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Abdulelah M Aldhahir,1 Heba M Bintalib,2,3 Rayan A Siraj,4 Jaber S Alqahtani,5 Omar A Alqarni,6 Abdullah A Alqarni,7 Hanin S Alghamdi,8 Mohammed M Alyami,9 Abdallah Y Naser,10 Alaa I Fatani,11 Hassan Alwafi11 1Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 2Department of Respiratory Care, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 3King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia; 4Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia; 5Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia; 6Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 7Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 8Department of Respiratory Therapy, King Fahad General Hospital, Jeddah, Saudi Arabia; 9Respiratory Therapy Department, Batterjee Medical College, Khamis Mushait, Saudi Arabia; 10Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan; 11Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi ArabiaCorrespondence: Abdulelah M Aldhahir, Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Saudi Arabia, Tel +966557775561, Email Aldhahir.abdulelah@hotmail.comBackground: Nomophobia has been highly prevalent among health discipline students. However, there is no available data on the prevalence of nomophobia among respiratory therapy (RT) students in Saudi Arabia.Methods: A cross-sectional survey using the nomophobia questionnaire (NMP-Q) was conducted and distributed using a convenience sample of RT students through an online platform (Survey Monkey) between September and November 2022.Results: Overall, 1428 RT students, with males accounting for 773 (54%), responded to the online survey. The prevalence of nomophobia among RT students was 97.3% (1390). The mean (±SD) of the total NMP-Q items scores was 62 (± 22), indicating a moderate level of nomophobia among the RT students. Female RT students had significantly higher nomophobia scores than male RT students (63 (47– 80) vs 59 (43– 75); p < 0.001)). Single RT students had significantly higher nomophobia scores than married RT students (62 (46– 78) vs 46 (37– 64); p < 0.001)). RT students who were living outside the family home had significantly higher nomophobia scores than RT students who were living with their family (66 (54– 78) vs 60 (44– 77); p = 0.001)). RT students with a GPA of 4.50 to 5.00 had the highest nomophobia score (63 (46– 79); p = 0.005)). RT students who were in their third year had the highest nomophobia score (66 (48– 80); p < 0.001)). RT students who reported no academic warnings had the highest nomophobia score (63 (48– 80); p < 0.001)). RT students who spent ≥ five hours studying per week had the highest nomophobia score (64 (51– 80); p < 0.001)).Conclusion: Nomophobia is common among RT students, with the majority experiencing a moderate level. Being female, single, living outside the family home, and having a higher academic performance were risk factors associated with higher nomophobia levels.Keywords: nomophobia, respiratory therapy, NMP-Q

