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Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a novel class of oral hypoglycemic agents commonly prescribed in type 2 diabetes (T2D). They have been shown to slow the progression of diabetic nephropathy and improve cardiovascular outcomes in high-risk individuals, although major cardiovascular and renal outcome clinical trials have excluded renal transplant patients. The aim of this review was to determine the outcomes and safety with use of SGLT2 inhibitors in renal transplant patients with diabetes. We conducted a review of randomized controlled trials, cohort studies, case series and case reports that assessed use of SGLT2 inhibitors in patients post-renal transplant with either pre-existing T2D or new-onset diabetes after transplant. The outcomes assessed included blood pressure, renal allograft function (estimated glomerular filtration rate), proteinuria (urinary albumin-to-creatinine ratio), glycemic control, body weight and adverse effects. A total of 9 studies, which included 144 patients, were reviewed. SGLT2 inhibitor use in renal transplant patients demonstrates either a small or nonsignificant reduction in blood pressure and results in overall stable renal allograft function. It also results in modest improvement in glycemic control as well as weight reduction. The incidence of adverse effects is low and reversible, as reported in previous nontransplant clinical trials. Overall, our findings suggest beneficial outcomes with no significant adverse effects or complications with the use of SGLT2 inhibitors in renal transplant patients with diabetes; however, these findings are based on small trials, and thus well-designed trials in this population are warranted.

Background: The upgrowth and rapid prevalence of pandrug-resistant Acinetobacter baumannii strains that have a pathogenic activity to cause several infections are of considerable influence on the health of communities worldwide. No infections by these bacterial strains were recorded before 1998, and currently, the numbers are on the rise. Methods: The A. baumannii strains were isolated from male and female patients in Medical Microbiology Department, King Fahd Medical City (KFMC) in Riyadh, Saudi Arabia between 1/1/2020 to 29/12/2020. The statistical analysis was performed base on sex, age, source of samples, and response to commercially available antibiotics. The A. baumannii strains that resisted all the antibiotics including colistin and imipenem were selected for the synergic test. Results: The data showed that 62.28%, 77.07% of 342 A. baumannii strains were isolated from males and patients over 35 years of age. A. baumannii strains (pandrug-A. baumannii) that can resist all tested antibiotics were 8.19%. The major source of the A. baumannii isolates was the respiratory system (>50%). Among all isolates (N = 342), azidothymidine-resistant A. baumannii strains were more than 85%. There is a statistically significant difference (P < 0.05) in the number of colistin-resistant A. baumannii strains isolated from males comparing with the female. The combinations of colistin and silver nanoparticles or imipenem and silver nanoparticles resulted in synergistic action led to reduction of MICs of colistin, imipenem, and silver nanoparticles (more than four-fold reduction). Also, the combinations of colistin and imipenem had high synergistic action. Conclusion: The pandrug-resistant A. baumannii strains may represent a current and future threat that must be fought, and the synergy action of antibiotics and nanoparticles may be one of the available, rapid, and easy strategies to confront this global problem.

A 53-year-old man with a subcutaneous implantable cardioverter-defibrillator (S-ICD) presented with inappropriate shocks. He underwent device extraction, and the lead was freed using a rotating mechanical dilator sheath. As patients with S-ICDs get older, extractions will become more complicated and more common. We have described a novel method of S-ICD lead extraction. (Level of Difficulty: Advanced.), Central Illustration

Carcinoma of the breast is the most prevalent cancer among Egyptian women and constitutes 29% of National Cancer Institute cases. Median age at diagnosis is one decade younger than in countries of Europe and North America and most patients are premenopausal. Tumours are relatively advanced at presentation. The majority of tumours are invasive duct subtype and the profile of hormone receptors is positive for estrogen receptors and /or progesterone receptors in less than half of cases. This overview examines genetic changes, potential and established predictive and prognostic markers and end results of surgery, radiotherapy and systemic therapy for early, locally advanced and metastatic disease stages. Disease presentations common to the region and early detection strategies are presented

Background: Status epilepticus (SE) is a serious neurological emergency that is associated with increased morbidity and mortality. There is emerging interest in understanding the clinical characteristics and identification of the prognosis of children with SE. Objective: To identify the clinical profile and prognosis of children presenting by status epilepticus. Methodology: This is a descriptive analytical study carried out on 31 children who presented by convulsive SE and were admitted to the pediatric intensive care unit. Clinical data, Complete blood count, C-reactive protein, erythrocyte sedimentation rate, serum glucose & electrolytes and cerebrospinal fluid analysis were estimated. Magnetic resonance imaging was done to all included children. Results: Most of the children who presented with SE were younger than 5 years of age (45.2% were

The review, based on modern literature data and the results of many years of research conducted by the authors, highlights the problem of comorbidity (multimorbidity) in children with bronchial asthma (BA). There is a grouping of concomitant diseases in children with asthma depending on the type of comorbidity (causal, complicated, unspecified, reverse). Based on epidemiological data, observational and cohort studies, systematic reviews and meta-analyses, information on the frequency of BA in children with various comorbid diseases and comorbid diseases in children with BA was summarized. Scientific, theoretical and practical significance of comorbidity in BA, diagnostic and treatment programs in pediatric patients suffering from BA and comorbid diseases are substantiated.

In recent decades, Iraq has witnessed several military operations. This has led to huge damages to the infrastructure of some main cities. The traditional construction methods seem not to be able to fulfill the rapid reconstruction works needed, while prefabricated building systems seem to be promising. This paper aims at evaluating the possibilities of using prefabrication systems for schools building as a pilot study for wider adoption. An extensive literature review was carried out to identify the features of construction prefabrication and its requirements. Then a thorough investigation of the possibilities of adopting this approach in Iraq and the major expected obstacles was carried out. A questionnaire survey has been conducted with (96) stakeholders who have experience in prefabricated building projects. The results showed that the highest rating of benefits went to time and productivity, while the highest rating of obstacles went to lack of government support. Therefore the top proposed action included the adoption of a clear governmental strategy for change. Finally, the respondents agreed that school building is the most suitable type of projects to start with.

