Predicting mechanical neck pain intensity in computer professionals using machine learning: identification and correlation of key features.

Introduction: Mechanical neck pain has become prevalent among computer professionals possibly because of prolonged computer use. This study aimed to investigate the relationship between neck pain intensity, anthropometric metrics, cervical range of motion, and related disabilities using advanced machine learning techniques. Method: This study involved 75 computer professionals, comprising 27 men and 48 women, aged between 25 and 44 years, all of whom reported neck pain following extended computer sessions. The study utilized various tools, including the visual analog scale (VAS) for pain measurement, anthropometric tools for body metrics, a Universal Goniometer for cervical ROM, and the Neck Disability Index (NDI). For data analysis, the study employed SPSS (v16.0) for basic statistics and a suite of machine-learning algorithms to discern feature importance. The capability of the kNN algorithm is evaluated using its confusion matrix. Results: The "NDI Score (%)" consistently emerged as the most significant feature across various algorithms, while metrics like age and computer usage hours varied in their rankings. Anthropometric results, such as BMI and body circumference, did not maintain consistent ranks across algorithms. The confusion matrix notably demonstrated its classification process for different VAS scores (mild, moderate, and severe). The findings indicated that 56% of the pain intensity, as measured by the VAS, could be accurately predicted by the dataset. Discussion: Machine learning clarifies the system dynamics of neck pain among computer professionals and highlights the need for different algorithms to gain a comprehensive understanding. Such insights pave the way for creating tailored ergonomic solutions and health campaigns for this population.

Revisiting the clinical utilization of cardiopulmonary exercise testing in Saudi Arabia after 2 decades: A cross-sectional study.

OBJECTIVES: To assess the prevalence of cardiopulmonary exercise testing (CPET) usage and identify barriers among major hospitals and medical centers in Saudi Arabia. We also aim to compare these findings with data from nearly 2 decades ago. METHODS: In this cross-sectional study, 70 major hospitals and medical centers were contacted, and 52 (74.2%) responded. The participants involved in this study were healthcare providers proficient in carrying out CPET from different specialties. The survey comprised 21 items covering CPET utilization, exercise mode characteristics, common protocols, types of patients or disorders, and barriers to not carrying out CPET. RESULTS: The majority (n=37; 71.9%) of the centers reported a lack of CPET utilization. Of the 15 centers that used CPET, only 11 carried out regular CPET. Cardiac-related conditions were the most commonly referred clinical cases (n=7), followed by pulmonary conditions and cardiopulmonary fitness. The common barriers to carrying out CPET have remained unchanged compared to 2 decades ago - that is, the lack of equipment or trained technicians. However, there has been a 14.1% increase in the utilization of CPET and a 10.1% increase in the use of treadmill mode compared to a survey carried out 2 decades ago. CONCLUSION: Although CPET utilization has increased over 2 decades, this still falls below the desired benchmark. This highlights the need for collaborative efforts among policymakers, and healthcare institutions to address barriers and improve CPET integration into clinical practice.

Investigating the relationship between lifestyle factors, family history, and diabetes mellitus in non-diabetic visitors to primary care centers.

We investigated the risk levels associated with diabetes mellitus. They were assessed based on whether anyone in their family had a history of diabetes. The data collected are measurements of blood pressure, weight, height, and smoking habits, as well as physical activity and educational status. Based on the American Diabetes Association's (ADA) recommendations, the questionnaire included a diabetes risk assessment. The risk of diabetes was 76.3% among participants with a family history of diabetes. There is a 41.1% chance of diabetes among those participants whose fathers had diabetes, and a 39.3% chance of diabetes among those participants whose mothers had diabetes. Additionally, those participants who have siblings with diabetes were 24% at high risk for developing diabetes. The prevalence of the risk of having a family history of diabetes is higher in the women in the family (RR = 3.12; P = 0.0001) as compared to the men in the family (RR = 1.9; P = 0.0001). Risk of diabetes more in the male (1.13 times higher) in the current study based on the ADA scale. There is evidence that various factors, including lifestyle choices, physical attributes, and family history, influence the risk of developing diabetes in the current study. The results of the current study indicate that there is a strong association between patients with T2D and those who have a family history of diabetes. Considering Saudi Arabia's high diabetes risk, evidence-based lifestyle modifications are needed.