Jaber S Alqahtani,1 Abdulelah M Aldhahir,2 Zaid Alanazi,3 Emad Zahi Alsulami,4 Mujahid A Alsulaimani,5 Abdullah A Alqarni,6 Abdullah S Alqahtani,1 Ayadh Yahya AlAyadi,1 Musallam Alnasser,1 Ibrahim A AlDraiwiesh,1 Saeed M Alghamdi,7 Hussam M Almarkhan,1 Abdullah S Alsulayyim,2,8 Saad M AlRabeeah,1 Mohammed D AlAhmari1 1Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia; 2Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia; 3Family Medicine Department, Northern Area Armed Forces Hospital (NAAFH), Hafar Al Batin, Saudi Arabia; 4Family Medicine Department, Armed Forces Hospital in King Abdulaziz Airbase, Dhahran, Saudi Arabia; 5Basic Medical Unit, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia; 6Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 7Respiratory Care Program, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, 24382, Saudi Arabia; 8National Heart and Lung Institute, Imperial College London, London, SW7 2BX, UKCorrespondence: Jaber S Alqahtani, Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia, Email Alqahtani-Jaber@hotmail.comBackground: Smoking behavior has been associated with poor academic performance among adult students worldwide. However, the detrimental effect of nicotine dependence on several students’ academic achievement indicators is still unclear. This study aims to assess the impact of smoking status and nicotine dependence on grade point average (GPA), absenteeism rate and academic warnings among undergraduate health sciences students in Saudi Arabia.Methods: A validated cross-sectional survey was conducted, in which, participants responded to questions evaluated cigarette consumption, urge to consume and dependency, learning performance, days of absentees, and academic warnings.Results: A total of 501 students from different health specialties have completed the survey. Of whom, 66% were male, 95% ranging between the age of 18– 30 years old, and 81% reported no health issues or chronic diseases. Current smokers estimated to be 30% of the respondents, of which 36% revealed smoking history of 2– 3 years. The prevalence of nicotine dependency (high to extremely high) was 50%. Overall, smokers had significantly lower GPA, higher absenteeism rate, and higher number of academic warnings when compared to nonsmokers (p< 0.001). Heavy smokers demonstrated significantly less GPA (p=0.036), higher days of absences (p=0.017), and more academic warnings (p=0.021) compared to light smokers. The linear regression model indicated a significant association between smoking history (increased pack-per-year) and poor GPA (p=0.01) and increased number of academic warning last semester (p=0.01), while increased cigarette consumption was substantially linked with higher academic warnings (p=0.002), lower GPA (p=0.01), and higher absenteeism rate for last semester (p=0.01).Conclusion: Smoking status and nicotine dependence were predictive of worsening academic performance, including lower GPA, higher absenteeism rate and academic warnings. In addition, there is a substantial and unfavorable dose–response association between smoking history and cigarette consumption with impaired academic performance indicators.Keywords: smoking, nicotine dependence, academic performance, health sciences, student

Jaber S Alqahtani,1 Mohammed D AlAhmari,1,2 Hajed M Al-Otaibi,3 Saad M AlRabeeah,1 Noor A Al Khathlan,4 Abdulelah M Aldhahir,5 Abdullah S Alqahtani,1 Khalid S Alwadeai,6 Saleh S Algarni,7,8 Rayan A Siraj,9 Abdullah A Alqarni,3 Mohammed A Almeshari,6 Saeed M Alghamdi,10 Mohammed AlTaweel,11 Musallam Alnasser,1 Jithin K Sreedharan,1 Abdullah A Almojaibel,4 Mushabbab Alahmari,12 Yousef S Aldabayan,9 Bodor H Bin Sheeha,13 Fahad H Alahmadi,14 Abdullah S Alsulayyim,5,15 Eidan M Alzahrani16 1Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi Arabia; 2Dammam Medical Complex, Dammam Health Network – Eastern Health Cluster, Dammam, 32245, Saudi Arabia; 3Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 4Respiratory Care Department, Imam Abdulrahman bin Faisal University, Dammam, 34212, Saudi Arabia; 5Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, 45142, Saudi Arabia; 6Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11451, Saudi Arabia; 7Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 14611, Saudi Arabia; 8King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 9Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, 31982, Saudi Arabia; 10Respiratory Care Program, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, 24382, Saudi Arabia; 11Respiratory Care Department, AlMaarefa University, Riyadh, 13713, Saudi Arabia; 12Department of Respiratory Therapy, Faculty of Applied Medical Sciences, University of Bisha, Bisha, 67714, Saudi Arabia; 13Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11564, Saudi Arabia; 14Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, 42353, Saudi Arabia; 15National Heart and Lung Institute, Imperial College London, London, SW7 2BX, UK; 16Department of Physiotherapy, Prince Sultan Military College of Health Sciences, Dammam, 34313, Saudi ArabiaCorrespondence: Jaber S Alqahtani, Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia, Email Alqahtani-Jaber@hotmail.comBackground: Despite recent advancements in the respiratory care (RC) profession, no single institution in the Kingdom of Saudi Arabia (KSA) offers a master’s degree program in RC.Methods: A nationwide and validated survey was used to explore the current needs and interests in establishing RC master’s degree programs in the KSA. The process included representatives from the healthcare industry, universities, and professional societies.Results: A total of 1250 stakeholders across the KSA completed the survey. The sample includes 722 (58%) males, 504 (40%) respiratory therapists, 547 (44%) students, 138 (11%) leaders, and 61 (5%) were academic respondents. Most respondents were from Central 491 (39%) and Eastern 307 (25%) regions, with 1003 (80%) of the total sample worked or studied in governmental sectors. A total of 574 (82%) of the leaders and RTs had Bachelor degree and 430 (61%) of them had 1– 5 years working experience. According to 80% of the employers and employees, only 0– 5% of the RTs in their organization had a master’s degree. The calculated mean % of the agreement (agree/strongly agree) on the needs was 83% in all needs’ assessment items, which shows a great support for establishing a master’s in RC to meet the personal, professional and society needs. The mean % of the agreement for the level of interests among all participants was 86%, indicating a great level of interests in establishing a master degree in RC. The agreement % on the needs assessment and level of interests in establishing a master degree in RC in KSA were ≥ 80% in each stakeholder group.Conclusion: There are obvious needs and interests in establishing master’s degree programs in RC in the KSA. A master’s degree in RC should be established to address the growing needs for advanced RC services throughout the nation and enhance RC research.Keywords: respiratory care, master degree, education, Saudi Arabia, NCAAA, accreditation

