.

Background and aim Assessing the knowledge of healthcare professionals regarding the Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) approach is crucial since it prioritizes the initial assessment and treatment of patients who are critically ill, regardless of the underlying cause or their age. Since adherence requires knowledge, this study aimed to evaluate the knowledge level of the ABCDE approach among healthcare professionals. Methods This cross-sectional study among healthcare professionals was performed from April to August 2023 in Taif City, Saudi Arabia. The study included healthcare professionals employed in departments exposed to patients with critical illnesses and excluded those from other specialties and individuals from outside Taif City. Data was collected via Google Forms using a previously validated questionnaire designed to assess the ABCDE approach knowledge among healthcare professionals. Statistical analysis was conducted using IBM SPSS, version 26. Results The study included 242 healthcare professionals with a mean (SD) age of 35.77 (9.93) years. About half of the participants were female (52.5%) nurses (50.8%) and had been working in intensive care units (ICU) and neonate intensive care units (NICU) (41.4%). The mean (SD) of the participants' working experience was 9.28 (8.295) years. The overall mean test score was 52.94 % (SD 16.27). The mean knowledge score among males was significantly higher than females (56.37% vs. 49.85%, respectively) (p-value= 0.001). The mean knowledge score was significantly higher among medical specialists and residents (63.308% and 55.67%) than among nurses (46.34%) (p-value <0.001). Attending an advanced trauma life support course and theoretical lecture significantly impacted the total knowledge score among the participants (p-values= 0.001 and <0.001, respectively). The total knowledge significantly increased with age (r: 0.265, p-value <0.001). Years of experience correlated with total knowledge score; with increasing years of experience, the total knowledge was significantly increased (r: 0.248, p-value <0.001). Conclusion The ABCDE approach is a valuable tool for the initial examination and treatment of patients in acute medical and surgical emergencies. The findings indicate that there is a need for further awareness programs and training on the ABCDE approach, as the total knowledge score among healthcare professionals was found to be suboptimal. Further research is needed to assess the association between knowledge level and clinical performance in different healthcare settings within Saudi Arabia.

Short and Long-Term Clinical Outcomes in Octogenarian Patients With Non-ST-Elevation Myocardial Infarction: A Comparative Analysis of Revascularization Strategies Versus Medical Management.

INTRODUCTION: As the primary cause of morbidity and mortality among older individuals, cardiovascular disease remains a major concern. Choosing between revascularization and medical management of elderly patients remains controversial. This study aims to evaluate the clinical implications of these treatment approaches in the context of non-ST-elevation myocardial infarction (NSTEMI) in octogenarian patients. METHODS: This observational cohort study involved 41 octogenarian patients who were diagnosed with NSTEMI from 2019 to 2021 and were managed by revascularization (with either percutaneous coronary intervention, coronary artery bypass graft surgery, or both) or conservative medical therapy. All NSTEMI patients were diagnosed based on symptoms, electrocardiographic changes, and cardiac biomarkers. The study compared the short- and long-term outcomes of 13 patients in the revascularization group and 28 in the medical therapy group. RESULTS: Overall, the mean patient age was 84.63 years. Eighteen patients were men (43.9%), and 23 were women (56.1%). The most prevalent disease among the sample was hypertension (34 patients, 82.9%), followed by diabetes mellitus (27 patients, 65.9%) and prior ischemic heart disease (21 patients, 51.2%). Almost all patients in the revascularization-treated group developed complications after the procedure (84.6%), while 46.4% of the patients in the medication-only group developed a complication later on. The revascularization-treated group showed higher mortality rates in both the short- and long-term (23.1% and 38.5%, respectively) compared to the medication-only group, which showed better survival rates numerically in both the short- and long-term (14.3% and 32.1%, respectively). This was not statistically significant. CONCLUSION: Revascularization treatment in elderly patients with NSTEMI was associated with a higher risk of complications and a higher mortality rate compared with conservative medical management. Patients managed with only medications had a better survival rate in both the short- and long-term.

Dynamic Compression Plating Versus Antegrade Intramedullary Nailing for the Treatment of OTA/AO 12-A Fractures: A Retrospective Cohort Study.