The Egyptian institutions, especially the industrial ones adopted for the development of environmental policies and of Standard ISO 14001 concerned with environmental management systems in order to improve and develop the environmental protection systems and OHSAS 18001 ohsas own occupational health and safety management in order to risk to personnel reduction, it will achieve many of the goals of industrial enterprises of including: gain a competitive advantage, entering into new markets, raise the efficiency of workers, improve the quality provided and speed product delivery of the markets, and the study aimed to identify the impact of the adoption of environmental policies in the risks to the environment and working to reduce the development, the study used a systematic induction and deduction through a questionnaire has been applied to 100 single workers factory Super phosphate complex chemical Inc.'s victory for intermediate Chemicals Abu Rawash mono, and the study found: - the presence of a substantial relationship between the application of environmental policies and the risks in the industrial enterprises, the more used environmental policy system the lower the risk, the study suggested: issuing regulations depending specialized industrial activities include regulations and standards associated with each industrial activity to ensure specific specialized standards.

The beneficial live microbes of humans and animals are termed probiotics, and the chemical compounds that improve the growth of probiotics are known as prebiotics. Paraprobiotics and postbiotics refer to dead or inactivated living cells of probiotics and healthful metabolic products that are produced by the living cells of probiotics, respectively. Although the healthful, functional, nutritional, and immune benefits of probiotics and prebiotics are scientifically well established beyond a reasonable doubt, their potential biological roles against COVID-19 infection still warrant further clinical and laboratory investigation.

Objective Toll-like receptors (TLR) are one of the key molecules that alert the immune system to the presence of microbial infections. This study attempts to elucidate the role of TLR2 and TLR4 polymorphisms in neonatal sepsis. Methods A case–control study including 30 neonates with confirmed sepsis compared with 20 neonates in a control group. TLR2 and TLR24 gene polymorphisms were confirmed by polymerase chain reaction. Results The majority of infections were attributed to gram-negative organisms (72.5%) namely Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Results also revealed that incidence of TLR polymorphism was significantly different between the sepsis and control groups (p = 0.016). The most common polymorphism was TLR2; Arg 753 Gln (16.7%). Presence of TLR polymorphism was also associated with a longer duration of therapy (a median of 10 days for cases with positive polymorphism compared with 6.5 days for negative cases; p = 0.001). Conclusion This pilot study suggests that any polymorphisms in TLR2 and TLR4 might have a role that interferes with the innate immune response of newborn.

In this study, a wide-band compact patch antenna array is developed for 60 GHz band applications. The antenna array consists of eight identical elements. Each element is a simple microstrip-fed rectangular radiating patch printed on the top side of a Rogers 5880 substrate. A rectangular ground plane is printed on the bottom side. To adjust the impedance matching for broadband operation, a complete circular-shaped slot and a part of circular-shaped slot are etched off the ground plane and the patch, respectively. A technique to feed the array elements unequally is employed for design a more compact antenna structure with improved gain and impedance bandwidth. An electromagnetic band-gap (EBG) reflector below the array structure is employed to decrease backward radiation and improve front-to-back (F/B) radiation ratio. The antenna array with the EBG reflector has a compact size with overall dimensions of 17.5 × 22 × 1.262 mm3. It achieves operation bandwidth from 56.5 to 65.2 GHz (|S11| ≤ − 10 dB), which covers the 60 GHz unlicensed band (57–64 GHz). The gain variation is from 12 to 16 dBi over the entire operating band. These features make the proposed antenna array system a suitable candidate for industrial, scientific and medical (ISM) broadband applications at 60 GHz band.

The objective of the present work was to observe and profile various antibiotic resistant strains of Staphylococcus aureus and highlight the need for continuous surveillance. Data regarding antibiotic-resistant S. aureus strains isolated and identified at the Medical Microbiology Department, King Khalid Hospital, Riyadh was obtained. Bacterial isolates were collected from several sites of infections in patients and an evaluation of susceptibility were carried out using a fully automated Vitek2 system. Relative frequency (%), odds ratios and Ward's minimum variance were calculated. The results showed that wounds were a source of more than 40% of the S. aureus (MRSA) strains that have ability to resist methicillin, and more than 45% of the methicillin-susceptible S. aureus (non-MRSA) strains. 40% of the isolates were MRSA (N = 251), and all MRSA strains were sensitive to vancomycin, daptomycin, teicoplanin, tigecycline, nitrofurantoin, and itraconazole while all non-MRSA (N = 338) strains were sensitive to vancomycin, cefoxitin, daptomycin, gentamicin, oxacillin, teicoplanin, tigecycline, and mupirocin. Strength of association between antibiotic-resistant S. aureus strains and source of samples (site of infection) was established. The study concluded that S. aureus strains had developed resistance towards 20 (for non-MRSA) and 22 (for MRSA) of the antibiotics tested. All MRSA strains were non-sensitive to amoxicillin/clavulanate, ampicillin cefoxitin, cefazolin, imipenem, oxacillin, and penicillin.

There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. The main purpose of the study is to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the Patient Health Questionnaire-Anxiety Depression Scale (PHQ-ADS). Of 1138 participants, 71.0% were female, 69.0% Arabs, 70.0% Non-Qataris, and 77.0% were

Diffuse Large B-cell lymphoma (DLBCL) is an aggressive disease with heterogeneous outcome and marked variable response to chemotherapy. We assessed promoter hypermethylation (PM) for a panel of tumor suppressor genes in 75 DLBCLs compared to 20 lymphoid hyperplasia (LH) and 30 normal control, using methylation specific PCR. Results were correlated to patients’ clinic-pathological characteristics, immunophenotyping, and patients’ outcome. DAPK1, RUNX3, MT1G, MGMT, CDH1 and p16 PM were detected in 38.7% (29/75), 49.3% (37/75), 46.7% (35/75), 44% (33/75), 49.3% (37/75) and 42.7% (32/75);respectively, of DLBCL patients compared to LH group (P

