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This study investigated the help-seeking attitude of undergraduates at the University of Ilorin Nigeria toward mental health issues. The study employed a descriptive survey design. A multistage sampling method was used in selecting a total of 400 participants. The demographic data and research questions were examined using percentage distribution. The hypotheses were tested using t-tests and Analysis of Variance (ANOVA) statistical methods at a significance level of 0. 05. The help-seeking attitude of respondents towards mental health difficulties did not vary significantly based on gender. However, there were substantial differences depending on age, degree of study, and students' place of residence. The vast majority of undergraduates rather talk to friends and family about their mental health problems than seek psychotherapy or medical help. School counsellors need to educate students on the significance of seeking help from trained mental health professionals.

Cloud computing security and data protection are becoming increasingly critical as its use increases. The research we present demonstrates how undercover sharing techniques and homomorphic encryption can be combined to protect private information in cloud computing scenarios. We create a reliable, private, and confidential computation platform by utilizing this dual approach. Our strategy involves protecting data while dividing it among multiple servers. By using this distribution, the system is less likely to suffer from single points of failure and has a higher security level. To ensure information privacy and security, data encryption restricts access to authorized individuals only. As an additional feature, we employ homomorphic encryption to enable operations on encrypted data without direct access to the originals. By using this feature, sensitive data is protected from disclosure or misuse while being processed. Therefore, original data confidentiality can be preserved when computing on encrypted shares. Several performance tests were conducted to prove our strategy’s practicality and effectiveness. Our considerations extended beyond encryption and decryption time and processing overhead. In our research, we demonstrate that our method strikes the right balance between security and computational efficiency.

Ali Shuaib Biomedical Engineering Unit, Department of Physiology, Faculty of Medicine, Kuwait University, Safat, 13110, KuwaitCorrespondence: Ali Shuaib, Biomedical Engineering Unit, Department of Physiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat, 13110, Kuwait, Email ali.shuaib@ku.edu.kwAbstract: This perspective paper provides a comprehensive examination of artificial intelligence (AI) in healthcare, focusing on its transformative impact on clinical practices, decision-making, and physician-patient relationships. By integrating insights from evidence, research, and real-world examples, it offers a balanced analysis of AI’s capabilities and limitations, emphasizing its role in streamlining administrative processes, enhancing patient care, and reducing physician burnout while maintaining a human-centric approach in medicine. The research underscores AI’s capacity to augment clinical decision-making and improve patient interactions, but it also highlights the variable impact of AI in different healthcare settings. The need for context-specific adaptations and careful integration of AI technologies into existing healthcare workflows is emphasized to maximize benefits and minimize unintended consequences. Significant attention is given to the implications of AI on the roles and competencies of healthcare professionals. The emergence of AI necessitates new skills in data literacy and technology use, prompting a shift in educational curricula towards digital health and AI training. Ethical considerations are a pivotal aspect of the discussion. The paper explores the challenges posed by data privacy concerns, algorithmic biases, and ensuring equitable access to AI-driven healthcare. It advocates for the development of comprehensive ethical frameworks and ongoing research to guide the responsible use of AI in healthcare. Conclusively, the paper advocates for a balanced approach to AI adoption in healthcare, highlighting the importance of ongoing research, strategic implementation, and the synergistic combination of human expertise with AI technologies for optimal patient care.Keywords: artificial intelligence, healthcare transformation, AI integration strategies

The key purpose of the Study is to examine if institutional quality complements the relationship between Ownership Structure and Corporate Social Responsibility disclosure and performance in the light of legitimacy and agency theory. To the best of my knowledge, it is the first study in literature of finance. The sample comprises of 112 top-performing listed firms (based on market capitalization) at Pakistan Stock Exchange from 2010 to 2019. Institutional quality comprised of world governance indicators which is developed via principal component analysis, an instrumental variable approach and content analysis are used for CSR Disclosure Index to demonstrate the relationship between ownership structure and CSR. The resources complementary phenomenon is adopted to examine the institutional quality's role. Our results show significantly positive impact of Institutional and Foreign Ownerships on CSR while negative significant influence of CEO Duality and Family Ownership on CSR, suggesting that well governed firms will be more socially responsible. In addition, the findings suggest the institutional quality's positive moderating role on the relationship between ownership structure and CSR, signifying the institutional quality's complementary role for the weak corporate environment in Pakistan. Our findings are robust to a series of tests by using Generalized Method of Moment (GMM).