Rayan A Siraj,1 Ahmed M Alrajeh,1 Ahmad E Alhaykan,1 Abdullah A Alqarni,2 Fahad H Alahmadi,3 Abdulelah M Aldhahir,4 Jaber S Alqahtani,5 Samah Bakhadlq,5 Saeed M Alghamdi,6 Saleh S Algarni,7,8 Abdulrhman S Alghamdi,9 Khalid S Alwadeai,9 Abdulelah S Alsulami,10 Tawah H Alsindi,11 Mushabbab A Alahmari12 1Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, Saudi Arabia; 2Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 3Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia; 4Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 5Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia; 6Clinical Technology Department, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, 21961, Saudi Arabia; 7Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 8King Abdullah International Medical Research Center, Riyadh, 12271, Saudi Arabia; 9Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 10Department of Respiratory Care Services, King Abdulaziz Medical City, Ministry of National Guard, Jeddah, Saudi Arabia; 11Department of Respiratory Therapy Program, Inaya Medical College, Riyadh, Saudi Arabia; 12Department of Respiratory Therapy, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi ArabiaCorrespondence: Rayan A Siraj, Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, 31982, Saudi Arabia, Email rsiraj@kfu.edu.saObjective: Depression is a common comorbidity in patients with asthma with a significant impact on clinical management. However, little information is available about physicians’ perceptions and current practices in identifying and managing depression in individuals with asthma in Saudi Arabia. Thus, this study aims to assess physicians’ views and current practices of identifying and managing depression in patients with asthma in Saudi Arabia.Methods: A cross-sectional study was employed. Between September 2022 and February 2023, an online survey was distributed to physicians (general practitioners and family, internal and pulmonary medicine specialists) in Saudi Arabia. Descriptive statistics were performed to analyze the collected responses.Results: Out of 1800 invited participants, a total of 1162 physicians completed the online survey. Nearly 40% of the respondents received adequate training for managing depression. More than 60% of physicians reported that depression interferes with self-management and worsens asthma symptoms, while 50% viewed the importance of regular screening for depression. Less than 40% (n=443) aim to identify depression during patients’ visits. Of those, only 20% always screen for depression in asthma patients. Physicians show a low level of confidence when asking patients about their feelings (30%), being able to recognize depression (23%), and knowing if patients have depression (23%). The most common barriers linked to recognizing depression are high workload (50%), lack of time to screen for depression (46%), limited knowledge about depression (42%), and poor training (41%).Conclusion: The rate of recognizing and confidently managing depression in asthmatic patients is significantly low. This is attributed to high workload, poor training, and limited knowledge about depression. There is a need to support psychiatric training and implement a systematic approach to depression detection in clinical settings.Keywords: asthma, depression, management