IntroductionQatar is a small but high-income Middle Eastern country with a large influx of migrants each year. However, the impact of changing population structure and urbanization on prevalence of generalized anxiety symptoms remains unexplored to date. Materials & MethodsA total of 2,640 participants interviewed by phone using the Generalized Anxiety Disorder (GAD-7) and the Patient Health Questionnaire (PHQ-2). Bivariate and multinomial logistic regression analyses were conducted to explore the associations of ethnicity (Arab versus Non-Arab) with severity and symptom profile of GAD and overlap with depressive symptoms. ResultsThe point prevalence of mild, moderate, and severe symptoms were 13.4% (95% CI: 11.9 – 15.0), 2.7% (95% CI: 2.0 – 3.5), and 0.9% (95% CI: 0.6– 1.4), respectively. Arab ethnicity was associated with mild GAD (OR=1.78, p=0.009) and moderate-to-severe GAD (OR=2.36, p=0.044). Relative to non-migrants, migrant types were not significantly associated with mild or with moderate-to- severe GAD. Interactions between depressive symptoms and ethnicity were evident and statistically significant for the association with mild GAD versus no GAD (OR=0.34, p=0.003). ConclusionsEthnicity moderated the association of depression symptoms and GAD severity, with potential implications for early screening and community intervention.

Background: There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, COVID-19 infection and mortality rates.Aim: To identify factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic.Method: We conducted a cross-sectional online survey in Qatar between July and December 2020 after the first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the PHQ-ADS scale. Results: Of 1138 participants, 71.05% were female, 69.0% Arabs, and 70.0% Non-Qataris. 77% were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with PHQ-ADS; Arab ethnicity (OR=1.67, p=0.026), never married (OR=2.04, p < 0.001 (versus married), prior history of psychiatric disorder (versus no history) (OR=1.76, p=0.039), increased worries due to social media use for COVID-related news/updates (OR=1.72, p=0.003), those with a history of COVID-19 (OR=1.76, p=0.039), loneliness (OR=1.91, p < 0.001), and lower levels of religiosity (OR=0.96, p=0.039). These associations also pertained in the reduced model, with exception of religiosity which was only marginally statistically significant (OR=0.97, p=0.055).Conclusions: The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, and similar crises, and assist with early intervention to treat sufferers.

This manuscript outlines the progress of education in the field of medical oncology in Egypt over the past 50 years. The manuscript illustrates the origin of the Egyptian medical oncology program since the creation of the only specialized cancer center in the country, the National Cancer Institute of Cairo University (NCI-Cairo) in 1969, from Cairo University Medical School. The manuscript also outlines the NCI-Cairo’s educational program for developing a cadre of academic medical oncologists for NCI-Cairo, other Egyptian medical institutions, and countries in the Middle East and Africa. We also emphasize the capacity building that resulted over the past 50 years from academic and professional standpoints, the changing curriculum in medical oncology, and the differences between the medical oncology and clinical oncology education programs in the country. Medical oncology research resulted from international collaborations and highlighted needs for cancer prevention and control. Finally, we propose possible future directions for medical oncology education and research in the country and a roadmap for low- and middle-income countries (LMICs) that are developing their medical oncology programs.

Background: Effective public health measures in tackling the global COVID-19 pandemic necessitate understanding risk of hesitance or resistance to vaccine uptake in different populations. The Middle East and North Africa currently lacks vital representative vaccine hesitancy data. Methods: We conducted the first representative national phone survey using probability sampling among the adult population of Qatar, between December 2020 and January 2021, to identify the prevalence and potential determinants of vaccine willingness. This was categorized into: vaccine acceptance (strongly agree), vaccine resistance (strongly disagree) and vaccine hesitance (somewhat agree, neutral, somewhat disagree). Bivariate and multinomial logistic regression models estimated associations between vaccine willingness and fifteen sociodemographic, work-, and health-related variables. Findings: In the total sample, 42.7% (95%CI: 39.5-46.1) were classified as accepting, 45.2% (95%CI: 41.9-48.4) hesitant, and 12.1% (95%CI: 10.1-14.4) resistant. Those in the vaccine resistance group reported no source of endorsement will increase their confidence in accepting the vaccine (58.9% vs. 5.6% vs. 0.2%, respectively). Hesitancy and resistance were explained by female gender, Arab ethnicity, migrant status/type, and concerns about vaccine side-effects. COVID-19 related bereavement, personal infection, and quarantine status were not significantly associated with any group. Absence of or lack of concern about contracting the virus was solely associated with resistance. Interpretation: COVID-19 vaccine resistance, hesitance, and concern about side-effects is high in Qatar’s population compared with those globally. Urgent public health engagement should focus on women, Qataris (non-migrants) and those of Arab ethnicity. Funding: This study was funded by the Emergency Response Grant at Qatar University (QUERG-CAS-2020-1). Declaration of Interests: P.M.H. reports personal fees from Janssen, Lundbeck, Otsuka, New Bridge Pharmaceuticals and Sunovion, outside the submitted work. All other authors report no conflicts of interest. Ethics Approval Statement: The study was reviewed and approved by the Institutional Review Boards at Qatar University (QU-IRB 1338-EA/20) and Hamad Medical Corporation (MRC-05-089).

Stack Overflow is one of the largest and most popular question-answering (Q&A) websites. It accumulates millions of programming related questions and answers to support the developers in software development. Unfortunately, a large number of questions are not answered at all, which might hurt the quality or purpose of this community-oriented knowledge base. Up to 29% of Stack Overflow questions do not have any answers. There have been existing attempts in detecting the unanswered questions. Unfortunately, they primarily rely on the question attributes (e.g., score, view count) that are not available during the submission of a question. Detection of the potentially unanswered questions in advance during question submission could help one improve the question and thus receive the answers in time. In this paper, we compare unanswered and answered questions quantitatively and qualitatively by analyzing a total of 4.8 million questions from Stack Overflow. We find that topics discussed in the question, the experience of the question submitter, and readability of question texts could often determine whether a question would be answered or not. Our qualitative study also reveals several other non-trivial factors that not only explain (partially) why the questions remain unanswered but also guide the novice users to improve their questions. We develop four machine learning models to predict the unanswered questions during their submission. According to the experiments, our models predict the unanswered questions with a maximum of about 79% accuracy and significantly outperform the state-of-the-art prediction models.