The high rate of depression among undergraduate students has raised deep concerns among counselors and medical practitioners. Thus, this study examined university student depression risk variables. Moderating factors were gender, age, level of study, and parental occupation status. Survey research was descriptive. This survey covered all 55,000 undergraduates at the University of Ilorin. The study included 420 undergraduates sampled using purposive, proportional, and simple random methods. The 1 study used the "Risk Factors for Depression Questionnaire" (RFDQ) to obtain data. Percentages were utilized for demographic data, while mean and rank-order were employed to answer the research question. The t-test and ANOVA were used to test the four null hypotheses at the 0.05 level. The data shows that academic family and psychological factors are the main risk factors for students’ depression. The study found no significant differences in depression risk factors among undergraduates by level of study or parent occupation status, although gender and age revealed a significant difference. Based on the findings, undergraduates should be encouraged to receive adequate medical checkups to ensure cognitive and physical health wellness, regardless of gender, age, level of study, or parental occupation status, to address depression concerns. Mental health counselors should teach in-school adolescents depression prevention and management skills.

Husain Arian,1 Dhari Alroudan,1 Qutaibah Alkandari,1 Ali Shuaib2 1Department of Plastic Surgery, Jahra Hospital, Al-Jahra, 40206, Kuwait; 2Biomedical Engineering Unit, Department of Physiology, Faculty of Medicine, Kuwait University, Safat, 13110, KuwaitCorrespondence: Ali Shuaib, Biomedical Engineering Unit, Department of Physiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat, Kuwait, Email ali.shuaib@ku.edu.kwAbstract: An increasing number of people are opting for cosmetic surgeries. For many years, the physical and aesthetic appearance of Caucasians has been considered to be ideal. However, it is now commonly acknowledged that attractiveness and aesthetic standards vary among cultural backgrounds and ethnic groups and that Western attractiveness criteria no longer apply to all. Herein, we conducted a comprehensive review of studies that examined cultural and ethnic variations in preferences for facial, breast, and gluteal aesthetics, as well as reviewed studies that investigated ethnic disparities in attitudes and motivations for cosmetic surgery. A total of 4532 references were identified, 66 of which met the inclusion criteria. Several studies have reported that facial golden ratios are invalid for representing perceived attractiveness standards among different ethnicities. The majority of studies also indicated that facial aesthetic interventions should not aim to Westernize but to optimize ethnic traits. Significant ethnic differences in preferences for upper- and lower-pole breast proportions have been reported. The size of the buttocks and waist-to-hip ratio were identified as the main factors of buttock aesthetics, with buttock size preferences having a high ethnic diversity. Interest in cosmetic surgical procedures while maintaining ethnic identity continues to grow among young women worldwide. This comprehensive review strongly suggests that accommodating cultural and ethnic differences in aesthetic standards in cosmetic surgery planning can lead to more acceptable cosmetic outcomes.Keywords: cosmetic surgery, cultural variations, ethnicity, golden ratios, outcome

Bullied in-adolescents do experience certain psychosocial challenges and they employed varying coping strategies. However, the impact of demographic variables on the adjustment approaches used by adolescents enrolled in school is not sufficiently understood especially in Nigeria. A multi-stage sampling approach was used to obtain the study sample, resulting in 400 students identified as victims. Three instruments were used for their evaluation: Bullying Behaviour Scale; Psychosocial Challenges of Bullied Questionnaire; and Coping Strategies of Bullied Questionnaire. Results showed that age or type of school attended did not influence the psychosocial challenges experienced by bullied respondents, and it was also observed that students from private and public schools employed varying coping approaches. On this basis, it would be advisable for school counsellors to develop effective intervention strategies to help bullied students overcome their psychosocial challenges, and for school counsellors to focus more on bullied adolescents in their schools to train them in the best methods of coping and overcoming victimisation experience.

Aims: The present study was conducted to assess the level of medication adherence and factors affecting adherence among Type-2 Diabetes Mellitus (T2DM) patients. Methods: A prospective cross-sectional study was carried out among T2DM patients who were presented to the outpatient department of general medicine. A well-designed data collection form was used to gather information pertaining to various socio-demographic and medical variables. A previously validated and translated 8-item self-reported questionnaire was used to assess the level of medication adherence. Data was analysed using SPSS Version 29.0. Results: Among the total 369 subjects enrolled, a majority were found to be males, and the mean age of the population was observed as 56.84 ± 11.32. A total of 125 (33.8%) subjects were found to be within the category of high adherence, 161 (43.6%) subjects were found to have moderate level of adherence and 83 (22.4%) had low level of adherence. On analysis, various medical variables were found to have a statistically significant association with medication adherence. Conclusion: The findings of the present study would form the basis for all the future implications including education intervention programmes to improve the level of adherence towards anti-diabetic medications, which ultimately results in better health outcomes.