Assessment of Risk Factors and the Relationship between Hypothyroidism with Hypertension in Diabetes Mellitus Patients: A Cross-Sectional Community-Based Study.

(1) Background: hypertension (HTN) and diabetes mellitus (DM) represent two widely noncommunicable diseases that are prevalent globally, and they often correlate with chronic health issues. There has been an acknowledged connection between diabetes, hypertension, and hypothyroidism for quite some time. However, the extent of thyroid dysfunction among the diabetic population is not uniform and significantly differs across different research studies. This study was conducted with the objective of identifying the risk factors associated with hypothyroidism as well as assessing the relationship between hypothyroidism and hypertension in patients with diabetes. (2) Materials and Methods: Participants aged 18 years and above were included in this study, while pregnant women were excluded. Trained health professionals measured sociodemographic, behavioural, food practices, and anthropometric information about the participants. Each respondent sought medical advice regarding their health, and a face-to-face interview enabled them to express concern about the likelihood of being diagnosed with diabetes mellitus and hypertension. (3) Results: The study encompassed 640 participants, with an average age of 49.20 ± 13.0 years. Among these participants, 65.5% were female, and 34.5% were male. Of the total, 31.25% were diagnosed with diabetes mellitus, and 18.75% had hypertension. Interestingly, co-occurrence of both conditions was observed in 9.68% of the population. A comparison of thyroid function and indicators of blood sugar levels yielded consistent results across the different patient groups. Specifically, for diabetes mellitus (DM) patients, the average levels were 3.4 ± 9.8 pg/mL for fT3, 0.9 ± 0.7 ng/dL for fT4, 3.3 ± 6.2 µiU/mL for TSH, 153.1 ± 68.0 mg/dL for fasting plasma glucose (FPG), 213.2 ± 97.2 mg/dL for postprandial glucose (PPG), and 8.3 ± 3.2% for HbA1c. (4) Conclusion: It is concluded that patients with hypertension had a significant prevalence of diabetes mellitus. Subclinical hypothyroid subjects must be frequently screened for hypertension. Of 120 individuals with hypertension, 45 (37.5%) were also diagnosed with diabetes. This co-occurrence was significantly higher in subjects aged over 50 years (26.7%), in the lower socio-economic class (18.5%), and among those who were married (14.7%). Additionally, patients with hypertension exhibited a high prevalence of diabetes across different educational backgrounds and occupations, with the highest prevalence among postgraduates (37.5%) and professionals (24.0%), respectively. These findings highlight the need for an integrated approach to the management of hypertension and diabetes, particularly in high-risk demographics.

Comparative effectiveness of 10-week equipment-based pilates and diaphragmatic breathing exercise on heart rate variability and pulmonary function in young adult healthy women with normal BMI - a quasi-experimental study.

BACKGROUND: The positive effects of Pilates and slow-controlled breathing exercises on health are examined in different studies. The purpose of the study was to investigate the effects of 10-week equipment-based Pilates, slow-controlled breathing exercises, and a combination of both on heart rate variability (HRV), pulmonary function, and body composition (BC) in young adult healthy women with normal BMI. METHODS: Forty female participants were assigned to either equipment-based Pilates group (PG), slow-controlled breathing exercise group (BG), equipment-based Pilates + breathing exercise group (PBG), and control groups (CG). Equipment-based Pilates exercise consists of training for two days a week and 50 min per day, and breathing exercises were done twice a week for 15 min a day for 8 weeks. In addition, PBG performed a 15-minute breathing exercise after each Pilates session. Pilates sessions were created with Reformer, Cadillac, Ladder Barrel, Chair Barrel, and Spine Corrector. On the other hand, breathing exercises were based on a controlled 5 s inhale and 5 s exhale cycles. RESULTS: Before and after the implementation, pulmonary function, HRV, and BC parameters were measured. The body weight and BMI improved in PG and PBG, and the percent body fat decreased only in PBG (p < 0.05). Both PG and PBG noted significant changes in HRV indices SDSD, SDNN, TP, HF, and LF. However, the RMSSD was recorded higher in only PBG. Similar changes were found in pulmonary parameters. The FVC, FEV1, VC, IC, TV, MVV, and VE im-proved in PBG. PG showed increases in VC and TV. The only changes found in BG were PEF and ERV. CONCLUSIONS: The finding highlights the ample effect of combined breathing and Pilates exercise on HRV, pulmonary function and body composition which has important implications for health promotion.

Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial.

Background and Objectives: The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods: A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results: Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0.001; and diastolic blood pressure: MD = 1.33 mmHg, 95% CI = 1.16, 1.50, p = 0.001) compared to the control group. Within the experimental group, there was also a significant decrease in systolic blood pressure (MD = -2.75 mmHg, 95% CI = -7.73, 2.22, p = 0.005) and diastolic blood pressure (MD = -0.83 mmHg, 95% CI = -5.81, 4.14, p = 0.02). Conclusions: This trial demonstrates the feasibility and potential benefits of low-to-moderate intensity aerobic exercise training in reducing resting blood pressure among sedentary older Saudis with hypertension residing in this aged care setting.

Measurement Properties' Evaluation of the Arabic Version of the Patient-Specific Functional Scale in Patients with Multiple Sclerosis.

Purpose: The aim of this study was to assess the reliability and validity of the Arabic version of the patient-specific functional scale (PSFS-Ar) in patients with multiple sclerosis (MS) disorder. Materials and Methods: Reliability and validity were examined in patients with multiple sclerosis using a longitudinal cohort study design. One hundred (N = 100) patients with MS were recruited to examine the PSFS-Ar, test-retest reliability (using the interclass correlation coefficient model 2,1 (ICC2,1)), construct validity (using the hypothesis testing method), and floor-ceiling effect. Results: A total of 100 participants completed the PSFS-Ar (34% male, 66% female). The PSFS-Ar showed an excellent test-retest reliability score (ICC2,1 = 0.87; 95% confidence interval, 0.75-0.93). The SEM of the PSFS-Ar was 0.80, while the MDC95 was 1.87, indicating an acceptable measurement error. The construct validity of the PSFS-Ar was 100% correlated with the predefined hypotheses. As hypothesized, the correlation analysis revealed positive correlations between the PSFS-Ar and the RAND-36 domains of physical functioning (0.5), role limitations due to physical health problems (0.37), energy/fatigue (0.35), and emotional well-being (0.19). There was no floor or ceiling effect in this study. Conclusions: The study results showed that the PSFS-Ar is a self-reported outcome measure that is useful for detecting specific functional difficulties in patients with multiple sclerosis. Patients are able to express and report a variety of functional limitations easily and effectively, as well as to measure their response to physical therapy. The PSFS-Ar is, therefore, recommended for use in Arabic-speaking countries for clinical practice and research for patients with multiple sclerosis.

Effectiveness of a Therapeutic Exercise Program to Improve the Symptoms of Peripheral Neuropathy during Chemotherapy: Systematic Review of Randomized Clinical Trials.

BACKGROUND: Therapeutic exercise has an important role to manage chemotherapy-induced peripheral neuropathy symptoms. However, there is little evidence of its effectiveness. OBJECTIVE: To synthesize the evidence regarding therapeutic exercise during chemotherapy to improve peripheral neuropathy symptoms. DATABASES: PubMed, CINAHL, Cochrane Library, PEDro, ScienceDirect, Scopus, Web of Science and BIREME. METHODOLOGY: Randomized clinical trials were included. GRADE was used to synthesize evidence and an inverse variance model for meta-analysis. RESULTS: Up to May 2022, 2172 references were analyzed and 14 studies that evaluated 1094 participants were included. The exercises were highly effective in improving pain threshold and moderately effective in improving peripheral neuropathy symptoms at the 8-week follow-up and the 4-24 weeks. Furthermore, the evidence was low in improving thermal threshold, tactile and vibratory sensitivity. CONCLUSION: Therapeutic exercise generates a significant reduction in peripheral neuropathy symptoms in patients in short- and long-term follow-up with a moderate level of evidence quality.