Introduction In elderly patients, goal-directed haemodynamic therapy (GDHT), depth of anaesthesia monitoring and lung-protective ventilation have been shown to improve postoperative outcomes. The aim of this study was to evaluate current practices concerning strategies of anaesthesia optimisation in patients aged ≥ 75 years. Patients and methods A multicentre observational study was performed from February to May 2015 in 23 French academic centres. On 30 consecutive days in each centre, patients ≥ 75 years with at least one major comorbidity undergoing elective or emergency procedures (femoral-neck fractures surgery, intraperitoneal abdominal surgery or vascular surgery) were included. Patient characteristics and data related to GHDT, management of hypotension, monitoring of temperature and depth of anaesthesia, lung ventilation, point of care haemoglobin testing were collected. Results In total, 807 patients were included. Only 2% of patients [95% CI: 1–3] received GHDT in full accordance with guidelines. Depth of anaesthesia monitoring was largely performed (53% [95% CI: 50–56]). The multifaceted strategy of lung-protective ventilation combining low tidal volumes (6–8 mL/kg), PEEP of 5–8 cm cmH2O, and repeated recruitment manoeuvres, was performed in only 4% [95% CI: 3–5] of patients. A centre effect was a major determinant of variation concerning implementation of these strategies. Discussion In patients’ ≥ 75 years, strategies of anaesthesia optimisation are not in accordance with eligible guidelines. Implementation of these techniques varies independently of factors related to the patient or the type of surgery and may be dependent on the generated constraints.

Submillimeter-wave and THz sensing of cornea leverage the layered tissue structure for assessments of corneal water content and thickness. The cornea is bounded by air on the anterior and an optically thick body of water on the posterior and thus presents as a lossy thin film lying atop a lossy termination. Resolution of the cornea’s lossy longitudinal modes via frequency domain reflectometry in a band sufficiently low (e.g. 220 GHz – 330 GHz) for significant penetration allows simultaneous estimates of corneal tissue water content (CTWC) and central corneal thickness (CCT). However, since the cornea is spherical, efficient coupling to longitudinal modes requires normal incidence across the interrogated area and thus a converging spherical phase front whose curvature matches the corneal surface curvature [1, 2].

Publisher Copyright: © 2021 IEEE An efficient Fourier optics method for synthesizing a required incident beam to compute the internal and scattered electromagnetic fields from known spherical surface electric field distribution is presented.

There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. This study intended to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the PHQ-ADS scale. Of 1138 participants, 71.05% were female, 69.0% Arabs, and 70.0% Non-Qataris. 77 % were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with PHQ-ADS; Arab ethnicity (OR=1.67, p=0.026), never married (OR=1.69, p < 0.015), prior psychiatric history (OR=1.80, p=0.009), Social Media induced worries (OR=1.72, p=0.003), history of COVID-19 (OR=1.76, p=0.039), loneliness (OR=1.91, p < 0.001), and lower levels of religiosity (OR=0.96, p=0.039). The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, similar national events and assist with early intervention to treat sufferers.

Global COVID-19 pandemic containment necessitates understanding the risk of hesitance or resistance to vaccine uptake in different populations. The Middle East and North Africa currently lack vital representative vaccine hesitancy data. We conducted the first representative national phone survey among the adult population of Qatar, between December 2020 and January 2021, to estimate the prevalence and identify potential determinants of vaccine willingness: acceptance (strongly agree), resistance (strongly disagree), and hesitance (somewhat agree, neutral, somewhat disagree). Bivariate and multinomial logistic regression models estimated associations between willingness groups and fifteen variables. In the total sample, 42.7% (95% CI: 39.5–46.1) were accepting, 45.2% (95% CI: 41.9–48.4) hesitant, and 12.1% (95% CI: 10.1–14.4) resistant. Vaccine resistant compared with hesistant and accepting groups reported no endorsement source will increase vaccine confidence (58.9% vs. 5.6% vs. 0.2%, respectively). Female gender, Arab ethnicity, migrant status/type, and vaccine side-effects concerns were associated with hesitancy and resistance. COVID-19 related bereavement, infection, and quarantine status were not significantly associated with any willingness group. Absence of or lack of concern about contracting the virus was solely associated with resistance. COVID-19 vaccine resistance, hesitance, and side-effects concerns are high in Qatar’s population compared with those globally. Urgent public health engagement should focus on women, Qataris (non-migrants), and Arab ethnicity.

Background: Knowledge of correlates of sleep duration is limited to developed countries with dearth of studies conducted in countries of the Eastern Mediterranean Region (EMR). Qatar is a rapidly developing country in the EMR with three distinct population groups Qatari nationals (QNs) or natives; higher income white-collar expatriates (WCEs), and blue-collar workers (BCEs) who are mostly male laborers from South Asia. The. The aim of this study was to explore the association between sleep duration and chronic health conditions in a representative sample of Qatar’s general population. Methods: A total of 2,523 surveys were completed over the phone by trained interviewers; a final sample of 2,499 was retained. Descriptive and multinomial logistic regression analyses accounting for complex survey design were conducted in STATA 14. All regression models were adjusted for age, gender and social group using an alpha value of 0.05 for statistical significance. Results: The overall prevalence of sleeping < 7hrs was observed at 54%, while 42% of respondents reported sleeping 7-8hrs and 4% reported sleeping > 8hrs in the general population of Qatar. Participants who reported the poorest health status had increased odds of sleeping < 7hrs (OR 1.38, P=0.04) compared with those who reported good health after adjustment for covariates. Additionally, participants with two or more diagnosed illnesses had higher odds of sleeping < 7hrs (OR 1.58, P=0.02) compared to healthy participants. An increase in odds of sleeping < 7hrs was also observed in participants with obesity (OR 1.58, P=0.02). Conclusion: Qatar’s population exhibited high prevalence of short sleep duration, which was significantly associated with poor rated health, obesity, and chronic illness independent of age, gender, or social class.