The purpose of this study was to evaluate how parental influences affected students' academic performance in the Kwara State capital of Ilorin. Researchers have expressed worry over students' low academic performance in school, and it is commonly acknowledged that for students to fully benefit from their education, their parents must give them their entire support. The research was a survey. All primary school teachers in the city of Ilorin made up the study's population, and a mixed method approach was used on a sample of 215 respondents (of whom 200 completed questionnaires and 15 participated in interviews). Simple random and selective sampling methods were used to choose the sample. The data was gathered via a survey called the "Parental Factors Influence School Achievements of Children Questionnaire" (PFISAPQ). The factors taken into account were gender, age, educational background, and number of years of teaching experience. Demographic information was expressed as a percentage, and the two null hypotheses were tested using the 2-way ANOVA statistical tool at the 0.05 level of significance. Mean and rank order analysis was used to analyze the research questions, and thematic analysis was then used to analyze the subsequent questions raised to support the main research questions. The results showed that, among other things, parental involvement, parental oversight, parental involvement in extracurricular activities, parental academic background, parental interest in education, and parent-child relationships are the primary factors positively affecting children's academic success. Also, significant differences existed in the parental factors influencing school achievements of pupils as expressed by primary school teachers based on gender, age, educational qualification, and years of teaching experience. It was recommended that parents should be encouraged to improve their involvement in children’s academic activities by supporting them and being actively involved in encouraging pupils to learn and achieve maximally in school.

Background: Adequate knowledge, attitude and practices about the use of antibiotics are essential for effective treatment and the cure of diseases. Objective: To assess the knowledge, attitude and practice towards the use of antibiotics among the outpatients of the general medicine department and to find the factors that are significantly associated with it. Materials and methods: A prospective cross-sectional study of eight months duration was carried out among 263 outpatients, in the department of general medicine. The socio-demographic details pertaining to the patients were collected in a well-designed data collection form. The knowledge, attitude and practice of the subjects were assessed by using previously validated KAP questionnaire. Results: The highest number of subjects were found to be females, 135 (51.3%), and most of the subjects belonged to the age category of 18–34 years, 107 (40.7%). The mean score of knowledge, attitude and practice were found to be 62.74 ± 23.28, 76.96 ± 17.73, and 52.55 ± 14.06 respectively. Age, domiciliary status, educational qualification, occupation, and socio-economic class were found to be the factors significantly associated with knowledge. Factors significantly associated with attitude were found to be age, educational qualification and socio-economic class whereas only educational qualification and occupation were found associated with practice. Conclusion: The results of the current study will serve as the foundation for future implications to enhance public knowledge and perceptions regarding antibiotic usage.

Students’ living conditions may suffer as a result of climate change. This research examined the impact of climate change awareness on undergraduates’ beliefs about socio-emotional well-being in Nigeria. The total number of undergraduate students in Kwara state made up the study’s population, with the sample size being 589. The Climate Change and Mental Wellbeing Questionnaire (CCMWQ) was used to collect data from randomly selected undergraduate participants for the study. The acquired data was evaluated using descriptive statistics, t-test, ANOVA and PPMC at a significance level of 0.05. The results showed that most undergraduates are aware of climate change but have little understanding of its origins, effects, and preventive strategies. The results further revealed that the undergraduates’ level of climate change awareness influences their beliefs about their socio-emotional wellbeing. At different ages, participants’ opinions on how climate change would affect their socio-emotional health varied dramatically. Similarly, a correlation exists between climate change awareness and beliefs about socio-emotional well-being and awareness and attitude towards protecting the environment.

Bullying is a complicated issue that arises from intricate relationships between family members, peers, the school community, and culture. One of the key indicators of bullying is parental variables. Studies linking various parental factors to bullying behaviour or roles are scarce, particularly in Nigeria. Therefore, this study examined parental factors as predictors of in-school adolescents’ bullying behaviors in Kwara state, Nigeria. The population comprised 223, 893 in-school adolescents in Kwara State and a sample of 400 was drawn from this population across the State. The data were collected through the use of researchers’ designed scale. The data collected were analysed using descriptive and inferential statistic. In the results, parental factors significantly predict in-school adolescents bullying perpetration and victimization. Based on the findings of the study appropriate recommendations were made.

The main objective of this study is to design a custom-made weight-drop impactor device to produce a consistent spinal cord contusion model in rats in order to examine the efficacy of potential therapies for post-traumatic spinal cord injuries (SCIs).