BACKGROUND: Fractures of the humerus diaphysis are common and often result from motor vehicle accidents (MVAs). Treatment methods range from nonoperative approaches to various operative techniques, including antegrade intramedullary nailing (AIMN) and dynamic compression plate (DCP) fixation. This study aimed to compare the cost effectiveness and outcomes of plating and nailing for humerus diaphyseal fractures. METHODS:  A retrospective cohort study involving 59 cases of humerus diaphyseal OTA/AO 12-A fractures was conducted at King Saud Medical City (KSMC), a level I trauma center located in the center region in Riyadh, Saudi Arabia. Patients treated with AIMN, anterolateral plating, or posterior plating were included. Data on demographics, clinical parameters, radiographic healing, and costs were collected and analyzed. RESULTS: The average surgical duration was shorter in the AIMN group compared to the anterolateral and posterior plating groups but with no statistical significance (P > 0.05). The average length of stay (LOS) was shorter, and the change in hemoglobin levels was lower in the AIMN group when compared to other groups but without a statistically significant difference (P > 0.05). The average cost of AIMN was significantly higher than that of anterolateral and posterior plating groups (P < 0.0001). CONCLUSION:  While both nailing and plating procedures are options for treating OTA/AO 12-A fractures, AIMN carries a higher overall procedural cost. The practice of drain placement in our study population is likely the cause of the increased LOS in the plating groups. Relative additional analgesic requirements were associated with AIMN. Surgeons should consider meticulous hemostasis to avoid drain placement, which can decrease LOS, thus possibly decreasing unnecessary treatment costs of humerus shaft fractures.

The relationship between eggshell color, hatching traits, fertility, mortality, and some qualitative aspects of Japanese quail (Coturnix japonica) eggs.

Quail, one of the most important sources of meat and eggs, can aid in the reduction of the meat crisis if they are raised and cared for by small farmers. The current study investigated the impact of eggshell color variety on egg quality traits and hatching parameters of Japanese quail Coturnix japonica eggs. Therefore, 1,075 eggs were collected from female quails when they were 10-wk old. These eggs were distributed based on the color of their eggshells into 5 different classifications: eggshell with color type 1, very dark distributed brown spots on brown eggshell; eggshell with color type 2, small black spots on a white eggshell; eggshell with color type 3, widespread brown spots on brown eggshell; eggshell with color type 4, bubble egg, pin dotted on grayish brown color eggshell; and eggshell with color type 5, small brown spots on very clearly white eggshell. The characteristics of hatchability, internal and external egg quality, and the rate of embryonic death were then determined. The results showed that the percentage of fertility and commercial and scientific hatchability was greatly affected by eggshell color. There were also variations in the percentage of hatched chicks', early mortality rates, and late mortality rates based on eggshell color. According to the results of the current study, eggshell color has a significant impact on egg weight, egg width, and percentages of eggshell, yolk, and albumen but has no effect on shape index, egg length, or egg elongation. Based on the results, eggshells with color types 2 and 3 were recommended for use in hatching procedures due to their high levels of fertility (92.01 and 91.63%, respectively), scientific hatchability (82.92 and 83.93%, respectively), commercial hatchability (76.56 and 77.32%, respectively), and hatched chick (5.50 and 6.70, respectively). In addition, the late embryonic mortality rate was 0.00% for eggshells with color type 3. Therefore, the color of the eggshell can be employed as a key factor in guiding the eggs that are produced, whether they are going to be consumed at the table or used for hatching, to make breeding easier.

Virus-like particles as powerful vaccination strategy against human viruses.