Barriers and facilitators affecting physical activity among adults in Saudi Arabia during COVID-19 quarantine.

The quarantine period in Saudi Arabia from May to June 2020 due to the coronavirus disease (COVID-19) pandemic prevented many people from engaging in physical activity (PA), which may have had negative effects on their health. Therefore, it is important to understand the factors, barriers, and facilitators affecting PA of people during quarantine. This cross-sectional study was conducted using an electronic survey that was distributed to adults between 18 and 69 years old. The survey included demographic-related questions and the International Physical Activity Questionnaire-Short Form. The survey was completed by 1859 participants ranging in age from 18 to 69 years old (42.5% male, 57.5% female). The major factors influencing exercise were being male (odds ratio [OR] = 1.26; 95% confidence interval [CI] 1.03-1.53), being single (OR = 1.37; 95% CI 1.12-1.67), completing higher education at a Master/Doctorate level (OR = 1.83; 95% CI 1.23-2.72), and being resilient (OR = 1.05; 95% CI 1.03-1.08). The facilitators for doing regular exercise were having enough space at home (OR = 1.62), free time (OR = 1.77), good motivation (OR = 1.56), and being free from work (OR = 1.43) and family responsibilities (OR = 1.40). Sex, marital status, level of education and resilience were important factors affecting the type and level of PA during the quarantine period resulting from the COVID-19 pandemic.

Saudi Arabia, like many countries, implemented social distancing, quarantining, travel restrictions and closing recreation facilities to prevent the spread of coronavirus disease (COVID-19). As a result, many people were prevented from engaging in physical activity (PA), which may have had negative effects on their health. This study aims to understand the barriers and facilitators affecting PA of people during quarantine due to COVID-19. We distributed an electronic survey to adults aged between 18 and 69 years old. The survey included demographic-related questions and the 'International Physical Activity Questionnaire-Short Form' to measure their PA levels. There were 1859 survey respondents, of which 42.5% were male and 57.5% were female. The results showed that being a male, being single, completing higher education at a Master/Doctorate level and being resilient were the major factors influencing exercise. In addition, having enough space at home, free time, good motivation and being free from work and family responsibilities were the facilitators for doing exercise regularly.

In hypertensive individuals, sleep time and sleep efficiency did not affect the number of angina episodes: a cross-sectional study.

Previous studies have reported adverse effects of short and long sleep duration on cardiovascular health. However, how sleep time and sleep efficiency affect angina have not been studied in hypertensive individuals. This study aimed to assess the relationship of sleep with angina. Using a cross-sectional design, data from 1563 hypertensive individuals were collected from the parent Sleep Heart Health Study (SHHS). Age, alcohol use, average diastolic blood pressure (ADBP), average systolic blood pressure (ASBP), cigarette use, sleep time, sleep efficiency, percent time in stage N3 of sleep, and body mass index (BMI) were used as covariates. Multiple linear regression, the Chi-Square test, and Pearson's correlation coefficient were used for data analysis. Unadjusted sleep efficiency, sleep time, ADBP, and age were significant (p < 0.05) predictors of the number of angina episodes (Anginan). When the covariates were adjusted, only ADBP and ASBP were significant (p < 0.05) predictors of Anginan. Sleep efficiency, BMI, ADBP, sleep time, and age had a significant (p < 0.05) correlation with Anginan. In hypertensive individuals, sleep time and sleep efficiency did not affect Anginan when adjusted for covariates. ADBP and ASBP were found to be significant predictors of Anginan when the covariates were adjusted.

Impact of the loss of smell on the sleep quality and fatigue level in COVID­19 survivors.