In CFSCS the chief achievement is to counter consumer demand in real-time, that act will cut down the cost to experience productivity at an economical scale and give a chance to customers to practice a superior experience. The organizations practicing or implementing a strong CFSCS (customer-focused supply chain strategy) are performing at their excellence in the sales sector, share in the market, productivity, and high level of customer satisfaction. The supply chain mechanism is highly customer focused in CFSCS, Chief elements of the success are highly dependent on the 4Rs model (responsiveness, resiliency, reliability, and realignment) and provide better services at low cost as compared to the traditional supply chain model. The study explores that the 4Rs model in CFSCS is a chief driver for this purpose we develop various frameworks. Our field of proving the CFSCS 4Rs model is in the apparel industry.

The aim of this study is to empirically analyze the impact of corporate governance on stock liquidity and the moderating role of financial transparency, through the lens of information asymmetry and agency theory. The sample consists of non-financial firms listed on the Pakistan stock exchange during the 2009–2019 period. The study used an instrumental variable approach and new corporate governance index, developed with principal component analysis, to demonstrate a relationship between corporate governance and stock liquidity. The results show a significant, positive relationship between the corporate governance index and stock liquidity, suggesting that well governed firms have high liquidity. To the best of our knowledge, this is the first finance study to investigate the moderating impact of financial transparency on the relation between corporate governance and stock liquidity. The results show that financial transparency, as measured by multiple proxies, has a negative moderating impact on the relationship between corporate governance and stock liquidity, suggesting that corporate governance in Pakistan is weak. Together, the results suggest that Pakistani firms use financial transparency as a substitute for corporate governance to improve stock liquidity. The results are robust to a series of endogeneity checks using alternative proxies of stock liquidity.

The study analyzes the impact of ownership structure on dividend smoothing via the lens of agency and information asymmetry theory. The study also investigates the impact of ownership on dividend smoothing in the unexamined asymmetric context Dividend smoothing is measured via speed of adjustment and relative volatility. The study documents that higher individual, management, and institutional ownerships are positively associated with increased dividend smoothing. Consistent with the rental hypothesis in foreign-owned firms smooth less also concentrated firms bear with cuts and omissions. Foreign ownership has the opposite impact on dividend smoothing in adjusting dividends from below and above i.e., always prefer high dividends. Individual ownership has also exhibited a different impact in smoothing from below and above. Institutional owners avoid cuts and omissions and negatively affect SOA (smooth more) in case of adjusting dividends from above. Ownership concentration is negatively associated with dividend smoothing irrespective of whether the firm is smoothing from above or below. In contrast, management ownership negatively affected SOA in adjusting from above or below. Family firms in Pakistan smooth more to win minor shareholders' trust and signal that they sacrifice their private benefits to reduce the type II agency problem. Finally, the authors found a negative association between dividend smoothing and corporate governance quality. Over all the findings of the current study provides insight to the investors and regulators by offering dividend smoothing as an alternative monitoring mechanism to corporate governance.

The main aim of this study was to empirically analyze whether Institutional Quality moderates the relationship between corporate governance and stock liquidity through the light of agency and information asymmetry theory. To the best of our knowledge, this is the first finance study. The sample consists of 230 non-financial firms listed on the Pakistan stock exchange during the period of 2009–2019. We used an instrumental variable approach and our new Institutional Quality index composed of world governance indicators and a corporate governance index, developed via principal component analysis, to demonstrate a relationship between corporate governance and stock liquidity and check the moderating role of Institutional Quality by following the resources complementary phenomenon. Our results show a significant, positive relationship between the corporate governance index and stock liquidity, suggesting that well-governed firms have high liquidity. The results show that the Institutional Quality index has a positive moderating impact on the relationship between corporate governance and stock liquidity, suggesting that corporate governance in Pakistan is weak. Our results are robust to a series of endogeneity checks using alternative proxies of stock liquidity.