This systematic review aimed to investigate the drugs used and their potential effect on noninvasive ventilation (NIV).NIV is used increasingly in acute respiratory failure (ARF). Sedation and analgesia are potentially beneficial in NIV, but they can have a deleterious impact. Proper guidelines to specifically address this issue and the recommendations for or against it are scarce in the literature. In the most recent guidelines published in 2017 by the European Respiratory Society/American Thoracic Society (ERS/ATS) relating to NIV use in patients having ARF, the well-defined recommendation on the selective use of sedation and analgesia is missing. Nevertheless, some national guidelines suggested using sedation for agitation.Electronic databases (PubMed/Medline, Google Scholar, and Cochrane library) from January 1999 to December 2019 were searched systematically for research articles related to sedation and analgosedation in NIV. A brief review of the existing literature related to sedation and analgesia was also done.Sixteen articles (five randomized trials) were analyzed. Other trials, guidelines, and reviews published over the last two decades were also discussed. The present review analysis suggests dexmedetomidine as the emerging sedative agent of choice based on the most recent trials because of better efficacy with an improved and predictable cardiorespiratory profile.Current evidence suggests that sedation has a potentially beneficial role in patients at risk of NIV failure due to interface intolerance, anxiety, and pain. However, more randomized controlled trials are needed to comment on this issue and formulate strong evidence-based recommendations.Karim HMR, Šarc I, Calandra C, Spadaro S, Mina B, Ciobanu LD, et al. Role of Sedation and Analgesia during Noninvasive Ventilation: Systematic Review of Recent Evidence and Recommendations. Indian J Crit Care Med 2022;26(8):938-948.

Mohammed A Almeshari,1,2 Ziyad Alshehri,3 Jaber S Alqahtani,4 Ali M Alasmari,3 Ahmed A Alzahrani,3 Fahad H Alahmadi,3 Abdullah S Alsulayyim,5 Faraj K Alenezi,6 Khalid S Alwadeai1 1Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 2Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK; 3Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia; 4Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia; 5Department of Respiratory Care, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 6College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCorrespondence: Mohammed A Almeshari, Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia, Tel +966 11 469 3593, Email malmeshari@ksu.edu.saBackground: Respiratory Care Practitioner (RCP) is a vital healthcare professional in Saudi Arabia (SA). Many factors regarding the education of RCPs in SA are unknown, including the number of active institutions, levels of education and barriers to promoting the profession.Methods: A cross sectional-based survey was conducted between June 1st, 2020 and September 20th, 2020 in SA to explore the status of RCPs education. Institutions that offered RCP programs were identified through the Ministry of Education and Ministry of Defense academic programs websites. The RCP program directors were invited to participate in an electronic survey.Results: Among the 74 institutions searched, 23 indicated that they offered RC programs. Only 13 (56.52%) responded to the survey. Among all programs, four (17.39%) were inactive, 17 (73.91%) were governmental institutions, and only one (4.35%) obtained a national accreditation. From the 13 respondents, there were 1297 students enrolled and 123 full-time faculty members. None of the institutions reported offering postgraduate RC degrees. The respondents reported many barriers; however, shortage of staff (76.92%), lack of postgraduate programs (69.23%), lack of research activity (69.23%), and ineffective communications between institutions (61.54%) were the most reported barriers.Conclusion: The RC education in SA is developing but not well distributed throughout the country. The shortage of staff and the limited number of postgraduate degree holders potentially contributed to the delay in establishing postgraduate RC degrees, obtaining accreditation, and implementing subspecialties to advance the profession in terms of research and quality of care.Keywords: respiratory care, education, respiratory therapy, Saudi Arabia