Nowadays, viruses are not only seen as causative agents of viral infectious diseases but also as valuable research materials for various biomedical purposes, including recombinant protein production. When expressed in living or cell-free expression systems, viral structural proteins self-assemble into virus-like particles (VLPs). Mimicking the native form and size of viruses and lacking the genetic material, VLPs are safe and highly immunogenic and thus can be exploited to develop antiviral vaccines. Some vaccines based on VLPs against various infectious pathogens have already been licenced for human use and are available in the commercial market, the latest of which is a VLP-based vaccine to protect against the novel Coronavirus. Despite the success and popularity of VLP subunit vaccines, many more VLPs are still in different stages of design, production, and approval. There are still many challenges that require to be addressed in the future before this surface display system can be widely used as an effective vaccine strategy in combating infectious diseases. In this review, we highlight the use of structural viral proteins to produce VLPs, emphasising their intrinsic properties, structural classification, and main expression host systems. We also compiled the recent scientific literature about VLP-based vaccines to underline the recent advances in their application as a vaccine strategy for preventing and fighting virulent human pathogens. Finally, we presented the key challenges and possible solutions for VLP-based vaccine production.

Prevalence of Selective Serotonin Reuptake Inhibitor Use Among Pregnant Women From 2017 to 2020 in King Abdulaziz Medical City, Jeddah, Saudi Arabia: A Retrospective Study.

BACKGROUND: Perinatal depression is a mental health disorder that is associated with feelings of hopelessness, despair, and lack of motivation. Its effects on pregnant women are not limited to hemorrhage and hypertension and may lead to maternal mortality. As a result, maternal antidepressant usage during pregnancy has rapidly increased in the United States. Selective serotonin reuptake inhibitors (SSRIs) are considered one of the most prescribed antidepressants. Thus, this study aims to measure the prevalence of SSRI use during pregnancy. METHODS: A retrospective cross-sectional study was carried out in King Abdulaziz Medical City, Jeddah (KAMC-J), Saudi Arabia. The population consisted of all pregnant women aged 18 or older from the period of January 2017 to December 2020 (N=13484). The sampling technique was non-probability consecutive sampling. RESULTS: The study included 13,484 pregnant women, and further analysis revealed that 62 (0.459%) were exposed to at least one type of antidepressant during pregnancy. Of these, 12 (19.35%) had used more than one class of antidepressants. The majority of the sample, comprising 39 (62.90%) women, were between 34 and 44 years old. Furthermore, SSRIs were found to be the most commonly used antidepressant (41, 66.13%). In addition, fluoxetine was the most frequently prescribed antidepressant, with 23 (37.10%) patients receiving this medication. The dosage did not exceed 20 mg for the majority of the patients on SSRIs. CONCLUSION: This study measured the prevalence and patterns of SSRIs and use of different antidepressant classes during pregnancy. After calculating the prevalence of each class of antidepressants among 62 pregnant women exposed to antidepressants, the analysis concluded that SSRIs are the most prescribed antidepressant during pregnancy. This study contributes to the growing body of literature on the use of antidepressants during pregnancy and highlights the need for ongoing research in this area.

In response to the Saudi healthcare reform: a cross-sectional study of awareness of and attitudes toward the public health model among health students.

Background: Saudi Arabia's health sector is experiencing a significant transformation toward an emphasis on the public health model. This model is a population-based approach to preventing and controlling disease, and its importance becomes evident during infectious outbreaks and pandemics, such as COVID-19. This study aimed to assess the awareness and attitudes of health students in Jazan toward the public health model. Methods: This study applied a cross-sectional online survey. Data were collected from 3-18 November 2020 using Google Forms. A convenience sampling method was used with a final sample of 425 participants. Results: Most participants (71%) were aware of the public health model, with an average score of 11.36 out of 16. Multiple regression analysis revealed a significant association between the awareness level of the public health model and participants' demographics, namely, gender, major of study, year of study, and prior training in public health. Participants who completed public health training (ß = 0.220) had higher awareness scores than others. On the other hand, participants from public health (ß = -0.342), medicine (ß = 0.164), and nursing in Jazan (ß = 0.128) had higher awareness of the public health model than the reference group (Nursing at Addayer College). Addayer is an area located in the rural northeast of the Jazan region. In addition, final-year students (ß = 0.113) had higher awareness of the public health model than the reference group (year 2 pre-final students). Female participants (ß = -0.142) had lower awareness of the public health model than male participants. Most participants (95.3%) believed that the clinical care and public health models are essential for promoting people's health. However, 4.7% of participants believed that clinical health care is more important than public health. Conclusion: Health students, who are future healthcare professionals, must understand and value the public health model to support the planned health system reforms. It is recommended to evaluate how the education and training of students in public health, medicine, and nursing in Jazan impact the understanding and views of this cohort on the public health model compared to those of students in other health-related majors.