PURPOSE: Patients with Coronavirus disease 2019 (COVID-19) are reported to have symptoms such as shortness of breath, dry cough, headache, fatigue, and diarrhea. Loss of smell is a symptom that some patients have suffered from due to inflammation of olfactory epithelium and neuroinvasion of COVID-19 resulting in damage to the olfactory nerves and olfactory bulb. Losing an important sense such as smell might have unfavorable consequences on the lives of COVID-19 survivors; however, these unfavorable consequences have not been sufficiently investigated. METHODS: This was a cross-sectional descriptive study, 81 COVID-19 survivors (51.85% male) answered the Pittsburgh Sleep Quality Index, Fatigue Severity Scale, and Patient Health Questionnaire. RESULTS: COVID-19 survivors who lost their smell were more likely to have poor sleep quality, high fatigue severity, and depression symptoms compared to others who did not lose their smell. Most COVID-19 survivors who lost their smell were women and had breathing difficulties. CONCLUSION: Our knowledge of this relationship will assist in establishing more efficient treatment regimens that consider both psychological and physiological factors. Future research is needed to investigate the causality relationship between poor sleep quality, increased fatigue, and depression symptoms in COVID-19 survivors who experienced loss of the sense of smell.

Cost of healthcare rehabilitation services following road traffic injuries: Results from a Level-I trauma center in Saudi Arabia.

BACKGROUND: Road traffic injuries (RTIs) are the second leading cause of mortality in Saudi Arabia. The high rate of RTIs puts a strain on rehabilitation services. Yet, little is known of the economic burden of nonfatal RTIs and rehabilitation services. This study, therefore, aims to describe the annual rehabilitation costs associated with RTIs at a local trauma center. MATERIALS AND METHODS: This study was conducted among all the 17 years or older patients hospitalized at King Abdulaziz Medical City in Riyadh following RTIs and required rehabilitation care. We included 299 patients who met the inclusion criteria and were followed for one year after discharge from the index hospital. The data was abstracted through retrospective review of patients' medical records. All rehabilitative services utilized by the healthcare system were recorded. To describe the economic burden, the mean, median, standard deviation, and interquartile range (IQR) were calculated. Total costs were aggregated for all patients to estimate overall costs. RESULTS: The study population was relatively young (31 years ± 14.4). The total annual rehabilitation cost of patients was Saudi Riyals (SAR) 6,113,781 (IQR: 20,589.3 - 3,125 = 17,464.3), and the average for each patient was SAR 20,447 (median = 7875). Patients aged 40-59 years and ≥60 years accounted for the highest average rehabilitation cost of SAR 31,563.99 and 32,639.21, respectively. Rehabilitation visits incurred the highest cost (mean SAR 1,494,124), followed by bed utilization which cost SAR 1,311,972 and radiology examination at SAR 1,032,261. The cost of motorcycle injuries was relatively higher (SAR 44,441.0) than other injury mechanisms. CONCLUSION: This study underlines the economic burden of rehabilitation services resulting from RTIs. Public health interventions are needed to reduce the burden of RTIs by dealing with their preventable causes and improving road safety measures. These findings may be useful to policymakers and researchers to support and improve rehabilitation services in Saudi Arabia.

A cross-sectional study explores the association of physical activity with the severity of peripheral arterial disease from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Engaging in physical activity (PA) has been proved to reduce the risk of developing cardiovascular diseases. In patients with peripheral arterial disease (PAD), diminished PA predicts high overall mortality. However, the extent of the association of participation in PA with PAD severity is unknown. Therefore, the overarching aim of this study was to investigate the association between PAD severity, PA levels and patterns using the Hispanic Community Health Study/Study of Latinos. This was a cross-sectional cohort study that included 495 participants with PAD and a total of 12,281 participants without PAD from the Hispanic Community Health Study/Study of Latinos database. The Global Physical Activity Questionnaire was administered to assess the time spent weekly in performing moderate-to-vigorous PA (MVPA) during work, leisure time, and transportation. The ankle-brachial index (ABI) was used to measure PAD. PA status was categorized on the basis of MVPA as follows: physically active and physically inactive to insufficient. In addition, all participants were classified as follows: those with normal ABI who were physically active, those with normal ABI but who were physically inactive, those with PAD but were physically active, and those with PAD who were physically inactive. Complex sample for regression models were used to investigate the association between PA and the severity of PAD. Of the participants, 235 (47.5%) were physically inactive to insufficient, and 260 participants (52.5%) engaged in at least 150 min/wk of MVPA, which is the recommended PA level according to the guidelines of World Health Organization. Compared with who were highly active, the participants who engaged in low PA were twice as likely to have moderately severe ABI and 4 times as likely to have severe ABI, after adjustment for the covariates (age, smoking status, and body mass index). Hispanic/Latino adults with sever PAD in the US showed pattern of physical inactivity. Findings of this study highlight the association between PA and severity of PAD. These findings highlight the necessity of interventions in increasing PA in these participants. Future studies are required to identify appropriate exercise regimens or home-based programs to help patients with severe PAD meet the current PA recommendations.