Introduction: Obesity is a common comorbidity in patients with asthma and has a significant impact on health and prognoses. However, the extent to which overweight and obesity impact asthma, particularly lung function, remains unclear. This study aimed to report on the prevalence of overweight and obesity and assess their impacts on spirometry parameters in asthmatic patients. Methods: In this multicentre, retrospective study, we reviewed the demographic data and spirometry results of all adult patients with confirmed diagnoses of asthma who visited the studied hospitals’ pulmonary clinics between January 2016 and October 2022. Results: In total, 684 patients with confirmed diagnoses of asthma were included in the final analysis, of whom 74% were female, with a mean ± SD age of 47 ± 16 years. The prevalence of overweight and obesity among patients with asthma was 31.1% and 46.0%, respectively. There was a significant decline in spirometry results in obese patients with asthma compared with patients with healthy weights. Furthermore, body mass index (BMI) was negatively correlated with forced vital capacity (FVC) (L), forced expiratory volume in one second (FEV1), forced expiratory flow at 25–75% (FEF 25–75%) L/s and peak expiratory flow (PEF) L/s (r = −0.22, p < 0.001; r = −0.17, p < 0.001; r = −0.15, p < 0.001; r = −0.12, p < 0.01, respectively). Following adjustments for confounders, a higher BMI was independently associated with lower FVC (B −0.02 [95% CI −0.028, −0.01, p < 0.001] and lower FEV1 (B −0.01 [95% CI −0.01, −0.001, p < 0.05]. Conclusions: Overweight and obesity are highly prevalent in asthma patients, and more importantly, they can reduce lung function, characterised mainly by reduced FEV1 and FVC. These observations highlight the importance of implementing a nonpharmacological approach (i.e., weight loss) as part of the treatment plan for patients with asthma to improve lung function.

BackgroundChronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics.MethodFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle–Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias.ResultsThe databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias.ConclusionCOPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability.

Objective To investigate the trends in hospital admissions and medication prescriptions related to asthma and chronic obstructive pulmonary disease (COPD) in England and Wales. Methods An ecological study was conducted between April 1999 and April 2020 using data extracted from the hospital episode statistics database in England and the patient episode database for Wales. The Office of National Statistics mid-year population estimates for 1999 through 2020 were collected, and medication prescription data for 2004–2020 were extracted from the prescription cost analysis database. Results The total annual number of COPD and asthma hospital admissions for various causes increased by 82.2%, from 210,525 in 1999 to 383,652 in 2020, representing a 59.1% increase in hospital admission rate (from 403.77 in 1999 to 642.42 per 100,000 persons in 2020, p Conclusions Throughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups. Hospitalization rates were higher for women. Further observational and epidemiological research is required to identify the factors contributing to increased hospitalization rates.

The human papillomavirus (HPV) is a crucial but not the predominant cause of cervical cancer. This study aimed to identify HPV-16 L1 gene expression in human papillomavirus using a pap smear. A total of 120 serum samples, 60 samples were taken from infected females with papillomavirus and another 60 as healthy control. These samples were collected after pap smears were done. These women attended Al-Emam Hospital for delivery from March 1st, 2021, to February 28th, 2022. The levels of Pap-IgM and Pap-IgG were increasing among patients attacked by papilloma. The levels of viruses were higher than in levels than control groups, which was indicated by increases in the scores of mean and standard deviation (2.01±1.17, 0.11±0.02), (14.24±7.10, 0.4±0.17), respectively. Statistically, these differences between the levels of the studied groups were highly significant. The levels of the three markers Ca19.9, Ca125, and Ca15.3 were normal in levels among papilloma patients and the control group compared to the normal value of the three markers, which equaled N.V. (>37ng/ml). Statistically, these differences between the scores of the three markers, which were measured depending on mean and standard deviation, were highly significant. There is a low positive correlation between the levels of Pap-IgM (>1) with levels of Ca19.9 (>37) with (r=0.409**, P=0.000), while there is a moderate association between the levels of Pap-IgM (>1) with Ca125 (>35ng/ml) and Ca15.3 (>37ng/ml) levels with (r=0.574**, 0.565**, P=0.000, 0.000) respectively. Also, this table documents that there is a moderate positive correlation between the levels of Pap-IgG (>1) and the levels of the three tumor markers Ca19.9 (>37), Ca125 (>35), and Ca15.3 (>37) (r=0.521**, 0.592**, 0.647**). The HPV-16 L1 gene expression was investigated in patients infected with Papillomaviruses compared to healthy controls using real-time PCR. The results showed a high Ct value for patients and controls with a high Ct value of templates, preoperational to the gene concentration.