Nancy Abdel Salam Gomaa,1 Youssef AH Helmy,2 Sara Maher,2 Dina Hassanein,2 Asmaa Shuaib,2 Ahmed I Hegazy,2 Aliaa A Ali1 1Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Aliaa A AliDepartment of Pediatrics, Faculty of Medicine, Cairo University, Cairo University Specialized Pediatric Hospital, 1 Ali Basha Ibrahim Street, Giza, Cairo, 11562, EgyptTel +201001115611Email draliaaadel@yahoo.comPurpose: We aimed to identify the risk factors that may predispose preterm neonates to develop aggressive posterior retinopathy of prematurity (APROP).Methods: This retrospective case control study included 16 infants with APROP in zone 1 or posterior zone 2. Thirty-four gestational age and birth weight-matched controls with stage 2 or less ROP were included. We reviewed medical records on infant birth and postnatal characteristics.Results: Patients who developed APROP had a significantly longer duration of caffeine therapy, were significantly more likely to be small for gestational age (SGA), and were more likely to have a positive blood culture than patients who developed less severe ROP. Patients with APROP who required retreatment had received inotropes for a longer duration of time, had received more plasma transfusions, were more likely to have IVH, and had a greater decrease in the serum hemoglobin during hospitalization.Conclusion: Being SGA, receiving caffeine for a longer duration, and having culture-proven sepsis were associated with APROP. IVH, a low serum hemoglobin, the need for more plasma transfusions, and a longer duration of inotropes were associated with APROP which required retreatment.Keywords: aggressive posterior retinopathy of prematurity, caffeine, dopamine, preterm neonate, small for gestational age

The present research proposes an electronic performance monitoring framework based on ambidextrous leadership and social exchange theories in a dynamic environment. It reviews and integrates essential literature on electronic performance management (EPM), trust, and ambidextrous behavior. For this, authors have reviewed relevant literature on various themes and underpinned them for managing EPM. The study emphasizes individuals’ psychological foundations that demonstrate trust behavior and relationship with their leaders. Eventually, through an ambidextrous approach, managers gain steady performance and relationships with their subordinates through EPM. The study shows that ambidexterity benefits organizations; it enhances employees’ resources, resulting in enhanced performance that leads to the performance of an organization. The authors discuss the theoretical as well as practical implications of this study.

Abdullah Shuaib1,†, Husain Arian,1 Ali Shuaib2 1Department of General Surgery, Jahra Hospital, Jahra, Kuwait; 2Biomedical Engineering Unit, Department of Physiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait†Dr Abdullah Shuaib passed away on July 21, 2020Correspondence: Ali ShuaibBiomedical Engineering Unit, Department of Physiology, Faculty of Medicine, Kuwait University, Kuwait City, KuwaitTel +965 24636786Email ali.shuaib@ku.edu.kwAbstract: Artificial intelligence (AI) pertains to the ability of computers or computer-controlled machines to perform activities that demand the cognitive function and performance level of the human brain. The use of AI in medicine and health care is growing rapidly, significantly impacting areas such as medical diagnostics, drug development, treatment personalization, supportive health services, genomics, and public health management. AI offers several advantages; however, its rampant rise in health care also raises concerns regarding legal liability, ethics, and data privacy. Technological singularity (TS) is a hypothetical future point in time when AI will surpass human intelligence. If it occurs, TS in health care would imply the replacement of human medical practitioners with AI-guided robots and peripheral systems. Considering the pace at which technological advances are taking place in the arena of AI, and the pace at which AI is being integrated with health care systems, it is not be unreasonable to believe that TS in health care might occur in the near future and that AI-enabled services will profoundly augment the capabilities of doctors, if not completely replace them. There is a need to understand the associated challenges so that we may better prepare the health care system and society to embrace such a change – if it happens.Keywords: artificial intelligence, technological singularity, health care system

Purpose: The study aims to review the existing literature linked to the field of Organization Behavior Management (OBM) and provide a historical account of OBM development based on the existing literature. Design/methodology/approach: The study performs keywords search of published OBM articles from 1950 onwards in widely used research databases. All materials were reviewed, i.e., the title, abstract, background, and methodology, to determine whether they are in line with the objective of the current study. Findings: The historical review shows that OBM practices applied widely over the years were visible in various sectors in the late 1960s and early 1970s. By the end of the 1980s, the OBM discipline was well established. It has produced considerable evidence through behavior analytic interventions that modify human behavior at work. Research findings show that OBM practices help an individual to understand how to carry out one’s tasks/activities within the organization to improve business results. Research limitations: Research scholars have limited knowledge that provides an error-free study of the OBM field past events. The historical development of OBM involvements and their recent contributions can be found in research publications of the Journal of Organization Behavior Management (JOBM). Practical implications: The current study provides insights about the developmental phase of the OBM field and discusses how it changed the behavior analytic for enhanced delivery at workplaces. Historical events such as Skinner’s behavior modification account for the development of OBM that influences traditional management and is used today in a variety of situations by OBM practitioners. Originality/value: This paper provides a historical evaluation of the OBM practices. It expands our knowledge of the OBM field and its interventions over time. Reflections of the study highlight the need for OBM practices for the successful functioning of various types of organizations.