Aims: Q-LAMP aims to identify risk factors and resilience factors for symptoms of psychiatric illness during the pandemic. Study strengths include the 1-year longitudinal design and the use of standardized instruments already available in English and Arabic. The results will increase understanding of the impact of the pandemic on mental health for better support of the population during the pandemic and in future epidemics. Until an effective vaccine is available or herd immunity is achieved, countries are likely to encounter repeated ‘waves’ of infection. The identification of at-risk groups for mental illness will inform the planning and delivery of individualized treatment including primary prevention. Methodology: Longitudinal online survey; SMS-based recruitment and social media platforms advertisements e.g. Facebook, Instagram; Online consent; Completion time for questionnaires: approx. 20 to 30 minute; Baseline questionnaire with follow up at 3, 6, 9 and 12 months; Study completion date: Sept. 2021. Inclusion criteria: Currently living in Qatar; Qatari residents: citizens and expatriates; Age 18 years; read Arabic or English (questionnaire and consent form available in both languages). Instruments: Sociodemographic questionnaire including personal and family experience of COVID-19 infection; Standard instruments to assess psychiatric morbidity including depression, anxiety and PTSD; research team-designed instruments to assess social impact of pandemic; standard questionnaires to assess resilience, personality, loneliness, religious beliefs and social networks. Results: The analysis was based on 181 observations. Approximately, 3.5% of the sample was from the sms-recruitment method. The sample of completed surveys consisted of 65.0% females and 35.0% males. Qatari respondents comprised 27.0% of the total sample, while 52% of the sample were married, 25% had Grade 12 or lower level of educational attainment, and 46.0% were unemployed. Covid-19 appears to have affected different aspects of people’s lives from personal health to living arrangements, employment, and health of family and friends. Approximately, 41% to 55% of those who responded to the survey perceived changes in their stress levels, mental health, and loneliness to be worse than before the pandemic. Additionally, the wide availability of information about the pandemic on the internet and social media was perceived as source of pandemic-related worries among members of the public. Conclusion: The continued provision of mental health service and educational campaigns about effective stress and mental health management is warranted.

Background: There is emerging evidence that supports a role for inflammatory processes and insomnia in the pathophysiology of depression. However, little is known about the role of inflammation in depression and insomnia in non-clinical populations. Aims: We aimed to estimate the association between inflammatory illness, depression and insomnia in the Qatari population. We hypothesized that inflammatory illness would be associated with sub-clinical depression and insomnia in the Qatari population. Methods: We used probability-based sampling on a representative sample (N= 1,611) of Qatar’s adult household population. Face-to-face interviews were conducted using computer-assisted technology as part of the SESRI’s annual omnibus survey in 2019. We used the Espie’s (2014) Sleep Condition Indicator, to assess insomnia symptoms, and PHQ-9 and GAD-2 for subthreshold depression (SUBD), major depressive disorder (MDD), and anxiety. Health information including personal and family history of inflammatory disease were also collected. Univariate, bivariate, and multivariate statistics were conducted. Results: Among those with no inflammatory disease, the 30-day prevalence of subthreshold and major depression in those with insomnia disorder compared to those without insomnia was (SUBD: 5.3% vs 2.9%; MDD: 7.2% vs 0.6%, P

Rectal cancer is a common malignancy with a relatively poor prognosis. We assessed the possible prognostic and predictive role(s) of circulating tumor cells (CTCs) and K-ras mutations in locally advanced rectal carcinoma (LARC) patients. CTCs number and K-ras mutation status were assessed in the Peripheral blood and tumor tissue samples of 60 patients with LARC compared to control group (normal rectal mucosa). Data were correlated to relevant clinico-pathological features, response to treatment, disease free (DFS) and overall survival (OS) rates. K-ras mutations were present in 24/60 (40%) patients. Baseline CTCs (

In the present study, the chemical composition of Morinda citrifolia essential oils was determined by gas chromatography-mass spectrometry and was found to contain several anti-cancer compounds including L-scopoletin, nordamnacanthal, β-morindone, α-copaene, 9-H-pyrido[3,4-b]indole, β-thujene and terpinolene. The physico-chemical characterization of chitosan, chitosan nanoparticles and Morinda citrifolia essential oils loaded chitosan nanoparticles combination was carried out by Fourier transform infrared spectroscopy, powder X-ray diffraction and dynamic light scattering coupled with zeta potential. The morphological observation obtained by scanning electron microscopy and transmission electron microscopy provided clear indication that the immobile chitosan polymer formed a coating onto the Morinda citrifolia essential oils surface. The cytotoxic effect of Morinda citrifolia essential oils loaded chitosan nanoparticles against A549 cells were investigated, resulting in 54% inhibition at 40 μg/ml

BackgroundTo estimate the lifetime prevalence and potential determinants of psychotic experience(s) (PEs) in the general population of Qatar – a small non-war afflicted, conservative, high-income, middle-eastern country with recent rapid urbanization including an influx of migrants.MethodsA probability-based sample (n = 1353) of non-migrants and migrants were interviewed face-to-face and administered a 7-item psychosis screener adapted from the Composite International Diagnostic Interview, the Kessler 6-item psychological distress scale, and the 5 items assessing odd (paranormal) beliefs and magical thinking (OBMT) from the Schizotypal Personality Questionnaire. Using bivariate and logistic regression analyses, lifetime prevalence rates of PEs were estimated then compared before and after adjustment for socio-demographics, Arab ethnicity, psychological distress, and OBMT.ResultsPrevalence of PEs was 27.9%. Visual hallucinations were most common (12.8%), followed by persecutory delusions (6.7%) and auditory hallucinations (6.9%). Ideas of reference (3.6%) were least prevalent. PEs were significantly higher in Arabs (34.7%) compared with non-Arabs (16.4%, p < 0.001) with the exception of ideas of reference and paranoid delusions. Female gender was associated with a higher prevalence of PEs in the Arab group only (p < 0.001). Prevalence of PEs was significantly higher among Arabs (48.8% v. 15.8%, p < 0.001) and non-Arabs (35.2% v. 7.3%, p < 0.001) with OBMT. Arab ethnicity (OR = 2.10, p = 0.015), psychological distress (OR = 2.29 p = 0.003), and OBMT (OR = 6.25, p < 0.001) were independently associated with PEs after adjustment for all variables.ConclusionsEthnicity, but not migration was independently associated with PEs. Evidence linking Arab ethnicity, female gender, and psychological distress to PEs through associations with OBMT was identified for future prospective investigations.