Rainfall prediction remains a hot research topic in smart city environments. Precise rainfall prediction in smart cities becomes essential for planning security measures before construction and transportation activities, flight operations, water reservoir systems, and agricultural tasks. Precise rainfall forecasting now becomes more complex than before because of extreme climatic changes. Machine learning (ML) approaches can forecast rainfall by deriving hidden patterns from historic meteorological datasets. Selecting a suitable classification method for forecasting has become a tough job. This article introduces the Fuzzy Cognitive Maps with a Metaheuristics-based Rainfall Prediction System (FCMM-RPS) technique. The intention of the FCMM-RPS technique is to predict rainfall automatically and efficiently. To accomplish this, the presented FCMM-RPS technique primarily pre-processes the rainfall data to make it compatible. In addition, the presented FCMM-RPS technique predicts rainfall using the FCM model. To enhance the rainfall prediction outcomes of the FCM model, the parameter optimization process is performed using a modified butterfly optimization algorithm (MBOA). The performance assessment of the FCMM-RPS technique is tested on a rainfall dataset. A widespread comparison study highlights the improvements of the FCMM-RPS technique in the rainfall forecasting process compared to existing techniques with a maximum accuracy of 94.22%.

Recently, artificial intelligence (AI)-enabled technologies have been widely employed for complex industrial applications. AI technologies can be utilized to improve efficiency and reduce human labor in industrial applications. At the same time, fault diagnosis (FD) and detection in rotating machinery (RM) becomes a hot research field to assure safety and product quality. Numerous studies based on statistical, machine learning (ML), and mathematical models have been available in the literature for automated fault diagnosis. From this perspective, this study presents a novel sandpiper optimization with an artificial-intelligence-enabled fault diagnosis (SPOAI-FD) technique for intelligent industrial applications. The aim is to detect the existence of faults in machineries. The proposed model involves the design of a continuous wavelet transform (CWT)-based pre-processing approach, which transforms the raw vibration signal into a useful format. In addition, a bidirectional long short-term memory (BLSTM) model is applied as a classifier, and the Faster SqueezeNet model is applied as a feature extractor. In order to modify the hyperparameter values of the BLSTM model, the sandpiper optimization algorithm (SPOA) can be utilized, showing the novelty of the work. A wide range of simulation analyses were conducted on benchmark datasets, and the results highlighted the supremacy of the SPOAI-FD algorithm over recent approaches.

Jaber S Alqahtani,1,2 Yousef S Aldabayan,3 Abdulelah M Aldhahir,4 Ahmad M Al Rajeh,3 Swapna Mandal,1,5,&ast; John R Hurst1,5,&ast; 1UCL Respiratory, University College London, London, UK; 2Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia; 3Respiratory Care Department, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia; 4Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 5Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK&ast;These authors contributed equally to this workCorrespondence: Jaber S AlqahtaniUCL Respiratory, University College London, Rowland Hill Street, London, NW3 2PF, UKEmail Alqahtani-Jaber@hotmail.comBackground: Readmission following COPD exacerbation is a common and challenging clinical problem. New approaches to predicting readmissions are required to help mitigate risk and develop novel interventions.Methods: We conducted a prospective cohort study in 82 COPD patients admitted due to an exacerbation of COPD. Lung function measures [spirometry, forced oscillation technique (FOT) indices and peak inspiratory flow rate (PIFR)], inflammatory biomarkers and patient-reported outcomes including previous exacerbation history, breathlessness, quality of life and frailty were measured at admission and discharge. We prospectively followed patients for 30 and 90 days to identify predictors for readmission.Results: The readmission rate within 30 days was 38%, and 56% within 90 days. Previous exacerbations, higher COPD Assessment Test score at discharge, frailty, reduced PIFR and increased length of stay were significantly associated with 30-day readmission. PIFR at discharge and frailty had the highest predictive ability for 30-day readmission using area under receiver operating characteristic curves (AUC 0.86, 95% CI 0.78– 0.95, p < 0.001 and AUC 0.81, 95% CI 0.71– 0.90, p < 0.001, respectively). Ninety-day readmissions were significantly associated with previous exacerbations and hospitalisations, higher CAT score at discharge, frailty, depression, lower PIFR and greater expiratory flow limitation (EFL) in the supine position. The best predictive variable in multivariable analysis for both 30- and 90-day readmission was PIFR at discharge.Conclusion: PIFR, CAT score, frailty, and EFL were found to be associated with 30- and 90-day readmission following COPD exacerbation. These findings help identify those at highest risk and to optimise care prior to discharge.Keywords: COPD, exacerbation, admission, readmission, predictor, risk factor, PIFR, frailty, EFL