Abdullah Shuaib, Ahmed Khairy, Mohammed Aljasmi, Mohamed Alaa Sallam, Fareed Abdulsalam Department of Surgery, Jahra Hospital, Jahra, KuwaitCorrespondence: Abdullah Shuaib Email Shuaib.abdullah.77@gmail.comAbstract: Ileosigmoid knotting, also known as compound volvulus or double volvulus, is a rare surgical emergency causing intestinal obstruction. Principally, it is a closed-loop intestinal obstruction that involves the sigmoid and ileum. It is considered a rare cause of intestinal obstruction. Differentiation of ileosigmoid knot from simple sigmoid volvulus is important because endoscopic decompression in ileosigmoid knot might be hazardous and even fatal. Endoscopic decompression of ileosigmoid knot may lead to perforation or injury. The mortality rate of ileosigmoid knot in general may reach 48%. We present a case of a 30-year-old male patient who presented with ileosigmoid knot at our emergency room. The aim of reporting this case is to increase understanding of the condition to promote earlier diagnosis.Keywords: ileosigmoid knotting, compound volvulus, double volvulus

This study examines why and how job insecurity affects employees’ deviant behaviour at work. To develop our hypotheses, we build on the conservation of resources theory. Our hypotheses suggested that job insecurity would be positively related to work stress and workplace deviance. Moreover, an ethical work climate was hypothesised to moderate the relationship between work stress and workplace deviance. Using data from 174 employees working in Multi-National Corporations (MNCs) located in Pakistan, the findings indicated that job insecurity has consequences for work stress and two facets of workplace deviance. Further, we found that an ethical work climate prevents employees from both interpersonal and organisational deviant behaviour.

Objectives: To assess the feasibility and training effect of simulation training for ultrasound-guided percutaneous arteriovenous fistula (pAVF) creation in a lifelike flow model. Methods: Twenty vascular trainees and specialists were shown an instructional video on creating a pAVF in a dedicated flow model and then randomized to a study or control group. The procedure was divided into five clearly defined steps. Two observers rated the performance on each step, and the time to perform the exercise was recorded. The study group participants underwent supervised hands-on training on the model before performing a second rated pAVF creation. All participants subsequently completed a feedback questionnaire. Results: After supervised simulation training, the study groups participants increased their mean performance rating from 2.2 ± 0.9 to 3.2 ± 0.7. A mean of 3.8 ± 0.8 procedure steps was accomplished independently (control group 2.1 ± 1.4; p < 0.05). The time taken to perform the procedure was 15.6 ± 3.8 min in the study group (control group 27.2 ± 7.3, p < 0.05). The participants with previous experience in ultrasound-guided vascular procedures (n = 5) achieved higher overall mean scores 3.0 ± 0.8 and accomplished more steps without assistance (2.0 ± 1.0) during the simulation training compared to their inexperienced peers (1.5 ± 0.3 and 0.8 ± 0.4, respectively). The feedback questionnaire revealed that the study group participants strongly agreed (n = 7) or agreed (n = 3) that training on the simulation model improved their skills regarding catheter handling. Conclusions: The study group participants increased their overall performance after training on the simulator. More experienced attendees performed better from the beginning, indicating the model to be lifelike and a potential skill assessment tool. Simulation training for pAVF creation using a lifelike model may be an intermediate step between acquiring ultrasound and theoretical pAVF skills and procedure guidance in theatre. However, this type of training is limited by its reliance on the simulator quality, demonstration devices and costs.

This article examines the relationship of effort-reward imbalance (ERI) on employee stress by considering job burnout (BO), organizational (in)justice (OJ), and sensitivity to terrorism (STT). This study uses the effort-reward imbalance (ERI) framework as a job stress model. After describing terrorism and a brief discussion on organizational justice and some of its challenges, we introduced “sensitivity to terrorism” as a moderator in the ERI framework. Using a 432 sample size of questionnaire data collected from two big cities where terrorist attacks are rampant and received during a period when terrorist attacks were at a peak. After analyzing data in EFA, results from the hierarchical regression analysis provided support for our developed model. Overall, the statistical model is significant (p < 0.05). We found significant relationships between ERI and facets of BO. Organizational (in)justice mediated the influence of ERI on facets of BO. We also found that STT significantly moderated ERI and facets of burnout. The article concludes with some implications and guidelines for future research.