Effects of walking training on risk markers of cardiovascular disease in individuals with chronic spinal cord injury.

OBJECTIVE: To investigate the effects of an 8-week walking training program on glycemic control, lipid profile, and inflammatory markers in individuals with chronic spinal cord injury (SCI). DESIGN: A pilot, single-group, pretest-posttest study. SETTING: A neuromuscular research laboratory. PARTICIPANTS: Eleven participants with chronic SCI. INTERVENTION: An 8-week walking training program using a treadmill, a body weight-supported system, and an assistive gait training device. OUTCOME MEASURES: Levels of glycated hemoglobin (HbA1c), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), and interleukin-6 were assessed before and after the walking training. RESULTS: Following the walking training, there was a statistically significant decrease in HbA1c level (P<0.01) of uncertain clinical significance. The lipid profile improved after training, as shown by a statistically and clinically significant increase in HDL-C level (P<0.01) and a statistically significant decrease in LDL-C level (P<0.1) of no clinical significance. The ratio of LDL-C to HDL-C was significantly reduced (P<0.01). In regard to inflammatory markers, concentrations of IL-6 showed a significant reduction after training (P=0.05) of unknown clinical significance, while those of CRP trended to decrease (P=0.13). CONCLUSION: The findings of this pilot study suggest that an 8-week walking training program may produce favorable changes in risk markers of cardiovascular disease in individuals with chronic SCI as shown by clinically meaningful improvements in HDL-C, and small changes in the right direction, but uncertain clinical significance, in HbA1c, LDL-C and IL-6. A randomized controlled trial is needed to compare the effects of walking training on these outcome measures with those of other exercise modalities suitable for this population, and to see if more prolonged exercise exposure leads to favorable parameters of significant size to justify the exercise modality.

Physical activity patterns in adult population during the coronavirus pandemic: consideration of the role of resilience.

BACKGROUND: The aim of this study was to characterize patterns of physical activity (PA) and to examine whether resilience contributed to PA levels among adults during the COVID-19 pandemic. METHODS: This cross-sectional study was conducted during the COVID-19 quarantine period among adult population in the Kingdom of Saudi Arabia. The International Physical Activity Questionnaire Short Form (IPAQ-SF) and the Brief Resilience Scale (BRS) were used to assess the participants' activity and resilience levels. The Kruskal-Wallis Test was used to examine differences in PA across resilience levels. Spearman's correlation coefficient was used to assess the relationship between resilience and PA levels. Data were reported as medians and interquartile ranges. RESULTS: In total, 1859 individuals were included in the study (40% aged 26-35 years). The findings showed that 85% of the respondents engaged in PA and 15% were physically inactive. The majority (71%) participated in moderate-intensity PA. The median resilience score was 3.50 (0.85), indicating a medium level of resilience. A positive correlation was shown between the average resilience score and both walking (rs=0.01, P<0.001) and vigorous-intensity PA (rs=0.08, P=0.007). Data did not show a significant correlation between moderate-intensity PA and resilience score. CONCLUSIONS: Greater emphasis on PA engagement after the period of quarantine is needed. Resilience may play an important role in buffering the deleterious impact of quarantine on PA.

Exploring the relationship between students' learning satisfaction and self-efficacy during the emergency transition to remote learning amid the coronavirus pandemic: A cross-sectional study.