Background Acute exacerbations (AEs) and disease progression in interstitial lung disease (ILD) pose important challenges to clinicians and patients. AEs of ILD are variable in presentation but may result in rapid progression of ILD, respiratory failure and death. However, in many cases AEs of ILD may go unrecognised so that their true impact and response to therapy is unknown. The potential for home monitoring to facilitate early, and accurate, identification of AE and/or ILD progression has gained interest. With increasing evidence available, there is a need for a systematic review on home monitoring of patients with ILD to summarise the existing data. The aim of this review was to systematically evaluate the evidence for use of home monitoring for early detection of exacerbations and/or progression of ILD. Method We searched Ovid-EMBASE, MEDLINE and CINAHL using Medical Subject Headings (MeSH) terms in accordance with the PRISMA guidelines (PROSPERO registration number CRD42020215166). Results 13 studies involving 968 patients have demonstrated that home monitoring is feasible and of potential benefit in patients with ILD. Nine studies reported that mean adherence to home monitoring was >75%, and where spirometry was performed there was a significant correlation (r=0.72–0.98, p, First systematic review that provides supportive evidence for the feasibility and utility of home monitoring in ILD; further studies are necessary to evaluate approaches to detect exacerbation and/or progression https://bit.ly/2Y8OCJL

Objectives: To investigate the trends in hospital admissions for mental, behavioural and neurodevelopmental disorders (MBNDs) in England and Wales. Methods: This is an ecological study using the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data was collected for the period between April 1999 and March 2019. Results: The most common type of hospital admission was for mental and behavioural disorders due to psychoactive substance use, which accounted for 26.6%. The admission rate among males increased by 8.1% [from 479.59 (95% CI 476.90–482.27) in 1999 to 518.30 (95% CI 515.71–520.90) in 2019 per 1000 persons; p < 0.001]. The admission rate among females increased by 0.3% [from 451.45 (95% CI 448.91–453.99) in 1999 to 452.77 (95% CI 450.37–455.17) in 2019 per 1000 persons; p = 0.547]. The 15–59 years’ age group accounted for 65.1% of the entire number of such hospital admissions, followed by the 75 years and above age group, with 19.0%. Conclusion: We observed an obvious variation in MBNDs influenced by age and gender. Observational studies are needed to identify other factors associated with increased hospital admission rates related to MBNDs, specifically among the young population (aged 15–59 years) and males.