Spinal Cord Injury (SCI) causes interruption along the severed axonal tract(s) resulting in complete or partial loss of sensation and motor function. SCI can cause tetraplegia or paraplegia. Both these conditions can have lifelong excessive medical costs, as well as can reduce life expectancy. Preclinical research showed that Photobiomodulation therapy (PBMT), also known as Low-level laser (light) therapy (LLLT), possesses reparative and regenerative capabilities that have the potential to be used as a complimentary or supplementary SCI therapy. Despite the promising effects of PBMT, there are still no standardized irradiation parameters (i.e. different wavelengths, power, fluence, irradiance, beam type, beam diameters, and irradiation time) and there is also a lack of standardized experimental protocol(s), which makes it difficult to compare different studies. It is, nonetheless, essential to standardize such irradiation parameters in order to provide better PBMTs. The aim of this study, therefore, is to evaluate the delivery of light in a 3D voxelated SCI rat model for PBMT using different irradiation parameters (wavelengths: 660, 810, and 980 nm; beam types: Gaussian and Flat beam; and beam diameters: 0.04-1.2 cm) using Monte Carlo simulation. This study also aids in providing standardization for preclinical research for PBMT, which will eventually translate into clinical standardization upon clinical research studies and results.

We conducted an event-related potential (ERP) study using a 256-channel dense sensor array electroencephalography (EEG) system to examine how, and if the P200 neurophysiological signal is sexually dimorphic. We had two groups of participants: females (n= 15, mean age = 40.6 years old) and males (n = 15, mean age = 39.0 years old). ERPs from all participants were recorded while the participants performed an oddball task. Results showed that males on average had a significantly larger P200 peak amplitude and a significantly shorter P200 latency period. These results indicate that the P200 ERP is affected by sex. Therefore, suggesting that sex differences exist on an electrophysiological level, which may aid in better understanding of sex-biased biological influences, behaviors, neuropsychiatric disorders, and general brain function.

Age-related effects were studied in 14 younger (M = 34 years) and 14 (M = 47 years) older healthy participants. Event-related potential (ERP) recording was done using a 256-channel EEG system. Results indicated that ERP is affected by advanced age. There was a significant difference in P200 mean latency between the younger participants and older participants for the target (low-probability) stimuli, but no such significance was evident for the P200 mean latency during the presentation of the standard (high-probability) stimuli. As for the P200 mean peak amplitude, the results for the target (low-probability) stimuli did show a significant difference between the two age groups, while the results for the standard (high-probability) stimuli did not show any significant difference between the two age groups. The results of this study are explained in light of aging effects on attentional recruitment and frontal lobe intactness.

Background: The role of women and foreign medical graduates (FMGs) in cardiology research published in the United States has received limited study. Methods: We examined the characteristics of the first and last authors of all original contributions and review articles published in the Journal of the American College of Cardiology from October 1, 2015, to October 1, 2016. Results: A total of 345 articles were identified, with 687 first and last authors originating from ≥50 different countries. Overall, 17% of authors were women (20% of the first and 14% of the last authors). Overall, 86% of authors held a medical degree (MD) or equivalent, and 25% of those also held another advanced degree (PhD, MPH, and/or MBA). The proportion of authors with an advanced degree in addition to an MD/equivalent was higher among foreign graduates and international contributors as compared with American graduates (31% vs. 30% vs. 17%, respectively, p

Fatemah Buhamed,1 Maged Edward,2 Abdullah Shuaib21Department of General Surgery, Mubarak Al-kabeer Hospital, Kuwait, Kuwait; 2Department of General Surgery, Mubarak Al-kabeer Hospital, Kuwait, KuwaitAbstract: Acute appendicitis and acute cholecystitis are some of the most common surgical emergencies in the emergency department. Both conditions are common causes of abdominal pain. We had a discussion about co-existing acute appendicitis and cholecystitis and if it is a myth. The concurrent presentation of acute appendicitis and cholecystitis is thought to be rare. A PubMed search of MEDLINE was performed using a combination of the keywords “acute appendicitis” and “acute cholecystitis” to obtain case reports. The search returned 11 case reports of co-existent acute appendicitis and acute cholecystitis. The aim of this review is to broaden the prospective of emergency physicians to consider more than one pathology as the cause of abdominal pain. The concurrent presentation of acute appendicitis and cholecystitis is rare but should be considered to avoid complications such as perforation and septicemia.Keywords: synchronous, acute appendicitis, acute cholecystitis

Cellulose nanofibrils (CNF) were produced by high-pressure homogenization from kraft pulp in the presence of carboxymethyl cellulose (CMC) of varying molecular weights. CNF pretreated with 250 kD CMC exhibited the maximum specific surface area (SSA) of 641 m2/g, which is comparable to that of CNF pretreated by 2,2,6,6-tetramethyl-piperidinyl-1-oxyl (TEMPO)-meditated oxidation with a high degree of fibrillation. Rheological and microscopic analyses also indicated a high level of fibrillation for the CMC-pretreated CNF. In contrast, the reference CNF without the CMC pretreatment showed a lower level of fibrillation, which was reflected in decreased viscosity and the reduction of SSA by a factor of 19. With the high-degree fibrillation and low toxicity, the CMC pretreatment is a promising method for the production of high-quality CNF in an environmentally friendly way.