Developers often prefer dynamically typed programming languages, such as JavaScript, because such languages do not require explicit type declarations. However, such a feature hinders software engineering tasks, such as code completion, type related bug fixes and so on. Deep learning-based techniques are proposed in the literature to infer the types of code elements in JavaScript snippets. These techniques are computationally expensive. While several type inference techniques have been developed to detect types in code snippets written in statically typed languages, it is not clear how effective those techniques are for inferring types in dynamically typed languages, such as JavaScript. In this paper, we investigate the type inference techniques of JavaScript to understand the above two issues further. While doing that we propose a new technique that considers the locally specific code tokens as the context to infer the types of code elements. The evaluation result shows that the proposed technique is 20-47% more accurate than the statically typed language-based techniques and 5–14 times faster than the deep learning techniques without sacrificing accuracy. Our analysis of sensitivity, overlapping of predicted types and the number of training examples justify the importance of our technique.

Cancer of unknown primary (CUP) is a heterogeneous group of metastatic cancers characterised by early dissemination of metastases in the absence of any identifiable primary site. Most patients with CUP have poor prognosis with the traditional diagnostic and treatment modalities. Recognising the putative primary tumour is hypothesised to ameliorate the prognosis of patients with CUP by guiding treatment decisions. The active efforts in molecular oncology have shown that gene expression profiling is able to identify the primary tumour site and to determine targetable mutations. In this regard, liquid biopsy opens a new diagnostic, predictive and prognostic window in CUP that may lead to substantial improvement in the management of patients with CUP.

Polypropylene is frequently used in food contact applications, mainly for packaging or in food boxes to be used in microwave ovens. In this study, the biofilm elimination effect of selected essential oils (cinnamon, marjoram, and thyme) was evaluated against immature and mature biofilms of Escherichia coli and Listeria monocytogenes formed on polypropylene (PP) surfaces. The Response Surface Box-Behnken Design (BBD) with three variables and 17 assays was used to optimize concentration of essential oils (EOs) (1.1–15.8 mg/mL), disinfection time (10 min), and level of pH (4.5‐7.5) in the EO-based disinfection solutions. The optimized disinfectants were used against 24-, and 168-hour old biofilms formed on PP surfaces, and were successful in elimination of immature and mature biofilms, except cinnamon EO for E. coli where biofilms were destroyed only partially. The disinfectant effect of the EO-based natural solutions was in most cases equivalent or better compared to the per-acetic acid-based chemical sanitizer used in food industry or to sodium hypochlorite.

Objective: Pramlintide co-administration, used in conjunction with prandial insulin, has substantial clinical benefits to improve post-prandial glucose excursions, glycemic variability (GV) and time in range (TIR), but is associated with an increased injection burden that adversely affects adherence and persistence. A novel, fixed-ratio co-formulation of pramlintide and regular insulin (XP-3924) was evaluated in a phase 2 single injection study measuring XP-3924 pharmacokinetics (PK), glucose pharmacodynamics (PD), and its effects upon overall glycemic control. Methods: This was a Phase 2 randomized, open-label, active comparator-controlled, three-period cross-over study, which enrolled 18 adults with T1D to compare the PK and PD, glycemic affects and safety and tolerability of a single dose of XP-3924, to co-administration of regular insulin (Humulin® R) and pramlintide (Symlin®), and to an injection of regular insulin (RI) alone. Subjects were randomly allocated to a sequence of three treatments: XP-3924 (with 50% insulin reduction based their insulin to carbohydrate ratio), RI, or co-administration (RI with 50% insulin reduction plus a comparable pramlintide dose, co-administered as separate injections). The study drugs were administered subcutaneously 30 minutes before a 75-gram oral glucose challenge and glucose levels were monitored for 6 hours. Results: XP-3924 treatment resulted in a 62.3% reduction of hyperglycemia (blood glucose AUC0-3 hr >180 mg/dL) after the glucose challenge when compared to RI (p

Monica Zolezzi,1,2 Nawal Bensmail,2 Farah Zahrah,2 Salma Mawfek Khaled,3 Tayseer El-Gaili4 1Clinical Pharmacy and Practice, 2College of Pharmacy, 3Research Unit, Social and Economic Survey Research Institute, 4Student Counseling Center, Qatar University, Doha, Qatar Background: Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. Methods: A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students’ beliefs, attitudes, and help-seeking and treatment preferences). Results: A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as “medications to treat mental illness can cause addiction”, “mental illness is not like any other illness”, or that “mental illness is a punishment from God”, were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend’s support as treatment options. Significant differences in KAB about mental illness between genders, colleges, and college type were found only for a few items. Conclusion: The findings of this study suggest that a high percentage of students reported KAB about mental illness, that are considered stigmatizing. Students’ KAB about mental illness was consistent with that reported by the general population in Qatar. Nevertheless, the sample was small and as such, larger studies from a randomly selected population are needed to confirm these findings. Keywords: knowledge, attitude and behavior, university students, stigmatization, mental illness