Epidemiology of pediatric trauma in Makkah, Kingdom of Saudi Arabia: An observational cohort study.

OBJECTIVES: To explore the epidemiology and patterns of pediatric trauma in addition to length of hospital stay and outcome. METHODS: A single-center retrospective study of 605 patients aged 14 years and younger was carried out from January to December 2022. The study included all patients who experienced intentional or unintentional trauma aged 14 years or below in 2022 and excluded trauma that did not prompt an emergency room visit. RESULTS: Most pediatric trauma cases involved boys (69.1%, n=418), and girls comprised only 30.9% (n=187). Trauma was most common in children one to 5 years old (41.5%, n=251). Falling from a height was the most common mode of injury in both girls and boys (n=253, 41.8%). The most common body parts involved were the extremities (n=357, 59%), followed by the head (n=210, 34.7%). Most children were transferred to hospital via emergency medical services (n=234, 38.7%). In most cases, the child was admitted to the surgical ward (n=458, 75.7%), while others were managed in the emergency department without admission (n=93, 15.4%). Most patients were stable after receiving standard care (n=558, 92.2%). CONCLUSION: To reduce health care expenses and improve public health outcomes, prioritizing preventive measures is crucial. This includes increasing public awareness, implementing safety protocols, and enacting government regulations to prevent avoidable injuries.

Regional Myopericarditis Mimicking Inferior Myocardial Infarction Following COVID-19 Vaccination: A Rare Adverse Event.

We present the case of a 41-year-old man who developed myopericarditis after receiving the Pfizer COVID-19 vaccine. The patient experienced a sudden onset of chest and abdominal pain 16 days after vaccination. Electrocardiogram findings revealed deep T-wave inversion and minimal ST-segment elevation. Further investigation through coronary artery angiography and computed tomography identified an anomalous left main coronary artery. Magnetic resonance imaging confirmed the diagnosis of myopericarditis. This case highlights the importance of considering myopericarditis as a potential cause of chest pain and elevated cardiac biomarkers following COVID-19 vaccination, particularly in young individuals. Clinicians should be aware of this adverse event and include it in the differential diagnosis for patients presenting with similar symptoms after vaccination.

A Challenging Case of Heart Displacement by a Large Mediastinal Germ Cell Tumor.

Mediastinal germ cell tumors (GCTs) are rare and aggressive cancers originating from the germ cells in the mediastinum. Early detection and treatment are vital due to their high potential for metastasis and recurrence. We present a case of a 28-year-old man who exhibited a cough and shortness of breath. Laboratory tests revealed elevated tumor markers, alpha-fetoprotein, and beta-human chorionic gonadotropin. Imaging studies displayed a large mediastinal mass, causing the right displacement of the mediastinum and cardiac tamponade. The biopsy confirmed a non-seminomatous GCT, specifically a yolk sac tumor. The patient experienced pericardial effusion and cardiac tamponade after receiving two cycles of etoposide and cisplatin chemotherapy. To relieve the tamponade, an emergency pericardiocentesis was performed malignant GCTs necessitate prompt diagnosis and treatment and utilizing multimodal therapy such as chemotherapy to achieve tumor control. Due to the high risk of metastasis, vigilant surveillance for recurrence is essential, emphasizing the need for specific criteria for accurate early detection.

Correlation of Physical Activity to Mental Health State and Grade Point Average Among Medical Students in Saudi Arabia: A Cross-Sectional Study.