This study analyzed how people with disabilities are portrayed in picture books with the Coretta Scott King Award (CSKA) to address the intersectionality of African/African American racial identity and disabilities. Disability critical race theory was foundational for this study. The pool of 134 picture books that received the CSKA from 1971 to 2020 was used as the data for the systematic content analysis. For analysis, the researchers utilized a qualitative approach that guided axial coding and selective coding in looking for emerging themes. They found that 13 picture books portrayed African/African American characters with disabilities. The majority of these books did not necessarily emphasize the disabilities of these characters. When focusing on other dimensions of identity such as gender, age, disability type, and so on, the researchers found underrepresentation, invisibility, and marginalization issues, which led them to discussions of power relations. This study calls for future studies that can discover more portrayals of African/African American people with disabilities and that can deepen scholarly discussions about their representation in children's literature.

BackgroundThe double-blind OMEGA-REMODEL placebo-controlled randomized trial of high-dose omega-3 fatty acids (O-3FA) post-acute myocardial infarction (AMI) reported improved cardiac remodeling and attenuation of non-infarct myocardial fibrosis. Fatty acid desaturase 2 (FADS2) gene cluster encodes key enzymes in the conversion of essential omega-3 and omega-6 fatty acids into active arachidonic (ArA) and eicosapentaenoic acids (EPA), which influence cardiovascular outcomes.Methods and resultsWe tested the hypothesis that the genotypic status of FADS2 (rs1535) modifies therapeutic response of O-3FA in post-AMI cardiac remodeling in 312 patients. Consistent with known genetic polymorphism of FADS2, patients in our cohort with the guanine-guanine (GG) genotype had the lowest FADS2 activity assessed by arachidonic acid/linoleic acid (ArA/LA) ratio, compared with patients with the adenine-adenine (AA) and adenine-guanine (AG) genotypes (GG:1.62±0.35 vs. AA: 2.01±0.36, pConclusionGenetic profiling using FADS2 genotype can predict the therapeutic benefits of O-3FA treatment against adverse cardiac remodeling during the convalescent phase of AMI.Clinical trial registration informationclinicaltrials.gov Identifier: NCT00729430.

Background and Purpose: Size-specific dose estimates (SSDE) have been introduced into computed tomography (CT) dosimetry to tailor patients' unique sizes to facilitate accurate CT radiation dose quantification and optimization. The purpose of this study was to develop and validate an automated algorithm for the determination of patient size (effective diameter) and SSDE. Materials and Methods: A MATLAB platform was used to develop software of algorithms based on image segmentation techniques to automate the calculation of patient size and SSDE. The algorithm was used to automatically estimate the individual size and SSDE of four CT dose index phantoms and 80 CT images of pediatric patients comprising head, thorax, and abdomen scans. For validation, the American Association of Physicists in Medicine (AAPM) manual methods were used to determine the patient's size and SSDE for the same subjects. The accuracy of the proposed algorithm in size and SSDE calculation was evaluated for agreement with the AAPM's estimations (manual) using Bland-Altman's agreement and Pearson's correlation coefficient. The normalized error, system bias, and limits of agreement (LOA) between methods were derived. Results: The results demonstrated good agreement and accuracy between the automated and AAPM's patient size estimations with an error rate of 1.9% and 0.27% on the patient and phantoms study, respectively. A 1% percentage difference was found between the automated and manual (AAPM) SSDE estimates. A strong degree of correlation was seen with a narrow LOA between methods for clinical study (r > 0.9771) and phantom study (r > 0.9999). Conclusion: The proposed automated algorithm provides an accurate estimation of patient size and SSDE with negligible error after validation. Keywords: Algorithm, automation, body size, computed tomography scan, image segmentation, pediatric, radiation dosage, size-specific dose estimate, Author(s): Muhammad Kabir Abdulkadir (corresponding author) [1,2]; Noor Diyana Osman [1]; Anusha Achuthan [3]; Radin A. Nasirudin [1]; Muhammad Zabidi Ahmad [1]; Noor Hasyima Mat Zain [1]; Ibrahim Lutfi Shuaib [...]