The overarching objective of this study was to assess learning satisfaction among students and to determine whether online-learning self-efficacy was associated with online learning satisfaction during the emergency transition to remote learning. This cross-sectional study involved a survey distributed to 22 Saudi Arabian universities. The survey used in this study consisted of an online learning self-efficacy (OLSE) questionnaire and an electronic learning (e-learning) satisfaction questionnaire. A total of 1,226 respondents voluntarily participated in and completed the survey. Students in medical fields made up 289 (23.6%). A Kruskal-Wallis H test and a chi-square test were used to compare the student's satisfaction based on the educational variables. Spearman's correlation and multiple linear regression analyses were performed to assess the association between self-efficacy and satisfaction. The findings revealed degrees of satisfaction ranging between high satisfaction and dissatisfaction. The majority of students (51%) expressed high satisfaction, and 599 students (49%) reported experiencing a low level of satisfaction with e-learning. A comparison of groups with low and high satisfaction scores revealed a significant difference in the OLSE. High satisfaction was positively correlated with the OLSE domains: time management, technology, and learning. The OLSE regression analysis model significantly predicted satisfaction. It showed that the model, corrected for education level and grade point average of the students, significantly predicted e-learning satisfaction (F = 8.04, R2 = 0.59, p = .004). The study concluded that students' satisfaction with the e-learning experience is influenced by e-learning self-efficacy. The study's findings lead to the practical implications and identify the need to improve the remote learning, time management and technology self-efficacy to enhance students' satisfaction.

Associations between ankle-brachial index, diabetes, and sleep apnea in the Hispanic community health study/study of Latinos (HCHS/SOL) database.

BACKGROUND: Sleep apnea and diabetes mellitus (DM) negatively impact cardiovascular health. One important indicator of cardiovascular health is the Ankle-Brachial Index (ABI). Either low ABI or high ABI are signs of peripheral vascular impairment. Impaired vascular health and DM, together, might provoke sleep apnea; however, information regarding these relationships is limited. Therefore, this study aimed to investigate the association between ABI, DM status, and severity of obstructive sleep apnea in people of Hispanic/Latino descent who are diverse in culture, environmental exposures, nativity, socioeconomic status, and disease burden. METHODS: A cross sectional analysis from a multi-center epidemiologic study, Hispanic Community Health Study/Study of Latinos, was utilized and included 3779 participants (mean age 55.32 ± 7.67, females 57.9%). The sample was divided into 4 groups based on the American Diabetes Association diagnostic guidelines (no DM or DM), and the ABI status (normal and abnormal). Multiple linear regression analysis was used to determine the association of the four groups and other independent variables with severity of sleep apnea measured by apnea-hypopnea index. Kruskal-Wallis H test was used for comparisons between groups for the apnea-hypopnea index. The significant level was set at 0.01. RESULTS: There were significant differences between groups in the mean of apnea-hypopnea index (P < 0.001; no DM + normal ABI = 5.42 ± 9.66, no DM + abnormal ABI = 7.11 ± 11.63, DM + normal ABI = 10.99 ± 15.16, DM + abnormal ABI = 12.81 ± 17.80). Linear regression showed that DM and abnormal ABI were significantly associated with severe sleep apnea (ß = 3.25, P = 0.001) after controlling for age, sex, BMI, income, education, alcohol use, cigarette use, hypertension or related medication, stroke and statin use. CONCLUSION: These findings suggest that people with DM and abnormal ABI were more likely to have high apnea-hypopnea index compared to the other groups. We observed gradual increasing in the severity of sleep apnea from low abnormality groups to high abnormality groups for Hispanic/Latino. Further work should elucidate the association of DM, abnormal ABI and sleep apnea with longer term outcomes, and replicate this work in different populations.

Feasibility and trend of pulmonary function in a pilot trial of aerobic walking exercise in non-ambulatory stroke survivors.