INTRODUCTION: Physical activity (PA) significantly impacts mental health. However, studies addressing the influence of PA on the mental health and academic performance of medical students are scarce. MATERIALS AND METHODS: A cross-sectional study was carried out among 2,819 students pursuing their medical degrees in Saudi Arabia. PA was measured using the Global Physical Activity Questionnaire, and the state of their mental health was recorded using the Hospital Anxiety and Depression Scale. A multi-logistic regression was performed to predict the risk factor of poor academic performance. RESULTS: The prevalence of abnormal anxiety and depression levels were found to be 45.3% and 31.6%, respectively, which were comparatively more prevalent among students of younger age (p < 0.001). Students with abnormal anxiety levels had significantly lower grade point average (GPA) levels than others (p < 0.001). Those who were aged < 21 years, female gender, with chronic disease presence, low PA levels, and abnormal anxiety levels were independently associated with lower GPA levels (p < 0.05). CONCLUSION: Low PA and high anxiety and depression levels were found to affect the academic performance of medical students in Saudi Arabia. Hence, health education about the importance of PA should be directed to those students.

Cloning and Molecular Characterization of the Recombinant CVB4E2 Immunogenic Viral Protein (rVP1), as a Potential Subunit Protein for Vaccine and Immunodiagnostic Reagent Candidate.

The aim of the present study was, first, to clone the VP1 gene of the human coxsackievirus B4 strain E2 (CVB4E2) in the prokaryotic pUC19 plasmid expression vector then to compare it with the structural capsid proteins of the same strain using bioinformatic tools. PCR colony amplification followed through a restriction digestion analysis and sequencing process which affirmed the success of the cloning process. SDS-PAGE and Western Blotting were used to characterize the purified recombinant viral protein expressed in bacteria cells. The BLASTN tool revealed that the nucleotide sequence of the recombinant VP1 (rVP1) expressed by pUC19 highly matched the target nucleotide sequence of the diabetogenic CVB4E2 strain. Secondary structure and three-dimension structure prediction suggested that rVP1, such as wild-type VP1, is chiefly composed of random coils and a high percentage of exposed amino acids. Linear B-cell epitope prediction showed that several antigenic epitopes are likely present in rVP1 and CVB4E2 VP1 capsid protein. Additionally, phosphorylation site prediction revealed that both proteins may affect the signal transduction of host cells and can be involved in virus virulence. The present work highlights the usefulness of cloning and bioinformatics characterizations for gene investigation. Furthermore, the collected data are helpful for future experimental research related to the development of immunodiagnostic reagents and subunit vaccines based on the expression of immunogenic viral capsid proteins.

A C1 Jefferson Fracture With Vertebral Artery Occlusion and Cerebellar Infarction: A Case Report.

Jefferson fracture is a C1 fracture, which happens when an axial load is from the occiput downward to the C1 ring. Usually, it causes outward displacement of the C1 arch, which can injure the vertebral artery. We present a Jefferson fracture with vertebral artery injury, resulting in an asymptomatic ischemic stroke of the left cerebellum. Usually, vertebral artery injuries are asymptomatic since the contralateral vertebral artery and the collateral arteries will adequately supply the cerebellum. Vertebral artery injury (VAI) is typically treated with conservative management with anticoagulants and antiplatelet therapy.

The effect of therapeutic footwear on the recurrence and new formation of foot ulcers in previously affected diabetic patients in Jeddah, Saudi Arabia.

AIM: Diabetic foot ulcers (DFUs), which are a common serious complication of diabetes mellitus, (lifetime occurrence, 19%-34%) account for at least 85% of all lower-limb amputations in diabetic patients. Special footwear (therapeutic footwear) is frequently recommended for such patients to adapt to changes in their foot structure. We aimed to, measure the effect of therapeutic footwear on DFU development and recurrence among previously affected patients in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was performed between June and September 2022. The study targeted patients aged ≥18 years previously diagnosed with DFU. Participants were contacted by telephone to complete a questionnaire assessing footwear use and foot care. RESULTS: This study included 115 participants with a mean age of 61.9 ± 11.63; overall, 47% of participants used therapeutic footwear and 46% were adherent with wearing it. The DFU recurrence rate among patients who used therapeutic footwear was 27.8% versus 52.5% among patients who did not (p = 0.013). While using therapeutic footwear, patients with foot deformities reported a lower ulcer healing rate than those who did not (50% vs. 81.8%, p = 0.04). Patients who examined their feet had a lower recurrence rate than those who did not (38.5% vs. 50%, p = 0.43). CONCLUSION: Therapeutic footwear use was significantly associated with decreased DFU recurrence. Further investigation to enhance the evidence for the effectiveness of therapeutic footwear in DFUs is warranted.