Mosquitoes threaten the lives of humans, livestock, pets and wildlife around the globe, due to their ability to vector devastating diseases. Aglaia elaeagnoidea, commonly known as Priyangu, is widely employed in Asian traditional medicine and pest control. Medicinal activities include anti-inflammatory, analgesic, anticancer, and anesthetic actions. Flavaglines, six cyclopenta[b]benzofurans, a cyclopenta[bc]benzopyran, a benzo[b]oxepine, and an aromatic butyrolactone showed antifungal properties, and aglaroxin A and rocaglamide were effective to control moth pests. Here, we determined the larvicidal action of A. elaeagnoidea leaf aqueous extract. Furthermore, we focused on Priyangu-mediated synthesis of Ag nanoparticles toxic to Culex quinquefasciatus, Aedes aegypti and Anopheles stephensi. The plant extract and the nanolarvicide were tested on three mosquito vectors, following the WHO protocol, as well as on three non-target mosquito predators. Priyangu-synthesized Ag nanoparticles were characterized by spectroscopic (UV, FTIR, XRD, and EDX) and microscopic (AFM, SEM, and TEM) analyses. Priyangu extract toxicity was moderate on Cx. quinquefasciatus (LC50 246.43; LC90 462.09 μg/mL), Ae. aegypti (LC50 229.79; LC90 442.71 μg/mL), and An. stephensi (LC50 207.06; LC90 408.46 μg/mL), respectively, while Priyangu-synthesized Ag nanoparticles were highly toxic to Cx. quinquefasciatus (LC50 24.91; LC90 45.96 μg/mL), Ae. aegypti (LC50 22.80; LC90 43.23 μg/mL), and An. stephensi (LC50 20.66; LC90 39.94 μg/mL), respectively. Priyangu extract and Ag nanoparticles were found safer to non-target larvivorous fishes, backswimmers, and waterbugs, with LC50 ranging from 1247 to 37,254.45 μg/mL, if compared to target pests. Overall, the current research represents a modern approach integrating traditional botanical pesticides and nanotechnology to the control of larval populations of mosquito vectors, with negligible toxicity against non-target including larvivorous fishes, backswimmers, and waterbugs.

Aims: To estimate the prevalence of Insomnia Disorder in the household population of Qatar and explore potential associations with depressive and anxiety symptoms in addition to sociodemographic variables. Methods: Probability-based sampling was used to select a representative sample (N= 1,611) of Qatar’s household population. Face-to-face household interviews were conducted by trained staff using computer-assisted technology with consenting participants who were 18 years or older living in Qatar by the Social and Economic Research Institute (SESRI) at Qatar University as part of the Annual Omnibus survey in February/ March, 2019. The Sleep Condition Indicator (Epsie, 2014), a brief screening tool for DSM-5 criteria, was used to estimate the prevalence of insomnia in Qatar’s general population. Depressive and anxiety symptoms were ascertained using the PHQ-9 and GAD-2. Sociodemographic and health information including personal and family history of autoimmune disease were also collected. Univariate, bivariate, and multivariate statistics were conducted. Results: The prevalence of insomnia was 5.5% (95%CI: 4.3-6.7) and was higher in females (6.3%) than males (4.6%), though these differences were not statistically significant (P = 0.216). Insomnia was strongly associated with depressive (OR=5.4, P

Post-quantum cryptography is an emerging solution to the expected security breach, introduced by quantum computers, to the currently used public key cryptosystems. This paper presents an experimental study on the effect of the overhead associated with the wireless transmission of some of the newly developed post quantum cryptography algorithms through the Internet of Things networks. Experimental results of this work include the energy and time measurements for wireless transmission of chosen sample messages of these new cryptographic algorithms. In addition, recommendations are given for appropriate modules configurations and choice of suitable security algorithm for the Internet of Things networks.

Background Preclinical studies have suggested a synergistic effect of tamoxifen and capecitabine in estrogen receptor–positive cell lines. We evaluated the safety and efficacy of first-line chemoendocrine treatment in patients with metastatic breast cancer. Biochemical assessment was performed of serum levels of thymidine phosphorylase enzyme (TP), serum tamoxifen, hydroxytamoxifen, and 5-fluorouracil in relationship to efficacy. Patients and Methods This prospective phase 2 interventional study studied patients with estrogen receptor-positive, HER2− metastatic breast cancer who received either tamoxifen/capecitabine or letrozole/capecitabine as first-line treatment. The dose of capecitabine provided at 2000 mg per day continuously as a fixed dose. Results Forty women with a median age of 49.3 years were enrolled. For the whole study group, median progression-free survival (PFS) was 10 months and median overall survival (OS) was 23.3 months. The overall response rate was 60% and the clinical benefit rate 82.5%. Progesterone receptor positivity was associated with significantly longer PFS (12 vs. 7 months, P = .021). The most frequent adverse events were palmar–plantar erythrodysesthesia (62.5%), fatigue (62.5%), diarrhea (30%), abdominal pain (12.5%), and constipation (10%). Changes in serum level of TP were not correlated to response to treatment, PFS, or OS. Higher serum levels of tamoxifen and hydroxytamoxifen were correlated with higher response rates and longer PFS but not OS. Conclusion Chemoendocrine treatment is well tolerated, with no evidence of contradictory effects between the combination components. However, the efficacy data need more validation.

Aim & methods: To assess the impact of pretreatment serum levels of IL-18 and soluble IL-2 receptor (sIL-2R) on the clinical outcome of patients with diffuse large B-cell lymphoma treated with an R-CHOP protocol. Total 73 patients were included. Results: Elevated serum IL-18 (using mean as cutoff) was associated with numerically lower complete remission, and 3-year disease-free survival rates; however, the difference was not statistically significant. Nevertheless, the 3-year overall survival rates were significantly more favorable for the lower serum level group. Correspondingly, the complete remission, 3-year disease-free survival and overall survival rates for patients with low pretreatment sIL-2R levels were significantly better than individuals with higher levels. Conclusion: There is a growing body of evidence supporting the utility of pretreatment serum levels of sIL-2R and IL-18 as prognostic factors in diffuse large B-cell lymphoma patients., Lay abstract Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphomas in Egypt. Since the introduction of rituximab, the utility of International Prognostic Index in DLBCL patients treated in the rituximab era has been questioned. Instead, biologic prognostic factors including cytokines are increasingly being investigated to stratify DLBCL patients. In this prospective single arm Phase II study, there is evidence supporting the utility of pretreatment serum levels of IL-18 and sIL-2R, which can be easily measured in clinical practice, as potential prognostic factors that may add additional information regarding response to treatment and outcome in DLBCL patients and could help stratify poor risk patients for more aggressive treatment.