Background: Lung function is compromised in stroke survivors, which may cause fatigue and exercise intolerance. Furthermore, past studies of aerobic exercise have involved only stroke survivors who could walk independently. Stroke survivors who were unable to walk were not included in the previous research-investigating changes in lung function from walking exercise interventions. In this pilot study, the feasibility and the effect of aerobic walking exercise on lung function was examined in non-ambulatory stroke survivors using a treadmill, bodyweight support system, and a gait training device.Methods: This study was a single group trial. Eight non-ambulatory stroke survivors (five males, mean age 63.3 ± 13.7 years, seven with ischemic stroke) completed a low intensity walking exercise program (30 min/session; three sessions/week for 8 weeks) and lung function test. Before and after the intervention, vital capacity (VC) and forced vital capacity (FVC) using a spirometer were measured according to the guideline from American Thoracic Society/European Respiratory Society.Results: The rates of compliance and attrition were 100% and 10%; respectively, and no adverse events were reported. There were significant differences between pre- and post-intervention assessments in FVC (p = .09), percentage of predicted VC (p = .08), and percentage of predicted FVC (p = .08).Conclusions: In non-ambulatory stroke survivors, aerobic walking exercise is feasible and safe. Also, the results are promising and suggest that aerobic walking exercise may improve lung function; more data are needed.

Effect of Body Weight-Supported Treadmill Training on Cardiovascular and Pulmonary Function in People With Spinal Cord Injury: A Systematic Review.

Objective: To assess the current evidence with regard to the effects of body weight-supported treadmill training (BWSTT) on cardiovascular and pulmonary function in people with spinal cord injury (SCI) with a focus on outcomes of heart rate (HR), blood pressure (BP), and respiratory parameters. Methods: A systematic literature search was conducted through MEDLINE/PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database. Clinical trials involving adults with SCI and focusing on the effects of BWSTT on HR, BP, and respiratory measurements were included. The quality of included studies was assessed using the Downs and Black scale. The level of evidence of each study was identified using the Spinal Cord Injury Rehabilitation Evidence system. Results: Nine studies that met inclusion criteria were evaluated and included in this review. Overall, the quality index of all included studies was low. All studies scored less than 21 out of 28 on the Downs and Black scale. The level of evidence varied from level 2 to level 4. Level 4 evidence supports the use of BWSTT to decrease resting and exercise HR and improve heart rate variability. The use of BWSTT to improve respiratory parameters after SCI is supported by one study with level 2 evidence. The evidence that supports the use of BWSTT to improve resting BP is inconclusive. Conclusion: There has been low to moderate evidence to support the use of BWSTT in individuals with SCI to improve cardiovascular and pulmonary health. Future randomized controlled trials are needed to investigate the effect of BWSTT on cardiovascular and pulmonary function in people with SCI and compare BWSTT to other physical rehabilitation interventions.

Aerobic exercise improves measures of vascular health in diabetic peripheral neuropathy.

AIMS: Aerobic exercise improves vascular endothelial function in people with Type 2 diabetes mellitus (T2DM). There is minimal information available regarding vascular health in people with T2DM and diabetic peripheral neuropathy (DPN). Thus, the primary aim of this secondary analysis was to determine whether a 16-week aerobic exercise intervention could improve vascular health in people with T2DM and DPN. A secondary aim was to explore the relationship between changes in flow-mediated dilation (FMD) and the number of years since diagnosis of DPN. METHODS: We examined whether a 16-week aerobic exercise intervention would improve vascular health in people with T2DM and DPN. We used Doppler ultrasound to assess brachial artery diameter and peak shear at baseline and post-exercise. Paired t-tests were used to determine whether the outcome measures improved from baseline to post-intervention. Pearson correlation assessed the relationship between DPN (years) and the percent change score (pre- to post-intervention) for FMD. RESULTS: Seventeen individuals were included in the data analysis. After the intervention, peak diameter increased (3.9 (0.5) to 4.0 (0.5) mm; p = 0.07). Time to peak shear occurred at 60.5 (24.6) seconds when compared to baseline at 68.2 (22.7) seconds; p = 0.17. We found that a longer duration (in years) of DPN demonstrated a fair, negative relationship (r = -0.41, p = 0.19) with the percent change in FMD. CONCLUSION: Aerobic exercise was beneficial for improving measures of vascular health but these were not statistically significant. The magnitude of change may be affected by the duration of DPN.