Lessons Learned from the COVID-19 Outbreak as Experienced by ICU Nurses: Manifest Qualitative Content Analysis.

From the moment the World Health Organization (WHO) declared the coronavirus (COVID-19) a global pandemic, intensive care unit (ICU) nurses struggled to care for the COVID-19 patients. As the pandemic became increasingly critical, the task of daily care for critically ill patients fell upon the shoulders of ICU nurses. Understanding the lived experience of ICU nurses, as well as their perception of the experience, is important to identify key lessons to further improve ICU nurses' psychological well-being and resilience. This study explored the lived experiences of ICU nurses who cared for COVID-19 patients using exploratory manifest qualitative content analysis. The findings of this study revealed that these ICU nurses offer important information concerning the crucial role of nurses' family support and religious-spiritual practices in helping them to maintain well-being and cope with the intense situations caused by the pandemic. The lessons emerging from the study findings show that family support and religious-spiritual practices are resources for coping and resilience in times of future pandemics. This implies that ICU nurses who provide care during stressful emergency surges require relief by nurses working in other areas to provide them the opportunity to rest, reconnect with family and become emotionally re-energized.

Assessing The Effectiveness of Rainwater Harvesting Systems In Improving Wintering Bird Richness In Pre-Saharan Tunisia.

The impact of rainwater harvesting systems on biodiversity in hyperarid North African areas has not been assessed to date despite its demonstrated usefulness. The present study investigated this impact by considering the richness of wintering birds (RWB) in the Tataouine region (pre-Saharan Tunisia). We used data from three sets of variables-rainwater harvesting system type, microhabitat conditions, and topography-to determine the best predictors causing variation in the RWB by means of generalized linear mixed models. Our results show that the jessour system is the most attractive for the wintering bird species, followed by the tabia system, and lastly by the control areas. In the jessour system, RWB is influenced positively by slope and shrub cover and quadratically by tree cover, whereas this richness is affected positively by the extent of the herbaceous layer in the tabia system. In the control areas, RWB is negatively affected by elevation and quadratically affected by tree cover. Variation partitioning (VP) analysis reveals that (i) space is the most robust factor explaining the RWB in control areas (adj. R2 = 0.15, p = 0.001), (ii) microhabitat is central in the tabia system (adj. R2 = 0.10, p = 0.001), and (iii) the shared fraction between microhabitat and space is relevant in the jessour systems (adj. R2 = 0.20). Specific management actions, especially preserving, maintaining, and promoting these traditional systems, are suggested to improve the attraction of wintering bird species to the Tataouine region. The implementation of a scientific watch system is recommended to understand how changes take place in such an arid environment.

Safety Survey on Lone Working Magnetic Resonance Imaging Technologists in Saudi Arabia.

PURPOSE: The American College of Radiology (ACR) requires MR personnel not to work alone due to the increased risk of safety issues such as projectiles, aggressive patients, and technologist fatigue. As a result, we intend to assess the current safety of lone-working MRI technologists in MRI departments in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study using a self-report questionnaire was conducted in 88 Saudi hospitals. RESULTS: A response rate of 64% (174/270) was obtained among the 270 MRI technologists which were identified. The study discovered that 86% of MRI technologists had prior experience working alone. In terms of MRI safety training, 63% of MRI technologists received such training. A question about lone MRI workers' awareness of the ACR's recommendations revealed that 38% were unaware of such recommendations. Furthermore, 22% were misinformed, believing that working alone in an MRI unit is optional or depends on the individual's desire to work alone. Working alone has the primary consequence of being statistically significantly associated with projectile/object-related accidents/mistakes (p = 0.03). CONCLUSION: Saudi Arabian MRI technologists have extensive experience working alone without supervision. Most MRI technologists are unaware of lone working regulations, which has raised concerns about accidents/mistakes. There is a need for MRI safety training and adequate practical experience to raise awareness of MRI safety regulations and policies related to lone working among departments and MRI workers.