Background Antibiotic-resistant bacteria are one of the major global health issues that can affect humans, animals, and the environment. Antibiotic-resistant bacteria have emerged as opportunistic pathogenic bacteria that are frequently isolated from both clinical patients and healthy individuals. The aim of this study was to characterize the antibiotic-resistant bacteria isolated from powdered infant formulas marketed in Riyadh, Saudi Arabia. Methods Infant powdered milk formulas were purchased from different pharmacies located within Riyadh, and ten products of powdered milk formulas designed for children of various ages were then transferred to the laboratory in the Department of Botany and Microbiology at King Saud University, Riyadh. Isolation and purification of Bacillus species were both performed according to standard protocols. The identification test was performed using the automated Vitek 2 system (BioMerieux, France), and antibiotic sensitivity tests were performed using the disk-diffusion method incorporating standard antibiotic disks foramikacin (30 μg/disk), gentamicin (10 μg/disk), imipenem (10 μg/disk), moxifloxacin (5 μg/disk), cefoperazone (75 μg/disk), cefpodoxime (10 μg/disk), ceftazidime (30 μg/disk), and cefepime (30 μg/disk). Statistical analysis was performed using Ward’s method to obtain antibiotic resistance of the isolates. Results The results obtained from the milk samples indicated that all isolates were sensitive to amikacin, gentamicin, and moxifloxacin. A group of isolates obtained from milk was resistant to cefoperazone by 6.49%, cefpodoxime by 25.9%, ceftazidime by 14.28%, and cefepime by 19.48%. Conclusions Based on these findings, we concluded that the powdered infant formula marketed in Riyadh City may act as a source of bacterial isolates that are resistant to several standard antibiotics.

Background and Purpose— Left atrial enlargement has been shown to be associated with ischemic stroke, but the association with embolic stroke mechanisms remains unknown. We aim to study the associations between left atrial volume index (LAVI) and embolic stroke subtypes and atrial fibrillation (AF) detection on cardiac event monitoring in patients with embolic stroke of unknown source. Methods— Data were collected from a prospective cohort of consecutive patients with ischemic stroke admitted to a comprehensive stroke center over 18 months. Stroke subtype was classified into cardioembolic stroke, noncardioembolic stroke of determined mechanism (NCE), or embolic stroke of undetermined source (ESUS). Univariate and prespecified multivariable analyses were performed to assess associations between LAVI and stroke subtype and AF detection in patients with ESUS. Results— Of 1224 consecutive patients identified during the study period, 1020 (82.6%) underwent transthoracic echocardiography and had LAVI measurements. LAVI was greater in patients with cardioembolic stroke than NCE (41.4 mL/m 2 ±18.0 versus 28.6 mL/m 2 ±12.2; P 2 ±12.6 versus 28.6 mL/m 2 ±12.2; P =0.61). In multivariable logistic regression models, LAVI was greater in cardioembolic stroke versus NCE (adjusted odds ratio per mL/m 2 , 1.07; 95% CI, 1.05–1.09; P 2 , 1.00; 95% CI, 0.99–1.02; P =0.720). Among 99 patients with ESUS who underwent cardiac monitoring, 18.2% had AF detected; LAVI was independently associated with AF detection in ESUS (adjusted odds ratio per mL/m 2 , 1.09; 95% CI, 1.02–1.15; P =0.007). Conclusions— LAVI is associated with cardioembolic stroke as well as AF detection in patients with ESUS, 2 subsets of ischemic stroke that benefit from anticoagulation therapy. Patients with increased LAVI may be a subgroup where anticoagulation may be tested for stroke prevention.

This paper presents a design and simulation results for a Photoplethysmography (PPG) sensor front-end circuitry. An ultra-low power consumption is achieved since proposed integrated inverted cascode Transimpedance Amplifier (TIA) is incorporating a quasi-floating gate (QFG) topology. The proposed TIA has 0.3 Hz high-pass frequency that is less than the lowest frequency of PPG signal. The designed transimpedance gain of the proposed TIA is 119.9 dBΩ using a large area photodiode having a 20 pF capacitance. The TIA is followed by a Post Amplifier (PA) to increase the gain to 148.5 dBΩ. A buffer amplifier is desired as a last stage to drive the load capacitance of the next stage analog to digital converter (ADC). This proposed sensor system bandwidth is 4.5 kHz with an integrated input referred noise of 94 pA that is the average valued from Monte-carlo simulation. The total power consumption by the sensor front-end is approximately 30 μW.

Background Medication errors (MEs) are unintended failures in the drug treatment process that can occur during prescription, dispensing, storing, preparation or administration of medications. High alert medications (HAMs) are defined as those medications that bear the highest risk of causing significant patient harm when used incorrectly, either due to their serious adverse events or to a narrow therapeutic window. Nurses are responsible for administration of HAMs; incorrect administration can have a significant clinical outcome. This study aimed to assess the level of knowledge of HAMs among nurses in government hospitals in West Bank, Palestine. Methods A cross-sectional study was conducted in 2015, in West Bank, Palestine. Data were collected via a face to face interview questionnaire, which was taken from a previous study. Data were collected by convenient sampling. The questionnaire consisted of four parts: demographic characteristics of the nurses, drug administration knowledge (10 true-false questions), drug regulation knowledge (10 true-false questions), and self-evaluation. Results A total of 280 nurses participated in the study; these nurses were working in the emergency room (ER), intensive care unit (ICU), paediatric or medical ward. The response rate was 93%. Nurses were found to have insufficient knowledge about HAMs; 67.1% of participants had a score of less than 70%, with a mean total score of 59.9 ± 15.1. Factors associated with sufficient knowledge among nurses were HAMs training and ICU training, both with p-values of 0.002. Nurses with a master degree, those working in the ICU ward, head nurses, and male nurses were the most knowledgeable groups, with a p-values