Recently, artificial intelligence (AI) including machine learning (ML) and deep learning (DL) models has been commonly employed for the automated disease diagnosis process. AI in biological and biomedical imaging is an emerging area and will be a future trend in the field. At the same time, biomedical images can be used for the classification of Rheumatoid arthritis (RA) diseases. RA is an autoimmune illness that affects the musculoskeletal system causing systemic, inflammatory and chronic effects. The disease frequently becomes progressive and decreases physical function, causing articular damage, suffering, and fatigue. After a time, RA causes harm to the cartilage of the joints and bones, weakens the tendons and joints, and finally causes joint destruction. Sensors (thermal infrared camera sensor, accelerometers and wearable sensors) are more commonly employed to collect data for RA. This study develops an Automated Rheumatoid Arthritis Classification using an Arithmetic Optimization Algorithm with Deep Learning (ARAC-AOADL) model. The goal of the presented ARAC-AOADL technique lies in the classification of health disorders depending upon RA and orthopaedics. Primarily, the presented ARAC-AOADL technique pre-processes the input images by median filtering (MF) technique. Then, the ARAC-AOADL technique uses AOA with an enhanced capsule network (ECN) model to produce feature vectors. For RA classification, the ARAC-AOADL technique uses a multi-kernel extreme learning machine (MKELM) model. The experimental result analysis of the ARAC-AOADL technique on a benchmark dataset reported a maximum accuracy of 98.57%. Therefore, the ARAC-AOADL technique can be employed for accurate and timely RA classification.

Background: The epidemic of burnout has been widely documented among health discipline students. However, there is limited information available on the prevalence of burnout and its association with resilience among clinical-level respiratory therapy (RT) students. Methods: Between March 2022 and May 2022, a descriptive, cross-sectional study using a convenience sample of RT students and interns was conducted. A total of 559 RT students and interns from 15 RT programs responded to socio-demographic questions and the Maslach Burnout Inventory (MBI) and the Brief Resilience Scale (BRS) questionnaires. The data were analyzed using descriptive, inferential, and correlation tests. Results: Of the 559 respondents, 78% reported a high level of burnout. Within the three subscales of burnout, 52% reported emotional exhaustion (EE), 59% reported depersonalization (DP), and 55% reported low personal achievement (PA). The prevalence of burnout increased as students proceeded to senior years (p = 0.006). In addition, participants with higher grade point averages (GPA) reported a higher level of burnout. Only 2% of the respondents reported a high level of resiliency. Further, there were negative correlations between resilience and EE (r = −41, p < 0.001) and DP (r = −32, p = 0.03), and a positive correlation with low PA (r = 0.56, p = 0.002). Conclusion: The findings showed a high prevalence of burnout among RT students and interns during clinical training in Saudi Arabia. Resilience was associated with all domains of burnout and is likely to play a protective role. Therefore, there is a need for collaborative interventions to promote resiliency during clinical training to alleviate and overcome burnout symptoms.

BackgroundThe COVID-19 pandemic and associated preventative measures introduced a shock to the teaching paradigm in Saudi Arabia and the world. While many studies have documented the challenges and perceptions of students during the COVID-19 pandemic, less attention has been given to higher education staff. The aim of the present investigation is to evaluate the staff’s perception and experiences of online teaching during the COVID-19 pandemic.Materials and methodsA validated survey was conducted between December 2021 and June 2022 in Saudi Arabian Universities to assess the status of online teaching during the COVID-19 pandemic among faculty members. The collected responses were exploratively and statistically analyzed.ResultsA total of 1117 response was received. About 66% of the respondents were male and 90% of them hold postgraduate degree. Although rarely or occasionally teach online pre-COVID-19, only 33% of the respondents think the transition was difficult and 55% of them support the move. Most respondents received adequate training (68%) and tools (80%) and 88% of the respondents mentioned that they did not accrue additional workload in online study design. While the perception of online teaching was mostly positive (62%) with high satisfaction (71%). However, 25% of the respondents reported that a poor internet bandwidth was an obstacle and 20% was unable to track students’ engagement. Respondents with more years of experience, previous training, support, or perceived online transition as easy were also more likely to be satisfied with the process. Also, older respondents, those who support the transition and those with previous training were less likely to report barriers (allp< 0.001).ConclusionThe perception and experience of transition to online teaching during the COVID-19 pandemic in Saudi Arabia were positive. Low internet bandwidth and inability to track students’ limited effective online teaching. Work experience, previous training, and positive perception are the main factors that influence staff online teaching satisfaction.